Enablers and barriers to implementing obesity assessments in clinical practice: a rapid mixed-methods systematic review
Objectives This systematic review aims to improve our knowledge of enablers and barriers to implementing obesity-related anthropometric assessments in clinical practice.Design A mixed-methods systematic review.Data sources Medline, Embase and CINAHL to November 2021.Eligibility criteria Quantitative...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e063659.full |
| _version_ | 1828300713874161664 |
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| author | Evan Atlantis P Fahey David Lim Kath Peters Ritesh Chimoriya Canaan Negash Seifu Gill Murphy Bernadette Carr |
| author_facet | Evan Atlantis P Fahey David Lim Kath Peters Ritesh Chimoriya Canaan Negash Seifu Gill Murphy Bernadette Carr |
| author_sort | Evan Atlantis |
| collection | DOAJ |
| description | Objectives This systematic review aims to improve our knowledge of enablers and barriers to implementing obesity-related anthropometric assessments in clinical practice.Design A mixed-methods systematic review.Data sources Medline, Embase and CINAHL to November 2021.Eligibility criteria Quantitative studies that reported patient factors associated with obesity assessments in clinical practice (general practice or primary care); and qualitative studies that reported views of healthcare professionals about enablers and barriers to their implementation.Data extraction and synthesis We used random-effects meta-analysis to pool ratios for categorical predictors reported in ≥3 studies expressed as pooled risk ratio (RR) with 95% CI, applied inverse variance weights, and investigated statistical heterogeneity (I2), publication bias (Egger’s test), and sensitivity analyses. We used reflexive thematic analysis for qualitative data and applied a convergent integrated approach to synthesis.Results We reviewed 22 quantitative (observational) and 3 qualitative studies published between 2004 and 2020. All had ≥50% of the quality items for risk of bias assessments. Obesity assessment in clinical practice was positively associated with patient factors: female sex (RR 1.28, 95% CI 1.10 to 1.50, I2 99.8%, mostly UK/USA), socioeconomic deprivation (RR 1.21, 95% CI 1.18 to 1.24, I2 73.9%, UK studies), non-white race/ethnicity (RR 1.27, 95% CI 1.03 to 1.57, I2 99.6%) and comorbidities (RR 2.11, 95% CI 1.60 to 2.79, I2 99.6%, consistent across most countries). Obesity assessment was also most common in the heaviest body mass index group (RR 1.55, 95% CI 0.99 to 2.45, I2 99.6%). Views of healthcare professionals were positive about obesity assessments when linked to patient health (convergent with meta-analysis for comorbidities) and if part of routine practice, but negative about their role, training, time, resources and incentives in the healthcare system.Conclusions Our evidence synthesis revealed several important enablers and barriers to obesity assessments that should inform healthcare professionals and relevant stakeholders to encourage adherence to clinical practice guideline recommendations. |
| first_indexed | 2024-04-13T13:13:55Z |
| format | Article |
| id | doaj.art-56766d29b4e2465894f77712f59b7921 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-13T13:13:55Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-56766d29b4e2465894f77712f59b79212022-12-22T02:45:31ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-063659Enablers and barriers to implementing obesity assessments in clinical practice: a rapid mixed-methods systematic reviewEvan Atlantis0P Fahey1David Lim2Kath Peters3Ritesh Chimoriya4Canaan Negash Seifu5Gill Murphy6Bernadette Carr7Capital Markets CRC, Sydney, New South Wales, AustraliaSchool of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australiamedical studentSchool of Health Sciences, Western Sydney University, Penrith South, New South Wales, AustraliaSchoolof Health Sciences, Western Sydney University, Campbelltown, New South Wales, AustraliaSchoolof Health Sciences, Western Sydney University, Campbelltown, New South Wales, AustraliaTranslational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, AustraliaTheUniversity of Sydney, Sydney, New South Wales, AustraliaObjectives This systematic review aims to improve our knowledge of enablers and barriers to implementing obesity-related anthropometric assessments in clinical practice.Design A mixed-methods systematic review.Data sources Medline, Embase and CINAHL to November 2021.Eligibility criteria Quantitative studies that reported patient factors associated with obesity assessments in clinical practice (general practice or primary care); and qualitative studies that reported views of healthcare professionals about enablers and barriers to their implementation.Data extraction and synthesis We used random-effects meta-analysis to pool ratios for categorical predictors reported in ≥3 studies expressed as pooled risk ratio (RR) with 95% CI, applied inverse variance weights, and investigated statistical heterogeneity (I2), publication bias (Egger’s test), and sensitivity analyses. We used reflexive thematic analysis for qualitative data and applied a convergent integrated approach to synthesis.Results We reviewed 22 quantitative (observational) and 3 qualitative studies published between 2004 and 2020. All had ≥50% of the quality items for risk of bias assessments. Obesity assessment in clinical practice was positively associated with patient factors: female sex (RR 1.28, 95% CI 1.10 to 1.50, I2 99.8%, mostly UK/USA), socioeconomic deprivation (RR 1.21, 95% CI 1.18 to 1.24, I2 73.9%, UK studies), non-white race/ethnicity (RR 1.27, 95% CI 1.03 to 1.57, I2 99.6%) and comorbidities (RR 2.11, 95% CI 1.60 to 2.79, I2 99.6%, consistent across most countries). Obesity assessment was also most common in the heaviest body mass index group (RR 1.55, 95% CI 0.99 to 2.45, I2 99.6%). Views of healthcare professionals were positive about obesity assessments when linked to patient health (convergent with meta-analysis for comorbidities) and if part of routine practice, but negative about their role, training, time, resources and incentives in the healthcare system.Conclusions Our evidence synthesis revealed several important enablers and barriers to obesity assessments that should inform healthcare professionals and relevant stakeholders to encourage adherence to clinical practice guideline recommendations.https://bmjopen.bmj.com/content/12/11/e063659.full |
| spellingShingle | Evan Atlantis P Fahey David Lim Kath Peters Ritesh Chimoriya Canaan Negash Seifu Gill Murphy Bernadette Carr Enablers and barriers to implementing obesity assessments in clinical practice: a rapid mixed-methods systematic review BMJ Open |
| title | Enablers and barriers to implementing obesity assessments in clinical practice: a rapid mixed-methods systematic review |
| title_full | Enablers and barriers to implementing obesity assessments in clinical practice: a rapid mixed-methods systematic review |
| title_fullStr | Enablers and barriers to implementing obesity assessments in clinical practice: a rapid mixed-methods systematic review |
| title_full_unstemmed | Enablers and barriers to implementing obesity assessments in clinical practice: a rapid mixed-methods systematic review |
| title_short | Enablers and barriers to implementing obesity assessments in clinical practice: a rapid mixed-methods systematic review |
| title_sort | enablers and barriers to implementing obesity assessments in clinical practice a rapid mixed methods systematic review |
| url | https://bmjopen.bmj.com/content/12/11/e063659.full |
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