BackgroundParents' underestimation of their child's weight status can hinder active participation in overweight prevention programs. We examined the level of agreement between the parents' perception of their child's weight status and the child's actual weight status, moderating factors, and change over time. MethodsThis cross-sectional study used data collected in 2009 (n = 8105), 2013 (n = 8844) and 2017 (n = 11,022) from a community-based survey conducted among parents of children age 2-12 years in the Netherlands. Parents classified their perception of their child's weight status on a 5-point Likert scale. In 2009 and 2013, the child's BMI was calculated from selfreported data by parents. The level of agreement between the parent's perception of the weight status and the actual weight status was examined using Cohen's kappa. The role of demographic factors on parents' perception were examined using logistic regression.

Background: In most childhood obesity interventions, disadvantaged groups are underrepresented, and results are modest and not maintained. A long-term collaborative community-based approach is necessary to reach out to children from multi-ethnic backgrounds and achieve sustainable behavior change, resulting in sustained Body Mass Index-Standard Deviation Score (BMI-SDS) reductions. The objective is to determine the effects of GO! on BMI-SDS and Health-Related Quality of Life (HRQoL) for children and adolescents having overweight or obesity. Methods: A prospective, longitudinal cohort study was used to collect two-year follow-up data from November 2014 to July 2019. Children and adolescents (4-19 years old) from the low socioeconomic status and multi-ethnic district of Malburgen in the Dutch city of Arnhem were included. 178 children having overweight or obesity were recruited, with 155 children measured at baseline and after two years as a minimum, while 23 were lost to follow up. Participants attending the program for over six months were defined as completers (n=107) and participants attending the program for less than six months were defined as non-completers (n=48). The child health coach (CHC) acts as a central care provider in the collaborative community with healthcare providers from both medical and social fields. This coach coordinates, monitors and coaches healthy lifestyles, while increasing self-management for both children and parents. This is done in a customized and neighborhood-oriented manner and provided by all the stakeholders involved in GO!. The main outcomes are the change in BMI-SDS scores and HRQoL scores reported by participants.

Background: To counteract children with obesity, different protocols for combined lifestyle interventions (CLIs) are implemented by healthcare providers (HCPs). To understand the effects of CLI, we studied the implementation process, facilitators and barriers experienced by HCPs. Methods: A multiple case study design in which community-based CLIs (n = 4), implemented in a total of ten different communities, are conceptualized as a “case”. Qualitative data were collected via group interviews among HCPs (n = 48) regarding their implementation protocol, their network involvement and the adoption of the CLI in a community. Transcripts were coded and analysed using ATLAS.ti. Results: Barriers were the absence of a proper protocol, the low emphasis on the construction of the network and difficulty in embedding the CLI into the community. Funding for these activities was lacking. Facilitating factors were the involvement of a coordinator and to have everyone’s role regarding signalling, diagnosis, guidance and treatment clearly defined and protocolled. HCPs suggested adding certain professions to their team because they lacked expertise in parenting advice and providing mental support to children. Conclusions: Carrying out and adapting the content of the CLI to the community was experienced as easier compared to the management of the organizational aspects of the CLI. For these aspects, separate funding is essential. In the future, mapping the characteristics of a community will help to clarify this influence on the implementation even better.