Could embedding a health behaviour screening tool within routine primary health care be the answer to improving the health, wellbeing and development of children in the early years? This important question is being explored by Flinders Caring Futures Institute researcher and PhD candidate Dimity Dutch.
As an Accredited Practising Dietitian, Ms Dutch says she has always been interested in working with children and families to promote and establish positive health behaviours from a young age. Recognising that health and wellbeing is more than just what we eat, she is taking a holistic approach by focusing on modifiable health behaviours as an alternative to BMI screening in primary health care.
Traditionally, children have their height, weight and BMI charted on growth percentile charts by a GP or primary health care practitioner. However, Ms Dutch says measuring a child’s height and weight shouldn’t be relied upon as a sole measure of health. She highlights that there is often a disconnect between the number on a scale and a child’s overall health and wellbeing due to the complex and multifaceted world we live in.
“Without measuring behaviours, the health care practitioner may not get a clear idea of what advice they should provide, which referral pathways they should follow or what that child and family might need extra support with.
“What I want to do is modify the screening process to focus less on weight and shift to measuring health behaviours, generating more positive conversations around improving health and wellbeing in the early years.”
Particularly with nutrition, by engaging with parents in the health care settings they are already visiting, Ms Dutch says there are many behaviours that can be supported to help establish healthy habits that last for life.
“Many parents are also uncomfortable discussing their child’s weight, given the stigma surrounding childhood overweight and obesity. Weight-focused conversations can be polarising and make families want to disengage with the healthcare system.”
As part of her PhD, Ms Dutch will identify the current guidelines for health behaviour screening in primary health care. She will then work collaboratively with practitioners to determine facilitators, barriers and the resources that would be required to feasibly implement the screening tool in routine practice. She will also engage with parents, caregivers and other key stakeholders to gain their valuable feedback.
“I want to see whether a brief screening tool can be used in this setting, that captures all the behaviours that can impact a child’s health, wellbeing and development. This could include fruit and vegetable consumption, sleep, screen-time and physical activity. This tool could be used widely across the primary health care system to make every contact count.”
From a health monitoring perspective, such a tool could also support the tracking of behaviours over time and allow practitioners to readily compare the child’s behaviour to national recommendations.
“I hope that a brief health behaviour screening tool will facilitate more tailored and positive conversations to support the health and wellbeing of children,” Ms Dutch says. “Ultimately, the aim is to improve and support alignment towards national health behaviour recommendations and to identify poor health behaviours earlier, leading to improved health outcomes across the lifespan.”
Ms Dutch’s supervisory team includes Professor Rebecca Golley and Dr Lucy Bell.