4.3 Article

Child-Centred Health Dialogue for primary prevention of obesity in Child Health Services - a feasibility study

Journal

SCANDINAVIAN JOURNAL OF PUBLIC HEALTH
Volume 49, Issue 4, Pages 384-392

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/1403494819891025

Keywords

Primary care; preschool; primary prevention obesity; health promotion; child-centred; health literacy; family therapy

Funding

  1. Swedish Research Council for Health, Working Life and Welfare (FORTE)
  2. Region Skane
  3. Foreningen Mjolkdroppen Helsingborg

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The study tested the feasibility and outcomes responsiveness of a Child-Centred Health Dialogue model for primary prevention of obesity in 4-year-old children. Results showed that fewer children in the intervention group developed overweight or obesity after one year, although the difference was not statistically significant. The study demonstrates that the multicomponent intervention is feasible on a small scale and should be confirmed in a larger randomized controlled trial.
Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes. Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent Child-Centred Health Dialogue consisting of two parts: (1) a universal part directed to all children and (2) a targeted part for families where the child is identified with overweight. Results: In total, 203 children participated in Child-Centred Health Dialogue while 582 children received usual care. Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention. Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security. One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of five compared with the control group, and none had developed obesity. The difference in overweight prevalence at follow-up did not reach statistical significance. Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale. As almost all caregivers make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale.

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