Table 4 Subsystem 5 regarding healthcare: mechanisms, leverage points and action ideas
Mechanism | Description | Leverage point | System level (ILF) | Action idea name | Form of action idea | Action idea theory of change | External stakeholders involved |
|---|---|---|---|---|---|---|---|
(M7) Match between obesity healthcare services and the needs of adolescents with obesity and their parents | The working methods, organization and competences of healthcare professionals do not sufficiently fit the needs and possibilities of the multi-ethnic target group in Amsterdam East | (LP8) Increase the experienced support and effectiveness of the obesity care received by families from healthcare professionals | 4 – Feedback and delay | (A10) Organization-wide scan to identify to what extent the youth healthcare system is sensitive to ethnic diversity | Conduct an organization-wide assessment to determine the degree of diversity-responsiveness of the youth healthcare services and use this information to develop an action plan | If the working methods, organization and competences of youth healthcare professionals are more in line with the expectations and characteristics of the multi-ethnic target group in Amsterdam East, families could experience more support with regard to the obesity care they receive | Youth healthcare services |
|  |  |  | (A11) Examination room observations | Observe the communication between healthcare professionals and families in the examination room. Next, provide feedback to the healthcare professional about the communication and disseminate the learned lessons to healthcare professionals | The expectations of families and healthcare professionals do not always match. This results in families having a negative experience with regard to obesity care, making it difficult for families to improve their lifestyle. One of the contributors to this mismatch in expectations is suboptimal communication between families and healthcare professionals. By increasing awareness amongst healthcare professionals about communication with children with obesity and their parents, guidelines in obesity healthcare regarding communication can be improved. This could result in healthcare professional–family communication that matches the family’s expectation | Childhood obesity healthcare | |
|  |  |  | (A12) Popular scientific article about motivation | Interview healthcare professionals about their perspective on the motivation of children with obesity and their parents with regard to lifestyle changes. Next, write popular scientific article about the insights obtained from the professionals. And lastly, actively disseminate those insights amongst healthcare professionals | While many healthcare professionals are aware that obesity is caused by many factors besides individual factors, the family’s motivation is often mentioned as an important barrier for behaviour change. Increasing awareness amongst healthcare professionals around this topic could influence the attitude of healthcare professionals towards the family | Childhood obesity healthcare |