Staniford Leanne Jane, Breckon Jeff David, Copeland Robert James, Hutchison Andrew
Faculty of Health and Wellbeing, Sheffield Hallam University, UK.
J Child Health Care. 2011 Sep;15(3):230-44. doi: 10.1177/1367493511404722.
Over the past three decades, there has been a dramatic global increase in childhood obesity. A better understanding of stakeholders' perceptions of intervention requirements could contribute to developing more effective interventions for childhood obesity. This study provides a qualitative, in-depth, analysis of stakeholders' (children, parents and health professionals) perspectives toward the efficacy of childhood obesity treatment interventions. Twenty-six stakeholders were recruited using purposive sampling; semi-structured interviews were adopted to explore stakeholders' perceptions with data analysed using a framework approach. Stakeholders concurred that treatment should be family-based incorporating physical activity, nutrition and psychological components, and be delivered in familiar environments to recipients. However, incongruence existed between stakeholders towards the sustainability of obesity treatment interventions. Parents and children reported needing ongoing support to sustain behavioural changes made during treatment, while health professionals suggested interventions should aim to create autonomous individuals who exit treatment and independently sustain behaviour change. This study provides an insight into issues of stakeholder involvement in the obesity intervention design and delivery process. To promote long-term behaviour change, there needs to be increased congruence between the delivery and receipt of childhood obesity treatment interventions. Interventions need to incorporate strategies that promote autonomous and self-regulated motivation, to enhance families' confidence in sustaining behaviour change independent of health professional support.
在过去三十年里,全球儿童肥胖现象急剧增加。更好地了解利益相关者对干预需求的看法,有助于制定更有效的儿童肥胖干预措施。本研究对利益相关者(儿童、家长和健康专业人员)对儿童肥胖治疗干预效果的看法进行了定性、深入分析。采用目的抽样法招募了26名利益相关者;采用半结构化访谈来探索利益相关者的看法,并使用框架方法对数据进行分析。利益相关者一致认为,治疗应以家庭为基础,纳入体育活动、营养和心理成分,并在受助者熟悉的环境中进行。然而,利益相关者在肥胖治疗干预措施的可持续性方面存在不一致。家长和儿童表示,需要持续的支持来维持治疗期间所做出的行为改变,而健康专业人员则建议,干预措施应旨在培养能够脱离治疗并独立维持行为改变的自主个体。本研究深入探讨了利益相关者参与肥胖干预设计和实施过程中的问题。为了促进长期行为改变,儿童肥胖治疗干预措施的提供方和接受方之间需要增强一致性。干预措施需要纳入促进自主和自我调节动机的策略,以增强家庭在无需健康专业人员支持的情况下维持行为改变的信心。