Access to primary care child weight management programs: Urban parent barriers and facilitators to participation

Abstract

The prevalence and comorbidities of childhood obesity among low-income urban children are a significant health issue in the United States. Programs designed to assist families are underutilized. The aim of this study is to describe barriers and facilitators relevant to intervention program participation from the perspective of parents who have children who are overweight or obese. Systematic thematic analysis of focus groups and semi-structured interviews with parents from multiple urban pediatrics and family medicine practices were used to gather data. A framework analysis approach was used and a codebook of themes was developed. Transcripts were coded independently by the research team and consensus among researchers was reached. Forty-eight parents participated in the study. Perceived barriers to participation included (1) varied referral process (lack of follow-up or varying referral experience), (2) costs (time and program fee), (3) logistics (location and program schedule), and (4) child motivation. Perceived facilitators to participation included (1) systematic referral process (in-office referral and timely follow-up), (2) program content and organization, and (3) no cost. Multiple barriers and facilitators affect weight management program participation among families, which should be specifically targeted in future obesity interventions in order to effectively reach urban, minority parents and children.

A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia

“…National, State and private health service providers involved in the management of childhood overweight and obesity were not involved in these programs in a co-ordinated way. Systematic referral processes and timely follow-up are regarded as facilitators to participation, especially for vulnerable families [ 14 , 28 ]. The persistence of this issue, despite repeated service delivery, suggests that for weight management services to become part of routine universal care, greater clarity regarding stewardship is still needed.…”

Factors Influencing Parental Engagement in an Early Childhood Obesity Prevention Program Implemented at Scale: The Infant Program

“…Studies of the enablers and barriers to engagement have most frequently been conducted in the context of children with behavioural [ 13 , 25 , 30 , 32 ], mental health [ 20 ], or weight management issues [ 10 , 16 , 17 , 33 , 38 ], or children who have complex medical concerns [ 9 ] or vulnerable families [ 29 ]. Studies investigating first-time parents have focused on neonatal issues such as prematurity and neo-natal follow-up [ 18 ], home visitation programs [ 26 , 27 ], randomised controlled trials [ 39 , 40 ], and the perspectives of researchers [ 41 ].…”

What are the existing barriers to the efficiency of child obesity prevention programmes?

“…Z pohledu rodičů je nejčastěji zmiňovanou překážkou v compliance preventivnímu programu jejich náročný, povinnostmi přeplněný denní program a s tím související nedostatek času (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). Ať už se jedná o pozdní pří- Nedostatek personálu 1 9…”

“…Příčiny snížené compliance na společenské úrovni (8,20,(28)(29)(30). V podstatě stejně často jako čas je zmiňována i finanční stránka zdravého životního stylu (7,9,17,(21)(22)(23)(24)(25)(26)(31)(32)(33)(34). Dle rodičů je velmi často uváděna vyšší cena zdravých a čerstvých potravin (7,8,10,11,29,34), nedostatek peněz nazbyt na cestování na srazy v rámci projektu (19,32,34) i vysoké náklady na vybavení ke sportování, permanentky a platby za sportovní kroužky (28,29,35).…”

“…Nedostatek času i financí společně určuje také nízkou účast na intervenčních schůzkách preventivních programů (9). Problémem mohou být časy konání, které kolidují se směnami rodičů v zaměstnání nebo ve vedlejším pracovním poměru (9,10,23,31). Také jsou zmiňovány další rodinné povinnosti, jako například péče o další děti, což rodičům znemožňuje trávit odpoledne jinde než doma (7,9,10,36).…”