title: Obesity prevention in early life: an opportunity to better support the role of Maternal and Child Health Nurses in Australia.
abstract: BACKGROUND
  Because parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. However, little is known regarding the extent to which MCH nurses promote obesity prevention practices and how such practices could be better supported.
  
  
  METHODS
  This mixed methods study involved a survey of 56 MCH nurses (response rate 84.8 %), 16 of whom participated in semi-structured qualitative interviews. Both components aimed to examine the extent to which nurses addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behavior during routine consultations with young children 0-5 years. Key factors influencing such practices and how they could be best supported were also investigated. All data were collected from September to December 2013. Survey data were analysed descriptively and triangulated with qualitative interview findings, the analysis of which was guided by grounded theory principles.
  
  
  RESULTS
  Although nurses reported measuring height/length and weight in most consultations, almost one quarter (22.2 %) reported never/rarely using growth charts to identify infants or children at risk of overweight or obesity. This reflected a reluctance to raise the issue of weight with parents and a lack of confidence in how to address it. The majority of nurses reported providing advice on aspects of infant feeding relevant to obesity prevention at most consultations, with around a third (37 %) routinely provided advice on formula preparation. Less than half of nurses routinely promoted active play and only 30 % discussed limiting sedentary behaviour such as TV viewing. Concerns about parental receptiveness and maintaining rapport were key barriers to more effective implementation.
  
  
  CONCLUSIONS
  While MCH nurses are well placed to address obesity prevention in early life, there is currently a missed public health opportunity. Improving nurse skills in behaviour change counseling will be key to increasing their confidence in raising sensitive lifestyle issues with parents to better integrate obesity prevention practices into normal MCH service delivery.
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia ; Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), ᅟ, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Laws
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia ; Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), ᅟ, Australia.
authors.forename: K J
authors.initials: KJ
authors.lastname: Campbell
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia.
authors.forename: P
authors.initials: P
authors.lastname: van der Pligt
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia ; Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), ᅟ, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Ball
authors.affiliation: School of Population Health, University of Adelaide, Adelaide, Australia ; Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), ᅟ, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Lynch
authors.affiliation: Faculty of Health, University of Technology, Sydney, Australia ; Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), ᅟ, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Russell
authors.affiliation: University of Otago, Dunedin, New Zealand ; Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), ᅟ, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Taylor
authors.affiliation: Faculty of Health, University of Technology, Sydney, Australia ; Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), ᅟ, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Denney-Wilson
keywords: Children; Families; Infant feeding; Nurses; Obesity prevention; Primary health care