Abstract
BACKGROUND: Parents' support for the National Childhood Measurement Programme (NCMP, England) is typically mixed, with qualitative data from small samples of self-selecting parents highlighting different responses depending on whether their child is classified as a 'healthy' or alternative weight. OBJECTIVE: Using data from the Gemini cohort study, we explored parents' emotional and behavioural responses to feedback on their children's weight status. METHODS: We performed secondary data analysis on data collected when children were 12-13 years old (2019-2021). Their parents completed a questionnaire online, which included (optional) questions about the NCMP. Parents indicated the weight status assigned to their child by the NCMP and answered questions about the weight feedback, including an open-ended question about their emotional responses. RESULTS: There were 567 complete responses to the NCMP questions (55.8% of parents who completed the questionnaire). The majority of children were categorised as 'healthy weight' (n = 440, 77.6%). Among parents whose children were categorised as an alternative weight status (n = 101), 29.7%, 54.5% and 45.0% of those with children categorised as underweight, overweight or very overweight, respectively, reported that they took action following the NCMP feedback. Qualitative results highlighted emotional responses and inferences made about children's well-being based on the feedback received; parents usually reacted positively (happy, inferred their child was healthy) if their child was categorised as a healthy weight, and negatively (worried, inferred their child was not healthy) if their child was categorised as an alternative weight status. There was also some distrust of the feedback and the NCMP itself. CONCLUSION: The negative reactions of many parents to NCMP feedback, and the programme itself, highlight the need to involve parents and caregivers in the delivery of the NCMP and framing of feedback. Parent and caregiver input is vital to understand how best to communicate information about children's weight to parents, signpost them to support and what support pathway should be implemented to increase parent uptake.