P525 How high is the BMI? Overcoming the barriers to addressing obesity in the paediatric outpatient population

BackgroundChildhood obesity negatively impacts physical health, mental wellbeing and shortens life expectancy. A 2017 audit of 87 children attending our district hospital’s outpatient clinics (OPC) and rapid response unit (RRU) revealed: 15% of children were obese and 13% were overweight. 86% of ove...

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Bibliographic Details
Published in:Archives of disease in childhood 2019-06, Vol.104 (Suppl 3), p.A363
Main Authors: McBay-Doherty, Rhiannon, Sweeney, Eamonn, Orr, Karen, O’Connor, Bernadette, Anandarajan, Mugilan, McClean, Anne-Marie
Format: Article
Language:English
Subjects:
Body Composition
Body height
Body mass index
Body weight
Children
Childrens health
Families & family life
Family (Sociological Unit)
Feedback
Feedback (Response)
Focus Groups
Interviews
Life span
Obesity
Overweight
Pediatrics
Physical Health
Physicians
Questionnaires
Scientific Concepts
Training
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Summary:BackgroundChildhood obesity negatively impacts physical health, mental wellbeing and shortens life expectancy. A 2017 audit of 87 children attending our district hospital’s outpatient clinics (OPC) and rapid response unit (RRU) revealed: 15% of children were obese and 13% were overweight. 86% of overweight/obese children did not have their unhealthy weight addressed by a healthcare professional. Focus groups and questionnaires indicated staff often felt underprepared and apprehensive about addressing childhood obesity. Staff sometimes found it difficult to recognise if a child was overweight from raw height/weight data.AimsTo increase childhood obesity recognition by ensuring that 50% of children will have Body Mass Index (BMI) calculated and plotted and to maintain this practice.To increase staff knowledge, willingness and confidence to address childhood obesity with families.MethodsIHI QI methodology was used to introduce BMI plotting to RRU & OPC; beginning in October 2017. A multidisciplinary team including dieticians, physiotherapists, psychologists, nurses and doctors was established. Plan-Do-Study-Act cycles introduced practical changes including I-pads with an app for calculating BMI centiles. Staff received motivational interviewing training to have these crucial conversations with families. Staff and parent feedback were collected through questionnaires.ResultsBMI plotting was successfully introduced; going from a median of 0%–100% for both OPC and RRU and increasing the recognition of overweight/obese children to 100% by 3 months. At 12 months; BMI plotting in OPC was 60%; higher than our initial aim but showing room for improvement. 100% of staff who attended multidisciplinary training ‘agreed’/‘strongly agreed’ that it improved their willingness, confidence and preparedness to address obesity with families. At 12 months after intervention, 67% of overweight and obese children who had their BMI plotted had their weight concerns addressed during their outpatient appointment. 100% of 27 parents who provided feedback were supportive of the project and 100% stated that doctors have a duty to raise obesity with families.ConclusionsThis QI project has shown that introducing routine BMI plotting and providing staff with training to address obesity with families improves the recognition and response to children who are overweight/obese. We shared our innovative practice by hosting a regional paediatric obesity awareness day for all Northern Irish healt
ISSN:0003-9888
1468-2044
DOI:10.1136/archdischild-2019-epa.860