Barriers and facilitators to initial and continued attendance at community‐based lifestyle programmes among families of overweight and obese children: a systematic review

Abstract

SummaryThe success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community‐based lifestyle programmes among families of overweight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed‐method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition.

Time2bHealthy – An online childhood obesity prevention program for preschool-aged children: A randomised controlled trial protocol

“…A large proportion of Australian households are connected to the internet (83% in 2012-2013), including those in regional, rural and remote areas [52], potentially enabling widespread access to programs regardless of geographic location. The intervention also has the potential for broad reach as it negates many barriers associated with traditional delivery methods [15][16][17][18].…”

“…This is particularly true for programs that target young children. Despite the importance of parental involvement in overweight and obesity prevention and treatment programs, there are recognised barriers such as scheduling of appointments/ sessions [15], stigma, parental denial [16], childcare for other siblings [17], travel [18] and cost [15] that prevent parental involvement and potentially success of the programs.…”

A weight management programme for fathers of children aged 4–11 years: cultural adaptation and the Healthy Dads, Healthy Kids UK feasibility RCT

“…Other studies have reported that parents are more likely to enrol on programmes that focus on a healthy lifestyle, rather than on weight loss. 134 Although the HDHK programme in Australia was designed as a weight management programme, in its community roll-out, it used a more inclusive approach and focused on family healthy lifestyle practices. Our public involvement panel reinforced the difficulty and power imbalance in families, whereby a child or partner might suggest their father/partner joined the programme.…”

Is future fat fated?

“…Second, the study had a high dropout rate, with data being absent in 2,284 of the possible 7,372 subjects. This too could have been biasing; perhaps children with obesity excluded themselves from measurements because they felt stigmatized ? Last, the influence of the funding source—a beverage company—cannot be excluded .…”