title: "It's a balance of just getting things right": mothers' views about pre-school childhood obesity and obesity prevention in Scotland.
abstract: BACKGROUND
  The high prevalence of childhood obesity is a concern for policy makers and health professionals, leading to a focus on early prevention. The beliefs and perspectives of parents about early childhood obesity, and their views and opinions about the need for weight management interventions for this age group are poorly understood.
  
  
  METHODS
  A formative qualitative focus group study with parents of pre-school children took place in eight community-based locations throughout North-East Scotland to explore their ideas about the causes of early childhood obesity, personal experiences of effective weight management strategies, and views about the format and content of a possible child-orientated weight management programme. Study participants were recruited via pre-school nurseries.
  
  
  RESULTS
  Thirty-four mothers (median age 37 years) took part in the study, but only two believed their child had a weight problem. Participants (who focussed primarily on dietary issues) expressed a strong sense of personal responsibility to 'get the balance right' regarding their child's weight, and were generally resistant to the idea of attending a weight management programme aimed at very young children. At the same time, they described a range of challenges to their weight management intentions. These included dealing with intrinsic uncertainties such as knowing when to stop 'demand feeding' for weight gain, and judging appropriate portion sizes - for themselves and their children. In addition they faced a range of extrinsic challenges associated with complex family life, i.e. catering to differing family members dietary needs, food preferences, practices and values, and keeping their 'family food rules' (associated with weight management) when tired or pressed for time.
  
  
  CONCLUSIONS
  The findings have important implications for health professionals and policy makers wishing to engage with parents on this issue, or who are currently developing 'family-centred' early childhood weight management interventions. The challenge lies in the fact that mothers believe themselves to be the primary (and capable) agents of obesity prevention in the early years - but, who are at the same time, attempting to deal with many mixed and conflicting messages and pressures emanating from their social and cultural environments that may be undermining their weight management intentions.
authors.affiliation: Public Health Nutrition Research Group, Rowett Institute of Health and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK. f.douglas@abdn.ac.uk.
authors.forename: Flora
authors.initials: F
authors.lastname: Douglas
authors.forename: Julia
authors.initials: J
authors.lastname: Clark
authors.forename: Leone
authors.initials: L
authors.lastname: Craig
authors.forename: Jonina
authors.initials: J
authors.lastname: Campbell
authors.forename: Geraldine
authors.initials: G
authors.lastname: McNeill
mesh_terms: D000328:Adult; D001835:Body Weight; D002675:Child, Preschool; D004032:Diet; D004777:Environment; D005260:Female; D017144:Focus Groups; D005518:Food Preferences; D006801:Humans; D009035:Mothers / Q000523:psychology*; D016487:Parenting; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000517:prevention & control*; D036301:Qualitative Research; D012606:Scotland / Q000453:epidemiology; D012931:Social Environment; D012959:Socioeconomic Factors; D015430:Weight Gain