What do children, parents and staff think about a healthy lifestyles intervention delivered in primary schools? a qualitative study

ObjectivePrimary schools are crucial settings for early weight management interventions but effects on children’s weight are small and evidence shows that deficiencies in intervention implementation may be responsible. Very little is known about the roles of multiple stakeholders in the process of implementation. We used a multiple-stakeholder qualitative research approach to explore the implementation of an intervention developed to improve the diet and increase the levels of physical activity for children living in some of the most deprived areas of England.DesignFor this qualitative study, interviews and focus groups were carried out using semi-structured topic guides. Data were analysed thematically.SettingSeven primary schools (pupils aged 4 to 11) in Manchester, England.ParticipantsWe conducted 14 focus groups with children aged 5 to 10 years and interviews with 19 staff members and 17 parents.InterventionManchester Healthy Schools (MHS) is a multicomponent intervention, developed to improve diet and physical activity in schools with the aim of reducing and preventing childhood obesity.ResultsThree themes were developed from the data: common understandings of health and health behaviours; congruence and consistency of messages; negotiations of responsibility.ConclusionAll participant groups had a common conceptualisation of health as having physical and psychological components and that action could be taken in childhood to change behaviours that protect long-term health. When parents and staff felt a shared sense of responsibility for children’s health and levels of congruence between home and school norms around diet and physical activity were high, parents and children were more likely to accept the policies implemented as part of MHS. Effective two-way communication between home and school is therefore vital for successful implementation of this intervention.

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Design and Development of a Digital Weight Management Intervention (ToDAy): Qualitative Study

JMIR mhealth and uhealth ◽

10.2196/17919 ◽

2020 ◽

Vol 8 (9) ◽

pp. e17919

Author(s):

Charlene L Shoneye ◽

Barbara Mullan ◽

Andrea Begley ◽

Christina M Pollard ◽

Jonine Jancey ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Qualitative Study ◽

Focus Groups ◽

Weight Management ◽

Self Monitoring ◽

Management Intervention ◽

Monitoring Tools ◽

Diet And Physical Activity ◽

Weight Management Intervention

Background The Tailored Diet and Activity (ToDAy) study aims to build on the campaign by adding a digital intervention with the potential to provide wide-reaching, cost-effective weight management support. Objective The ToDAy study aims to build a tailored intervention using mobile technology to improve diet and physical activity behaviours in adults with overweight and obesity. The main objectives were to identify behavior change techniques for diet and physical activity (PA) change for weight loss and explore preferences for digital intervention features that would be effective in changing diet and PA behaviors. Methods This qualitative study uses the principles of a person-based approach to intervention development; the behavioral intervention technology framework; and the capability, opportunity, motivation, and behavior (COM-B) framework. Focus groups and telephone interviews were conducted with 56 adults in Western Australia. Open-ended questions and example intervention features were used to explore the usability and acceptability of the self-monitoring tools, knowledge about effective weight-loss strategies, and acceptability of tailored feedback. Findings from the focus groups and interviews were analyzed using thematic analysis. Results Qualitative findings revealed an awareness of key public health messages but a lack of confidence in how to perform these behaviors to help manage their weight. A total of 4 major themes were identified and mapped to the domains of the COM-B framework: (1) misinformation, (2) environmental support, (3) social norms, and (4) confidence. Conclusions This study explores users’ capability, opportunity, and motivation to perform the target behaviors for weight loss. The findings suggested that a digital weight management intervention using a mobile food record and activity trackers to inform tailored feedback may be acceptable and feasible. Participants expressed a preference for simple expert advice, digital self-monitoring tools, and visual feedback. International Registered Report Identifier (IRRID) RR2-10.2196/12782

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Design and Development of a Digital Weight Management Intervention (ToDAy): Qualitative Study (Preprint)

10.2196/preprints.17919 ◽

2020 ◽

Author(s):

Charlene L Shoneye ◽

Barbara Mullan ◽

Andrea Begley ◽

Christina M Pollard ◽

Jonine Jancey ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Qualitative Study ◽

