An opportunity to screen for child health behaviours in Primary Health Care

What do we already know?

Diet, physical activity, sedentary behaviour and sleep are key health behaviours established in the early years that support children to grow and develop well and can have significant influence on health across the life-course.

Primary Health Care is a valued and trusted setting for children and their families and has known responsibilities including monitoring health and providing counselling to families.

Current recommended practice in primary health care is to identify children with or at risk of overweight or obesity by monitoring growth, as a proxy for poor health behaviours. Growth monitoring has known limitations and challenges, impacting its acceptability and effectiveness in practice.

Screening for health behaviours could provide a more holistic insight into child health and would enable practitioners to provide tailored advice and support to families.

What did we do?

We conducted a systematic review to identify and describe screening tools using in primary health care settings that measure health behaviours (diet, physical activity, sedentary behaviour and sleep) in children from birth to 16 years. We wanted to know their effectiveness, acceptability and the resources required to support implementation.

What did we learn?

We identified 14 unique screening tools from the UK, Canada and USA. Tool characteristics and administration varied, including tool length, use of images and if the tool was completed on paper or electronically.

Only four screening tools measured all four health behaviours of diet, physical activity, sedentary behaviour and sleep.

Practitioners reported increased rates of screening, health behaviour counselling and self-efficacy to promote health behaviours.

Practitioners had mostly positive views on screening, and described tools as useful, important and beneficial. However, they described a lack of time and difficulty changing routine practice as factors limiting acceptability and feasibility in practice.

Caregivers were also receptive to screening in primary health care and valued the opportunity to discuss their child’s health behaviours with a practitioner.

So what?

This review highlights the potential of child health behaviour screening as an acceptable and feasible strategy to provide early intervention and anticipatory guidance in primary health care.

However, the acceptability, feasibility and effectiveness in an Australian context is unknown.

Dimity’s PhD aims to explore health behaviour screening in South Australian Primary Health Care. She has recently conducted workshops with primary health care practitioners to explore their perspectives on key features of a screening tool and the resources they would require to support implementation. Next steps will be to discuss this concept with Child and Family Health Nurses and use these findings to inform the development and testing of a tool in practice.

Watch this space!

Read the full paper here: Dutch D, Bell L, Zarnowiecki D, Johnson BJ, et al. Screening tools used in primary health care settings to identify health behaviours in children (birth to 16 years); A systematic review of their effectiveness, feasibility and acceptability. Obes Rev. 2024.

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