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Scopes, limitations and satisfaction in managing childhood obesity in primary and secondary healthcare services'time for improvements
  1. T Dhorajiwala1,
  2. W Thornton2,
  3. B Bose-Haider3,
  4. R Puttha4
  1. 1Paediatrics, Royal Manchester Children's Hospital, Manchester, UK
  2. 2Neonatology, Royal Blackburn Hospital, Blackburn, UK
  3. 3Paediatrics, Fairfield General Hospital, Bury, UK
  4. 4Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK


Aim The aim of this study was to evaluate the current practice of and resources available to health professionals providing care for children who are overweight or obese and to identify any scopes and barriers that have been encountered.

Methodology A questionnaire was sent out to health professionals in both primary and secondary care settings who were involved in providing care to children who are overweight or obese. This included general practitioners, practice nurses, paediatricians, health visitors and school nurses working in one of the largest Trusts in the North West of England. The questionnaire was approved by the Trust's Research and Ethics Department and was sent out by post with some questionnaires given out in meetings. All participants were asked to return the questionnaire anonymously

Results The authors received 139 responses. 50% of respondents worked within the Primary Care Trust, 39% worked within Secondary Care and 11% did not specify. The responses indicated that 15% of professionals did not measure height and weight and 33% of professionals did not calculate the body mass index even when they noted the child to be overweight. 33% of professionals were aware of the National Institute for Health and Clinical Excellence (NICE) guidelines and 88% did not have an obesity guideline within their own setting. The most common action was to follow-up the child in the practitioners own setting with low rates of referral to other professionals. There was a high degree of dissatisfaction with all aspects of managing obesity in children, in particular with respect to the training they had received, their ability to engage and counsel families and with resource availability including dietician, exercise programmes and specialist clinic availability.

Conclusion In spite of extensive campaigning by the government and the NICE obesity guidelines this survey highlights the need to improve basic training, develop guidelines and integrated care pathways and to provide essential multidisciplinary resources for tackling the increasing and global problem of childhood obesity which is a modifiable one yet a high risk factor to the main chronic health problems such as hypertension and diabetes.

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