P03 A novel childhood obesity risk estimation tool: findings from mixed methods feasibility testing within an enhanced health visiting service

Background

Childhood obesity is a pressing public health issue. A Childhood Obesity Risk Estimation tool (SLOPE CORE) has been developed based on prediction models using routinely available maternity and early childhood data to estimate risk of childhood obesity at 4–5 years. This study aimed to test the feasibility, acceptability and usability of SLOPE CORE within an enhanced health visiting service for disadvantaged families.

Methods

A mixed methods approach was used. Purposively sampled Health Visitors (HVs) working within an enhanced health visiting programme were trained to use the tool. HVs then recruited parents from their caseload into the study (convenience sampling), used the tool and HVs completed a system usability scale (SUS) questionnaire. HVs and parents were invited to take part in interviews or focus groups to explore their experiences of the tool. Qualitative data was analysed using thematic analysis (using NVivo software).

Results

Five HVs and seven parents took part in the study. HVs found the SLOPE CORE tool easy to use with a mean SUS of 84.4 (n=4, range 70–97.5), indicating excellent usability. Five HVs and three parents took part in qualitative work. The tool was acceptable and usable for both parents and HVs. Parents expressed a desire to know their child’s risk of obesity, provided this was accompanied by additional information, or support, to modify risk. HVs appreciated the health promotion opportunity presented by the tool, and felt it facilitated difficult conversations around weight, by providing ‘clinical evidence’ for risk, placing the focus of the conversation onto the tool result, rather than their professional judgement. HVs were concerned that using the tool may negatively impact their relationship with the parent. After using the tool HVs agreed that, for the majority of parents, a sensitive approach would mitigate any potential negative impacts from using the tool. Potential barriers to use of the tool included the need for internet access, and concerns around time needed to have a sensitive discussion around a conceptually difficult topic (risk).

Conclusion

The SLOPE CORE tool was found to be feasible and user-friendly in this small sample. The tool has the potential to add value in clinical practice, and may support targeting limited resources towards families most at risk of childhood obesity. Further research is needed to explore how the tool might be efficiently incorporated into practice, and to evaluate the impact of the tool, and any subsequent interventions, on preventing childhood obesity.