Risk and Protective Factors Associated with Childhood Obesity in a Sample of Low‐Income, Single Female, Parent/Guardian Households: Implications for Family Therapists

The purpose of this article is to emphasize the value of the family as a source of behavior change, particularly with respect to attaining achievable goals of weight loss and regular physical activity for youth and their families. We present a review of the literature, providing support for the value of the family in influencing children to form good diet and exercise behaviors and as a source of support and motivation for individuals seeking to lose or control their weight and to start and maintain a physically active lifestyle. Recognizing the importance of family behavior in the development of weight control and weight loss activities is essential. Future work should focus on identifying measurable parameters of family-level weight control behaviors and ways to apply those parameters to help create new interventions that use the strengths of the family for achieving weight control goals.

Objective To explore the barriers and facilitators experienced by those implementing a government-funded, community-based childhood weight management programme. Design Qualitative using semistructured interviews. Setting Two geographical regions in the south and west of Ireland. Participants 29 national-level and local-level stakeholders responsible for implementing the programme, including professionals from dietetics, psychology, public health nursing, physiotherapy, health promotion and administration. Methods Framework analysis was used to identify barriers and facilitators, which were mapped onto six levels of factors influencing implementation outlined by Grol and Wensing: the innovation, the individual professional, the patient, the social context, the organisational context and the external environment. Results Most barriers occurred at the level of the organisational context. For all stakeholders, barriers arose due to the multidisciplinary nature of the programme, including the lack of role clarity and added complexity of working in different locations. Health professionals’ low-perceived self-efficacy in approaching the subject of weight with parents and parental resistance to hearing about their child’s weight status were barriers to programme implementation at the individual professional and patient levels, respectively. The main facilitators of implementation, occurring at the level of the health professional, included stakeholders’ recognition of the need for a weight management programme and personal interest in the area of childhood obesity. Having a local lead and supportive colleagues were further implementation drivers. Conclusions This study highlights the complexities associated with implementing a multidisciplinary childhood weight management programme, particularly translating such a programme to a community setting. Our results suggest the assignment of clear roles and responsibilities, the provision of sufficient practical training and resources, and organisational support play pivotal roles in overcoming barriers to change. This evidence can be used to develop an implementation plan to support the translation of interventions into real-world settings.