Nurses should assess the family environment for socio-cultural conditions known to impact the nature and availability of interventions used for childhood obesity. These include the family’s ethnicity, the level of education of the parents/ primary caregivers, geography (e.g. rural or urban neighbourhood), and gender of the family members. Thus, nurses are in the position to practice culturally competent care.
Cultural competence refers to, “the ability to provide care with a client-centered orientation, recognizing the significant impact of cultural values and beliefs as well as power and hierarchy often inherent in clinical interactions, particularly between clients from marginalized groups and health care organizations” (RNAO, 2007b, p.70). For additional information on how to care for diverse populations, please review the RNAO BPG Embracing Cultural Diversity in Health Care: Developing Cultural Competence (2007b).
The expert panel recommends assessing these socio-cultural factors prior to implementing interventions and during routine follow-ups with the family. The assessment of economic, social and cultural influences on the family enables nurses to do the following:
1. Identify families at risk of poverty in order to provide appropriate information and referrals to resources that will increase income. For example, the simple question: “Do you have difficulty making ends meet at the end of the month?” may be a portal for supporting families to gain access to financial resources such as the Child Benefit, tax rebates, and other government benefits including those related to disability, Aboriginal status, and refugee status.
2. Identify and address conditions that may either hinder or facilitate healthy eating and physical activity practices over time. For example, the neighbourhood within which the family lives will have an impact on the foods and physical activities available to family members.
3. Support positive behavioural changes within the context of resources that are available to the family. For example, the income status of the family influences the types of foods that the family can realistically afford to support healthy eating.
4. Customize healthy eating and physical activity interventions to the family’s personal preferences. Thus, knowledge of the ethnicity that the family strongly identifies with may influence the types of foods and physical activities preferred by the family.