Implementing childhood obesity management in Ireland: stakeholder perspectives, priorities and recommendations for practice.

BACKGROUND

International targets to address the prevention and treatment of child and adolescent obesity (CAO) remain largely unmet. Engaging frontline healthcare professionals (HCPs) and health service managers (HSMs) to identify barriers and actionable solutions can support appropriate and sufficient health responses. We aimed firstly to explore perspectives, identify barriers, facilitators and priorities in CAO management among HCPs and HSMs in Ireland, using an implementation science lens. Secondly, we aimed to develop recommendations on how to improve health service delivery for CAO management.

METHODS

This study used focus groups alongside a nominal group technique and was an integral part of a comprehensive project exploring CAO management. Data were analysed and interpreted using thematic analysis, and themes were mapped to the Consolidated Framework for Implementation Research (CFIR) to identify strengths and gaps in the health system. We also performed data triangulation to achieve a broader understanding of the complexities involved in health service delivery for CAO management.

RESULTS

Twenty-two focus group discussions (FGDs) with 90 HCPs and 16 HSMs were conducted. Five main themes were developed: (i) diverse understanding and perception of CAO, (ii) service-level needs, (iii) partnership and integration, (iv) communication barriers and needs, and (v) policies, and politics. We mapped themes to the CFIR constructs and identified several facilitators and barriers in the current health system. Through nominal group technique, 21 priorities were identified. Five of these focused on improvements that can facilitate practice: (i) availability of clear care pathways, (ii) multidisciplinary team supports, (iii) HCP resources, (iv) training for HCPs, and (v) collaboration with stakeholders. We explored the alignment of priorities data with the themes identified from FGDs and with CFIR constructs. This informed the development of recommendations to strengthen health service delivery for CAO management.

CONCLUSION

The study highlights the need for diverse resources and stakeholder collaboration to enable effective implementation of health services for CAO, while also offering strategic recommendations aimed at strengthening CAO management in health systems.