Table 5 Qualitative data and response examples

The need for implementation of GHK strategy

“Bigger picture” (early detection and prevention, education, support for parents, holistic care)

“Routine screening allows for identification of children below/above a healthy weight, which results in early intervention of nutrition/weight management.”

“Promote health in children and increase awareness. Detect and prevent poor outcomes.”

“I find parents appreciate us taking an interest in their child's wellbeing and having options for further follow-up. Otherwise, many parents are unaware of the available options and just feel there is nothing that can be done”

“ By routine screening it makes parents aware of their child’s height and weight and also their BMI”

“We are empowering the parents/ patients with knowledge when we educate and refer their child”

high prevalence of childhood overweight and obesity

“We have an increasing number of the paediatric patients that are admitted to the ward and are above a healthy weight.”

“High population of disadvantaged/vulnerable families to poor access to health promotion and services. High rates of overweight clients”

“With the growing number of obese children, I think this service has been much needed and we'll embraced”

Core business

“Continuation of what we have been assessing weight & BMI & discussion with parents

“ We were already providing this within Child and Family health - but it's nice having a clear pathway and seeing other services performing this so we can get a more comprehensive picture”

Barriers to implementation

Too busy, not enough time

“Many staff feel overwhelmed with addition of this task on top of our already high demand, fast based environment.”

“Expected to implement without the additional space or staff into existing clinic time which is already at capacity.”

“It adds extra consultation time to an already stretched workforce”.

“Really inconvenient and time consuming tasks to complete in a time poor environment”

Won’t help/weight bias

Agree families need the service, but when provided the service, they often do not want the service thus not making it effective.”

Out of scope/not my role

“I can see how it may be appropriate in a situation such as a doctor, nurse, dietitian or nutritionist taking these measurements; however, it is outside the scope of my professional role.”

We are consistently being required to add more and more tasks to our day to day operations and this was not something that as Speech Pathologists we believed was essential to our role

Not appropriate setting

It takes time out of already short sessions on an area that is not my clinical field of expertise and in an area that can be quite sensitive”

“Agreed that it is important, but in the outpatient plaster clinic setting it seems out of place”

“We are not the first encounters for the children that need further help. These people are normally the family GP's childcare worker, teachers”

Negative impact on relationship

“While this is a worthwhile service, there are concerns around the appropriateness of allied health clinician to provide feedback on this to families and the risk of affecting engagement with families.”

“Concern exists around how the physical measuring of children's weight by psychologists will impact on the therapy space feeling safe, non-judgemental and client goal directed”

“The counselling staff would not get involved in weighing their clients - doing so blurs the boundaries in the therapy space and can affect the sense of trust and safety that clients feel with their counsellor”

No equipment, not appropriate location/space

Staff find it difficult to complete patients’ height and weight due to inadequate equipment”

“Poor location of scales & measuring devices”

“Measuring equipment not readily available and not appropriate for age groups”

Training

Most useful

“Face to face components as staff Q & A with trainer relating to the implementation in specific local services is helpful.”

“Both online and Face to Face. Online allows you to read up on things and Face to Face brings it all together”

Least useful

Lengthily online module, time consuming”

‘due to overall volume of online training staff have to complete the addition of extra and multiple module is difficult to prioritise in amongst a clinicians busy schedule”.

Training missing

“It can be a very challenging discussion with parents and can be a very emotional time for parents. It would be good to have training on this in particular”

“Ongoing update on patient progress”

“Further training requires re having discussion with families”

“How to carry out effective and culturally sensitive discussions about healthy weight with patients and parents/carers and especially adolescents”

“Would of like to do more role play”

“More strategies to engage parents who are not interested of don't think their child weight/BMI is an issue,”

Improvements in implementation

Equipment and better space

“Placing equipment in appropriate area to weigh and measure children respectfully eg. Not in the common area where patient sit for allied health, mental health, drug and alcohol services etc.”

“Having it in a more private place (ie. Not in the waiting room where everyone can see)”

“Having more equipment in each consult room”

“Having a height and weight machine in isolation rooms for ?COVID patients as the results can take up to 24 hours and then therefore delay the measurements.”

Flagging system

“Electronic remainder on client records- shared accountability to help clinicians keep a truck of when new measurements are required”

“Reminding staff at meetings regularly to screen.”

“To have an alert system on Powerchart to alert clinician when BMI/weight is above healthy weight for a patient once height and weight are entered.

Extra staff and extra time

“Having an extra person to do the screening as it takes a lot of time”

“Additional time allocated for the appointment”