Cultural Considerations in the Development of Pediatric Weight Management Interventions

Abstract Background: Multi-sector stakeholder engagement is essential in understanding what is needed for the implementation, dissemination and sustainability of pediatric weight management interventions (PWMI).Methods: We sought to examine the perspectives of stakeholders during the pre-implementation period of a two-arm, PWMI randomized controlled trial (RCT) in federally qualified health centers and YMCAs. We conducted the interviews prior to the implementation of the RCT and reached thematic saturation. Interviews were transcribed and coded using the Consolidated Framework for Implementation Research (CFIR) approach as the intent of the trial was to observe implementation and efficacy outcomes. Our aims were (1) to understand the core components needed for a successful PWMI and (2) to identify determinants and barriers to implementation and future wide-scale dissemination. We conducted the interviews prior to the implementation of the RCT and reached thematic saturation after interviewing 26 stakeholders representing 13 groups. Interviews were transcribed and coded using the framework analysis approach.Results and discussion: We identified themes that stakeholders perceived as core components of a PWMI: a formal curriculum with illustrative examples for patients (i.e. demonstrating how much sugar is in sugary beverages), a patient and family centered program, group visits, and inclusion of high-quality core personnel such as a community health worker, a physician, a behavior health clinician and a dietitian. Determinants of successful implementation and dissemination included partnerships among community and clinical organizations, sustained funding, supportive policies such as insurance reimbursement for community health workers and dietitians, and identifying and addressing needs of dissemination sites, and identifying and addressing patient barriers. These findings helped to identify the core components required for PWMIs and how best to address key determinants affecting implementation and dissemination. Trial registration: ClinicalTrials.gov: NCT03012126; registration date: 12 December 2016, https://clinicaltrials.gov/ct2/show/NCT03012126

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Predictors of Attendance in a Practical Clinical Trial of Two Pediatric Weight Management Interventions

Obesity ◽

10.1038/oby.2012.96 ◽

2012 ◽

Vol 20 (11) ◽

pp. 2250-2256 ◽

Cited By ~ 28

Author(s):

Chad D. Jensen ◽

Brandon S. Aylward ◽

Ric G. Steele

Keyword(s):

Clinical Trial ◽

Weight Management ◽

Management Interventions ◽

Pediatric Weight Management

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Unmet Social Needs and Adherence to Pediatric Weight Management Interventions: Massachusetts, 2017–2019

American Journal of Public Health ◽

10.2105/ajph.2020.305772 ◽

2020 ◽

Vol 110 (S2) ◽

pp. S251-S257 ◽

Cited By ~ 1

Author(s):

Micaela Atkins ◽

Ines Castro ◽

Mona Sharifi ◽

Meghan Perkins ◽

Giselle O’Connor ◽

...

Keyword(s):

Weight Management ◽

Parental Stress ◽

Social Needs ◽

Management Intervention ◽

Management Interventions ◽

Contact Hours ◽

Intervention Adherence ◽

Pediatric Weight Management ◽

Weight Management Intervention ◽

Child Age

Objectives. To examine effects of unmet social needs on adherence to pediatric weight management intervention (PWMI). Methods. We examined individual associations of positive screens for parental stress, parental depression, food insecurity, and housing insecurity with intervention adherence, and associations of 0, 1 or 2, and 3 or 4 unmet social needs with adherence, among children enrolled in a 2017–2019 comparative effectiveness trial for 2 high-intensity PWMIs in Massachusetts. Models were adjusted for child age, body mass index (BMI), parent BMI, and intervention arm. Results. Families with versus without housing insecurity received a mean of 5.3 (SD = 8.0) versus 8.3 (SD = 10.9) contact hours (P < .01). There were no statistically significant differences in adherence for families reporting other unmet social needs. Children with 3 to 4 unmet social needs versus without received a mean of 5.2 (SD = 8.1) versus 9.2 (SD = 11.8) contact hours (P < .01). In fully adjusted models, those with housing insecurity attended a mean difference of −3.14 (95% confidence interval [CI] = −5.41, −0.88) hours versus those without. Those with 3 or 4 unmet social needs attended −3.74 (95% CI = –6.64, −0.84) hours less than those with none. Conclusions. Adherence to PWMIs was lower among children with housing insecurity and in families with 3 or 4 unmet social needs. Addressing social needs should be a priority of PWMIs to improve intervention adherence and reduce disparities in childhood obesity. Trial Registration: ClinicalTrials.gov identifier: NCT03012126.

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Barriers Related to Delivering Pediatric Weight Management Interventions to Children and Families From Rural Communities

Children s Health Care ◽

10.1080/02739615.2013.816596 ◽

2013 ◽

Vol 42 (3) ◽

pp. 214-230 ◽

Cited By ~ 10

Author(s):

Crystal S. Lim ◽

David M. Janicke

Keyword(s):

Rural Communities ◽

Weight Management ◽

Children And Families ◽

Management Interventions ◽

Pediatric Weight Management

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Feedback Following a Family-Focused Pediatric Weight Management Intervention: Experiences From the New Impact Program

Journal of Patient Experience ◽

10.1177/23743735211008309 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110083

Author(s):

Kerry K Sease ◽

Laura J Rolke ◽

Jacqueline E Forrester ◽

Sarah F Griffin

Keyword(s):

Weight Management ◽

Readiness To Change ◽

Self Determination Theory ◽

Management Program ◽

Healthy Behaviors ◽

Management Intervention ◽

Telephone Interviews ◽

Management Interventions ◽

Included Patient ◽

Pediatric Weight Management

Weight management interventions have the potential to reduce body mass index and help families adopt healthier behaviors. This study examined feedback from families to identify central aspects of various intervention strategies based on self-determination theory constructs that have the strongest influence on patient success, with the aim of understanding how best to approach weight management in a clinical pediatric setting. Telephone interviews were conducted with 22 individuals (20 parents/guardians and 2 teenagers) who participated in a multidisciplinary weight management program and data was analyzed using inductive and deductive thematic analysis processes. Participants identified motivational interviewing strategies that were most influential to their success. Parents and patient’s identified barriers and facilitators to success included patient readiness to change, personal logistics, family engagement, and establishing long- and short-term goals. Successful pediatric obesity management requires consideration to both the patient and family’s readiness, structured implementation adaptations to address barriers, intentional efforts to move from external reward to internal motivation, and strategies to ensure families develop self-efficacy toward achievable healthy behaviors.

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