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

Abstract

The ‘early years’ is a crucial period for the prevention of childhood obesity. Health services are well placed to deliver preventive programs to families, however, they usually rely on voluntary attendance, which is challenging given low parental engagement. This study explored factors influencing engagement in the Infant Program: a group-based obesity prevention program facilitated by maternal and child health nurses within first-time parent groups. Six 1.5 h sessions were delivered at three-month intervals when the infants were 3–18 months. A multi-site qualitative exploratory approach was used, and program service providers and parents were interviewed. Numerous interrelated factors were identified, linked to two themes: the transition to parenthood, and program processes. Personal factors enabling engagement included parents’ heightened need for knowledge, affirmation and social connections. Adjusting to the baby’s routine and increased parental self-efficacy were associated with diminished engagement. Organisational factors that challenged embedding program delivery into routine practice included aspects of program promotion, referral and scheduling and workforce resources. Program factors encompassed program content, format, resources and facilitators, with the program being described as meeting parental expectations, although some messages were perceived as difficult to implement. The study findings provide insight into potential strategies to address modifiable barriers to parental engagement in early-year interventions.

Understanding, comparing and learning from the four EPOCH early childhood obesity prevention interventions: A multi‐methods study

“…The present results add to the growing body of evidence examining factors that need to be considered when designing an intervention to be delivered at scale. Specifically, our findings align with previous research by emphasising the need to ensure that facilitators are appropriately trained, key messages are repeated throughout a program and delivery occurs across childhood to avoid fade‐out effects of health gains 37,38 . A key message from the interviews was the need to seamlessly align the intervention with other efforts to prevent childhood obesity.…”

Participant Experiences of an Infant Obesity Prevention Program Delivered via Telephone Calls or Text Messages

“…The finding that some participants considered it difficult to adhere to the advice provided, and they considered this program burdensome on top of other commitments and responsibilities, has been shown in other studies [3,35,36]. Lack of compliance with the program was encountered in other infant obesity prevention programs delivered via more traditional modes e.g., face-to-face, and attributed to time constraints, travel distances, busy schedules and return of participants back to work [35][36][37].…”

Lessons on early childhood obesity prevention interventions from the Victorian Infant Program

“…Findings will inform strategies to address modifiable barriers, for example, early program promotion during pregnancy, flexible modes of delivery using web and app-based technologies, and codesign and referral through interagency collaborations to reach vulnerable parents. 4 In 2013, the Infant Program was selected by the Victorian Department of Health and Human Services as part of the Healthy Together Victoria (HTV) Initiative for small-scale implementation across select communities. Factors influencing translation of the program into routine practice were explored in sites implementing the program for at least 6 months.…”

“…Family-focused health services are well placed to support parents to develop knowledge, skills and confidence regarding child health behaviours, and parents are highly receptive to such support. 4 In Victoria, the universal free Maternal and Child Health (MCH) service provides 10 consultations between birth and age 3.5 years, with 80-90% attendance during the first…”