Focus Groups ◽

Weight Management ◽

Self Monitoring ◽

Management Intervention ◽

Monitoring Tools ◽

Diet And Physical Activity ◽

Weight Management Intervention

BACKGROUND The Tailored Diet and Activity (ToDAy) study aims to build on the campaign by adding a digital intervention with the potential to provide wide-reaching, cost-effective weight management support. OBJECTIVE The ToDAy study aims to build a tailored intervention using mobile technology to improve diet and physical activity behaviours in adults with overweight and obesity. The main objectives were to identify behavior change techniques for diet and physical activity (PA) change for weight loss and explore preferences for digital intervention features that would be effective in changing diet and PA behaviors. METHODS This qualitative study uses the principles of a person-based approach to intervention development; the behavioral intervention technology framework; and the capability, opportunity, motivation, and behavior (COM-B) framework. Focus groups and telephone interviews were conducted with 56 adults in Western Australia. Open-ended questions and example intervention features were used to explore the usability and acceptability of the self-monitoring tools, knowledge about effective weight-loss strategies, and acceptability of tailored feedback. Findings from the focus groups and interviews were analyzed using thematic analysis. RESULTS Qualitative findings revealed an awareness of key public health messages but a lack of confidence in how to perform these behaviors to help manage their weight. A total of 4 major themes were identified and mapped to the domains of the COM-B framework: (1) misinformation, (2) environmental support, (3) social norms, and (4) confidence. CONCLUSIONS This study explores users’ capability, opportunity, and motivation to perform the target behaviors for weight loss. The findings suggested that a digital weight management intervention using a mobile food record and activity trackers to inform tailored feedback may be acceptable and feasible. Participants expressed a preference for simple expert advice, digital self-monitoring tools, and visual feedback. INTERNATIONAL REGISTERED REPORT RR2-10.2196/12782

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Perceptions and Barriers to Physical Activity in Childhood and Adulthood Among Latinas

Health Behavior and Policy Review ◽

10.14485/hbpr.8.4.2 ◽

2021 ◽

Vol 8 (4) ◽

Author(s):

Rosenda Murillo ◽

Mariana Vazquez ◽

Isabel Leal ◽

Daphne Hernandez ◽

Qian Lu ◽

...

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Focus Groups ◽

Thematic Analysis ◽

Structured Interview ◽

Individual Interview ◽

Latina Women ◽

The Us ◽

Promotion Of Physical Activity ◽

Barriers To Physical Activity

Objective: The purpose of this qualitative study was to identify perceptions and barriers to physical activity in childhood and adulthood among Latina adults. Methods: We conducted 3 focus groups, 2 dyadic interviews, and an individual interview using semi-structured interview guides with 23 Latina women aged 21-35. A thematic analysis approach employing inductive and deductive coding was utilized to code, categorize, and summarize data into themes. Results: The themes that emerged focused on: (1) physical activity is enjoyable; (2) family influenced physical activity; (3) different lifestyle in the US influenced physical activity; (4) physical activity is important for health; and (5) responsibilities (eg, work, caregiving) as barriers to physical activity in adulthood. Conclusions: Perceptions and barriers to physical activity experienced in both childhood and adulthood should be considered in the promotion of physical activity among Latinas.

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Navigating the online world of lifestyle health information: an adolescent perspective (Preprint)

10.2196/preprints.35165 ◽

2021 ◽

Author(s):

Rebecca Raeside ◽

Si Si Jia ◽

Julie Redfern ◽

Stephanie R Partridge

Keyword(s):

