Background: Childhood obesity disproportionately affects low-income minority populations, yet there is a paucity of literature about effective interventions in this population. This study sought to understand the experience of low-income majority Hispanic families engaged in obesity treatment.Methods: We conducted six focus groups (2 = English, 4 = Spanish) with families who completed a community-based, familyoriented obesity treatment program, using standard qualitative focus group interview methods. Transcripts were recorded, transcribed, and analyzed for thematic content. Two coders using the software program ATLAS.ti (v.7.0; Scientific Software Development GmbH, Berlin, Germany) coded each transcript independently; reflexive team analysis with three study team members was used to reach a consensus.Results: Participants (n = 37) indicated high program satisfaction. Parents reported buying less junk/fast food, increased consumption of fruits and vegetables, preparing and eating more meals as a family, and increasing their families' physical activity (PA). Four barrier and facilitator themes emerged. Barrier themes were time and financial cost, parent's lack of time and energy, influence of family members, and challenges regarding physical environment. Facilitator themes were skill building around healthy eating and parenting, family involvement, and long-term health concerns. Unanticipated findings, parents reported, were that changes resulted in children sleeping better, feeling happier, and less irritability.Conclusions: Despite low-income families experiencing barriers to lifestyle changes to manage obesity, they made positive dietary changes and increased PA by learning specific skills and including the whole family in those changes. Additionally, some unexpected benefits were noted, including improved sleep, less irritability, and children appearing happier. Future studies should consider using these parent-identified outcomes as secondary measures of program effectiveness.

Use of this stakeholder-informed data could assist in the development of future culturally tailored interventions aimed at reducing the rates of early childhood obesity in the Latino population.

Objective: To investigate changes in beliefs around obesity, nutrition, and physical activity among low-income majority Latino families who participated in a community-based family-inclusive obesity intervention. Methods: Six focus groups were conducted with a predominately Latino low-income population, who completed the Healthy Living Program (HeLP). Two groups were conducted in English and four groups were conducted in Spanish, and were recorded, translated, transcribed, and analyzed for thematic content. Two coders independently coded transcripts then reflexive team analysis with three members was used to reach consensus. Results: Thirty-seven caregivers representing thirty-three families participated in focus groups. A number of themes emerged around changes in beliefs about obesity, nutrition, and physical activity (PA) as a result of the HeLP curriculum. Regarding obesity, the themes that emerged focused on the acceptability of children being overweight and the importance of addressing weight at an early age. Changes in beliefs regarding nutrition emerged, noting changes in the use of food as a reward, the multiple benefits of a healthy diet, and for some participants change in their beliefs around the adaptability of traditional foods and habits. Regarding physical activity, themes emerged around the difficulty of engaging in PA due to unsafe conditions and finding creative indoor and outdoor activities with whole family participation and becoming aware of the benefits of PA. Conclusions: Parental changes in beliefs about obesity, nutrition, and physical activity as a result of a family-inclusive weight management program in a population of low-income predominately Latino families can aid and inform the development of future weight management programs for this population.

Overweight and obese children in low-income households have limited access to weight loss programs. Low-cost programs should be evaluated in this population. The objective of the current study is to determine weight change among 7 to 17-year-old participants in Take Off Pounds Sensibly (TOPS), a national, low-cost weight loss program. This nonconcurrent prospective study analyzes the cumulative change in weight z-score for overweight and obese children and adolescents who joined TOPS from 2008 to 2011 and consecutively renewed their annual membership. The study includes 586 individuals. At 1-year, cumulative mean (SD) weight z-score change was −0.13 (31). In general, mean change in weight z-scores was no different in subsequent years. Mean weight z-score of children and adolescent TOPS participants who renew their program membership decreased significantly in the first year. Randomized controlled trials should prospectively evaluate this program in children and adolescents.