Conversation Cards for Adolescents© – Helping adolescents make healthy lifestyle changes 

Today’s post comes from Maryam Kebbe, a fourth year Doctoral student studying under the supervision of Dr. Geoff Ball in the Department of Pediatrics at the University of Alberta. Maryam has a passion for patient-oriented obesity research in children and plans to continue doing health research in this area after completion of her PhD.

As readers are probably well aware, often times, the first line of treatment for adolescents seeking health services for obesity management consists of behavioural changes targeting nutrition, physical and sedentary activities, and sleep habits, including an addressing possible issues of mental health.

However, health professionals often encounter a lack of adherence to a healthy behaviours by adolescents with overweight or obesity, resulting in challenges in maintaining or losing weight. This may be due to a number of factors, including difficulties in changing established habits and a lack of consideration for adolescents’ priorities in managing weight. To help with clinical consultations, both adolescents and health professionals can benefit from tools and resources that can be tailored to adolescents with obesity attempting to change their lifestyle habits.

Our team conducted a multi-phase project that included adolescents, health professionals, and researchers to develop Conversation Cards for Adolescents (CCAs), an adolescent-tailored, bilingual (English and French) clinical tool aimed at streamlining conversations and facilitating lifestyle behavior change in adolescents via collaborative goal- setting. Specifically, we completed a review of the literature (1) and a qualitative study including in-person interviews, focus groups, and patient engagement panels (2-5) from which we identified 153 factors that help, may help, or deter adolescents with obesity from adopting healthy lifestyle behaviors. Next, we asked adolescents to prioritize (online survey) and validate (telephone consultations) these factors to help refine our tool (6). The design of this tool included another three rounds of refinements with The Burke Group in collaboration with Obesity Canada.

CCAs comprise a deck of 45 cards. Each card contains an individual statement pertaining to a barrier, enabler, or potential enabler (15 statements per category) that adolescents often encounter in making and maintaining healthy lifestyle changes. These cards are organized across seven categorical suits: nutrition, physical activity, sedentary activity, sleep, mental health, relationships, and clinical factors.

CCAs are intended to be used by adolescents and health professionals and are complementary to an already existing deck of cards (Conversation Cards©) created for parents and health professionals by our research team in 2012 (7-10). Our future steps include completion of a pilot randomized controlled trial to determine the feasibility and user experience of using CCAs by adolescents with obesity and health professionals working in primary care.

Click on the links for more information on CCs and CCAs and order details.

References

1. Kebbe M, Damanhoury S, Browne N, Dyson M, McHugh TL, Ball GDC. Barriers to and enablers of healthy lifestyle behaviors of adolescents with obesity: a scoping review and stakeholder consultation. Obesity Reviews, 2017; 12: 1439-1453.
2. Kebbe M, Perez A, Buchholz A, Scott S, McHugh TLF, Dyson M, Ball GDC. Health care providers’ delivery of health services for obesity management in adolescents: a multi- centre, qualitative study. BMC Health Services Research, 2019; Under Review.
3. Kebbe M, Perez A, Buchholz A, McHugh TLF, Scott SD, Richard C, Dyson MP, Ball GDC. Recommendations of adolescents with obesity to facilitate healthy lifestyle changes: a multi-centre, qualitative study. BMC Pediatrics, 2018; Under Review.
4. Kebbe M, Perez A, Buchholz A, McHugh TLF, Scott SD, Richard C, Mohipp C, Dyson MP, Ball GDC. Barriers and enablers for adopting lifestyle behavior changes among adolescents with obesity: a multi-centre, qualitative study. PLoS ONE, 2018; 13: e0209219.
5. Kebbe M, Perez A, Buchholz A, Scott SD, McHugh TLF, Richard C, Dyson MP, Ball GDC. Adolescents’ involvement in decision-making for pediatric weight management: a multi-centre qualitative study on perspectives of adolescents and health care providers. Patient Education and Counseling, 2019; In Press.
6. Kebbe M, Perez A, Buchholz A, McHugh TLF, Scott SD, Richard C, Dyson MP, Ball GDC. Conversation Cards for Adolescents: a communication and behavior change tool for health care providers and adolescents with obesity. Health Services Research, 2019; Under Review.
7. Kebbe M, Byrne J, Damanhoury S, Ball GDC. Following suit: using Conversation Cards for priority-setting in pediatric weight management. Journal of Nutrition Education and Behavior, 2017; 49: 588-592.
8. Ball GD, Farnesi BC, Newton AS, Holt NL, Geller J, Sharma AM, Johnson ST, Matteson CL, Finegood DT. Join the conversation! The development and preliminary application of conversation cards in pediatric weight management. Journal of Nutrition Education and Behavior, 2013; 45: 476-478.
9. Farnesi BC, Ball GD, Newton AS. Family-health professional relations in pediatric weight management: an integrative review. Pediatric Obesity, 2012; 7: 175-186.
10. Farnesi BC, Newton AS, Holt NL, Sharma AM, Ball GD. Exploring collaboration between clinicians and parents to optimize pediatric weight management. Patient Education and Counseling, 2012; 87: 10-17.