A new deck of cards can change the conversation about health and weight with teens

Teens can empower themselves about their own health with a new tool in clinics

Tamara Vineberg and Judith Chrystal - 03 September 2019

Talking to teens about their health and weight can be a challenge, especially when it concerns lifestyle behaviours. That's why Maryam Kebbe and Geoff Ball created Conversation Cards for Adolescents© to empower clinicians and their teen patients to have these critical conversations.

"We know most teens with obesity do not meet healthy lifestyle recommendations and tend to drop out of care prematurely," says Kebbe. As part of her PhD, she wanted to develop a tool to improve the care that these teens receive and based her work on existing evidence showing that there are beneficial health outcomes when patients are engaged. Her initiative was bolstered by requests from clinicians for a teen-tailored, bilingual tool to use in weight management clinics and parents' desire to involve their kids in discussions.

Involving patients in the research is integral to her success. Kebbe gathered information from teens with obesity to examine the factors that they believe hindered or facilitated lifestyle behaviour change. She focused on those related to diet, physical activity, sedentary behaviour, sleep and mental health. Kebbe then turned her work to designing the tool itself.

Although most would presume teens' preference for an online tool such as a mobile app, Kebbe discovered that teens wanted something tangible, further highlighting the importance of engaging patients in all stages of the project. Ball had earlier success creating a deck of CONversation Cards© for clinicians and parents of younger children with obesity and Kebbe wanted to see if a similar approach also would help teens.

Conversation Cards for Adolescents© include 45 palm-sized cards with a statement on each that guides conversations between teens and healthcare professionals working in weight management. Teens choose cards from among seven themes (nutrition, physical activity, sedentariness, sleep, mental well-being, relationships and clinical factors) and three categories (barriers, enablers, recommendations). The card choice indicates the teen's own priorities for discussions with clinicians to address healthy lifestyle and weight.

These cards help to shift conversations from a narrow focus to a broader discussion around teens' overall health. "We're looking beyond weight as an outcome to identify the numerous factors that could be contributing to this excess weight gain, directly or indirectly," says Kebbe. "The cards help to uncover that complexity when it comes to obesity and lifestyle choices."

The cards are tailored to teens and being used by clinicians. Kebbe and Ball are partnering with colleagues at the Northeast Community Health Centre in Edmonton to test the cards in a clinical setting. They hope to recruit 50 teens with obesity to be involved as part of a pilot randomized control trial. Adolescents in both experimental and control groups will set lifestyle-based goals, however only those in the experimental group will use the new cards.

Both English and French decks of Conversation Cards for Adolescents© are available for order on the Obesity Canada website. The project received funding from multiple agencies, including the Alberta Health Services Maternal, Newborn, Child & Youth Strategic Clinical Network, Obesity Canada, Alberta Health Services Chair in Obesity Research, Canadian Institutes of Health Research, the Alberta Strategy for Patient-Oriented Research, and the Stollery Children's Hospital Foundation through the Women and Children's Health Research Institute.