ENTREN-F family-system based intervention for managing childhood obesity: Study protocol for a randomized controlled trial at primary care

Family systems approaches in pediatric obesity management: a scoping review

“…Effective parenting skills may vary based on existing dynamics within the family but may include limit-setting, active listening and communication, autonomy-support, parental role-modeling, etc. 16 Families Improving Together (FIT) : Focused on improving parenting skills around communication, autonomy support, and social support [ 36 ] Families on the Move (FOTM) : Focused on limit setting, re-framing the problem, re-framing parent role and child responsibility, exercising parental leadership, exercising parental general skills, promoting parent–child effective communication, promoting problem-solving skills, increasing self-efficacy in parental role of providing a positive family environment [ 43 ] [ 28 – 30 , 32 – 41 , 43 – 47 , 52 , 53 , 56 , 61 – 63 , 65 – 68 , 70 – 72 , 75 – 77 ] The Parenting Strategies for Eating and Activity Scale (PEAS) [ 53 ] The Parenting Dimensions Inventory (PDI-S) [ 56 ] The Parenting Stress Index [ 67 , 68 ] The Authoritative Parent Index [ 39 ] The Child Feeding Questionnaire [ 39 , 41 ] Newest Vital Sign [ 46 ] Parenting practices scale [ 33 ] Family Communication Strengthening both verbal and non-verbal communication among family members to create a supportive environment within the home. Communication strategies (e.g., active listening, openness, respect) can enhance emotional connections, foster productive discussions that can help in problem-solving and decision-making, and allow individuals to feel heard and validated within the family unit 14 Families Improving Together (FIT) : Targeted family communication strategies, including active listening, using push–pull language, and problem solving [ 35 ] [ …”

“…Adolescents were encourage to bring a friend to [one] session, and friends were integrated into the activities [ 71 ] [ 29 , 33 , 35 – 40 , 42 , 43 , 47 , 49 , 50 , 56 , 60 – 63 , 70 – 72 ] The Youth Quality of Life (YQOL) Inventory, including a social relationship subscale [ 49 ] The Support for Exercise Scale (revised version) [ 56 ] The Social Support for Eating Habits and Exercise Scale [ 61 ] Parent Relationship with Peer Group Scale [ 33 ] Family Functioning Family member roles and interactions that affect day-to-day living within the home environment, including acceptance and understanding of one another, family decision-making and problem-solving processes, and general communication among family members. Simply described as the overall healthiness of a family unit 10 Multidisciplinary FBBT : Nutrition-related topics and systemic interventions to facilitate family functioning by reinforcing family resources and improving the emotional climate for adolescents with obesity [ 57 ] [ 30 , 31 , 33 , 35 – 40 , 47 , 56 , 57 , 60 , 64 , 70 – 72 ] The Self-Report Family Inventory (SFI), including the conflict resolution, cohesion, and family nurturance subscales [ 60 ] The Family Adaptability and Cohesion Evaluation Scales IV (FACES IV) [ 67 , 68 ] The Family Climate Scale [ 72 ] Family Questionnaire (FQ) [ …”

“…Simply described as the overall healthiness of a family unit 10 Multidisciplinary FBBT : Nutrition-related topics and systemic interventions to facilitate family functioning by reinforcing family resources and improving the emotional climate for adolescents with obesity [ 57 ] [ 30 , 31 , 33 , 35 – 40 , 47 , 56 , 57 , 60 , 64 , 70 – 72 ] The Self-Report Family Inventory (SFI), including the conflict resolution, cohesion, and family nurturance subscales [ 60 ] The Family Adaptability and Cohesion Evaluation Scales IV (FACES IV) [ 67 , 68 ] The Family Climate Scale [ 72 ] Family Questionnaire (FQ) [ 31 ] Family Assessment Device General Functioning [ 29 ] Parental Role Modelling The ability of a parent to act as a role model and model healthy lifestyle behaviours through their actions. Recognizing parents as agents of change for their child’s habits and behaviours 8 Families on the Move (FOTM) : The intervention emphasizes parents as change agents who role model behavioural change by setting goals themselves [ 43 ] Family Connections : Parents provide an example of healthy lifestyle behaviours for their child, and model enjoyment of healthy foods and physical activity [ 44 ] [ 30 , 32 , 43 – 46 , 53 , 58 , 59 , 61 – 63 , 73 , 74 ] The Comprehensive Feeding Practices Questionnaire [ 53 ] The Weight Control Strategies Scale (WCSS) [ 74 ...…”

“…Parents seek input from adolescents and negotiate rules and behaviour changes together [ 35 ] [ 35 – 40 , 42 , 48 , 56 , 61 – 63 , 70 , 71 ] None mentioned Shared Decision-Making Encouraging collaboration when making decisions, particularly those surrounding health behaviours and activities such as meal planning, physical activity preferences, etc. 5 Family Connections : The intervention promoted the involvement of children in decision making for enjoyable physical activity [ 44 ] [ 35 – 40 , 44 – 46 , 56 , 60 , 70 , 71 ] None mentioned Home Environment Addressing barriers to healthy living that exist within the physical home environment 6 Multidisciplinary Treatment Program : Focused on removing unhealthy food triggers from the home environment [ 58 ] Family Connections : Provided strategies to restructure the home environment to support healthy food and activity options, while reducing options for unhealthy choices [ 44 ] [ 28 , 30 , 44 – 46 , 58 , 59 , 61 – 63 , 73 , 74 ] Home Monitoring Checklist [ 28 ] Confusion, Hubbub, and Order Scale [ 28 ] Empowerment Providing adequate tools, resources, support, and information to enhance an individual’s confidence surrounding ce...…”

“…It further targeted positive parenting skills through parenting style, parental monitoring, shared decision making, and communication, while promoting family bonding and family support in weekly goal setting [ 35 ]. Other interventions that were more explicit on their family systems approaches were the Multisystemic Therapy, which included baseline assessment of the family’s strengths and weaknesses to target individual family needs related to FST concepts [ 62 , 63 , 88 ], the SHINE intervention, which provided detailed and specific descriptions of FST integration in their design [ 70 , 71 ], and ENTREN-F, which focused on behavioural parenting strategies, parental educational styles, feeding practices, communication skills and adaptive dynamics in the home environment [ 30 ].…”