1.7.15

Primary prevention of childhood obesity, second edition.

Primary prevention of childhood obesity, second edition.

Registered Nurses' Association of Ontario (RNAO). Primary prevention of childhood obesity, second edition. Toronto (ON): Registered Nurses' Association of Ontario (RNAO); 2014 May. 140 p. [265 references]

Major Recommendations
The levels of evidence supporting the recommendations (Ia, Ib, IIa, IIb, III, IV) are defined at the end of the "Major Recommendations" field.
Practice Recommendations
Assessment
Recommendation 1.1
Routinely assess children's nutrition, physical activity, sedentary behaviour, and growth according to established guidelines, beginning as early as possible in a child's lifespan.
(Level of Evidence = IV)
Recommendation 1.2
Assess the family environment for factors (e.g., parenting/primary caregiver influences and socio-cultural factors) that may increase children's risk of obesity.
(Level of Evidence = IV)
Recommendation 1.3
Collaborate with school leaders to assess elementary-school environments for risk and protective conditions that influence childhood obesity, including:
  • Student demographics
  • School policies
  • Food and physical activity environments
(Level of Evidence = IV)
Recommendation 1.4
Assess neighbourhoods for community-level risk and protective conditions that influence childhood obesity.
(Level of Evidence = IV)
Planning
Recommendation 2.1
Engage community stakeholders when planning primary-prevention interventions for childhood obesity.
(Level of Evidence = IIb)
Recommendation 2.2
Develop interventions that are:
  • Universally applied, as early as possible (Level of Evidence = IV)
  • Targeted toward multiple behaviours (Level of Evidence = IV)
  • Implemented using multiple approaches (Level of Evidence = IIa)
  • Inclusive of parents/primary caregivers and the family (Level of Evidence = IIa), and
  • Implemented simultaneously in multiple settings (Level of Evidence = IIa)
Implementation
Recommendation 3.1
Support exclusive breastfeeding for the first six months of life followed by breastfeeding and complementary feeding up to two years of age or beyond.
(Level of Evidence = III)
Recommendation 3.2
Provide education and social support to help parents/primary caregivers to promote healthy eating and physical activity in infants and toddlers.
(Level of Evidence = Ib)
Recommendation 3.3
Collaborate with parents/primary caregivers, educators and support staff (e.g., teachers, child care providers, school leaders) to promote healthy eating and physical activity in all settings where preschool children gather.
(Level of Evidence = Ib)
Recommendation 3.4
Collaborate with school communities to promote regular physical activity among elementary-school children.
(Level of Evidence = IIb)
Recommendation 3.5
Facilitate and support the integration of health and nutrition education into elementary-school programs and support the improvement of the school food environment.
(Level of Evidence = IIa–III)
Evaluation
Recommendation 4.1
Monitor and evaluate the effectiveness of the family's approach to healthy eating and physical activity.
(Level of Evidence = IV)
Recommendation 4.2
Evaluate the effectiveness and sustainability of school- and community-based primary-prevention initiatives.
(Level of Evidence = IV)
Recommendation 4.3
Advocate and support the evaluation of an organization's compliance with healthy public policies, and the impact of such policies on childhood eating behaviours and physical activity.
(Level of Evidence = III)
Education Recommendations
Recommendation 5.1
Incorporate foundational primary-prevention curricula based on this Guideline into the undergraduate education of nurses and other health-care providers.
(Level of Evidence = IV)
Recommendation 5.2
Health-care professionals should participate in continuing education to enhance their ability to support the positive behavioural and environmental changes for children, families, and communities recommended in this Guideline.
(Level of Evidence = IV)
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