Enhancing Growth Monitoring Practices through Provincial Childhood Growth Measurement Guidelines. What s Up Doc? Research Showcase February 2015

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Eustace Singleton
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1 Enhancing Growth Monitoring Practices through Provincial Childhood Growth Measurement Guidelines What s Up Doc? Research Showcase February 2015 Farah Bandali, Laura Crawford, Deborah McNeil, Cyne Johnston

2 Faculty/Presenter Disclosure Faculty/Presenter: Farah Bandali Relationships with commercial interests: (Complete as it applies to you during the past two calendar years ) Grants/Research Support: Childhood Growth Measurement received support from the Alberta Cancer Prevention Legacy Fund , Alberta Health Services Speakers Bureau/Honoraria: N/A Consulting Fees: N/A Other: N/A 2

3 Outline Background Goal and overview of Childhood Growth Measurement (CGM) Protocol and resources to support your practice Evaluation findings Summary and Next steps 3

4 Background Childhood growth monitoring and surveillance was identified as one of three pillars of a comprehensive provincial strategy to address childhood obesity As the first step, establishing a standardized growth measuring program for infants, preschoolers and children was prioritized Implementing standardized growth measuring practices will contribute to the development of a childhood growth surveillance and referral system in future years 4

5 Accurate, reliable measurements Accurate, reliable measurements are fundamental to growth monitoring If measurements are in error, then the foundation of the growth assessment is also in error, leading to: o Incorrect interpretation of growth patterns o Missed or unnecessary referrals Contributes to surveillance system o Creates a picture of growth of Alberta s children o Population level data collected is important for program planning, implementation and evaluation 5

6 Goal Childhood Growth Measurement (CGM) Enhance growth monitoring practices and child health outcomes by implementing provincial guidelines to ensure accurate and reliable measurements of infants, children and adolescents (birth to 19 years) 6

7 Components of accurate measuring There are 3 components of accurate measuring: A standardized measurement technique Quality equipment that is calibrated and accurate Trained measurers who are reliable and precise in their technique 7

8 Target Groups AHS staff, students, volunteers involved in growth measurement within an AHS program or at an AHS site in the province of Alberta Primary care physicians, staff, students, volunteers involved in growth measurement external to AHS 8

9 Engagement Stakeholder engagement and collaboration were employed: Throughout the planning and implementation Informed and guided the development of the protocol, training, resources and evaluation 9

10 Literature Review Gathered evidence on growth measuring practices 10

11 Environmental Scan Key informant interviews to identify current CGM practices, guidelines and referral processes revealed: Varied protocols, data collection and storage Protocols and practices not aligned with WHO Child Growth Standards Current surveillance data had significant limitations 11

12 Protocol Childhood Growth Measurement Protocol - Public Health and Clinical Settings, hservices.ca/hp/if-hpcgm-measurementprotocol.pdf 12

13 Equipment and Calibration Quality equipment which is regularly calibrated and accurate is essential to achieving accurate measurements Equipment: specifications Calibration: guidelines and Recording Form Template 13

14 Resources Childhood Growth Measurement protocol, training resources, equipment specifications and calibration guidelines, Frequently Asked Questions and video are available on AHS external website:

15 Training module for trainers Childhood Growth Measurement Training Module Date: Insert date of training session January

16 Training videos Available on the AHS external website o Full Length - 11:50 minutes o Measuring 0-24 months - 3:33 minutes o Measuring 2-19 years - 1:46 minutes 16

17 Job aides posters

18 Evaluation: Phase 1 Key Findings To assess the effectiveness of the processes used to develop and implement CGM protocol in public health Stakeholder engagement was identified as key factor in the success of this initiative Train the trainer: 96% Agreed or Strongly Agreed that training provided them with the knowledge and resources to train front line staff Front line: 97% reported that training met their expectations; 98% felt it was adequate for their needs as professionals who regularly measure children s growth 18

19 Evaluation: Phase 2 Findings To assess the impact of the protocol and training on front line practice in public health 91% of the respondents agreed that staff received sufficient training to implement the CGM protocol 19

20 Protocol elements and frequency of practice in public health (n=78) Protocol Element Infants 2 to 24 months are weighed wearing a clean, dry diaper If infants under 24 months can t be measured lying down, 0.7 cm is added to their standing height to convert to length Bulky clothing (e.g., coats, jackets, sweaters) and hats are removed when measuring weight Weight measurements are taken to the closest 0.1 kg (100g) for children 2 to 19 years Height measurements are taken to the closest 0.1 cm for children 2 to 19 years Always 67.95% (53) 33.33% (26) 92.31% (72) 91.03% (71) 84.62% (66) Measurements are recorded immediately after taking them 75.64% (59)

21 Barriers and unanticipated outcomes Most frequently cited barrier was regarding equipment and space 15/35 responses were no or no real change in impact (as a result of the protocol) [The protocol is] solid, reliable tool for measurement of infants/children 21

22 Summary CGM guidelines and resources addresses the need for standardized practices across the continuum of care Use of CGM guidelines and resources by physicians and other primary care providers will contribute to standardized approach to growth monitoring across the province 22

23 Next Steps Develop a sustainability plan based on evaluation findings and recommendations Continue to facilitate implementation across the continuum of care in Alberta Faculties of Nursing at University of Alberta and Grant MacEwan University utilize the CGM materials for student training 23

24 Thank you for your attention!

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