Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, WA 98145, USA.
J Public Health Manag Pract. 2013 Jul-Aug;19(4):E1-E10. doi: 10.1097/PHH.0b013e31825ceaf9.
Successful obesity intervention efforts depend on effective recruitment and retention, an ongoing challenge for community-based programs.
We sought to provide insights into the most salient factors affecting family enrollment and retention in community-based programs for overweight youth and their families. We especially sought to understand potentially modifiable program factors affecting participation.
: We conducted semistructured, in-depth, face-to-face interviews with parents of overweight children within 1 year of referral to a public health grant-funded community-based healthy lifestyle promotion program. Purposeful sampling was used to select participants across program sites, by level of program completion, and child age and sex. Transcribed interviews were coded independently by 2 staff with a structured codebook and then analyzed by themes through an iterative process using Atlas.ti. The Integrative Model of Behavior served as an orienting theoretical framework.
Community-based child obesity intervention program in King County, Washington.
Twenty-three parents from diverse socioeconomic backgrounds were interviewed, of which 10 completed the program, 9 did not complete, and 4 did not enroll.
MAIN OUTCOME MEASURE(S): Parent-reported factors related to enrollment and retention.
Key parent reasons for program enrollment included: (a) addressing both eating and activity, (b) concern about child's weight, (c) seeking help outside the family, and (d) structured parent-child time. Parents perceived a lack of child motivation to enroll; some youth initially opposed attending, which was overcome through positive program experience. All families described barriers to attending, and some identified specific strategies or skills they used to overcome barriers. No single program design emerged to address every family's needs. Instead, using the themes of accessibility and accountability, we present parent- recommended design options.
To meet different families' needs, public health and health care agencies offering youth health promotion programs should consider providing program options that vary intensity level and weight loss emphasis.
成功的肥胖干预措施依赖于有效的招募和保留，这是社区为基础项目的一个持续挑战。
我们旨在提供对影响超重青少年及其家庭参与社区为基础项目的最相关因素的深入了解。我们特别希望了解可能影响参与的可修改的项目因素。
我们对刚被推荐参加公共卫生资助的社区健康生活方式促进项目的超重儿童的家长进行了半结构式、深入的、面对面访谈。通过方案地点、方案完成程度、孩子年龄和性别，采用目的抽样选择参与者。由 2 名工作人员对转录的访谈进行独立编码，并使用 Atlas.ti 通过迭代过程按照主题进行分析。行为综合模型是一个导向性理论框架。
华盛顿州金县的社区为基础的儿童肥胖干预项目。
23 名来自不同社会经济背景的家长接受了访谈，其中 10 名完成了方案，9 名未完成，4 名未入组。
与入组和保留相关的家长报告因素。
家长参加方案的主要原因包括：（a）同时解决饮食和活动问题，（b）关注孩子的体重，（c）寻求家庭以外的帮助，以及（d）安排有父母和孩子共同参与的时间。家长认为孩子缺乏参加的动力；一些孩子最初反对参加，但是通过积极的项目体验克服了这一点。所有家庭都描述了参加的障碍，一些家庭还确定了他们用来克服障碍的特定策略或技能。没有单一的方案设计可以满足每个家庭的需求。相反，我们根据可及性和问责制的主题，提出了家长推荐的设计方案。
为了满足不同家庭的需求，提供青少年健康促进项目的公共卫生和医疗保健机构应该考虑提供不同强度水平和减肥重点的方案选择。
