Barriers to engage parents in child obesity prevention and control: a multiple stakeholder analysis using the Family Ecological Model

Abstract

Barriers to engage parents in child obesity prevention are not well understood. We addressed this gap by utilizing the Family Ecological Model to identify and characterize barriers experienced by stakeholders in five sectors: WIC, health care, school, afterschool, child care. We conducted semi‐structured interviews with 40 stakeholders to identify factors influencing child obesity within their community and barriers to engage parents in prevention. Data were drawn at baseline from a multi‐sector study designed to reduce child obesity in two communities in eastern Massachusetts. Interviews were transcribed, coded, and summarized using NVivo 10. Stakeholders reported a wide range of barriers affecting parent engagement in child obesity prevention and control. Five main themes across sectors were identified, including family cultural beliefs (e.g. “chubby is healthy”), limited community resources, parents’ lack of education/awareness, lack of time, lack of money. Stakeholders also described poor cross‐sector communication and parents’ perceived lack of control over children's food intake as negatively affecting parental engagement. No obvious contradictory themes across sectors were identified and the results did not differ substantially between communities, suggesting that community stakeholders could share resources and work collectively to support parent engagement in obesity prevention.