Physical Activity ◽

Social Media ◽

Focus Groups ◽

Health Information ◽

Life Stage ◽

Health Behaviours ◽

Activity Levels ◽

Digital Platforms ◽

Virtual Focus Groups ◽

Online Lifestyle

BACKGROUND Adolescence is a critical life stage characterised by an interplay of biological, social and environmental factors. Such factors influence lifestyle health related trajectories, including dietary behaviours, physical activity levels, body weight and sleep hygiene. Generation Z (born 1995-2015) are the most internet-dependent and technologically savvy generation in history with increasing rates of smartphone ownership in both developed and developing nations. Gaps exist in our understanding of what online platforms adolescents are using and the barriers and facilitators of these platforms to seek lifestyle health information. OBJECTIVE We evaluated adolescents’ perceptions on the use of contemporary digital platforms (websites, social media platforms and smartphone apps) to seek information or advice related to lifestyle heath. METHODS Virtual focus groups were held via Zoom teleconference between July to August 2021. Eligible participants were 13-18 years, living in Australia and had searched for online lifestyle health information in the previous three months. For this study, lifestyle health information referred to key behaviours and risk factors for chronic disease, namely, diet, physical activity, weight management and sleep. Participants were recruited through an existing database of research participants and networks of the research team. Focus groups were analysed using the Framework approach, where data is systematically searched to recognize patterns in the data and manage, analyse and identify themes. Focus group audio files were transcribed verbatim and independently coded by two researchers (RR, SJ). Through an iterative and reflexive process, a final coding matrix was agreed on by all researchers and used to thematically analyse the data. RESULTS Five focus groups were held (n=32, mean age 16.3(1.4), 18/32, 56% female, 13/32, 41% spoke language other than English at home). Thematic analysis revealed participants searched for information both actively (e.g., on Google or YouTube) and passively (e.g., scrolling social media and using existing apps preloaded to their smartphone such as Apple ‘Health’, Samsung ‘Health’ or ‘Google Fit’ apps). Participants identified that the most helpful information was well-organised in terms of aesthetic appeal and layout, came from a credible and reliable source (e.g. any sponsorships disclosed) and expressed the need for the information to be relatable. Mixed views were reported for the application of lifestyle health information found online. Some participants reported behaviour change, while others noted that certain advice was hard to maintain and incorporate into their lifestyle. CONCLUSIONS This study highlights the abundance and complexity of lifestyle health information online for adolescents. Adolescents in the digital age seek access to information that is appealing, credible, relevant and actionable for lifestyle health behaviours. To appeal to the needs of adolescents, future interventions for adolescents relating to lifestyle health must consider co-design methodological approaches. Furthermore, the regulation of lifestyle health information available online warrants further investigation.

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Influences on diet and physical activity choices of 11–13-year-olds in a school setting

Health Education Journal ◽

10.1177/0017896919826606 ◽

2019 ◽

Vol 78 (5) ◽

pp. 545-556 ◽

Cited By ~ 2

Author(s):

Camilla A McHugh ◽

Lindsey Anderson ◽

Jenny Lloyd ◽

Stuart Logan ◽

Katrina Wyatt

Keyword(s):

Physical Activity ◽

Focus Groups ◽

School Environment ◽

Food Choices ◽

Future Research ◽

Framework Analysis ◽

Future Health ◽

Diet And Physical Activity ◽

Activity Choices ◽

The Impact

Objective: This paper uses a qualitative approach to explore the factors that influence diet and physical activity choices of 11–13-year-olds with a particular focus on the impact of the school environment. Design: Qualitative focus groups. Setting: Three purposively sampled secondary schools in Devon, UK. Method: A total of 53 students, aged 11–13, took part in six focus groups. Thematic, framework analysis was used to analyse the data. Result: Four overarching themes emerged: (1) health now and in the future; (2) the role of others; (3) provision, temptation and addiction; and (4) boundaries, strategies and support. Participants demonstrated good knowledge of what constitutes a healthy lifestyle and its importance for future health, although it was not necessarily seen as a priority at this stage of life. Key influences on their choices were their peers and family, although participants also identified that the school environment influences the food choices they make while there. Conclusion: In this study, 11–13-year-olds identified that schools could do more to support them to make healthier food choices. However, future research needs to understand the constraints schools face in terms of food provision in order to highlight possible opportunities for intervention.

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How young children learn independent asthma self-management: a qualitative study in Malaysia

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-318127 ◽

2020 ◽

Vol 105 (9) ◽

pp. 819-824

Author(s):

Siti Nurkamilla Ramdzan ◽

Ee Ming Khoo ◽

Su May Liew ◽

Steven Cunningham ◽

Marilyn Kendall ◽

...

