Abstract

The objective of the current study was to identify challenges of making and sustaining healthy lifestyle changes for families with children/adolescents affected by obesity, who were referred to a multicomponent healthy lifestyle assessment and intervention programme in Aotearoa/New Zealand (NZ). Secondary qualitative analysis of semi-structured interviews. Taranaki region of Aotearoa/NZ. Thirty-eight interviews with parents/caregivers (n 42) of children/adolescents who had previously been referred to a family-focused multidisciplinary programme for childhood obesity intervention, who identified challenges of making healthy lifestyle changes. Participants had varying levels of engagement, including those who declined contact after their referral. Participant-identified challenges included financial cost, impact of the food environment, time pressures, stress, maintaining consistency across households, independence in adolescence, concern for mental health and frustration when not seeing changes in weight status. Participants recognised a range of factors that contributed towards their ability to make and sustain change, including factors at the wider socio-environmental level beyond their immediate control. Even with the support of a multidisciplinary healthy lifestyle programme, participants found it difficult to make sustained changes within an obesogenic environment. Healthy lifestyle intervention programmes and families' abilities to make and sustain changes require alignment of prevention efforts, focusing on policy changes to improve the food environment and eliminate structural inequities.

Highlights

  • No interviews included in this secondary analysis included children or adolescents as participants, as the topic of implementing healthy lifestyle changes was not raised by these participants

  • The current study shows that families in NZ face a range of challenges when attempting to make healthy lifestyle changes in current environments

  • Our results suggest that implementing healthy lifestyle changes is challenging even with the support of a healthy lifestyle intervention due to a range of external socio-environmental factors

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Summary

Methods

Programme context Whanau Pakari is an assessment and intervention programme involving weekly group sessions delivered by a multidisciplinary team, including a physical activity coordinator, dietitian and psychologist[16,20]. The sessions incorporated family physical activity sessions, including a variety of sports and games to engage participants’ interests; psychology sessions, including discussion of topics such as self-esteem and how to maintain healthy lifestyle changes; and dietary sessions, including portion sizes, the concept of healthy food, virtual supermarket tours and cooking sessions[20]. The research team collaborated to finalise the themes, with previously agreed respectful parameters allowing the authors to debate, challenge and refine interpretations of the data. It was agreed to apply the ‘Give-Way’ rule throughout the wider study if there was disagreement over the interpretation of the data concerning Maori participants[26,27,28], whereby any final decision involving interpretation of Maori participants’ experiences would pass to a Maori researcher

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