Obesity prevention and the role of hospital and community-based health services: a scoping review.
Health services
Obesity
Prevention
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
05 Jul 2019
05 Jul 2019
Historique:
received:
03
04
2019
accepted:
14
06
2019
entrez:
7
7
2019
pubmed:
7
7
2019
medline:
14
11
2019
Statut:
epublish
Résumé
Control of obesity is an important priority to reduce the burden of chronic disease. Clinical guidelines focus on the role of primary healthcare in obesity prevention. The purpose of this scoping review is to examine what the published literature indicates about the role of hospital and community based health services in adult obesity prevention in order to map the evidence and identify gaps in existing research. Databases were searched for articles published in English between 2006 and 2016 and screened against inclusion and exclusion criteria. Further papers were highlighted through a manual search of the reference lists. Included papers evaluated interventions aimed at preventing overweight and obesity in adults that were implemented within and/or by hospital and community health services; were an empirical description of obesity prevention within a health setting or reported health staff perceptions of obesity and obesity prevention. The evidence supports screening for obesity of all healthcare patients, combined with referral to appropriate intervention services but indicates that health professionals do not typically adopt this practice. As well as practical issues such as time and resourcing, implementation is impacted by health professionals' views about the causes of obesity and doubts about the benefits of the health sector intervening once someone is already obese. As well as lacking confidence or knowledge about how to integrate prevention into clinical care, health professional judgements about who might benefit from prevention and negative views about effectiveness of prevention hinder the implementation of practice guidelines. This is compounded by an often prevailing view that preventing obesity is a matter of personal responsibility and choice. This review highlights that whilst a population health approach is important to address the complexity of obesity, it is important that the remit of health services is extended beyond medical treatment to incorporate obesity prevention through screening and referral. Further research into the role of health services in obesity prevention should take a systems approach to examine how health service structures, policy and practice interrelationships, and service delivery boundaries, processes and perspectives impact on changing models of care.
Sections du résumé
BACKGROUND
BACKGROUND
Control of obesity is an important priority to reduce the burden of chronic disease. Clinical guidelines focus on the role of primary healthcare in obesity prevention. The purpose of this scoping review is to examine what the published literature indicates about the role of hospital and community based health services in adult obesity prevention in order to map the evidence and identify gaps in existing research.
METHODS
METHODS
Databases were searched for articles published in English between 2006 and 2016 and screened against inclusion and exclusion criteria. Further papers were highlighted through a manual search of the reference lists. Included papers evaluated interventions aimed at preventing overweight and obesity in adults that were implemented within and/or by hospital and community health services; were an empirical description of obesity prevention within a health setting or reported health staff perceptions of obesity and obesity prevention.
RESULTS
RESULTS
The evidence supports screening for obesity of all healthcare patients, combined with referral to appropriate intervention services but indicates that health professionals do not typically adopt this practice. As well as practical issues such as time and resourcing, implementation is impacted by health professionals' views about the causes of obesity and doubts about the benefits of the health sector intervening once someone is already obese. As well as lacking confidence or knowledge about how to integrate prevention into clinical care, health professional judgements about who might benefit from prevention and negative views about effectiveness of prevention hinder the implementation of practice guidelines. This is compounded by an often prevailing view that preventing obesity is a matter of personal responsibility and choice.
CONCLUSIONS
CONCLUSIONS
This review highlights that whilst a population health approach is important to address the complexity of obesity, it is important that the remit of health services is extended beyond medical treatment to incorporate obesity prevention through screening and referral. Further research into the role of health services in obesity prevention should take a systems approach to examine how health service structures, policy and practice interrelationships, and service delivery boundaries, processes and perspectives impact on changing models of care.
