Child Growth: Improving the Assessment and Communication
Date
2024-01-15
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Abstract
Childhood obesity is a major public health concern worldwide. Accurate assessment of child weight and effective communication of weight information to parents are key steps to promote optimal growth in children and prevent obesity. However, there are questions about which growth tools are the most appropriate to assess children’s weights in early years, a critical time for the diagnosis of obesity risk to facilitate timely interventions. Additionally, most parents do not understand growth information and often normalize their children’s unhealthy weights. While guidance recommends using growth charts for educating parents, there are gaps in the literature concerning the knowledge and perceptions of healthcare providers, as chart users, on growth charts as tools to assess and communicate child growth information. These gaps are addressed in this dissertation. The overarching aim of this dissertation is to explore the accuracy of clinical assessment and communication of child weight assessments, applying concepts and methodologies from public health, knowledge translation and epidemiology. In the first manuscript, we updated the evidence on the practice of age correction to promote the accurate assessment of preterm growth. Using longitudinal data for children born extremely and very preterm in Canada, our findings support the practice of age correction for all growth measures including weight, length/height and head circumference through 3 years corrected age. The second manuscript is an observational study assessing weight classifications in infancy and obesity prediction according to weight-for-length and body mass index, using Canadian public health data. The analyses demonstrated agreement between weight-for-length and body-mass-index weight classifications in infancy, warranting an assessment of the potential benefits of using body-mass-index to monitor infants’ weights. The third manuscript is an observational cross-sectional study exploring the knowledge and perceptions of Canadian healthcare providers of growth charts as tools to assess and communicate child growth. Data were gathered via a survey distributed to national medical and allied health organizations. Findings indicated substantial inconsistencies and variability in clinical practices of child weight assessments, including in the choice of the appropriate chart to use according to age, and the cut-offs to identify high and low weights. The results of the three manuscripts contribute to the field of child weight assessment, which are integrated into clinical recommendations and directions for future research.
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Keywords
Childhood obesity, Weight assessments, Growth charts, Preterm birth, Age correction, Body mass index, Child growth
Citation
Elmrayed, S. A. A. (2024). Child growth: improving the assessment and communication (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.