Parental reactions to weight screening in young children: a randomized controlled trial

Abstract

Background: Parental inability to recognize child overweight and physician reluctance to instigate discussion prevents behaviour change.

Objective: To evaluate parental acceptance of child overweight status following screening.

Methods: Interviewers used motivational interviewing or best practice care to discuss overweight status of 271 young children (BMI ≥ 85^th ) with parents using simple traffic-light BMI charts. Follow-up sessions two weeks later (n = 251, 93%) were coded qualitatively to assess parental reactions to the information (overweight diagnosis) and how it was presented (feedback condition).

Results: Eight-two percent of parents rated the charts positively with few (8-10%) feeling judged. Motivational interviewing parents viewed feedback as more empathetic (relative risk, 95% CI: 4.07, 1.64-10.09), but more uncomfortable (12.2, 1.48-100.1) than best practice care parents. Overall, 65.2% of parents accepted their child was overweight, 22.1% were ambivalent and 12.7% rejected the information. Although motivational interviewing parents were less likely to accept it (OR, 95% CI: 0.49, 0.37-0.64) and more likely to be ambivalent (2.01, 1.17-3.47), the most important predictor of acceptance was a positive experience of feedback (P < 0.001).

Conclusions: Simple traffic-light charts facilitate discussion of child overweight status with parents. Style of feedback is less relevant than ensuring a positive experience for parents to increase acceptance of the weight information.

Keywords: Growth charts; parental reaction; traffic light; weight screening.