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Revised draft Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Children and Adolescents

ID: 
33
Personal Details
Organisation Name: 
South Australian Child and Family Health Nurses Association
Additional Information
In regard to your comments, do you have a Conflict of Interest to disclose?: 
No
Specific questions
Question 2: What would help you implement these recommendations into practice?: 

The recommendations in the document require some changes in resources for child and family health nurses in SA and some changes in the referral process. 

Currently Child and Family Health Nurses in SA do not complete BMI measurements and do not have access to BMI percentile charts.  To implement the recommendations nurses would require the resources, training in use of BMI and support from the employer.  As an Association we support these practice changes. Nurses are also not completing waist measurements and the above also applies

Currently Child and Family Health Nurses in SA are unable to refer children directly to the hospital or a paediatric service.  Current practice is to refer to a GP who then can refer on.  There are however some barriers to this occurring including, the family have an additional appointment (and cost) and may be deterred by this, and/or the GP may not agree with the assessment and may not initiate the referral.  Child and Family Health Nurses provide services to children aged 0-5 years and are a key stakeholder in the primary assessment of children in this age group, particularly in completing the 4-5 year old health check with a large majority of children accessing this service through Child and Family Health Nurses.  As an Association we would support the change of being able to refer directly to a paediatric or hospital service to ensure children assessed with BMI >95% are provided appropriate assessment and intervention.

Specific comments
Comments: 
9.1 Identifying overweight and obesity

Refer to comments in Question 2.

Further definition is required of waist measurements.  From which age group are waist measurements recommended only over 5 years? and is this recommended as a primary screen for all children.  Is waist measurement on its own without BMI concerns an indicator for referral.

General comments
Comments: 

Overall the guidelines are easy to navigate and read.  They provide clear recommendations. 

Separation of child and adult would be beneficial.

Page reviewed: 6 September, 2012