Recommendations for approaching the introduction section of manuscripts and grant applications.

Research on dental and dental hygiene education is key to improving learning, teaching, and oral health care in academic dental institutions. Faculty should be able to write research proposals and reports properly to secure funding for research and share the findings of studies with stakeholders. Specifically, they should demonstrate why the study matters in the introduction section of their text. Our experience in mentoring dental and dental hygiene faculty shows that some have difficulty justifying the importance of their studies due to the way they approach the introduction section. This short communication provides 3 recommendations to help faculty approach and write this section adequately, which can be useful for writing other sections of manuscripts and grant applications.

La recherche sur l'éducation en matière d'art dentaire et d'hygiène dentaire joue un rôle clé dans l'amélioration de l'apprentissage, de l'enseignement et des soins de santé buccodentaire dans les établissements universitaires dentaires. Le corps professoral devrait pouvoir rédiger des offres de service et des rapports de recherche de façon adéquate en vue d'obtenir du financement pour la recherche et de partager les résultats des études avec les parties intéressées. Plus précisément, il devrait démontrer l'importance de l'étude dans l'introduction de ses textes. Notre expérience en matière de mentorat du corps professoral de l'art dentaire et de l'hygiène dentaire montre que beaucoup de personnes ont de la difficulté à justifier l'importance de leurs études en raison de la façon dont ils abordent la section d'introduction. Ce bref article fournit 3 recommandations qui aideront au corps professoral à aborder cette section et à la rédiger de manière adéquate, ce qui peut être utile lors de la rédaction d'autres sections de manuscrits et de demandes de subventions.

Helping children and families to enrol in weight management: What can stakeholders do?

Many children and their families do not benefit from multidisciplinary clinical care (MCC) for paediatric weight management because they do not enrol in (initiate) treatment. The purpose of this report was to highlight practical recommendations to enhance the enrolment of Canadian children in MCC, which were drawn from multisite Canadian studies (quantitative and qualitative) that we completed recently. Recommendations to stakeholders, including primary care providers, MCC providers and decisions makers, were organized according to opportunities, motivation and barriers to enrol. Findings from our research suggested that enrolment in MCC can be improved by increasing opportunities and motivation to enrol as well as reducing the impact of enrolment barriers.

Predicting Enrollment in Multidisciplinary Clinical Care for Pediatric Weight Management.

OBJECTIVES: To characterize the children who were referred, determine the proportion of referred children who enrolled, and examine factors associated with enrollment in multidisciplinary clinical care for pediatric weight management. STUDY DESIGN: This cross-sectional study included the population of children (2-17 years of age; body mass index of ≥85th percentile) referred to 1 of 3 hospital-based multidisciplinary weight management clinics in Alberta, Canada, from April 2013 to April 2016. Referral and enrollment data were obtained from Alberta Health Services databases. Bivariate and multivariable logistic regression models were used to determine the independent and combined effects of predictors of enrollment. RESULTS: Of the 2014 children (51.8% male; mean body mass index z-score: 3.42 ± 0.03) referred to multidisciplinary clinical care, 757 (37.6%) enrolled in care. Most referred children had severe obesity and were referred by physicians. Several factors independently predicted enrollment; however, in our most parsimonious multivariable model, only the time gap (OR, 0.94; 95% CI, 0.88-0.99; P = .03) between the attendance date of the orientation session and the booking date of initial appointment predicted enrollment for all children. Body mass index z-score (OR, 0.81; 95% CI, 0.67-0.98; P = .03) and time gap (OR, 0.92; 95% CI, 0.85-0.99; P = .02) predicted enrollment in children with severe obesity exclusively. CONCLUSIONS: Fewer than 40% of referred children enrolled in multidisciplinary clinical care. Reducing the duration of enrollment and providing additional support for treatment initiation to children with severe obesity may enhance treatment uptake for pediatric weight management.

Parent Recommendations to Enhance Enrollment in Multidisciplinary Clinical Care for Pediatric Weight Management.

