Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden.
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
BMC Public Health. 2023 Apr 4;23(1):646. doi: 10.1186/s12889-023-15552-8.
The rise in overweight and obesity among children is a global problem and effective prevention interventions are urgently required. Parents play an important role in children's lifestyle behaviours and body weight development and therefore there is a great need to investigate how to involve parents effectively in health promotion and prevention programmes. The aim of the study was to describe parents' experiences of barriers and facilitators of participating in the Healthy School Start Plus (HSSP) intervention study.
HSSP is a parental support programme, conducted in Sweden, with the aim to promote a healthy diet, physical activity and preventing obesity in 5-7-year-old children starting school. In total 20 parents from 7 schools participated in semi-structured telephone-based interviews. The data was analysed using qualitative content analysis, with a deductive approach based on the Consolidated Framework for Implementation Research (CFIR).
Parental experiences of barriers and facilitators informing the implementation of the HSSP intervention were identified within all five domains of the CFIR. Two additional constructs, not included in the CFIR were identified: Social factors and Cooperation. The findings of parental experiences of barriers and facilitators related to the importance of (1) adaptation of the intervention to fit the abilities of the parents with different social and cultural backgrounds; (2) the need for continuous delivery of information related to healthy behaviours; (3) the commitment and efforts of the deliverers of the intervention; (4) the need for repetition of information related to healthy behaviours given by the deliverers of the intervention; (5) encouragement and facilitation of the involvement of the family and key people around them through the intervention activities and by the deliverers of the intervention; (6) awareness of unexpected impacts and social and cultural conditions complicating the execution of the intervention and; (7) cooperation and a well-functioning interaction between parents and school staff.
Barriers and facilitators indicated by the parents highlighted that interventions like the HSSP need to be adapted to fit the parents' abilities, with reminders, follow-ups and delivery of relevant information. Variations in social and cultural conditions need to be taken into consideration. The commitment of the school and the interaction between the school staff and the family as well as key people around them appears to be important.
The Healthy School Start Plus trial was retrospectively registered in the International Standard Randomised Controlled Trial Number Registry on January 4, 2018 and available online at ClinicalTrials.gov: No. NCT03390725.
儿童超重和肥胖问题日益严重，因此迫切需要有效的预防干预措施。父母在儿童生活方式行为和体重发育方面发挥着重要作用，因此，需要研究如何有效地让父母参与健康促进和预防计划。本研究旨在描述父母参与“健康学校启动加”（HSSP）干预研究的障碍和促进因素的经验。
HSSP 是一项在瑞典开展的父母支持计划，旨在促进 5-7 岁即将上学的儿童健康饮食、体育活动和预防肥胖。共有来自 7 所学校的 20 名家长参加了基于电话的半结构化访谈。数据采用基于整合实施研究框架（CFIR）的演绎法进行定性内容分析。
在 CFIR 的所有五个领域内，都确定了父母在实施 HSSP 干预方面的经验障碍和促进因素。还确定了两个未包含在 CFIR 中的附加结构：社会因素和合作。父母在经验障碍和促进因素方面的发现与以下几个方面有关：（1）适应父母的能力，父母具有不同的社会和文化背景；（2）需要不断提供与健康行为相关的信息；（3）干预提供者的承诺和努力；（4）需要重复干预提供者提供的与健康行为相关的信息；（5）通过干预活动以及干预提供者鼓励和促进家庭及其周围关键人员的参与；（6）意识到意外影响和使干预执行复杂化的社会和文化条件；（7）父母和学校工作人员之间的合作以及良好的互动。
父母提出的障碍和促进因素表明，像 HSSP 这样的干预措施需要适应父母的能力，需要提供提醒、跟进和相关信息。需要考虑社会和文化条件的差异。学校的承诺以及学校工作人员与家庭及其周围关键人员之间的互动似乎很重要。
健康学校启动加试验于 2018 年 1 月 4 日在国际标准随机对照试验编号注册库中进行了回顾性注册，可在 ClinicalTrials.gov 上在线获取：编号 NCT03390725。