Keyword(s):

Qualitative Study ◽

Focus Groups ◽

Primary Schools ◽

Health Centre ◽

Smooth Transition ◽

Self Management ◽

Theory Approach ◽

Individual Interviews ◽

National Medical ◽

Children With Asthma

ObjectiveWe aimed to explore the views of Malaysian children with asthma and their parents to enhance understanding of early influences on development of self-management skills.DesignThis is a qualitative study conducted among children with asthma and their parents. We used purposive sampling and conducted focus groups and interviews using a semi-structured topic guide in the participants’ preferred language. All interviews were audio-recorded, transcribed verbatim, entered into NVivo and analysed using a grounded theory approach.SettingsWe identified children aged 7–12 years with parent-reported, physician-diagnosed asthma from seven suburban primary schools in Malaysia. Focus groups and interviews were conducted either at schools or a health centre.ResultsNinety-nine participants (46 caregivers, 53 children) contributed to 24 focus groups and 6 individual interviews. Children mirrored their parents’ management of asthma but, in parallel, learnt and gained confidence to independently self-manage asthma from their own experiences and self-experimentation. Increasing independence was more apparent in children aged 10 years and above. Cultural norms and beliefs influenced children’s independence to self-manage asthma either directly or indirectly through their social network. External influences, for example, support from school and healthcare, also played a role in the transition.ConclusionChildren learnt the skills to self-manage asthma as early as 7 years old with growing independence from the age of 10 years. Healthcare professionals should use child-centred approach and involve schools to facilitate asthma self-management and support a smooth transition to independent self-management.Trial registration numberMalaysian National Medical Research Register (NMRR-15-1242-26898).

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Perceptions of eating practices and physical activity among Malaysian adolescents in secondary schools: a qualitative study with multi-stakeholders

Public Health Nutrition ◽

10.1017/s1368980020002293 ◽

2020 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Shooka Mohammadi ◽

Tin Tin Su ◽

Angeliki Papadaki ◽

Muhammad Yazid Jalaludin ◽

Maznah Dahlui ◽

...

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Secondary Schools ◽

Focus Groups ◽

Healthy Eating ◽

Rural Schools ◽

School Based ◽

Adolescent Participation ◽

Depth Interviews ◽

Malaysian Adolescents

Abstract Objective: To conduct formative research using qualitative methods among stakeholders of secondary schools to explore their perceptions, barriers and facilitators related to healthy eating and physical activity (PA) among Malaysian adolescents. Design: A qualitative study involving eight focus groups and twelve in-depth interviews. Focus groups and interviews were recorded and transcribed verbatim. An inductive thematic analysis approach was used to analyse the data. Setting: Four secondary schools in Perak and Selangor states (two urban and two rural schools) in Malaysia. Participants: Focus groups were conducted with seventy-six adolescents aged 13–14 years, and in-depth interviews were conducted with four headmasters, four PA education teachers and four food canteen operators. Results: Stakeholders thought that adolescents’ misperceptions, limited availability of healthy options, unhealthy food preferences and affordability were important challenges preventing healthy eating at school. Low-quality physical education (PE) classes, limited adolescent participation and teachers’ commitment during lessons were perceived as barriers to adolescents being active at school. Affordability was the main challenge for adolescents from rural schools. Stakeholders perceived that a future school-based intervention should improve the availability and subsidies for healthy foods, provide health education/training for both adolescents and PE teachers, enhance active adolescent participation in PE and develop social support mechanisms to facilitate engagement with PA. Conclusions: These findings provide important insights into developing school-based lifestyle interventions to improve healthy eating and strengthening PA of Malaysian adolescents.

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Adolescent diet and physical activity in the context of economic, social and nutrition transition in rural Maharashtra, India: a qualitative study

Public Health Nutrition ◽

10.1017/s1368980020002220 ◽

2020 ◽

pp. 1-10

Author(s):

Kejal Joshi-Reddy ◽

Veena Kamble ◽

Pooja Kunte ◽

Polly Hardy-Johnson ◽

Caroline HD Fall ◽

...

