Childhood Obesity

Most primary care providers in Ontario see young patients and their families who are at risk of developing obesity. The Preventing Childhood Obesity Tool helps guide conversations with patients and their families about healthy lifestyle choices and goal-setting. It is intended to be used with paediatric patients (2-17 years of age) and their families, irrespective of patient weight.

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PreventingChildhoodObesity2016

Childhood obesity poses an urgent and serious challenge globally, and here in Canada as well. Nearly one in three (32%) Canadian children are at an unhealthy weight. Children with obesity are four times more likely to remain obese adults, and are at an increased risk of developing chronic physical and mental health problems.

The Preventing Childhood Obesity Tool is designed to help guide conversations with paediatric patients (2-17 years of age) and their families over a series of visits that focus on healthy lifestyle choices and goal-setting. These discussions should take place with all patients because weight is not necessarily an accurate reflection of lifestyle and nutrition choices. The information in the Tool is designed to provide support in:

  • Discussing healthy lifestyles and agreeing on a plan
  • Measuring and documenting growth
  • Interpreting growth
  • Completing a healthy lifestyle record

Project Overview

Childhood obesity poses an urgent and serious challenge globally, and here in Canada as well. Childhood obesity is reaching alarming proportions in several countries including Canada. In the late 1970s, about 15% of children were overweight or obese. Today, 32% of Canadian children aged 5-17 are either overweight or obese, with prevalence of obesity almost twice as high in boys compared to girls.

Children with obesity are four times more likely to remain obese as adults, and are at an increased risk of developing chronic conditions and mental health problems. As children age, they are at a greater risk of developing high blood pressure, type 2 diabetes, heart disease and arthritis. Chronic conditions associated with obesity in children, such as heart disease, reproductive problems and cancer, may not appear until adulthood. However, social and emotional issues, including depression, anxiety, and bullying often start much earlier.

Despite the challenges in tackling the obesity epidemic, primary care providers identified a need for better tools to support their patients and families to address childhood obesity. Existing tools are primarily focused on weight alone, and do not address other factor related to adopting a healthy lifestyle. Only 5-10% of patients responded to well-designed obesity interventions and the effects of these interventions faded after only one or two years.

Development Process

The Preventing Childhood Obesity Tool is one of several developed as part of the Knowledge Translation in Primary Care Initiative. This multi-year initiative is a collaboration between Centre for Effective Practice (CEP), the Ontario College of Family Physicians (OCFP), and Nurse Practitioners’ Association of Ontario (NPAO). Funded by the Ministry of Health and Long-Term Care, this initiative will support primary care providers with a series of clinical tools and health information resources. Learn more about the Knowledge Translation in Primary Care Initiative.

As part of this initiative, CEP conducted a Primary Care Needs Assessment to determine topics of interest to primary care providers. In this survey providers identified the need for more effective resources to help patients with childhood obesity.

The Preventing Childhood Obesity Tool was developed using CEP’s integrated knowledge translation development methods. CEP ensures that health care providers are engaged throughout the tool development process, using a User Centered Design methodology to test the usability of tools from a provider perspective. For the Preventing Childhood Obesity project, CEP worked with the clinical lead, Dr. Yoni Freedhoff, and a clinical working group.

The project team reviewed and evaluated evidence from clinical practice guidelines and relevant studies. The information and recommendations included in the final version of the Tool reflects currently best available evidence.

Meet the Team

 The need for a more effective approach to managing childhood obesity was identified by primary care providers in Ontario as part of the Knowledge Translation in Primary Care Initiative. The Centre for Effective Practice enlisted the collaboration of a clinical lead and clinical working group.

Clinical Lead

Yoni_FreedhoffYoni Freedhoff MD, CCFP, ABOM
Dr. Yoni Freedhoff, is an assistant professor of family medicine at the University of Ottawa, and is the medical director of Ottawa’s Bariatric Medical Institute. Dr. Freedhoff is widely considered to be Canada’s most outspoken obesity expert and he appears regularly in both national and international media. His award winning blog Weighty Matters has enjoyed over 12 million visits, and he also writes regularly for Psychology Today, US News and World Report, The Globe & Mail, and the Huffington Post. His first book for the public, The Diet Fix: Why Diets Fail and How to Make Yours Work was a number one national Canadian best seller, while his handbook geared at health professionals, Best Weight: An Practical Guide to Office-Based Obesity Management, at his and his co-author’s request, is freely available for download from the Canadian Obesity Network.

A Clinical Working Group comprised of a family physician, paediatricians and a primary care nurse practitioner oversaw the development of this tool:

  • Dr. Mario Elia (MD, CCFP)
  • Dr. Patricia Parkin (MD, FRCPC)
  • Dr. Daniel Flanders (MD, FRCPC)
  • Dr. Luisa Barton (DNP, PHCNP)

Supporting Material

Here are some additional resources and sources of information. These supporting materials are hosted by external organizations and we cannot guarantee the accuracy and accessibility of their links. CEP will make every effort to keep these links up to date.

Presentation

For educational and bibliographic purposes only. Please notify the Centre for Effective Practice ([email protected]) if you wish to use or reprint the slide deck.

 

Copyright & Disclaimer

 CEP fully supports the use of the Preventing Childhood Obesity Tool by providers, educators, decision-makers and others. Please read the following information prior to use of the Tool to ensure appropriate permission is sought and appropriate citation is used.

Creative Commons License

Creative Commons Preventing Childhood Obesity is a product of the Centre for Effective Practice. Permission to use, copy and distribute this material for all non-commercial and research purposes is granted, provided that all copies, modifications, and distributions contain full reproductions of this Creative Commons License and the following Disclaimer along with appropriate citations. Use of the Preventing Childhood Obesity Tool for commercial purposes or any modifications of the tool are subject to charge and use must be negotiated with Centre for Effective Practice (Email: [email protected]).

For statistical and bibliographic purposes, please notify the Centre for Effective Practice ([email protected]) of any use or reprinting of the tool.

Please use this citation when referencing the tool:
Reprinted with Permission from Centre for Effective Practice (January 2016). Preventing Childhood Obesity. Toronto: Centre for Effective Practice.

Disclaimer

Preventing Childhood Obesity (the “Tool”) contains links to websites and other external resources (“Third Party Resources”) that are operated by and/or created by third party organizations. These third party organizations are solely responsible for the information contained in, and the operation of (as applicable), their respective Third Party Resource(s).

This Tool was developed for licensed health care professionals in Ontario as a guide only and does not constitute medical or other professional advice. Primary care providers and other health care professionals are required to exercise their own clinical judgment in using this Tool.

Neither the Centre for Effective Practice (“CEP”), Ontario College of Family Physicians, Nurse Practitioners’ Association of Ontario, Government of Ontario, the contributors to this Tool, nor any of their respective agents, appointees, directors, officers, employees, contractors, members or volunteers: (i) are providing medical, diagnostic or treatment services through this Tool; (ii) to the extent permitted by applicable law, accept any responsibility for the use or misuse of this Tool by any individual including, but not limited to, primary care providers, or entity, including for any loss, damage or injury (including death) arising from or in connection with the use of this Tool, in whole or in part; or (iii) give or make any representation, warranty or endorsement of any of the Third Party Resources, that are owned or operated by third parties, including any information or advice contained therein.