Weight-Related Messages in Well-Child Visits: What Do Teens Desire?

Authors

Andrew S. Bossick, Henry Ford Health SystemFollow
Gwen Alexander, Henry Ford Health SystemFollow
Tanya Troy, Henry Ford Health System
Heather Olden, Henry Ford Health System
Charles Barone, Henry Ford Health SystemFollow
Andrea E. Cassidy-Bushrow, Henry Ford Health SystemFollow

Publication Date

8-15-2016

Keywords

well-child visit, qualitative data

Abstract

Background/Aims: With the United States’ prevalence of childhood obesity at approximately 17%, well-child visits are a critical time to discuss well-being, physical activity and other concerns. Discussion of healthy weight is a key component of these pediatric visits. Appropriate delivery of weight-related messages to adolescents and their families is critical. Accusatory messages may distance adolescents from health care, whereas nondirect approaches could suggest unhealthy weight is nonproblematic. Feedback on weight-related messages during the well-child visit may improve health care delivery in this setting.

Methods: Opinions on weight, weight-related messaging, blood pressure and lipid testing knowledge were collected through focus groups with adolescents 14–18 years old. Eligible adolescents had a body mass index > 85th percentile and/or a diagnosis of high blood pressure or high cholesterol. A framework matrix method was used for data analysis.

Results: Four focus groups, stratified by gender, were held (16 participants [9 male]; mean age 15.7 ± 1.05 years). Teens expressed that a relationship based on provider trust, built over time, with personal and parental responsibility, are important aspects of the well-child “team.” Adolescents voiced strong desire for parental inclusion in health-related discussions. Ideal parental involvement was described as supportive and encouraging to provider recommendations. Teens expressed a lack of knowledge and awareness, along with misconceptions, about health consequences due to unhealthy weight, blood pressure and cholesterol. Providers were described as a resource to discuss weight-related topics; teens expected and welcomed weight-related conversations. Adolescents appreciated casual conversations based on activities and interests, although a serious approach was considered helpful to encourage meaningful changes. Discussions about blood pressure, cholesterol and diabetes were categorized as “scary” and “overwhelming.”

Conclusion: Our data suggest a provider-adolescent relationship built on trust, team work, support and encouragement creates a positive atmosphere for weight-related messages for teens during a well-child visit. Adolescents described long-standing patient-provider histories, suggesting a pediatric medical home concept may be critical in positive discussions of weight. Next steps include analyzing similar parent and provider focus group data and incorporating focus group concepts into a patient-centered, brief, educational intervention for providers focusing on weight-related messages during the well-child visit.

Recommended Citation

Bossick AS, Alexander G, Troy T, Olden H, Barone C, Cassidy-Bushrow AE. Weight-related messages in well-child visits: what do teens desire? J Patient Cent Res Rev. 2016;3:219-20.