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Table 5 Scope of literature by category. Category 5: Health staffs or consumers perceptions of obesity and obesity prevention

From: Obesity prevention and the role of hospital and community-based health services: a scoping review

Study (author, year, country)

Clinical focus

Study type

Main findings and limitation

Brown, Stride et al. 2007 [51]

UK

Primary care nurses

Patterns of clinical practice, beliefs and attitudes of primary care nurses in relation to obesity management

Self-completed postal questionnaire.

4 PCTs

544 staff- 398 responses (72%)

Majority of nurses agreed

-Obesity causes health problems

-Patients not motivated to change but not due to lack of self-control

- empathy towards patients, rewarding to work with obese

-saw weight management as part of role

-did not find it awkward or sensitive issue to raise but patients perceived awkwardness. Nurses did not feel effective in role

-nurses with higher BMI less likely to have negative view towards obesity

- Obesity an issue of lifestyle choice

-very few have specific training and didn’t think had organisational support

Durant et al. 2009 [32]

USA

Community health

Survey to look at patient perception of health impact of weight. Analysis looked at ethnicity

1467 surveyed

- Large disparities on racial/ethnic grounds as to whether weight seen as negative for health

- Those people whose health care provider had discussed weight had better understanding of health issues

Heslehurst et al. 2011 [33]

Maternity based health professionals

Qualitative interviews with staff working in maternity services on their views of maternity services role in caring for obese women

- Health and safety issues of working with obese women has improved but more needs to be done to address psychosocial issues, to provide clinical guidelines on weight management in pregnancy and population health initiatives to prevent obesity in pregnancy.

Smith et al. 2011 [34]

(UK)

Maternal obesity

Semi-structured interviews and focus groups evaluating understanding of community based maternal obesity initiatives; community service providers views on maternal obesity services and their role in prevention and management of obesity

- Current public health and community service provision lacks structured maternal obesity objectives

Gunther et al. 2012 [35]

United Kingdom

Doctors and nurses in primary healthcare

Barriers and enablers of managing obesity in GP Qualitative interviews

Thematic analysis

7 GPs; 7 practice nurses; 9 O/O pts

- Barriers- stigma, cost of private services, previous patient experience, health professionals not wanting to take responsibility for obesity management; lack of consistency, lack of skills, lack of NHS services

i.e. found lots of barriers

- Highlighted that preventative measures that concentrate on attitudes, behaviour and short-term goals can be associated with significant health benefits.

Nahm 2012 [50]

USA

Nurses

Preventive health care behaviours of USA based nurses

Online study asked about diet, exercise, weight, stress and preferred preventive health status

- Nurses were aware of appropriate preventive health measures but did not translate into their own self care

Leslie et al. 2013 [36]

Maternity- Gestational weight gain

Views of socially disadvantaged, O/O newly pregnant women on GWG and resources to help with this

Survey at 12 week visit

- Lack of awareness of excessive GWG

Robson et al. 2013 [37]

United Kingdom

Mental health- nursing role

Postal questionnaire to 585 mental health nurses to examine attitudes to physical health care

- Mental health nurses do feel they have role in giving advice on diet and exercise but not cancer screening or smoking cessation.

- More positive attitudes amongst nurses who has received physical health training post registration

Schauer et al. 2014 [38]

Primary healthcare- doctors and nurses

Semi-structured interviews with 30 doctors, doctor assistants and nurses

3

- Clinicians report addressing weight with those who have weight-related chronic conditions, are established patients, or have a change in weight since the previous visit.

- Most clinicians address weight in the context of managing or preventing chronic conditions.

- Many clinicians base advice on their own experiences with weight.

Tol 2014 [46]

Holland

Overweight or obese adults

Readiness to change and intentions round how to make change

On-line questionnaire for adults overweight or obese

- Found that adults who are medically in need of weight-related care are ready to lose weight, only a few intend to use weight related care.

Kable et Al 2015 [39]

Australia

Nurses

Nurses perceptions, practices and knowledge with regard to providing healthy lifestyle advice to pts. O/O

676 surveys sent, 99 returned, 79 usable (15% response rate)

- Small numbers

- 68% considered healthy lifestyle advice within scope; 28% calculated body mass, 44% mentioned physical activity solutions, 25% focused on reducing calories

- Knowledge about weight management was variable

McElwaine et al. 2013 [8]

Community Health

Telephone survey of people accessing community health services regarding what preventive advice they received regarding risk factors (smoking, alcohol consumption, fruit and vegetable intake and physical activity)

- Generally preventive are not opportunistically provided.

- Highest rates for smoking, lowest for fruit and vegetable consumption.

- Favourable view towards receiving preventive advice

Bartlem et al. 2015 [40]

Australia

Mental health

Telephone interviews with community mental health service clients re: engagement in smoking, fruit and vegetable consumption, alcohol consumption and physical activity

- High prevalence of risk behaviours plus high rate of people wanting to change behaviour