Barriers & facilitators associated with initial and continued attendance at community-based interventions among families of overweight & obese children – Preliminary findings

Ms. Emily Kelleher, University College Cork

Childhood Obesity•In Ireland, almost 1 in 4 children are

carrying excess weight(1)

•Programmes to treat childhood obesity should ideally be family-based and should combine healthy eating, physical activity and behavioural components(2)

Rationale for Review

•The success of these programmes relies heavily on family attendance and retention

•Majority of families referred to treatment decline

•High programme attrition negatively impacts family and health service

Aim of Review

•To synthesise the findings of a range of studies investigating factors influencing attendance at community-based lifestyle programmes among families of overweight or obese children

▫Specifically to explore the barriers and facilitators related to initial and continued attendance

MethodsPubMed(n=978)

CINAHL(n=258)

EMBASE(n=513)

PsychINFO

(n=401)

Inclusion and Exclusion Criteria

Articles published in English if they;

1. were original research studies, 2. included children aged 4-12 years,3. had a primary focus on pediatric weight

management that4. incorporated lifestyle (i.e. diet, physical

activity and behavioural components),5. reported on the factors influencing

attendance at family-based programmes delivered in the community setting

Records after duplicates removed

(n=1405)

Additional records identified through other sources

(n=27)

Records identified through systematic database searching

(n=2105)

Records screened(n=1432)

Records excluded(n=1354)

Full-text articles assessed for eligibility

(n=78)

Excluded articles(n=65)

- Hospital-based (n=17)- Does not explore attendance (n=10)- No full-text / conference abstract (n=9)- Not lifestyle intervention (n=7)- University setting (n=6)- Not original study (n=3)- Unsuitable age-group (n=3)- Not community-only (n=3)- Does not explore family perspectives (n=2) 

Studies included in review(n=13)

Quantitative (n=6)Qualitative (n=6)

Mixed-methods (n=1)

Results I

Facilitators for

Enrolment

Programme

ParentChild

Making friends

Improving WeightImproving

Fitness Improving Appearance

Existing Co-morbidities

Improve child's psychological well-being

Desire for ‘outside’ help

Understood Health Risks

Learn new skills

Family-approach

Lifestyle approach

Results II

Barriers to Enrolment

Programme

ParentChild

Family

Stigma Gender

Stigma

Denial of issue

No perceived need

Changing family circumstances

Scheduling conflicts

Rural / suburban areas Logistics

Sustainability

Results III

Facilitators for

Continued Attendanc

e

Programme

ParentChild

Making new friends

Group support

Having fun

Programme staff

Family approach

Practical sessions

Regular communication

Results IV

Barriers to Continued Attendanc

e

Programme

ParentChild

Family

Gender

Unrealistic expectations

Unemployment

Changing family circumstances

Scheduling conflicts

Ethnic MinorityLower

SEA

Lone-parents

LogisticsProgramme staff

Conclusions & Recommendations I•Programme marketing materials should

be bright and fun, highlighting positive psychological impacts

•Highlight opportunity to try new activities/learn new skills

•Ensure families’ expectations are consistent with programme goals

Conclusions & Recommendations II•Ensure programmes are delivered in a familiar

and accessible setting

•Discuss and troubleshoot barriers to attendance with families before programme commencement

•Enhance and incorporate family-approach

•Future research should explore strategies to encourage participation with hard to reach groups