OBJECTIVE: To explore parents' recommendations to enhance enrollment in multidisciplinary clinical care for managing pediatric obesity. STUDY DESIGN: Data for this interpretative description study were collected through individual, semistructured interviews that were audiorecorded, transcribed verbatim, and analyzed thematically. Parents (n = 79) were recruited from 4 multidisciplinary weight management clinics in Canada located in Edmonton, Hamilton, Montreal, and Vancouver. RESULTS: Most interviewed parents had children with obesity (body mass index ≥95th percentile; 84.2%), were female (87.3%), had postsecondary education (69.6%), and were white (75.9%). Parents' recommendations referred to enrollment opportunities, information about obesity services, motivation for treatment, and accessibility to obesity services. Specifically, parents recommended to increase referral options and follow-up contacts with families during the enrollment process, inform referring physicians and families about the availability and characteristics of obesity services, enhance families' motivation for treatment, prevent families from getting discouraged, make services more appealing to families, and address accessibility issues (eg, offering multiple options for appointment times, providing support for transportation). CONCLUSIONS: Parents' recommendations support the need for family-centered approaches to enhance enrollment; however, their feasibility, acceptability, and effectiveness remain to be tested empirically.

Why do parents discontinue health services for managing paediatric obesity? A multi-centre, qualitative study.

OBJECTIVE: To explore parents' reasons for discontinuing tertiary-level care for paediatric weight management. METHODS: Participants were parents of 10-17year olds (body mass index [BMI] ≥85th percentile) who were referred for paediatric weight management. Parents were recruited from three Canadian sites (Vancouver, BC; Edmonton, AB; Hamilton, ON) and were eligible if their children attended at least one clinical appointment and subsequently discontinued care. Data were collected using semi-structured individual interviews that were digitally recorded, transcribed, and analysed using an inductive manifest content analysis. RESULTS: Parents (n=29) of children [mean age: 14.7±1.8years; mean BMI percentile: 98.9±1.6; n=17 (58.6%) boys] were primarily female (n=26; 89.7%), Caucasian (n=22; 75.9%), and had a university degree (n=23; 79.3%). Reasons for discontinuing care were grouped into three categories: (i) family factors (e.g., perceived lack of progress, lack of family support, children's lack of motivation), (ii) logistical factors (e.g., monetary costs, distance, scheduling), and (iii) health services factors (e.g., unmet expectations of care, perceived limited menu of services, no perceived need for further support). CONCLUSIONS: A range of multi-level factors influenced attrition from tertiary-level paediatric weight management. Our data suggest that experimental research is needed to examine whether addressing reasons for attrition can enhance families' retention in care and ultimately improve health outcomes for children living with obesity.

Recommendations From Parents to Improve Health Services for Managing Pediatric Obesity in Canada.

OBJECTIVE: Although parents are uniquely positioned to offer first-hand insights that can be used to improve health services for managing pediatric obesity, their perspective is underexplored. Our objective was to characterize parents' recommendations for enhancing tertiary-level health services for managing pediatric obesity in Canada. METHODS: Semistructured, one-on-one interviews were conducted with parents of children who initiated treatment at 1 of 4 Canadian tertiary-level, multidisciplinary weight management clinics. Parent perspectives were elicited regarding the strengths and weaknesses of the health services they received as well as areas for potential improvement. Interviews were audio-recorded and transcribed verbatim. We used qualitative description as the methodological framework and manifest content analysis as the analytical strategy. RESULTS: Parents (n = 65; 88% female; 72% Caucasian; 74% with at least some postsecondary education; 52% >$50,000 CDN household income) provided a range of recommendations that were organized according to health care: 1) accessibility, 2) content, and 3) delivery. The most common recommendations included increasing scheduling options (44%; n = 29), tailoring services to families' needs and circumstances (29%; n = 19), placing greater emphasis on physical activity (29%; n = 19), altering program duration (29%; n = 19), incorporating interactive elements (25%; n = 16), information provision (25%; n = 16), and providing services at sites closer to participants' homes (24%; n = 15). CONCLUSIONS: Parents' recommendations to enhance health services for managing pediatric obesity concerned modifiable factors related to accessibility, content, and delivery of care. Further research is needed to evaluate whether implementing suggested recommendations improves clinically relevant outcomes including attrition, quality of care, and success in weight management.