Attitudes of Clinicians Treating Children with Obesity Nation Wide
ACT NOW Patient Perspective Study
Principal Investigator: Dr. Karen Bailey
Co-Investigator: Dr. Katherine Morrison
Study Coordinator: Bethany Easterbrook, BKin.
Research Assistant: Christina Sguazzin, BA.
Funding: McMaster Surgical Associates, McMaster Children’s Hospital Foundation
The ACT NOW-A Patient Perspective study was launched in July 2013. This study is being conducted in follow-up to the “ACT NOW” project and aims to interview children and their caregivers attending the Growing Healthy Weight Management program at the Children's Exercise and Nutrition Centre at McMaster Children's Hospital to understand their attitudes, preferences for knowledge acquisition, and decision making towards treatment for pediatric obesity. It is essential to understand this information in order to develop innovative strategies to break down the barriers to children receiving effective interventions for obesity in Canada. Unearthing common themes and fostering an understanding of children’s and caregivers experiences with pediatric obesity will be critical in informing the advancement pediatric obesity treatment across the nation. To date, the study has interviewed 15 children and 15 caregivers.
ACT NOW: A Choice Based Conjoint National Survey
Principal Investigator: Dr. Karen Bailey
Funded By: Hamilton Health Sciences New Investigator Award, McMaster Surgical Associates Innovation grant
This choice based conjoint survey is studying a sample of physicians who provide care for children ages 2-18 to understand their attitudes, preferences for knowledge acquisition, knowledge of obesity and treatment options, patient demographics, and treatment referral patterns of morbidly obese children and adolescents in Canada.
This study revealed 9 categories and 45 themes with regional, specialty and experiential differences. Surgery as means of achieving success appeared predominantly in Quebec and Ontario. Half of surgeons felt surgery was the only successful treatment option; other clinicians favoured behavioral interventions. All respondents expressed family involvement as integral to treatment success. Experienced physicians and clinicians in Western Canada stated a need for evidence to improve patient care, while inexperienced physicians placed greater emphasis on early detection and home environments. Physicians in Quebec and Ontario emphasized education of physicians and parents to improve treatment. All physicians, regardless of region, indicated a need for program development and system change with the greatest need in the East. Many respondents advocated moving away from assigning blame and towards encouraging healthy lifestyles.
National Choice-based Conjoint Survey Experiment
In total 30 paediatric surgeons completed the CBC experiment out of 198 participants (15%). Utilizing importance scores an early intervention group and an acute intervention group emerged. The early intervention group (30%, 59/198) were sensitive to variations in patient and family support. They would likely intervene if patients were significantly obese, with normal lipid levels, were pre–diabetic, had high blood pressure, and obesity was associated with lifestyle factors. The acute intervention group (70%, 139/198), were likely to intervene if patients were morbidly obese, lipid levels were abnormal, patients required insulin for diabetes, blood pressure was very high, or obesity was having a major effect on the patient’s mental health. Paediatric surgeons where overwhelmingly associated with the acute intervention group (N=28/30), with only 2 (6.7%) surgeons in the early intervention group.
Publication in the Journal of Pediatric Surgery
Results from the ACT NOW qualitative study have been published in the May 2013 edition of the Journal of Pediatric Surgery.
Article Featured on MDLinx.com
Dr. Karen Bailey's published article, Understanding academic clinicians varying attitudes toward the treatment of childhood obesity in Canada: A descriptive qualitative approach, was featured on the healthcare website MDLinx.com. Click here for a link the review of Dr. Bailey's article.
Canadian Association of Pediatric Surgeons (CAPS) Annual Meeting
Dr. Bailey presented on at the podium on "Understanding Paediatric Surgeons’ Decision Making for the Treatment of Childhood Obesity Across Canada: A Choice-based Conjoint Experiment" during the CAPS 2013 Annual meeting. Dr. Bailey has previously presented the results of the ACT NOW qualitative study at the 2012 CAPS annual meeting, as well as the American Society for Metabolic and Bariatric Surgery Annual Meeting.