Lessons learned from a family-focused weight management intervention for obese and overweight children

Abstract

Objective: Treatment for childhood obesity is characterised by high attrition rates and failure to achieve weight maintenance. It is therefore important to develop more effective programmes. The aim of the present qualitative study was to explore the views of parents, children and health trainers to identify issues which can inform the development of more effective programmes. Design: A qualitative study combining in-depth interviews and focus groups. Participants were selected purposively from current and past attendees. Setting: WATCH-IT, a UK-based community child weight management programme. Subjects: Twenty-three families who had previously attended (or were currently attending) WATCH-IT were interviewed. Focus groups with ten trainers explored their views of the intervention. Results: Parents and children had different goals for involvement, with parents focusing on psychological benefits, while children concentrated on goals relating to weight loss and physical fitness. Parents were found to struggle to provide consistent support to their children and this was exacerbated by family dynamics. The child's commitment to lose weight, support from their family and a good relationship between the child and their trainer were viewed as important keys to successful weight management. Conclusions: The study will guide the design of existing and future programmes by providing insights into issues that challenge successful engagement. It highlights the possible value of exploring the therapeutic relationship between trainers and participants. Keywords Obesity management Children InterventionChildhood obesity is rising almost universally (1,2) . Given the significant long-term health consequences of childhood obesity it is important to consider how best to manage children who are already overweight or obese. The most recent Cochrane review of interventions for childhood obesity examined the results of sixty-four randomised controlled trials and concluded that programmes that involved the whole family and included aspects around nutrition, behaviour modification and physical activity were more effective than those targeting the obese child alone (3) . Although lifestyle interventions can reduce the level of obesity in children and adolescents, attrition rates for interventions were often high (3) . Evidence also suggests that, while children might lose weight following a lifestyle intervention, they often remain in the obese category (4) . It is therefore important to understand those factors associated with success on weight management programmes.Psychological theory can be used to understand how the beliefs of young people, family members and health trainers may influence young people's weight management behaviours. Bandura's Social Cognitive Theory (5) (SCT) proposes that behaviour is a function of aspects of the person and the environment, and that the primary drivers of behaviour change include skills (e.g. ability to exercise more or control calorie intake), self-efficacy (belief in one's ability to perf...

Community Awareness Pregnant Women and Child Health in Four North Carolina County

“…Although initiatives to improve health and prevent disease should focus on education, knowledge and skills [7], the lack of education may be related to acculturation and lack of belief in healthy outcomes [8], which has been linked to obesogenic behaviours, especially in ethnic minorities in the US and the United Kingdom [9]. For instance, acceptable health "standards" in some ethnic minority groups are determined by themselves, their family, and their immediate social/cultural circle and not by others outside their circle, such as health care providers [10].…”

“…Research continues to find unsympathetic and unhelpful providers as a barrier to health improvement, while support from others is integral to positive behavior change especially as it relates to pregnancy outcomes and childhood health [8,13]. For instance, the successful Centering Parenting model shifts the focus from clinician dominant to a supportive group that focuses on partnerships among families and communities empowered by skills and knowledge to focus on prevention based health for mothers and children [11].…”

Exploring Parental Perceptions of Self-Efficacy, Role Modeling and Factors Contributing to Family Health Practices from an Employer-Provided Family Weight Management Program: A Mixed Methods Study

“…The causes of the obesity and overweight phenomena are complex and a range of social and environmental factors influence weight status of an individual (French, Story, & Jeffery, 2001;Golley, Hendrie, Slater & Corsini, 2010;O'Brien et al, 2007;Sallis & Owen, 2002;Twiddy, Wilson, Bryant, & Rudolf, 2012). Increases in the consumption of foods with high caloric content and low nutritional value, prepackaged foods, fast foods (French, Lin, & Guthrie, 2003;French et al, 2001;O'Brien et al, 2007), soft drinks (Eaton et al, 2008;French et al, 2003;O'Brien et al, 2007;Reedy & Krebs-Smith, 2010;Van Lippevelde et al, 2013), and the passive over consumption of foods add to the current obesity epidemic (Ahmad, Ahmad, & Ahmad, 2010).…”

“…Family health and weight management interventions have shown some evidence of success; however, research suggests no one approach may be more effective and factors that are related to parental connection, participation and involvement of familial health and weight management needs further investigation (Berry et al, 2014;Edwardson & Gorely, 2010;Golley et al, 2010;Twiddy et al, 2012;West, Sanders, Cleghorn, & Davies, 2010). While research in family health and wellness programs commonly examine relationships of role modeling and self-efficacy as predictors, determinates, and/or moderators of program effectiveness, many studies use quantitative analysis in the findings.…”

“…While research in family health and wellness programs commonly examine relationships of role modeling and self-efficacy as predictors, determinates, and/or moderators of program effectiveness, many studies use quantitative analysis in the findings. Although significant, researchers have suggested that qualitative examination is needed to gain a more thorough understanding of family health and weight management issues (Luttikhuis et al, 2009;Twiddy et al, 2012). This is an important but often omitted step in family health and wellness research (Berge, Arikian, Doherty, & Neumark-Sztainer, 2012).…”