Community stakeholders' perceptions of barriers to childhood obesity prevention in low-income families, Massachusetts 2012-2013.

Claudia Ganter,Kirsten K Davison,Alyssa Aftosmes-Tobio,Emmeline Chuang,Mary Giannetti,Thomas Land,Rachel E Blaine

doi:10.5888/pcd12.140371

Abstract

IntroductionThe etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors. Policymakers and researchers are promoting social–ecological approaches to obesity prevention that encompass multiple community sectors. Programs that successfully engage low-income families in making healthy choices are greatly needed, yet little is known about the extent to which stakeholders understand the complexity of barriers encountered by families. The objective of this study was to contextually frame barriers faced by low-income families reported by community stakeholders by using the Family Ecological Model (FEM).MethodsFrom 2012 through 2013, we conducted semistructured interviews with 39 stakeholders from 2 communities in Massachusetts that were participating in a multisector intervention for childhood obesity prevention. Stakeholders represented schools; afterschool programs; health care; the Special Supplemental Nutrition Program for Women, Infants, and Children; and early care and education. Interviews were audio-recorded, transcribed, coded, and summarized.ResultsStakeholder reports of the barriers experienced by low-income families had a strong degree of overlap with FEM and reflected awareness of the broader contextual factors (eg, availability of community resources, family culture, education) and social and emotional dynamics within families (eg, parent knowledge, social norms, distrust of health care providers, chronic life stressors) that could affect family adoption of healthy lifestyle behaviors. Furthermore, results illustrated a level of consistency in stakeholder awareness across multiple community sectors.ConclusionThe congruity of stakeholder perspectives with those of low-income parents as summarized in FEM and across community sectors illustrates potential for synergizing the efforts necessary for multisector, multilevel community interventions for the prevention of childhood obesity.

Highlights

The etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors
Stakeholder reports of the barriers experienced by low-income families had a strong degree of overlap with Family Ecological Model (FEM) and reflected awareness of the broader contextual factors and social and emotional dynamics within families that could affect family adoption of healthy lifestyle behaviors
Results illustrated a level of consistency in stakeholder awareness across multiple community sectors

Summary

Introduction

The etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors. Policymakers and researchers are promoting social–ecological approaches to obesity prevention that encompass multiple community sectors. The etiology of childhood obesity is multidimensional and includes familial, organizational, and societal factors. VOLUME 12, E42 MARCH 2015 social ecological approaches to obesity prevention that encompass multiple community sectors [3,4,5,6,7,8]. To effectively support behavior change through a synergistic, multisector approach, stakeholders in participating sectors must be aware of the complex and multifaceted barriers to behavior change encountered by families, low-income families [9,10,11,12,13]. To our knowledge, the extent to which stakeholders are informed about families’ experiences in relation to obesity prevention has not been documented in obesity prevention research

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