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Digital Media ◽

Parental Influence ◽

Activity Patterns ◽

Nutrition Transition ◽

Dietary Behaviour ◽

Household Food Security ◽

Adolescent Diet ◽

Diet And Physical Activity

Abstract Objective: To explore the perceptions of adolescents and their caregivers on drivers of diet and physical activity in rural India in the context of ongoing economic, social and nutrition transition. Design: A qualitative study comprising eight focus group discussions (FGD) on factors affecting eating and physical activity patterns, perceptions of health and decision-making on food preparation. Setting: Villages approximately 40–60 km from the city of Pune in the state of Maharashtra, India. Participants: Two FGD with adolescents aged 10–12 years (n 20), two with 15- to 17- year-olds (n 18) and four with their mothers (n 38). Results: Dietary behaviour and physical activity of adolescents were perceived to be influenced by individual and interpersonal factors including adolescent autonomy, parental influence and negotiations between adolescents and caregivers. The home food environment, street food availability, household food security and exposure to television and digital media were described as influencing behaviour. The lack of facilities and infrastructure was regarded as barriers to physical activity as were insufficient resources for public transport, safe routes for walking and need for cycles, particularly for girls. It was suggested that schools take a lead role in providing healthy foods and that governments invest in facilities for physical activity. Conclusions: In this transitioning environment, that is representative of many parts of India and other Lower Middle Income Countries (LMIC), people perceive a need for interventions to improve adolescent diet and physical activity. Caregivers clearly felt that they had a stake in adolescent health, and so we would recommend the involvement of both adolescents and caregivers in intervention design.

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Physical activity in paid work time for desk-based employees: a qualitative study of employers’ and employees’ perspectives

10.21203/rs.2.13936/v3 ◽

2020 ◽

Author(s):

Gemma Ryde ◽

Patricia Atkinson ◽

Martine Stead ◽

Trish Gorely ◽

Josie Evans

Keyword(s):

Mental Health ◽

Physical Activity ◽

Qualitative Study ◽

Focus Groups ◽

Work Performance ◽

Performance Outcomes ◽

Paid Work ◽

Physical And Mental Health ◽

Work Time ◽

High Workload

Abstract Background: Poor physical and mental health of employees create significant problems in the workplace. Physical activity (PA) has been shown as an effective strategy for preventing and treating numerous physical and mental health issues as well as work performance outcomes. However, there are many barriers to taking part in PA (such as lack of time) with participation rates typically low. Providing PA in paid work time might be a way to overcome these issues, yet employers’ and employees’ opinions of this concept are unknown. The aim of this study was to explore employee and employer perspectives of PA in paid work time. Methods: Workplaces were recruited through existing contacts on the research team. Focus groups and interviews were conducted with employees and managers at one University and two executive non-departmental public bodies in central Scotland with mainly desk-based employees. Both managers and employees were involved to gain perspectives throughout the organisational hierarchy and were interviewed separately to reduce social desirably bias. All discussions were digitally recorded and transcribed verbatim. Data were analysed thematically for both managers and employees but due to significant overlap in themes between the groups, these are reported together in the results.Results: Three out of five organisations approached took part in this qualitative study. Two individual interviews were held with strategic managers, five focus groups with middle managers (n=16) and nine with employees (n=45). Benefits were anticipated by managers and employees for both employees themselves and the organisation and included improved mental health, productivity and more favourable perceptions of the employer. Despite these widely acknowledged benefits, significant barriers were identified and included the structure and nature of the working day (high workload, front line job requirements), workplace culture and norms (resentment from colleagues, no break culture) and organisational concerns (cost of lost time, public perceptions). Conclusion: This study suggests that there are significant barriers to PA in paid work time. Whilst numerous anticipated benefits were conveyed by both employees and managers, PA in paid work time is unlikely to become common place until changes in attitudes and the culture towards movement at work occur.

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