Table 6 List of the barriers (n = 20) selected for priority ranking
Sixteen barriers mentioned by participants and also identified in the SR | ||
Level of the barrier | Brief description (identifying label) | |
Practitioner (PCP) | Lack of knowledge, skills, and confidence (P1) | |
Lack of familiarity with guideline (P2) | ||
Disagreement with guideline/ evidence underpinning the guideline (P3) | ||
Practitioner-parent interaction | Harm to practitioner-parent relationship (P7) | |
Fear of offending parents (P8) | ||
Family (assumptions of PCPs) | Socioeconomic challenges (F1) | |
Lack of motivation to change (F2) | ||
Families with multiple complex problems (F3) | ||
Lack of understanding and skills (F5) | ||
Parental excess weight and lifestyle (F6) | ||
Misperception of healthy infant weight gain (F7) | ||
Organisation | Lack of training (O1) | |
Lack of tools and resources (O2) | ||
Lack of time (O3) | ||
Lack of collaboration between practitioner groups (O4) | ||
Lack of role support from organisation (O5) | ||
Four barriers that were identified in the SR but were not spontaneously mentioned by participants | ||
Level of the barrier | Brief description (identifying label) | Rationale for including them for ranking |
Practitioner | Belief: my advice does little to prevent obesity (P4) | Frequently reported as a barrier in the SR; 53% of participants rated it as locally relevant |
Uncertainty about identifying infants as being affected with excess weight (P5) | 66% rated it as not locally relevant; Included because: (i) frequent finding in the SR; (ii) HVs reported very low use of BMI and uncertainty about relevance of BMI in 0-2; this makes it difficult for HVs to identify excess weight gain in infants | |
Belief: primary prevention is parents’ responsibility (P6) | More than half (53%) of participants rated this barrier as relevant; 34% rated it as not relevant | |
Parent | Unhealthy infant/ child feeding practices (F4) | Frequently reported as a parent-level barrier in the SR; 85% of participants rated it as relevant |