Proactive assessment of obesity risk during infancy (ProAsk): a qualitative study of parents’ and professionals’ perspectives on an mHealth intervention.

Rose, Jennie; Glazebrook, Cris; Wharrad, Heather; Siriwardena, A. Niroshan; Swift, Judy Anne; Nathan, Dilip; Weng, Stephen; Atkinson, Pippa; Ablewhite, Joanne; McMaster, Fiona; Watson, Vicki; Redsell, Sarah

Abstract

Background:
Prevention of childhood obesity is a public health priority. Interventions that establish healthy growth trajectories early in life promise lifelong benefits to health and wellbeing. Proactive Assessment of Obesity Risk during Infancy (ProAsk) is a novel mHealth intervention designed to enable health professionals to assess an infant’s risk of future overweight and motivate parental behaviour change to prevent childhood overweight and obesity. The aim of this study was to explore parents’ and health professionals’ experiences of the overweight risk communication and behaviour change aspects of this mHealth intervention.

Methods:
The study was conducted in four economically deprived localities in the UK. Parents (N=66) were recruited to the ProAsk feasibility study when their infant was 6-8 weeks old. Twenty two health visitors (HVs) used a hand-held tablet device to deliver ProAsk to parents when their infants were 3 months old. Parents (N=12) and HVs (N=15) were interviewed when infants in the study were 6 months old. Interview data were transcribed and analysed thematically using an inductive, interpretative approach.

Results:
Four key themes were identified across both parent and health visitor data: engaging and empowering with digital technology; unfamiliar technology presents challenges and opportunity; trust in the risk score; resistance to targeting. Most participants found the interactivity and visual presentation of information on ProAsk engaging. Health visitors who were unfamiliar with mobile technology drew support from parents who were more confident using tablet devices. There was evidence of resistance to targeting infants at greatest risk of future overweight and obesity, and both parents and health visitors drew on a number of reasons why a higher than average overweight risk score might not apply to a particular infant.

Conclusions:
An mHealth intervention actively engaged parents, enabling them to take ownership of the process of seeking strategies to reduce infant risk of overweight. However, cognitive and motivational biases that prevent effective overweight risk communication are barriers to targeting an intervention at those infants most at risk.

Trial registration: NCT02314494. Date registered 11th December 2014.

Citation

Rose, J., Glazebrook, C., Wharrad, H., Siriwardena, A. N., Swift, J. A., Nathan, D., …Redsell, S. (2019). Proactive assessment of obesity risk during infancy (ProAsk): a qualitative study of parents’ and professionals’ perspectives on an mHealth intervention. BMC Public Health, 19, Article 294. https://doi.org/10.1186/s12889-019-6616-5

• Journal Article Type: Article
• Acceptance Date: Mar 1, 2019
• Online Publication Date: Mar 12, 2019
• Publication Date: Mar 12, 2019
• Deposit Date: Mar 5, 2019
• Publicly Available Date: Mar 11, 2019
• Journal: BMC Public Health
• Electronic ISSN: 1471-2458
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Article Number: 294
• DOI: https://doi.org/10.1186/s12889-019-6616-5
• Keywords: Childhood obesity; infant; prediction; prevention; parents; health visitor; risk communication; mHealth
• Public URL: https://nottingham-repository.worktribe.com/output/1607997
• Publisher URL: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6616-5
• Additional Information: Received: 7 August 2018; Accepted: 1 March 2019; First Online: 12 March 2019; : Permission to conduct the study was provided by East of England (Essex) NHS Research Ethics Committee on 26th February 2015 (Reference number 15/EE/0011). Research governance permissions were provided by the two NHS Trusts covering the study localities. Written informed consent was obtained for all participants and confirmed verbally before the interviews were conducted.; : Not applicable.; : The authors declare that they have no competing interests.; : Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.