Development and feasibility testing of an interactive, educational programme to facilitate Proactive Assessment of Obesity Risk during Infancy: ProAsk

Children who are above healthy weight are more likely to be ill and to miss time off school. Being overweight in childhood can also sow the seeds for health problems in later life such as heart disease and diabetes. Most overweight children become overweight adults.
One solution is to try to prevent children becoming overweight by intervening very early in life. Researchers have looked at some of the factors which suggest that a baby may be at greater risk of becoming overweight compared to other babies without these risk factors. We have developed a questionnaire which asks parents about these risk factors such as whether their baby was heavy at birth and how quickly their baby is gaining weight. As with all such questionnaires there is a risk that some babies might be identified as at greater risk of becoming overweight children when they are not.
This research project will design a computer-based interactive educational programme to enable health visitors to present this questionnaire to parents, calculate a baby's risk and feed that risk back to parents. Where necessary, health visitors will also present some possible solutions, such as additional help around feeding.
However, the question remains as to whether parents would like to know about their baby's risk of overweight and what they could do to keep their child healthy. We also need to know how health visitors feel about giving this sort of information to parents so the project will ask both health visitors and parents for their views. Parents will also be asked if they would be willing to enter a future study that calculates their baby's overweight risk score and, if this is high, offers additional health visiting support with diet, feeding and physical activity.

Childhood obesity risk can be identified during infancy and risk models have been developed with moderately good levels of predictability. The Infant Risk of Obesity Checklist (IROC) [1] is a screening tool that can be used with infants at 4 months. However, the impact of implementing risk prediction models into clinical practice has not been explored. This study will design and develop a computer-based educational programme, using interactive multimedia digital technologies, which will sensitively contextualise the problem of childhood obesity and facilitate communication between health practitioners and parents about obesity risk and prevention during infancy. The Proactive Assessment of Obesity Risk during Infancy (ProAsk) programme will be theoretically grounded in the Expanded Health Belief Model (EHBM) [2] and include the IROC [1] and strategies to improve parental feeding behaviour, infant diet and physical activity. A feasibility study will assess parents' and health practitioners' views about obesity risk communication and use a causal model [3] to determine the fit between the intervention strategies and outcome measures, ascertain recruitment and retention rates, determine the availability of data and data collection methods to inform the design of a future definitive trial to evaluate the benefits and harm of ProAsk compared with current practice.
1. Weng S, Redsell, SA, Nathan, D, Swift, JA, Yang, M, Glazebrook, C: Developing an algorithm to estimate overweight risk in childhood from predictors during infancy. Pediatrics, 2013, Published on-line 15th July 2013 doi: 10.1542/peds.2012-3858.
2. Strecher V, Rosenstock I: The Health Belief Model. San Francisco, CA: Jossey-Bass; 1997.
3. Hardeman W, Sutton S, Griffin S, Johnston M, White A, Wareham NJ, Kinmonth AL: A causal modelling approach to the development of theory-based behaviour change programmes for trial evaluation. Health education research 2005, 20(6):676-687.