Implementing eating disorder prevention program ‘Confident Body, Confident Child’ into community child health services: a knowledge translation study

Dr Shelley Roberts1,2, Ms Lyza Norton1,2, Ms Vicki Attenborough1, Ms Narelle O’Connor1, A/Prof Susan Moloney1, Dr Francoise Butel1, Dr Laura Hart3

1Gold Coast Hospital and Health Service, Gold Coast, Australia, 2Griffith University, Gold Coast, Australia, 3University of Melbourne, Melbourne, Australia

Body dissatisfaction is a predictor for low self-esteem, depression, unhealthy eating patterns, overweight/obesity and eating disorders in children and adolescents. Foundations for negative body image develop in early childhood; hence, prevention programs should target children. Confident Body, Confident Child (CBCC) is an evidence-based program providing parenting strategies to promote body satisfaction and healthful eating among children aged 2-6 years. As RCTs have proven its effectiveness, we sought to translate CBCC into community child health services.

Our team of dietitians, child health nurses (CHNs), paediatricians and academics adapted CBCC to the needs of CHNs, who provide >30,000 occasions of service/year to children and parents at our health service. We delivered CBCC training and resources to CHNs, for use in their clinics with parents; and using an implementation-effectiveness hybrid design, concurrently evaluated CBCC implementation and effects.

Twenty-six CHNs (all female; mean age 52.7 ±9.5 years) completed CBCC training. Process evaluation found CBCC was implemented as planned and reached 56% of CHNs across the health service. Outcome evaluation showed small but mostly non-significant improvements in CHN knowledge of child body image and attitudes towards overweight. CHNs used CBCC in 67% of their clinic appointments with parents. In interviews, CHNs expressed CBCC was highly useful and valuable in practice; and implementation had been sustained.

This is the first study to evaluate population-wide CBCC implementation in a real-world health service setting with CHNs. Findings highlight the potential for using pragmatic, implementation-focused methodologies to translate preventive eating disorder programs into community child health services.


Dr Shelley Roberts is an Allied Health Research Fellow in a conjoint position between Griffith University and Gold Coast Hospital and Health Service. Her background is in nutrition and dietetics, and she is an Accredited Practicing Dietitian. Dr Roberts’ research focuses on improving nutrition among hospitalised patients, with particular interests in patient participation in care and patient centred care; healthcare technologies; and integrated knowledge translation.

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