{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:50:23Z","timestamp":1782211823450,"version":"3.54.5"},"reference-count":53,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1168119"],"award-info":[{"award-number":["GNT1168119"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018822","name":"Western Sydney University","doi-asserted-by":"publisher","award":["GNT1168119"],"award-info":[{"award-number":["GNT1168119"]}],"id":[{"id":"10.13039\/501100018822","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There has been an increasing prevalence of childhood overweight and obesity worldwide and locally, with a quarter of Australian children now considered overweight. To address this, the New South Wales government in Australia released guidelines calling for all public dental services to identify children above a healthy weight and refer them to appropriate services. This study was part of a larger study that aimed to codesign and pilot implementation strategies to facilitate the translation of these guidelines into dental staff's practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A pre\u2010post\u2010test design was used to evaluate the strategies across two health districts in NSW. Strategies were codesigned by dental staff and parents of patients and included linguistically appropriate resources; discharge summaries from referral pathways; refresher training; involvement of dental assistants; templates for longitudinal BMI measures and growth assessment flyers for patients. A validated questionnaire measuring intention to engage in the guidelines and self\u2010reported practice was distributed to interested staff before and after the delivery of strategies (2019\u20132022). Data describing dental staff's' actual practices over this time were also retrieved from patient information management systems. Descriptive and inferential statistics were used to assess the study outcomes and any differences across districts (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was no improvement in behavioural determinants of providing a growth assessment as indicated by the overall intention to engage in Children's Healthy Weight guideline (iCHEW) scale scores, however attitude scores had the largest observed improvement (from 30.1 to 35.2) and this was most pronounced in District 2 (27.2\u201334.3). A significant improvement in adherence to children's healthy weight guidelines was also seen in District 2 (increase of 20.54%, 95% CI 14.09\u201327.44). In District 1, children had 1.5 times the odds of receiving a growth assessment if they were treated by a dental officer (OR\u2009=\u20091.54; 95% CI 1.00\u20131.72). Conversely, children in District 2 had significantly lower odds of receiving a growth assessment if they were treated by a dental officer (OR\u2009=\u20090.203; 95% CI 0.12\u20130.35) or if they were treated at a satellite clinic (OR\u2009=\u20090.572; 95% CI 0.45\u20130.73).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dental staff can play a key role in addressing childhood overweight and obesity, although this can be challenging. The findings suggested some improvements in behavioural determinants and self\u2010reported behaviours following supportive strategies. Further research to confirm these findings using larger sample sizes is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cdoe.70088","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:33:29Z","timestamp":1782210809000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of Child Healthy Weight Guidelines in the Dental Setting: A Pilot Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3198-472X","authenticated-orcid":false,"given":"Amy R.","family":"Villarosa","sequence":"first","affiliation":[{"name":"Australian Centre for Integration of Oral Health (ACIOH) School of Nursing &amp; Midwifery, Western Sydney University  Sydney New South Wales Australia"},{"name":"National Centre for Epidemiology and Population Health Australian National University  Canberra Australian Capital Territory Australia"},{"name":"Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6475-8804","authenticated-orcid":false,"given":"Della","family":"Maneze","sequence":"additional","affiliation":[{"name":"Australian Centre for Integration of Oral Health (ACIOH) School of Nursing &amp; Midwifery, Western Sydney University  Sydney New South Wales Australia"},{"name":"School of Nursing University of Wollongong  Wollongong New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-3005","authenticated-orcid":false,"given":"Lucie","family":"Ramjan","sequence":"additional","affiliation":[{"name":"Australian Centre for Integration of Oral Health (ACIOH) School of Nursing &amp; Midwifery, Western Sydney University  Sydney New South Wales Australia"},{"name":"Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"},{"name":"School of Nursing University of Wollongong  Wollongong New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Patterson\u2010Norrie","sequence":"additional","affiliation":[{"name":"Australian Centre for Integration of Oral Health (ACIOH) School of Nursing &amp; Midwifery, Western Sydney University  Sydney New South Wales Australia"},{"name":"Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"},{"name":"School of Medicine, Faculty of Health Western Sydney University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Australian Centre for Integration of Oral Health (ACIOH) School of Nursing &amp; Midwifery, Western Sydney University  Sydney New South Wales Australia"},{"name":"Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"},{"name":"Oral Health Services South Western Sydney Local Health District  Sydney New South Wales Australia"},{"name":"School of Dentistry, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Yaacoub","sequence":"additional","affiliation":[{"name":"Australian Centre for Integration of Oral Health (ACIOH) School of Nursing &amp; Midwifery, Western Sydney University  Sydney New South Wales Australia"},{"name":"School of Dentistry, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Oral Health Services Nepean Blue Mountains Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Kumar","sequence":"additional","affiliation":[{"name":"School of Dentistry, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Oral Health Services Nepean Blue Mountains Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6795-2546","authenticated-orcid":false,"given":"Ajesh","family":"George","sequence":"additional","affiliation":[{"name":"Australian Centre for Integration of Oral Health (ACIOH) School of Nursing &amp; Midwifery, Western Sydney University  Sydney New South Wales Australia"},{"name":"Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"},{"name":"School of Nursing University of Wollongong  Wollongong New South Wales Australia"},{"name":"School of Dentistry, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519\u2010020\u201000341\u20109"},{"key":"e_1_2_10_3_1","unstructured":"Economics T \u201cGhana Mortality Rate Neonatal (Per 1 000 Live Births) \u2013 WB Data \u201daccessed September 17 2025 https:\/\/tradingeconomics.com\/ghana\/mortality\u2010rate\u2010neonatal\u2010per\u20101\u2010000\u2010live\u2010births\u2010wb\u2010data.html."},{"key":"e_1_2_10_4_1","unstructured":"Australian Institute of Health and Welfare \u201cOverweight and Obesity Among Australian Children and Adolescents \u201dAustralian Institute of Health and Welfare accessed March 7 2024 https:\/\/www.aihw.gov.au\/reports\/overweight\u2010obesity\/overweight\u2010obesity\u2010australian\u2010children\u2010adolescents\/summary."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-018-0131-0"},{"key":"e_1_2_10_6_1","unstructured":"World Health Organization \u201cNoncommunicable Diseases: Childhood Overweight and Obesity \u201dWorld Health Organisation accessed January 3 2024 https:\/\/www.who.int\/news\u2010room\/questions\u2010and\u2010answers\/item\/noncommunicable\u2010diseases\u2010childhood\u2010overweight\u2010and\u2010obesity."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/AHMT.S101631"},{"key":"e_1_2_10_8_1","volume-title":"Population\u2010Based Approaches to Childhood Obesity Prevention","author":"World Health Organization","year":"2012"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119695257.ch25"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4262-3"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.6803"},{"key":"e_1_2_10_12_1","unstructured":"National Health and Medical Research Council \u201cClinical Practice Guidelines for the Management of Overweight and Obesity in Adults Adolescents and Children in Australia \u201d(2013) 1864965908 https:\/\/www.nhmrc.gov.au\/about\u2010us\/publications\/clinical\u2010practice\u2010guidelines\u2010management\u2010overweight\u2010and\u2010obesity."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2018.05.004"},{"key":"e_1_2_10_14_1","unstructured":"Royal Australian College of General Practitioners \u201cGeneral Practice Management of Children With Obesity and Overweight \u201daccessed December 21 2023 https:\/\/www.racgp.org.au\/racgp\u2010digital\u2010events\u2010calendar\/online\u2010event\u2010items\/webinars\/general\u2010practice\u2010management\u2010of\u2010children\u2010with\u2010obesi."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12223"},{"key":"e_1_2_10_16_1","unstructured":"Commonwealth of Australia \u201cNational Obesity Strategy2022\u20132032: Enabling Australians to Eat Well and Be Active \u201d(2022) https:\/\/www.health.gov.au\/sites\/default\/files\/documents\/2022\/03\/national\u2010obesity\u2010strategy\u20102022\u20102032_0.pdf."},{"key":"e_1_2_10_17_1","unstructured":"Australian Government Department of Health \u201cNational Obesity Strategy 2022\u20132032: Enabling Australians to Eat Well and Be Active \u201d(2022) https:\/\/www.health.gov.au\/sites\/default\/files\/documents\/2022\/03\/national\u2010obesity\u2010strategy\u20102022\u20102032_0.pdf."},{"key":"e_1_2_10_18_1","unstructured":"Australian Research Centre for Population Oral Health \u201cChild Oral Health and Dental Visiting in Australia: The National Dental Telephone Interview Survey (NDTIS) 2021 \u2013 Final Report \u201d(2021) https:\/\/health.adelaide.edu.au\/arcpoh\/ua\/media\/825\/2021child\u2010ndtis\u2010finalreport.pdf."