Albright Charlotte A, Pratt Keeley J, Martin Sarah B, Hulshult Hannah, Brown Callie L, Lewis Kristina H, Skelton Joseph A
Wake Forest School of Medicine, Winston-Salem, North Carolina.
Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio.
Clin Obes. 2020 Apr;10(2):e12354. doi: 10.1111/cob.12354. Epub 2020 Jan 21.
Spouses are known to influence the outcomes of an individual's attempt at weight loss, but little is known about the broader influence of, and on, the family. The objectives were to explore: (a) the effects of an adult weight management program on the family and (b) family factors that help or hinder patient weight loss.
A qualitative design was employed to explore triadic family members' experiences of patient participation in a weight management program. Semi-structured interviews were conducted with patients, partners and children (ages 7-18). Questions included support for patient participation and weight loss, dietary choices, meal preparation, physical activity routines, the home-food environment, communication about health and family dynamics. Thematic analysis was used, where codes and categories of codes were then grouped together to create themes and subthemes.
Nineteen triadic interviews were conducted (57 total). Seven themes emerged, including four related to Outcomes (objective 1): (a) shift in family dynamics, (b) family behaviour change, (c) child observations of family change, (d) indirect benefit to partner; and three related to Process (objective 2): (e) level of accountability, (f) patient perception of support and (g) support is essential and flexible.
Future research and clinical applications from these themes should seek to determine the positive behaviour change that was evident in the families that were interviewed, where the culmination of family interactions, expectations and concurrent partner weight loss indicates the potential longevity of weight management programs beyond patients' own participation.
众所周知，配偶会影响个人减肥的效果，但对于家庭更广泛的影响以及家庭对减肥的影响却知之甚少。本研究的目的是探讨：（a）成人体重管理计划对家庭的影响，以及（b）有助于或阻碍患者减肥的家庭因素。
采用定性设计，以探究家庭成员三方对患者参与体重管理计划的体验。对患者、配偶和儿童（7至18岁）进行了半结构化访谈。问题包括对患者参与和减肥的支持、饮食选择、膳食准备、体育活动习惯、家庭食物环境、关于健康的沟通以及家庭动态。采用主题分析法，将代码和代码类别分组以创建主题和子主题。
共进行了19次三方访谈（总计57人）。出现了七个主题，其中四个与结果（目标1）相关：（a）家庭动态的转变，（b）家庭行为的改变，（c）孩子对家庭变化的观察，（d）对配偶的间接益处；三个与过程（目标2）相关：（e）问责程度，（f）患者对支持的感知，以及（g）支持至关重要且灵活。
基于这些主题的未来研究和临床应用应致力于确定在接受访谈的家庭中明显出现的积极行为变化，在这些家庭中，家庭互动、期望以及配偶同时减肥的结果表明体重管理计划在患者自身参与之外可能具有长期效果。
