Talking to children about weight–how is guidance for parents being used by professionals?

Background: One in five children starting primary school in England are living with overweight or obesity, rising to one in three by the end of primary school. In England, the prevalence of overweight/obesity of children is monitored through the annual National Child Measurement Programme (NCMP). Research suggests parents often lack confidence in discussing weight with their children. In 2021, evidence-based guidance was produced for parents of young children to facilitate these conversations, but it is unclear how this guidance is being promoted to parents or used by public health practitioners (PHPs). This study evaluated the implementation of parental guidance on talking to children about weight. Methods: We conducted a mixed-methods study, including a national online survey and in-depth qualitative interviews with public health practitioners working on children’s healthier lifestyles programmes in the UK. Invitations to participate were distributed via the Office of Health Improvement and Disparities (OHID) and regional and national networks. Online interviews were audio-recorded, transcribed, and analysed thematically. Survey data were descriptively reported. Results: Twenty-one participants completed the survey; twenty-four were interviewed. Practice varied between organisations with the guidance being used in NCMP letters to parents, in follow-up phone calls with parents, and in training NCMP staff and other health or education professionals. Participants valued the evidence-based guidance and its compassionate tone, feeling it gave them, and parents, confidence in addressing a sensitive topic. Some felt it was too lengthy for parents with learning disabilities or low literacy levels. Others identified a need for similar guidance for older children. Though helpful, participants acknowledged the guidance was only one small part of a necessary systems-wide approach to promoting healthy weight. Conclusions: The guidance is a useful tool but needs systematic promotion to increase use and effectiveness. Further work is warranted to develop adapted versions for other populations.