},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/bar.2011.9961"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.orcp.2019.03.005"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12229"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300234"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12240"},{"key":"e_1_2_10_24_1","unstructured":"NSW Ministry of Health \u201cGrowth Assessment and Dietary Advice in Public Oral Health Services \u201daccessed January 3 2024 https:\/\/www1.health.nsw.gov.au\/pds\/ActivePDSDocuments\/GL2019_001.pdf."},{"issue":"396","key":"e_1_2_10_25_1","first-page":"371","article-title":"Clinical Guidelines: Their Implementation in General Practice","volume":"45","author":"Conroy M.","year":"1995","journal-title":"British Journal of General Practice"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)92244-N"},{"issue":"5","key":"e_1_2_10_27_1","first-page":"417","article-title":"Addressing Childhood Overweight and Obesity in the Dental Office: Rationale and Practical Guidelines","volume":"32","author":"Tseng R.","year":"2010","journal-title":"Pediatric Dentistry"},{"key":"e_1_2_10_28_1","unstructured":"Effective Practice and Organisation of Care \u201cEPOC Taxonomy \u201daccessed January 3 2024 https:\/\/epoc.cochrane.org\/epoc\u2010taxonomy."},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200108002-00003"},{"key":"e_1_2_10_30_1","unstructured":"Healthy Kids NSW \u201cOnline Learning \u201daccessed September 18 2024 https:\/\/pro.healthykids.nsw.gov.au\/online\u2010learning\/."},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.orcp.2018.07.002"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010019\u20100954\u20107"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40900\u2010022\u201000356\u20108"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.orcp.2022.06.006"},{"key":"e_1_2_10_35_1","unstructured":"Australian Bureau of Statistics \u201c2021 Census QuickStats: Sydney \u2013 South West \u201daccessed September 19 2024 https:\/\/www.abs.gov.au\/census\/find\u2010census\u2010data\/quickstats\/2021\/127."},{"key":"e_1_2_10_36_1","unstructured":"Australian Bureau of Statistics \u201c2021 Census QuickStats: Blue Mountains \u201daccessed September 19 2024 https:\/\/www.abs.gov.au\/census\/find\u2010census\u2010data\/quickstats\/2021\/LGA10900."},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102018\u2010009036"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010016\u20100437\u2010z"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20104\u201050"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010022\u201001245\u20100"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1080\/03054985.2012.731208"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X19005053"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1057\/9780230583993_2"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511997303.009"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312118773261"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14620"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010018\u20100726\u20109"},{"key":"e_1_2_10_49_1","first-page":"77","volume-title":"Elaborating Professionalism: Studies in Practice and Theory","author":"Nembhard I. M.","year":"2011"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.2307\/259164"},{"key":"e_1_2_10_51_1","unstructured":"Australian Bureau of Statistics \u201cCensus of Population and Housing: Socio\u2010Economic Indexes for Areas (SEIFA) Australia 2016 \u201d(2018) https:\/\/www.abs.gov.au."},{"key":"e_1_2_10_52_1","unstructured":"New South Wales Health \u201cNSW Plan for Healthy Culturally and Linguistically Diverse Communices: 2019\u20132023 \u201d(2019) https:\/\/www1.health.nsw.gov.au\/pds\/ActivePDSDocuments\/PD2019_018.pdf."},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010022\u201013256\u2010z"},{"issue":"3","key":"e_1_2_10_54_1","first-page":"269","article-title":"Organizational Cynicism: Bases and Consequences","volume":"126","author":"Abraham R.","year":"2000","journal-title":"Genetic, Social, and General Psychology Monographs"}],"container-title":["Community Dentistry and Oral Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.70088","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cdoe.70088","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.70088","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:33:57Z","timestamp":1782210837000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cdoe.70088"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":53,"alternative-id":["10.1111\/cdoe.70088"],"URL":"https:\/\/doi.org\/10.1111\/cdoe.70088","archive":["Portico"],"relation":{},"ISSN":["0301-5661","1600-0528"],"issn-type":[{"value":"0301-5661","type":"print"},{"value":"1600-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]},"assertion":[{"value":"2024-11-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cdoe.70088"}}