Barriers Related to Delivering Pediatric Weight Management Interventions to Children and Families From Rural Communities

Lim, Crystal S.; Janicke, David M.

doi:10.1080/02739615.2013.816596

Cited by 21 publications

(21 citation statements)

References 39 publications

(43 reference statements)

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“…This is concerning given these families are already more likely to experience a higher burden of disease [ 2 ]. These challenges are consistently reported in the literature [ 29 , 30 ], most notably the stigma of being overweight and denial of the issue amongst some parents [ 31 ] and the specific needs of families living in rural areas in relation to transportation difficulties, time constraints, limited access and availability of healthy foods, and lower socio economic position [ 32 ]. In both Queensland and NSW, their State-level response to families of children with overweight or obesity was limited to a one-size-fits-all program.…”

Section: Discussionmentioning

confidence: 99%

A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia

et al. 2018

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BackgroundThe prevalence of childhood obesity poses an urgent global challenge. The World Health Organization (WHO) Commission on Ending Childhood Obesity recommends the provision of appropriate family-based, lifestyle weight management services through universal health care to support families of children with overweight or obesity; however, there are few examples of their implementation ‘at scale’. The purpose of this research was to compare and contrast the impact of system and organisational factors on the implementation of childhood obesity management services within two Australian States (New South Wales and Queensland) to comprehensively describe their influence on the achievement of the WHO recommendation.MethodsPurposeful stratified sampling was used to select health service study sites (n = 16) representative of program implementation (none, discontinued, repeated) and geographic location within each State. Within each health service site, staff involved in program delivery, co-ordination and management roles participated (n = 39). An additional 11 staff involved in implementation at State level also participated. The Consolidated Framework for Implementation Research (CFIR) was used to develop interview scripts. Telephone interviews were recorded and transcribed. Transcripts were thematically coded and scored according to CFIR constructs and rating rules to identify enablers and barriers to implementation according to sample characteristics.ResultsNew South Wales achieved ongoing implementation; Queensland did not. Enablers included a quality evidence-based program, State government recognition of the urgency of the health issue and a commitment to address it, formally appointed and funded internal implementation leaders, strong communication and reporting at all levels. Barriers included the complexity of the health issue, in particular a lack of clear roles and responsibilities for local health service delivery, inadequate ongoing funding and challenges in meeting the diverse needs of families.ConclusionsThis research is an important progression of the evidence base in relation to the translation of childhood obesity management trials into routine health service delivery. Understanding enablers and barriers to program implementation ‘at scale’ is imperative to inform future planning and investment by Australia and WHO member states to meet their commitment to deliver childhood weight management services as part of universal health coverage.Electronic supplementary materialThe online version of this article (10.1186/s13012-018-0801-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia

et al. 2018

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“…37 For example, incorporating food field trips into behavioral family weight management interventions has been suggested as one way to address barriers families experience when identifying healthier foods to purchase in rural communities. 27 Similar field trips could be conducted to parks and recreational spaces so parents and children become more aware of resources available in their rural community. However, parental involvement is essential to utilize parks spaces outside a safe walking distance from families’ homes.…”

Section: Discussionmentioning

confidence: 99%

“…38 In rural communities examples may include modifying the physical environment by creating more parks and safe child play areas, installing sidewalks along rural roads, and creating family and community programs that provide education about and emphasize health behaviors. 27 Given 20% of children participating in this study did not have access to a park or recreational facility within 10 miles of their home, there is a need for additional community infrastructure promoting physical activity in rural communities. Unfortunately, research findings are rarely included in state legislative policy efforts to support environments conducive to physical activity and to address obesity related concerns.…”

Section: Discussionmentioning

confidence: 99%

“…25 Aspects of the rural environment, such as limited access to recreational facilities, gyms, and other safe places to engage in physical activity, may make adopting healthier lifestyles more challenging for families living in rural communities. 26,27 Therefore, understanding the impact of the environment on intervention effectiveness is paramount to maximize intervention cost-effectiveness with rural children and families, which are one of the largest medically underserved populations in the country. 28 …”

Section: Introductionmentioning

confidence: 99%

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Park Density Impacts Weight Change in a Behavioral Intervention for Overweight Rural Youth

Armstrong

Lim

Janicke

2015

Behavioral Medicine

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Currently, over 30% of youth are overweight or obese. Limited access to parks and recreational facilities is related to physical inactivity and obesity. Environmental factors may also impact the effectiveness of pediatric weight management interventions. Most research concerning the built environment and child weight status has been conducted in urban settings, despite rural children being disproportionately overweight and obese compared to their urban peers. The current study examined the relationship between park density and weight change among 93 overweight rural youth (ages 8-14) participating in a randomized controlled trial examining the effectiveness of a behavioral family weight management intervention. Results revealed that increased park density was associated with decreases in BMI z-score over time for youth in the behavioral family weight management intervention, but not those in the wait-list control group. In rural communities it is important to consider the environmental context when designing prevention and treatment programs addressing childhood obesity.

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“…Cooperative Extension offices, used in similar research (Lim & Janicke, ; Ming‐Chin et al., ), were identified as community partners with good client outreach capabilities to assist in recruiting a convenience sample. A senior center and a transit center were also identified as good contacts to recruit participants.…”

Section: Methodsmentioning

confidence: 99%

Barriers and Facilitators for Fruit and Vegetable Consumption Among Adults in Rural Counties

Tallant

Rettig

Tennyson³

2018

Family & Consum Sci Res J

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Research exploring factors affecting fruit and vegetable intake in rural populations is lacking. The purpose of this study was to identify barriers to and facilitators for eating fruits and vegetables among a convenience sample of rural‐dwelling adults in North Carolina. Twenty‐three women and men from five counties provided information in focus groups and completed demographic questionnaires. Analyses revealed barriers that included cost, time, schedule limitations, lack of options, food safety concerns, and inconvenience. Facilitators included having gardens, lower prices, having local and in‐season produce, and accessibility. Solutions to barriers were planning ahead and convenience. Facilitators included behavior changes and environmental supports.

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Barriers Related to Delivering Pediatric Weight Management Interventions to Children and Families From Rural Communities

Cited by 21 publications

References 39 publications

A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia

A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia

Park Density Impacts Weight Change in a Behavioral Intervention for Overweight Rural Youth

Barriers and Facilitators for Fruit and Vegetable Consumption Among Adults in Rural Counties

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