Meet Dr Grace O’Malley, Clinical Lead of CHI Child and Adolescent Obesity Service located in Dublin, Ireland. The multidisciplinary team Dr O’Malley leads consists of seven full-time and ten part-time staff from general paediatrics, nursing, dietetics, physiotherapy, occupational therapy, psychology, social work, and administration. This paediatric COM offers comprehensive obesity treatment including medical and nursing evaluation; pharmacotherapy; nutrition therapy; psychological evaluation and counselling support; behaviour modification; physiotherapy, exercise therapy and rehabilitation; occupational therapy; social work; and telemedicine. Further details at www.w82go.ie.
Please describe the education and training activities that your COM provides.
Our COM offers five hours of e-learning training in paediatric obesity (www.childhoodobesity.ie) for health professionals in Ireland. The training consists of one core module and four advanced modules. These modules cover: physical activity; paediatric-specific considerations in obesity management; psychosocial elements; nutrition; sleep; practical intervention advice; general medical knowledge; orthopaedics; and endocrinology. After successful completion of the e-learning training, health professionals are then able to apply for Clinical Skills Training at the CHI Child and Adolescent Obesity Service. In addition, our service delivers webinars to health professionals both internal and external to CHI and we are also delivering training to staff in the new regional community specialist paediatric obesity management teams.
Further to our education work for health professionals, our treatment incorporates education and practical training for parents, teenagers and children attending our service.
Is your COM currently involved in research projects? If so, please briefly describe them.
There are three major projects our COMs is currently involved in. The first is a study to explore the impact of the e-learning training in paediatric obesity (available at www.childhoodobesity.ie) on knowledge, attitudes and behaviours of health professionals. The second is developing an immersive learning and simulation-based training tool to help healthcare professionals develop respectful and empowering communication between children and adolescents with obesity and their parents. The third is the LANDSCAPE study –a project which aims to explore the views of all stakeholders in the management of child and adolescent obesity, to inform the implementation and planning of designated services for child and adolescent obesity. It includes identifying the barriers and facilitators for implementing, accessing and engaging with childhood obesity services and gathers information of the experiences of families navigating and accessing obesity treatment.
Please describe your COM’s patient care philosophy and approach.
We aim to promote and provide child-centred, research-informed healthcare to the highest standards of safety and excellence. We do this in partnership with each other, with children, young people and their families. Our values are child-centred, compassionate, and progressive and our vision is healthier children and young people throughout their development regardless of severity of obesity.
Please share a recent clinical case, describe relevant challenges and how your team addressed and/or solved them in your COMs.
A recent clinical case involved two siblings from a rural area of Ireland referred to our National tertiary service. The older sibling was initially referred to our service with complications secondary to obesity which required him to be admitted as an inpatient for evaluation. His younger sibling was then also referred to the service. Their social circumstances were difficult, and they were linked with TUSLA (Child and Family Agency). Challenges included the severity of obesity and associated health complications, complex social circumstances and difficulties with recommendations being carried over at home. The multidisciplinary team addressed these by conducted a thorough holistic assessment, supporting the family’s strengths and treating the observed complications related to physical, mental and emotional health. Medical social work input supported attendance at in-person appointments, virtual appointments, and liaison with family support workers and the schools encouraged carry over of recommendations at home and in school. These cases required regular meetings and liaison between our service, social services, community services, primary care and the school regarding health and welfare.
Team members of this paediatric COM have authored and co-authored several recent publications and presentations of interest to the COMs network since 2022. Find them here:
- A qualitative study exploring the perceptions of health among pre‐teen girls from disadvantaged communities in Dublin (Dow et al., 2023)
- Accepting and Embracing Responsibilities (O’Malley, 2023)
- Addressing child and adolescent obesity management in Ireland: identifying facilitators and barriers in clinical practice (Ferdous et al., 2023)
- Developing an empathy-informed Communications Toolkit for primary healthcare practitioners (O’Brien & O’Malley, 2023)
- Evaluating 12 Years of Implementing a Multidisciplinary Specialist Child and Adolescent Obesity Treatment Service: Patient-Level Outcomes (Wyse et al., 2022)
- Guidelines for treating child and adolescent obesity: A systematic review (Tully et al., 2022)
- Obesity in children and adolescents: epidemiology, causes, assessment, and management (Jebeile et al., 2022)
- Obesity in adults: a 2022 adapted clinical practice guideline for Ireland (Breen et al., 2022)
- Hospital service use among children with obesity in ireland: a micro-costing study (Tully et al., 2022)
- Toward Systems Models for Obesity Prevention: A Big Role for Big Data (Tufford et al., 2022)
- Usability and engagement testing of mHealth Apps in paediatric obesity: a narrative review of current literature (Arthurs et al, 2022)
- Bone Response to High-Intensity Interval Training versus Moderate-Intensity Continuous Training in Adolescents with Obesity (Julian et al., 2022)
- Championing the use of people‐first language in childhood overweight and obesity to address weight bias and stigma (Weghuber et al., 2022)
This edition of the ‘Meet the COMs’ featured the Child and Adolescent Obesity Service located in Dublin, Ireland led by Dr Grace O’Malley. Dr. O’Malley provided valuable insights into this COM’s multidisciplinary approach, educational initiatives, involvement in research projects, patient care philosophy, and recent clinical cases. Additionally, publications and presentations of interest to the COMs network were highlighted. Thank you, Dr. O’Malley, for sharing your expertise and experiences!