Childhood obesity: overarching, statewide governance as a successful enabler to an integrated approach for prevention and management

摘要

Background : Queensland now has the fourth highest rate of childhood overweight and obesity in the country, with over one in four (26%) children classified as overweight or obese. Internationally, the 2017 OECD report “Caring for Quality in Health” strongly supports patient-centred integrated care as the critical enabler in addressing chronic disease. Previous statewide efforts in childhood obesity prevention and management have been fragmented and unsustainable. Without an established statewide, multidisciplinary governance structure, obesity action strategies will remain directionless and ineffective. Aims and Objectives : To establish a novel, overarching inclusive childhood obesity governance structure to support the development of embedded prevention and treatment strategies, that will lead to scalable, equitable solutions for children and adolescents who overweight and obese throughout Queensland. Methods : The current Paediatric Obesity Working Group (POWG) was created in 2015, as an inclusive statewide, multidisciplinary platform to support the development of shared equitable service models across Queensland. The POWG functions under the authority of the Queensland Child and Youth Clinical Network (QCYCN) and reports directly to the QCYCN steering committee and involves members from across the sector. Results : Under the auspice of the POWG, Children’s Health Queensland (CHQ) has established an integrated approach to paediatric obesity management, supported by a concurrent research plan. Novel Lady Cilento Children’s Hospital and Ipswich community-based multidisciplinary weight management clinics have been developed. Multiple clinics are run weekly, seeing over 40 patients per month. The research plan exists to provide an evidence-base to support the effectiveness of CHQ’s childhood multidisciplinary obesity clinic, and investigate sustainability options. Outcomes from all initiatives will be published within a resultant obesity Model of Care to be released and made available across the statewide healthcare sector. Based on the success of the above approaches, a Centre of Excellence for Childhood Obesity is being developed and is proposed to operate four programs over a 3-year period: Prevention; Treatment ; Education and Research. This Centre of Excellence aims to further enhance, support and lead the integrated, systems approach to paediatric obesity across Queensland. Conclusions : The development of a highly inclusive, comprehensive and engaged overarching governance structure increases the likelihood of successful, scalable, equitable and integrated services across the sector. A multidisciplinary, cross-sector approach with the appropriate governance will ensure that children and adolescents who are overweight or obese across Queensland will receive the right care at the right place at the right time. Format : - Timing: 60 minutes. - Speakers: Robyn Littlewood, Jackqueline Walker, Ayala Rogany, Catherine Bonifant - Combination of discussion and group work Target audience: providers within the health care (across the continuum of care: prevention, primary, secondary, tertiary quaternary), education and policy systems. Learnings/take away : Participants will understand in detail the importance of the following points: - Family-centred approaches at all levels of healthcare - Multicomponent interventions and strategies for prevention and treatment - The need for consistent screening and identification - The role of recognised leaders - Training for health professionals and other providers.