Communicating with families and clients

This section provides strategies:

To accurately assess a child’s weight status and identify those above a healthy weight
To aid the management of a child who is identified as being overweight or obese
To assist in communicating and counselling families about preventing childhood overweight and obesity in an effective and empathetic manner

The 5As approach can be used – Ask, Assess, Advise, Assist, Arrange.

Are the family’s/child’s concerns weight-related?

Have there been previous attempts at weight loss, and/or a change in eating or exercise habits? Has there been success or otherwise?

A detailed history should be taken and include:

sleep patterns/problems
systemic issues
psychosocial or behavioural problems
history of type 2 diabetes and overweight/obesity
ethnicity – including Aboriginal and Torres Strait Islander, Asian, Middle Eastern, Maori/Pacific and South Sea Islander
current physical activity/exercise behaviours
eating patterns and disordered eating.

Assess weight status and identify children above a healthy weight:

Plot on age and gender specific growth chart child height, weight, weight status:

World Health Organisation growth charts (2006): Growth Standards recommended for monitoring infants and children aged 0 to 2 years
Centers for Disease Control growth charts (2000): recommended for monitoring growth for children and adolescents aged 2-18 years.
Waist circumference; child waist-to-height ratio
NSW Healthy Kids assessment tools

Assessment of family lifestyle and behaviours, and awareness and attitude of:

Physical examination: acanthosis nigricans, blood pressure, blood tests as appropriate.

Use sensitive language, avoid stigmatisation or blaming
Use strength-based language, emphasizing health over weight
Employ motivational interviewing techniques
Focus on choosing healthier food and drink options, and physical activity, as opposed to focusing on weight loss
Increase physical activity behaviours and decrease sedentary behaviours, including limiting screen time
Consider SMART goals, and an action plan

Negotiate relevant contextual factors e.g. age, culture, language, disability, expressed need
Collaborative goal setting with parents and child, define SMARTER goals (specific, measurable, achievable, relevant, timely, associated emotion and reward)
Intervention – Communicate key healthy lifestyle messages to parents and child using best-practice; family focused; frequent contacts
Free Australian apps for clients:
- EasyDietDiary – online diet diary, exercise tracker and nutrient analysis tool
- CalorieKing – nutrient analysis calculator and diet record tool

Refer to other health professional(s) as appropriate
Refer to the Get Healthy Service
Refer to suitable healthy lifestyle program(s) as appropriate
Refer to tertiary services (Multidisciplinary Obesity Clinic) within catchment areas
Refer to Staff Wellbeing Programs within Hospital and Health Services
Health practitioner participation in Project ECHO^TM
Refer to the Good Start Program