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The acceptability and feasibility of using a 3D body size scale to initiate conversations about weight in toddlerhood: a mixed-methods study

Lookup NU author(s): Dr Elizabeth EvansORCiD, Dr Martin Tovee



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2020 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation. Background: Health Care Professionals struggle to initiate conversations about overweight in toddlerhood. A novel 3D body size scale (3D BSS) may facilitate engagement with this topic during pediatric appointments. Objectives: To explore barriers and facilitators to using the 3D BSS through a mixed-methods design. Methods: For the qualitative phase, parents of toddlers (n = 38) participated in semi-structured interviews introducing the 3D BSS of 4–5-year-old children. For the quantitative phase, pre- and post-interview questionnaires were administered to ascertain the acceptability of the 3D BSS. Results: Parents rated the 3D BSS as “very” (n = 20, 52.6%) to “moderately” (n = 12, 31.6%) acceptable. Thematic analysis revealed four barriers to acceptability: i) the sensitive nature of child weight, ii) the belief that weight does not determine health, iii) the visual normalisation of overweight and iv) the need to account for individual variation in growth patterns. However, these barriers could be overcome through three facilitators: i) the provision of expert guidance ii) the value of simple tools, and iii) tailoring conversations to familial needs. Conclusions: Parents considered the 3D BSS an acceptable visual resource to discuss child weight during routine appointments. However, the acceptability of the tool was conditional on a sensitive, collaborative, and tailored delivery approach.

Publication metadata

Author(s): Tommerup K, Smith AD, Evans EH, Croker H, Steptoe A, Tovee MJ, Fildes A, Llewellyn C

Publication type: Article

Publication status: Published

Journal: Pediatric Obesity

Year: 2021

Volume: 16

Issue: 2

Print publication date: 01/02/2021

Online publication date: 20/08/2020

Acceptance date: 28/07/2020

Date deposited: 19/10/2020

ISSN (print): 2047-6302

ISSN (electronic): 2047-6310

Publisher: John Wiley and Sons Ltd


DOI: 10.1111/ijpo.12715


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