A qualitative examination of contributing factors and treatment considerations for pediatric obesity among parents of rural preschoolers.

Abstract

The primary purpose of this study was to gather qualitative information related to contributors of pediatric obesity in rural preschoolers, as well as potential changes to obesity interventions that could help promote the health and well-being of children and families in this population. Qualitative focus groups were conducted with 17 parents (all mothers, 19 -26 years old [M ϭ 24.7]) of children 2-5 years old with obesity. All study participants resided within a rural area (in a town or county with a population Ͻ20,000) and focus groups were held near their homes. Six primary themes were identified through framework analysis of focus group data: (a) limited access to healthy food options in grocery stores and restaurants; (b) challenges with providing recreational alternatives to screen time, especially those that promote physical activity; (c) severely limited access to weight-management services; (d) comfort and acceptability of telemedicine and other technological advancements for behavioral health services; (e) endorsement of the belief that parents are the primary agents of change for preschoolers' health behaviors and weight status; and (f) general time management difficulties, which limit the feasibility of traditional face-to-face interventions and have a negative impact on their child's sleep duration. These themes are discussed in detail, and put into the context of potential changes that could be made to current obesity intervention options for preschoolers living in rural communities. These include using telemedicine to increase reach, considering parent-only interventions, and incorporating behavioral sleep medicine intervention components.

Introduction to special issue: Improving clinical practices in pediatric psychology through qualitative research.

“…Two articles in this special issue used qualitative methods to formulate models of care. Van Allen, Lancaster, and Seegan (2017) used focus groups with rural mothers of preschoolers with obesity to understand their perspectives of factors that contribute to obesity for their children and hamper their efforts to manage their child’s weight. The investigation provides insight into barriers at various levels within the social ecology (e.g., family: time management difficulties; health care system: inadequate availability of services; community: lack of healthy food choices) and also some potential solutions to these barriers.…”

Effectiveness of a paediatric weight management intervention for rural youth (iAmHealthy): Primary outcomes of a cluster randomised control trial

“…2,3 Youth in rural areas have 26% greater odds of having obesity compared to youth in urban areas. 4 These increased rates are likely caused by multiple factors including limited access to recreational facilities 5,6 and healthy food at grocery stores and restaurants, 7,8 low sidewalk availability 9 and difficulties finding recreational alternatives to screen time 8 which results in youth engaging in fewer health-promoting behaviours. [10][11][12] Additionally, rural primary care providers face extensive barriers in relation to implementing treatment and preventative interventions for childhood obesity (e.g., limited specialists in the community, time constraints and few community resources to refer families to) which results in families from rural communities having limited access to programmes or medical advice that may support weight management.…”