Parent and Carer Experiences of Health Care Professionals' Communications About a Child's Higher Weight: a Qualitative Systematic Review.

Objective: The objective of this systematic review was to identify, critically appraise, and synthesize the best available qualitative evidence on parent and carer experiences of communications by health care professionals (HCPs) concerning children's higher weight.

Introduction: A child's higher weight can be a sensitive issue to discuss in health care, but successful communication with parents can increase parental compliance with treatment and improve overall family welfare. Public discourse on obesity has shifted in recent years and created pressure to change the way that weight is discussed in health care. It is, therefore, important to explore how parents and carers experience the communication about children's higher weight to ensure an effective, up-to-date, and ethical counseling on childhood obesity.

Inclusion Criteria: This qualitative review included studies that focused on the experiences of parents or carers of children (birth to 12 years) with a higher weight who received a verbal or written communication from HCPs about their child's weight.

Methods: The following databases were systematically searched from 2010 onward: MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (Ovid), Scopus, LILACS, and the Finnish health sciences database MEDIC. ProQuest Dissertations and Theses (ProQuest) were searched for unpublished articles. The search was conducted in July 2022 and updated in October 2023. No country or language limits were applied. A manual search was used to supplement the database searches. Study selection including title and abstract screening, full-text screening, and critical appraisal and data extraction were performed by 2 reviewers. The research findings were categorized and aggregated into synthesized findings. The synthesized findings were assigned confidence scores and categories and finalized synthesized findings were agreed upon by all reviewers.

Results: The 33 studies included varied in qualitative study design and methodological quality. There were over 900 eligible participants (parents and carers) and 147 unequivocal and credible research findings. The research findings yielded 8 categories and 3 synthesized findings with low confidence scores. The synthesized findings were: i) Parents receiving communication on a child's higher weight experience strong feelings that can affect their parenting, ii) A health care professional's active and individual communication, with the sensitive use of words, creates a good communication experience for parents; and iii) Parents want to receive information about the child's higher weight that is useful to them and is based on an acceptable weight estimation.

Conclusion: Although confidence in the synthesized findings is low, the results of this review indicate that communication on a child's higher weight in health care should meet the parents' expectations and the family's situation and needs. Having the skills to deal with heightened emotions, the expertise and empathy as a professional, and providing appropriate information create a good communication experience for the parents. In addition, parents' desire to protect their child and the strengthening of the parenting experience should be acknowledged to conduct safe communication.