Why does communication matter?
We all know that discussing a child’s weight can be difficult, particularly overweight, as it is a sensitive topic with stigma attached. Establishing a good relationship with parents and communicating effectively can help weight-related discussion and subsequent outcomes. Research shows interactions between a health care professional and their patient are important in promoting adherence and better self-care skills, which in turn can have positive effects on health and well-being1.
Communication and motivation
What is motivation?
Motivation drives your daily behaviours and concerns the reasons you do what you do at any given moment. You require motivation to get up in the morning, to do your shopping, to go to work – that is, we must see some reason for engaging in these behaviours otherwise you would stay in bed all day. Motivation, therefore, is a necessary foundation for health behaviour change.
As a practitioner working with parents of young children, you can support parents to promote a healthy weight for their child through encouraging a healthy diet and a physically active lifestyle. For a parent to be motivated to engage in health-supporting behaviours to manage their child’s weight, three things must happen:
- the parent must recognise their child’s weight is not in the healthy range;
- the parent must value the importance of their child being a healthy weight; and
- the parent must recognise their own role in managing their child’s weight and feel they are capable of making the required lifestyle changes.
Because society is becoming more overweight, people are beginning to lose touch with what a healthy weight looks like, particularly in children. Therefore, it is not surprising many parents are unable to recognise if their child is overweight (even health professionals struggle to tell by looking at a child whether they are a healthy weight). The impact of this lack of awareness is that parents may appear to lack concern for their child’s weight issue, or to be unmotivated to make lifestyle changes (where in reality this is not the case).
Whilst providing parents with information about their child’s weight status and educating parents on the consequences of unhealthy weight in childhood is important (see module on consequences of unhealthy weight), education alone will rarely motivate others to change. Despite most advice being well meaning, if given without permission or in an inappropriate manner, such advice can backfire, anger parents and cause them to disengage (through a feeling they are being blamed or ‘told off’). It is therefore important to consider the way you convey information to parents, and how the communication strategies you use can influence parental motivation and subsequent engagement with lifestyle change.
Types of motivation
A popular theory of motivation is Self-Determination Theory2 (SDT). According to SDT, there are two types of motivation; autonomous motivation (also called self-determined motivation) and controlled motivation. Autonomous motivation is the most likely to lead to long-term behaviour change.
Autonomous motivation is motivation that comes from the self. A parent who is autonomously motivated will value the importance of their child’s weight and will want to make healthy lifestyle changes. They will feel like it is their choice to change, rather than feeling pressured by anyone else. Consequently, they are likely to put effort into physical activity and dietary changes and persevere in the face of obstacles.
Controlled motivation comes from external forces. A parent who experiences controlled motivation may feel pressured or coerced by other people (e.g. GP, family member, children’s center staff) to make healthy lifestyle changes. They will feel it is not her choice to do this, but it is something they are being made to do (e.g. to gain approval from others). Consequently, they may make little effort in physical activity or dietary changes, doing only the minimum that is required to take the pressure off.
REFLECTION : Can you give an example of when you felt motivated to make a change in your life? What helped motivate you? Was your motivation autonomous or controlled?
1Street, R. L., et al. (2009). "How does communication heal? Pathways linking clinician–patient communication to health outcomes." Patient education and counseling 74(3): 295-301