McMaster University

McMaster University

ACT (Attitudes of Clinicians Treating Children with Obesity Nation Wide: A Choice Based Conjoint National Survey)

ACT NOW. Attitudes of Clinicians Treating Children with Obesity Nation Wide

ACT NOW Patient Perspective Study

Act Now Patient Perspective

Principal Investigator: Dr. Karen Bailey

Co-Investigator: Dr. Katherine Morrison

Study Coordinator: Bethany Easterbrook, BKin.

Research Assistant: Christina Sguazzin, BA.

Funding: McMaster Surgical Associates, McMaster Children’s Hospital Foundation

The ACT NOW-A Patient Perspective study was launched in July 2013. This study is being conducted in follow-up to the “ACT NOW” project and aims to interview children and their caregivers attending the Growing Healthy Weight Management program at the Children's Exercise and Nutrition Centre at McMaster Children's Hospital to understand their attitudes, preferences for knowledge acquisition, and decision making towards treatment for pediatric obesity.  It is essential to understand this information in order to develop innovative strategies to break down the barriers to children receiving effective interventions for obesity in Canada.  Unearthing common themes and fostering an understanding of children’s and caregivers experiences with pediatric obesity will be critical in informing the advancement pediatric obesity treatment across the nation. To date, the study has interviewed 15 children and 15 caregivers.

ACT NOW: A Choice Based Conjoint National Survey

Principal Investigator: Dr. Karen Bailey
Funded By: Hamilton Health Sciences New Investigator Award, McMaster Surgical Associates Innovation grant

Study Summary

This choice based conjoint survey is studying a sample of physicians who provide care for children ages 2-18 to understand their attitudes, preferences for knowledge acquisition, knowledge of obesity and treatment options, patient demographics, and treatment referral patterns of morbidly obese children and adolescents in Canada.

Study Results

Qualitative

This study revealed 9 categories and 45 themes with regional, specialty and experiential differences. Surgery as means of achieving success appeared predominantly in Quebec and Ontario. Half of surgeons felt surgery was the only successful treatment option; other clinicians favoured behavioral interventions. All respondents expressed family involvement as integral to treatment success. Experienced physicians and clinicians in Western Canada stated a need for evidence to improve patient care, while inexperienced physicians placed greater emphasis on early detection and home environments. Physicians in Quebec and Ontario emphasized education of physicians and parents to improve treatment. All physicians, regardless of region, indicated a need for program development and system change with the greatest need in the East. Many respondents advocated moving away from assigning blame and towards encouraging healthy lifestyles.

National Choice-based Conjoint Survey Experiment

In total 30 paediatric surgeons completed the CBC experiment out of 198 participants (15%). Utilizing importance scores an early intervention group and an acute intervention group emerged.  The early intervention group (30%, 59/198) were sensitive to variations in patient and family support. They would likely intervene if patients were significantly obese, with normal lipid levels, were pre–diabetic, had high blood pressure, and obesity was associated with lifestyle factors. The acute intervention group (70%, 139/198), were likely to intervene if patients were morbidly obese, lipid levels were abnormal, patients required insulin for diabetes, blood pressure was very high, or obesity was having a major effect on the patient’s mental health. Paediatric surgeons where overwhelmingly associated with the acute intervention group (N=28/30), with only 2 (6.7%) surgeons in the early intervention group.

Publication in the Journal of Pediatric Surgery

Results from the ACT NOW qualitative study have been published in the May 2013 edition of the Journal of Pediatric Surgery.

Article Featured on MDLinx.com

Dr. Karen Bailey's published article, Understanding academic clinicians varying attitudes toward the treatment of childhood obesity in Canada: A descriptive qualitative approach, was featured on the healthcare website MDLinx.com. Click here for a link the review of Dr. Bailey's article.

Canadian Association of Pediatric Surgeons (CAPS) Annual Meeting

Dr. Bailey presented on at the podium on "Understanding Paediatric Surgeons’ Decision Making for the Treatment of Childhood Obesity Across Canada: A Choice-based Conjoint Experiment" during the CAPS 2013 Annual meeting. Dr. Bailey has previously presented the results of the ACT NOW qualitative study at the 2012 CAPS annual meeting, as well as the American Society for Metabolic and Bariatric Surgery Annual Meeting.

 

 

 

Resources

 

Publications

  • Bailey K, Pemberton J, Frankfurter C. Understanding Clinicians’ Varying Attitudes Towards Medical and Surgical Treatment of Childhood Obesity Across Canada: A Descriptive Qualitative Approach. Journal of Pediatric Surgery. 2013 May; 48(5):1012-9. http://dx.doi.org/10.1016/j.jpedsurg.2013.02.019.

 

Manuscripts in Progress

  • Bailey K, Cunningham C, Pemberton J, Morrison KM. Understanding Academic Clinician’s Decision Making for the Treatment of Childhood Obesity across Canada: A Choice-based Conjoint Experiment. In progress: target journal is CMAJ for March 2014 submission.
  • Frankfurter C, Cunningham C, Pemberton J, Morrison KM, Bailey K. Academic Clinicians’ Intention to Treat Pediatric Obesity in Canada. In progress: target journal is CMAJ for February 2014 submission.

 

Abstracts

  • Bailey K, Cunningham C, Pemberton J, Morrison K. Understanding Paediatric Surgeons’ Decision Making for the Treatment of Childhood Obesity Across Canada: A Choice-based Conjoint Experiment. Canadian Association of Pediatric Surgeons (CAPS) 45th annual meeting. Charlottetown, PEI. 2013-9-26.Published online September 2013. http://www.caps.ca/upload-files/2013_CAPS_Annual_Meeting_Booklet.pdf
  • Bailey K, Otal D, Pemberton J. Understanding Clinician Attitudes Towards Medical and Surgical Treatment of Childhood Obesity Across Canada: A Descriptive Qualitative Approach. Canadian Association of Pediatric Surgery (CAPS) Annual Meeting. Victoria, Canada. 2012-09-20. Published Online September 2012.http://www.caps.ca/upload-files/2012_CAPS_Annual_Meeting_Booklet.pdf
  • Bailey K, Pemberton J, Otal D. Understanding Physician Attitudes Towards Medical and Surgical Treatment of Childhood Obesity Across Canada: A Descriptive Qualitative Approach. American Society for Metabolic and Bariatric Surgery Annual Meeting. San Diego, USA. 2012-06-17.

 

Presentations

  • Bailey K, Cunningham C, Pemberton J, Morrison K. Understanding Paediatric Surgeons’ Decision Making for the Treatment of Childhood Obesity Across Canada: A Choice-based Conjoint Experiment. Canadian Association of Pediatric Surgeons (CAPS) 45th annual meeting. Charlottetown, PEI. 2013-9-26.

 

Poster Presentations

  • Bailey K, Pemberton J, Otal D. Understanding Physician Attitudes Towards Medical and Surgical Treatment of Childhood Obesity Across Canada: A Descriptive Qualitative Approach. American Society for Metabolic and Bariatric Surgery Annual Meeting. San Diego, USA. 2012-06-17. Act Now Poster PDF
Valid XHTML 1.0 Transitional Level Double-A conformance, W3C WAI Web Content Accessibility Guidelines 2.0