Background Rates of childhood obesity are increasing. Traditional strategies including school nurses are overwhelmed. Strategies to discuss weight and impact on health, including ‘Make every contact count’, are challenging in the Emergency Department (ED), in part due to rising attendances and an increasingly strained service. Other ‘Quick-win’ interventions (e.g. smoking cessation) have been attempted in ED. Ascertaining the current attitudes of clinicians towards addressing obesity in the ED and the barriers they face can support development of long term solutions to obesity management in children.
Aims Explore whether clinicians working in EDs address paediatric obesity, identify obstacles, and seek opinions on whether this can be improved.
Methods A survey was distributed to clinical staff seeing children in EDs through the PERUKI network. Data were analysed to identify current attitudes towards addressing obesity, obstacles, and ideas for improvement.
Results 693 responses were received from 57 sites. Current rates of addressing obesity are low. 127 (18.3%) respondents address it with nearly every/every patient. Paediatric/Paediatric Emergency Medicine (PEM) doctors are more likely than Non-paediatric/PEM doctors or Advanced Care/Emergency Nurse Practitioners. (AC/ENP) (25.6% v 12.3%, χ2=20.26, p<0.0001). Barriers included: lack of referral options (78.6%), time (77.8%), concern regarding negative responses (77.3%), obesity being a familial issue (61%) and lack of training (53.1%). ‘Concern regarding negative responses’ was the most commonly cited barrier for those from Non-Paediatric/PEM doctors (83.2%) and AC/ENP’s (84.1%). ‘Lack of training’ was higher amongst Non-Paediatric/PEM doctors (63.9%) and AC/ENP’s (71%). ‘Concern regarding negative responses’ was also highest in those working 0–5 yrs in ED (81.6%), whereas ‘Lack of time’ was the biggest barrier in those working over 10 years in ED. To improve addressing obesity within EDs clinicians requested support with diagnosis, easier referral pathways, training, and changes in ethos both within departments and at local and national levels.
Conclusions Like other healthcare professionals, ED clinicians currently face many barriers in addressing obesity with their patients. However, by addressing these at a local and national level, the majority of ED clinicians feel they can have a role in helping to address the paediatric obesity crisis.
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