Evaluation of models for health supportive family conversation intended to turn a negative weight development in preschool children

Introduction: Obesity in children is a growing health problem in the world. In Sweden, 14-15 percent of 4-year-old children are overweight and 3 percent are obese. Prevention of overweight and obesity is most effective if started as early as possible. Studies have shown the need for involving the family since parents’/guardians’ attitudes and beliefs may be crucial for the development of the child's eating habits and have thus a key role in the preventive work regarding a healthy lifestyle for the children. In Sweden, the Child Health Service (CHS) comprises a comprehensive universal nurse-led CHS program with health surveillance directed to the children and their parents, including parental support. The CHS have the opportunity to pay attention to early development of overweight and implement measures that can contribute to a healthy lifestyle during childhood as well as adulthood. The need for evidence based methods/models to be used in combating child overweight and obesity is obvious. However, there is a lack of evidence based models to prevent the prevailing childhood obesity used by clinical active nurses. Purpose: The overall purpose is to evaluate models for health supportive family conversations to families with preschool children with the intent to turn a negative weight development. Method: The study has a longitudinal design with health supportive family conversations being evaluated both qualitatively and quantitatively. A strategic sample will be applied on CHS centers from different socioeconomic areas in the southern part of Sweden. The models that will be used are the Calgary Family Assessment Model (CFAM) and The Calgary Family Intervention Model (CFIM). The models have its their theoretical foundation in e.g. theories of systems, communication, and change. The study will have a naturalistic approach with a pre-posttest design in which nurses in CHS are trained in the model for health supportive family conversations. Supervision will be provided during the intervention. Children’s IsoBMI and The Lifestyle Behavior Checklist will be used as pre- and post-test and at the 12 month follow-up. Evaluation interviews will be held with the families and the nurses separately. Preliminary results: A pilot interview showed that the health supportive family conversations led to increased knowledge and understanding about the family lifestyles related to the child obesity. Involvement of the family lead to a consciousness within the family about ingredients in sweet drinks and food. The fact that the CHS nurse was the one who conducted the conversations were of great importance, since the nurse was well known to the family