Effective Communication with Families: Childhood Obesity

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Effective Communication with Families Childhood
Obesity
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Changes in Child Health

• Strides in child health
• Immunizations
• Poverty, nutrition
• Injury prevention, seatbelts
• Oral health
• Tobacco prevention

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At least, up til now

• ? in youth overweight
• Threatens health of a generation
• Because of this epidemic
• Youth may be 1st generation
• To not live as long as
  their parents generation!

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Obesity in the U.S.

• Rise in Obesity Rates
• 75 in 10 years
• nearly 100 in 20 years!
• In children
• Overweight has doubled
• In teens
• Overweight has tripled
• In adults
• two-thirds are overweight or obese

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Obesity in Michigan

• Adults
• 61 overweight or obese
• High School Students
• 24 overweight or at risk
• Low Income Children
• 2-5 years old
• 29 overweight or at risk

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Solutions

• Educate, Motivate, Act!
• Take responsibility
• Practitioners address childhood obesity
• Communication is key

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Communication Techniques

• Lifestyle Advice
• Well Child or Urgent Visit
• lt 1 minute
• Children currently not at risk for overweight

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Lifestyle Advice

• To stay healthy and energized
• 5 servings of fruits/vegetables
• Limit TV time
• lt2 hours/day
• 1 hour of physical activity
• Avoid sugary beverages

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Communication Techniques

• Brief Focused Advice
• Well Child Visit
• lt 3 minutes
• Children who are overweight/at risk

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Brief Focused Advice

• Engage the patient/parent
• Share information
• Make a key advise statement
• Arrange for follow up

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Communication Techniques

• Brief Negotiation Cognitive
  Behavior Skills
• Follow Up Visit or Weight Management Intervention
• 10 minutes
• Single or multiple sessions
• Children who are overweight/at risk

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Negotiation and Cognitive Skills

• Open the Encounter
• Negotiate the Agenda
• Assess Readiness
• Explore Ambivalence
• Tailor the Intervention
• Close the Encounter

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ABCs of Counseling and Motivating

• Ask Open-Ended Questions
• How, What, Describe, etc
• Assess what the patient knows
• How concerned are you?
• What practices to change?

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ABCs of Counseling and Motivating

• Body Language
• Put patient at ease
• Use eye contact without barriers
• Convey respect
• Counsel in a private setting

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ABCs of Counseling and Motivating

• Care and Empathy
• Do not criticize
• Acknowledge patients feelings
• Answer questions without judgment
• Use nonjudgmental language

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Overweight Sensitivity Do no Harm

• INSTEAD OF.
• Obesity
• Ideal Weight
• Personal Improvement
• Focus on Weight
• Diets or Bad Foods
• Exercise

• USE
• Overweight
• Healthier Weight
• Family Improvement
• Focus on Lifestyle
• Healthier Food Choices
• Physical Activity

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Who Do You Communicate With?

• 2-5 Years Old
• Communicate with parent
• Child in room

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Who Do You Communicate With?

• 6-12 Years Old
• Communicate with parent or both
• The 1st encounter
• Take parent to office to discuss in private

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Who Do You Communicate With?

• Over 12 Years Old
• Communicate with teen or both
• The 1st encounter
• Have parent leave exam room first

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Brief Negotiation Skills

• Effective for
• Contemplative/ambivalent patients
• Ask open ended questions
• Listen
• Summarize
• Empathetic, accepting, collaborative

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Cognitive Behavior Skills

• Effective for
• Patients ready/willing to change
• Develop awareness of
• Eating habits
• Activity
• Parenting behavior
• Identify problem behaviors

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Cognitive Behavior Skills

• Problem solve
• Modify problem behaviors
• Set weekly goals
• Use positive rewards
• Keep records
• Weight checks

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Stages of Behavior Change
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Precontemplation

• Get off my back
• Others may confront your need for change
• Feel angry and helpless
• Constructive ways to encourage change

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Contemplation

• I want to stop feeling so stuck
• You want to change
• Not ready yet
• Counter anxiety with excitement and knowledge

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Preparation

• Ill start tomorrow
• Know change is best
• Not sure how to begin
• Develop a plan of action

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Action

• Here I go
• Life is exhilarating, sometimes terrifying
• So is change
• Learn methods and get support

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Maintenance

• Keep moving forward
• Reaping benefits of change
• Know relapse is common
• Create plan for dealing with slips and achieving
  long-term success

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Termination

• Home free
• Maintaining change is effortless
• No temptations, total confidence
• May not totally eliminate temptation
• Many people dont
• Still achieve lasting change

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Take Home Messages

• Addressing childhood obesity...
• Key for prevention/treatment
• Communicate appropriately with families
• Utilize important counseling techniques
• Lifestyle advice
• Brief focused advice
• Brief negotiation and cognitive behavior skills
• Understand stages of change...
• Determines intervention strategies