Barriers and facilitators to healthy living counselling in Canadian pediatric tertiary care: a survey of healthcare providers

Abstract

Abstract Background: The purpose of this study is to gather HCPs’ perspectives on current practices and attitudes to Healthy Living Counselling (HLC), along with identifying barriers and facilitators to delivering HLC during clinical encounters. Methods: A 39-item HCP Needs Assessment Survey was administered to 705 HCPs in the Pediatric Department of a tertiary pediatric hospital in British Columbia, Canada. The survey received 290 responses, resulting in a final sample size of 244 after applying exclusion criteria. Frequencies and proportions were reported. Linear regression and chi-squared tests were used to analyze associations between responses. Results: HCPs reported frequent measurement of height, weight, and BMI and supported addressing health behaviours with their patients. However, assessments of healthy living behaviours (e.g., physical activity, healthy eating, screen time) were reported as occurring "rarely/half of patient visits." HLC was more commonly provided to patients perceived as overweight/obese (19.4% for most/every visit) than those with healthy weights (7.7%). While HCPs exhibited confidence in discussing health behaviours, they had lower confidence in broaching weight-specific issues. Both practical (time constraints, available support) and interpersonal (therapeutic relationship concerns) barriers to HLC provision were identified. Conclusion: This study highlights the recognition among HCPs of the importance of HLC provision, along with a desire for improved training opportunities to enhance their skills. Future possible interventions include motivational interviewing and weight stigma training to bolster HCPs' confidence and efficacy in delivering HLC. These findings contribute valuable insights for enhancing HCPs' abilities and willingness to promote healthy living behaviours among pediatric patients.