Parental experiences of primary health professional support with child health behaviours and growth: a scoping review.

Abstract

This review examined the experiences of parents/carers of 0-5-year-olds engaging with primary health professionals (PHPs) regarding child growth or associated health behaviours (nutrition, physical activity, sedentary behaviour, sleep). Six databases - MEDLINE, CINAHL, Embase, Scopus, Maternity and Infant Care Database, and PsycINFO - were searched. Eligible studies described parent-reported experiences engaging with PHPs, in both clinician- and parent-initiated interactions, regarding child growth or health behaviours in primary healthcare settings, published between 2003 and 2023. Data was synthesised using a convergent integrated approach, with barriers and facilitators to engagement mapped to the Capability, Opportunity, and Motivation model of behaviour. Eighty-seven papers (85 studies) were included, mostly conducted in the United States of America (n = 17), United Kingdom (n = 15) or Australia (n = 10). Most studies were qualitative (n = 50) and reported experiences of discussing feeding and nutrition (n = 75), with few exploring physical activity (n = 5), sedentary behaviour (n = 4), and sleep (n = 7). Barriers to discussing growth and health behaviours with PHPs included receiving ambiguous or conflicting advice; difficulty accessing services; and insufficient appointment time. Facilitators included personalised, timely, evidence-based advice, supported by appropriate resources, and delivered empathetically and without judgement. Studies reported positive (n = 25), moderate (n = 4), negative (n = 10), and variable (n = 34) levels of satisfaction with PHP support. This review highlights that PHPs frequently advise parents regarding child growth and health behaviours, particularly nutrition, in the early years. Improved PHP support may be facilitated using tools and professional development to support a consistent early childhood health promotion approach.