The experiences and understandings of obesity: Families’ decisions to attend a childhood obesity intervention

Abstract

Objectives: Although numerous interventions are in place to attempt to reduce the high prevalence of childhood obesity, uptake and success of these interventions vary. Little previous research has investigated the reasons why families choose to attend (or not attend) recommended interventions; this study has therefore investigated the experiences which influence the decisions to attend or not to attend a childhood obesity programme.Design: Eleven semi-structured interviews were employed to explore the experiences of families who had been invited onto a childhood obesity programme. Interviews were examined using interpretative phenomenological analysis.Results: Data were grouped into four themes which highlighted the differences and similarities between attendees and non-attendees. Barriers to attendance included parents either not recognising the condition in their children or not acknowledging its impact on health or wellbeing;parents having anxieties about their own participation in the programme; parents' views on their children's identities and parents believing that they have little control over their environment.Conclusions: It is suggested that obesity programmes must address preconceived negative perceptions regarding obesity, by carefully considering how the delivery of health information is presented, how it is understood, and how underlying identity may affect motivation to engage in new behaviours. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 IntroductionObesity is considered to be a 'lifestyle disease' with many contributing factors including genetic, economic, social, psychological, environmental and cultural elements (Butland et al., 2007). Childhood obesity poses many health risks; research has shown that 58% of children with a body mass index (BMI) above the 95th percentile have hypertension, hyperlipidaemia or insulin resistance and 25% have two or more of these (Allen et al., 2007;Roberts, 2007;Rudolf, 2004). It has also been found to affect psychological wellbeing, especially self-esteem (Dietz & Robinson, 2005). It is reported that most overweight or obese children become overweight or obese adults and it is projected that the current generation of children will have shorter life spans than their parents' generation (Ludwig, 2007; Butland et al., 2007).Overweight and obesity are stated as 'probably the most widespread threat to health and wellbeing' in England (Department of Health [DoH], 2011a). The annual results of the 2010/11 National Child Measurement Programme found that by 10-11 years old, a third (33.4%) of children in England were classified as either overweight or obese (The National Health Service [NHS] Information Centre, 2011). The UK government recognise that obesity has negative consequences for individuals, local communities, and to the NHS (as direct costs which are estimated at £5bn e...

Changing eating behaviours to treat childhood obesity in the community using Mandolean: the Community Mandolean randomised controlled trial (ComMando) – a pilot study

“…Before embarking on further primary care-based interventions, it seems necessary to try and establish exactly how the population perceives childhood obesity and whether or not it is considered a real risk to health. Ambivalence towards the recognition, [41][42][43] diagnosis and treatment of childhood obesity [44][45][46][47] seems to be a real barrier to engagement. Some data suggest that referral from a doctor, such as a GP, may increase the perception that 'something should be done': 48 this was not really borne out by our recruitment from GPs.…”

Parent engagement and attendance in PEACH™ QLD – an up-scaled parent-led childhood obesity program

“…Program enrolment is enhanced by a parent’s awareness of their child’s overweight status and desire to improve their child’s health [14, 15]. Program attendance is improved by children’s involvement in attendance decisions [16]; and program completion driven by a child’s development during a program, of social groups and improvement in their self-esteem and confidence [14, 16].…”

“…Program attendance is improved by children’s involvement in attendance decisions [16]; and program completion driven by a child’s development during a program, of social groups and improvement in their self-esteem and confidence [14, 16]. Identified barriers to program engagement include: delivery of a program in a clinical environment [16, 17]; mismatch in pre-conceived perceptions of the intervention [15]; scheduling conflicts [18]; lack of family support [14, 18]; transportation barriers; and unmet expectations [15–18]. …”

Hvordan foreldre reagerer når barnet er overvektig

“…I studien vår, som i andre studier (16,18,21), er foreldre redde for at oppmerksomhet på vekt kan gi barnet et negativt syn på egen kropp. Å vaere foreldre til et barn i en stor kropp kan oppleves som en ambivalent prosess.…”

“…I dette ligger det et dilemma. Det er viktig at helsepersonell er opptatt av barnets selvfølelse og psykiske helse i tillegg til overvekten (16,19). Samtalen med foreldrene bør fokusere på muligheten for å ivareta barnets selvfølelse samtidig som det settes i gang nødvendige tiltak for å stoppe overvekten.…”