Identifiants
pubmed: 31277640
doi: 10.1186/s12913-019-4262-3
pii: 10.1186/s12913-019-4262-3
pmc: PMC6612151
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
453Références
Proc Nutr Soc. 2005 Feb;64(1):81-8
pubmed: 15877926
J Adv Nurs. 2007 Apr;58(1):23-34
pubmed: 17394613
J Adv Nurs. 2007 Aug;59(4):329-41
pubmed: 17635298
J Adv Nurs. 2007 Dec;60(5):535-43
pubmed: 17973717
J Obstet Gynecol Neonatal Nurs. 2008 Mar-Apr;37(2):176-84
pubmed: 18336441
Patient Educ Couns. 2008 Jul;72(1):56-62
pubmed: 18346861
J Gen Intern Med. 2008 Jun;23(6):821-3
pubmed: 18350338
Patient Educ Couns. 2009 Apr;75(1):53-7
pubmed: 19038523
Obesity (Silver Spring). 2009 May;17(5):1077-85
pubmed: 19197264
Am J Med. 2009 Apr;122(4 Suppl 1):S19-23
pubmed: 19410673
Am J Med. 2009 Apr;122(4 Suppl 1):S24-32
pubmed: 19410674
Am J Med. 2009 Apr;122(4 Suppl 1):S4-11
pubmed: 19410676
Obes Rev. 2010 May;11(5):371-9
pubmed: 19538441
Am J Obstet Gynecol. 2010 Feb;202(2):135.e1-8
pubmed: 19683692
Midwifery. 2011 Oct;27(5):e170-7
pubmed: 20188447
Implement Sci. 2010 Jan 15;5:2
pubmed: 20205791
Cochrane Database Syst Rev. 2010 Mar 17;(3):CD000984
pubmed: 20238311
Nurse Pract. 2010 Aug;35(8):33-8
pubmed: 20644450
Arch Intern Med. 2011 Feb 28;171(4):316-21
pubmed: 21357807
Int J Obes (Lond). 2012 Feb;36(2):178-85
pubmed: 21487396
Public Health. 2011 Aug;125(8):518-24
pubmed: 21794887
Obesity (Silver Spring). 2012 Aug;20(8):1639-44
pubmed: 21818146
Proc Nutr Soc. 2011 Nov;70(4):439-49
pubmed: 21854697
Psychiatr Clin North Am. 2011 Dec;34(4):717-32
pubmed: 22098799
Addiction. 2012 Jun;107(6):1066-73
pubmed: 22175545
Ann Intern Med. 2012 Sep 4;157(5):373-8
pubmed: 22733087
Nurs Outlook. 2012 Sep-Oct;60(5):e23-31
pubmed: 22770679
JAMA. 2012 Jul 18;308(3):243-4
pubmed: 22797640
Qual Prim Care. 2012;20(2):93-103
pubmed: 22824562
J Aging Health. 2012 Oct;24(7):1179-202
pubmed: 22918131
Matern Child Health J. 2013 Oct;17(8):1508-17
pubmed: 23065312
Int J Ment Health Nurs. 2013 Oct;22(5):409-17
pubmed: 23066812
BMC Pregnancy Childbirth. 2013 Jan 16;13:10
pubmed: 23324195
Midwifery. 2014 Jan;30(1):11-6
pubmed: 23419967
BMC Health Serv Res. 2013 May 06;13:167
pubmed: 23642238
BMC Pediatr. 2013 May 20;13:80
pubmed: 23688259
Aust J Prim Health. 2014;20(2):123-7
pubmed: 24176286
Mayo Clin Proc. 2013 Dec;88(12):1446-61
pubmed: 24290119
Fam Community Health. 2014 Jan-Mar;37(1):74-85
pubmed: 24297009
Cochrane Database Syst Rev. 2014 Feb 05;(2):CD008066
pubmed: 24500864
Qual Health Res. 2014 Apr 11;24(6):790-800
pubmed: 24728109
BMC Public Health. 2014 Jun 11;14:582
pubmed: 24916037
Patient Educ Couns. 2014 Oct;97(1):82-7
pubmed: 24976627
Lancet. 2014 Jul 5;384(9937):45-52
pubmed: 24996589
JAMA. 2014 Sep 3;312(9):943-52
pubmed: 25182103
Am J Prev Med. 2014 Oct;47(4):424-34
pubmed: 25240966
Psychiatr Serv. 2015 Aug 1;66(8):857-64
pubmed: 25930044
Nurs Health Sci. 2015 Dec;17(4):451-9
pubmed: 26202152
Health Aff (Millwood). 2015 Sep;34(9):1456-63
pubmed: 26355046
Implement Sci. 2016 Apr 02;11:46
pubmed: 27039077
Implement Sci. 2016 Apr 06;11:50
pubmed: 27052329
Public Health Res Pract. 2016 Jul 15;26(3):
pubmed: 27421344
Implement Sci. 2017 Aug 22;12(1):105
pubmed: 28830568