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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