Constraints to implementing guidelines for the identification, assessment, and management of childhood obesity in the clinical care setting: Prevention and treatment framework

The “Pathway for the Identification, Assessment and Management of Overweight and Obese Children & Youth” was developed to support healthcare providers in identifying and treating childhood obesity in British Columbia (Canada). PURPOSE: The study aimed to determine the feasibility and effectiveness of using the Pathway in clinical settings. METHODS: 13 healthcare providers (7 family physicians, 2 pediatricians, 2 registered dietitians, and 2 nurse practitioners) assessed the Pathway and participated in semi-structured interviews in 2015. A direct constant comparative analysis guided the coding of the interviews in the NVivo 9 software. RESULTS: The interviews uncovered the complexity of factors that influenced practices of healthcare providers. Three broad issues were identified as required if the “Pathway” were to be used and fully implemented in practices. First, the “Pathway” needs to be modified in terms of how it is presented and explained and be supplemented with appropriate documentation and resources for its implementation, Second, the constraints that limit implementation need to be addressed and should include a focus on both individual (i.e., the healthcare providers themselves) and environmental (i.e., factors within and outside of providers' organizations) factors. Lastly, there is a need to establish processes and/or infrastructure for adapting the “Pathway” to the local context as resources and supports vary by organizations and regions. CONCLUSION: Healthcare providers should be involved in screening and managing childhood obesity. Addressing the challenges found in this study will enable healthcare providers to take a more active role in addressing childhood obesity in their day to day practices.