Childhood obesity prevention in general practice: supporting implementation through co-ideation.

BACKGROUND: Childhood obesity is associated with physical and psychological complications thus the prevention of excess weight gain in childhood is an important health goal. Relevant to the prevention of childhood obesity, Australian general practice-specific, preventive care guidelines recommend General Practitioners (GPs) conduct growth monitoring and promote a number of healthy behaviours. However, challenges to providing preventive care in general practice may impact implementation. In October and November, 2022, a series of three workshops focusing on the prevention of childhood obesity were held with a group of Australian GPs and academics. The objective of the workshops was to determine practical ways that GPs can be supported to address barriers to the incorporation of obesity-related prevention activities into their clinical practice, for children with a healthy weight. METHODS: This paper describes workshop proceedings, specifically the outcomes of co-ideation activities that included idea generation, expansion of the ideas to possible interventions, and the preliminary assessment of these concepts. The ecological levels of the individual, interpersonal, and organisation were considered. RESULTS: Possible opportunities to support childhood obesity prevention were identified at multiple ecological levels within the clinic. The preliminary list of proposed interventions to facilitate action included GP education and training, clinical audit facilitation, readily accessible clinical guidelines with linked resources, a repository of resources, and provision of adequate growth monitoring tools in general practice. CONCLUSIONS: Co-ideation with GPs resulted in a number of proposed interventions, informed by day-to-day practicalities, to support both guideline implementation and childhood obesity prevention in general practice.

Adult survivors of childhood trauma: Complex trauma, complex needs.

BACKGROUND: Childhood trauma is common and can have profound consequences throughout a person's life. Adult survivors of childhood abuse pose a number of challenges for general practitioners (GPs). The diagnosis of their medical and psychiatric illnesses is complex; the therapeutic relationship can be both delicate and critical to recovery; and the treatments are varied, often expensive and frequently inaccessible. OBJECTIVE: The aim of this article is to provide a conceptual framework for the assessment and management of an adult survivor of childhood adversity. DISCUSSION: GPs can be effective and facilitate recovery-orientated, trauma-focused care, even when local services are limited. This model considers the person's presenting symptoms and the consultation interaction, and it is applicable regardless of diagnosis. Key principles include listening and engaging to understand why the person is presenting in this way, and approaching care in a targeted and collaborative manner. This can alleviate emotional distress for the patient, GP and care team.