Proactive assessment of obesity risk during infancy (ProAsk): Communicating future risk of childhood overweight to parents through digital technology
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Background and aims ProAsk is an interactive digital tool, which includes a validated algorithm based on childhood overweight risk factors. The tool enables Health Visitors (HVs) (Public Health Nurses) to feedback average or above average risk of obesity to parents and prompts discussion of potential areas for behaviour change to reduce risk. This paper reports the findings of a feasibility study of the implementation of ProAsk with UK HVs. Methods HVs (n=49) working in four deprived localities attended a ProAsk/ Motivational Interviewing training day. They recruited parents of infants 6-8 weeks old and used ProAsk with them at three months infant age. Quantitative data were collected on recruitment, response and retention rates and infant risk factors. Qualitative data were collected on acceptability and implementation of ProAsk and analysed thematically. Results Parents of 66/244 eligible infants (34 boys (52%) and 32 girls (48%)) were recruited. Themedian risk score was 6.7%. Using a risk threshold of 10%, 21 (40%) of infants were at above average risk. Those at risk had a higher birthweight (3.84kg vs 3.18kg), more rapid weight gain (defined as >0.67WFA z score) (19%vs 6.3%), more smoking in pregnancy (10% vs 0%), lower maternal BMI (22.3kg vs. 28.9kg). Qualitative interviews with parents (n=12) and HVs (n=14) suggested that the ProAsk intervention was acceptable but intervention fidelity was low. Conclusions HVs found recruiting parents into the ProAsk study challenging, although they were able to collect data from participants enabling obesity risk calculation. Future studies will need to address the barriers to implementing ProAsk into practice.