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Barriers and facilitators to implementing practices for prevention of childhood obesity in primary care: a mixed methods systematic review.

Lookup NU author(s): Dr Devashish RayORCiD, Professor Falko Sniehotta, Emerita Professor Elaine McCollORCiD



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


Primary care providers (PCPs) have an important role in prevention of excess weight gain in pre-school children. Guidelines exist to support PCPs' practices. This systematic review of PCPs' practice behaviours and their perceptions of barriers to and facilitators of implementation of guidelines was the first step towards the development of an intervention aimed at supporting PCPs. Five databases were searched to identify qualitative, quantitative, and mixed methods studies which examined PCP's practice patterns and factors influencing implementation of recommended practices. The convergent integrated approach of the Joanna Briggs Institute methodology for mixed methods reviews was used for data synthesis. Following analysis, the resultant factors were mapped on to the Capability, Opportunity, and Motivation model of Behaviour (COM-B). Fifty studies met the eligibility criteria. PCPs inconsistently implemented recommended practices. Barriers and facilitators were identified at the provider (e.g., lack of knowledge), parent (e.g., lack of motivation), and organisation level (e.g., inadequate training provision). Factors were mapped to all three components of the COM-B model: psychological capability (e.g., lack of skills), reflective motivation (e.g., beliefs about guidelines), automatic motivation (e.g., discomfort), physical opportunity (e.g., time constraints), and social opportunity (e.g., stigma). These findings reflect the complexity of implementation of childhood obesity prevention practices.

Publication metadata

Author(s): Ray D, Sniehotta F, McColl E, Ells L

Publication type: Review

Publication status: Published

Journal: Obesity Reviews

Year: 2022

Volume: 23

Issue: 4

Print publication date: 01/04/2022

Online publication date: 22/01/2022

Acceptance date: 17/12/2021

ISSN (electronic): 1467-789X


DOI: 10.1111/obr.13417