Barriers and facilitators of pediatric weight management among diverse families.
OBJECTIVE
To describe barriers and facilitators relevant to pediatric weight management from the perspective of at-risk overweight children and families.


METHODS
Systematic thematic analysis of semistructured interviews with overweight children and families from diverse backgrounds at a large, urban academic pediatrics practice.


RESULTS
Twenty-five parents and their children ages 2 to 18 years with mean body mass index percentile of 96th% (standard deviation 4.3) participated. Fifty-six percent were Black; 40% were Hispanic/Other race. Perceived barriers to successful weight management included (a) inadequate resources (financial, time, access to programming, knowledge), (b) challenging social contexts (cultural practices and expectations, interpersonal dynamics), (c) negative emotional state (lack of confidence, defeat, loneliness), and (d) denial. Participants described linkages to resources, child-parent--provider partnerships, and consistent support as key elements in successful weight management. Participants also endorsed technology use for weight management support.


CONCLUSIONS
Multiple barriers and facilitators affect weight management among at-risk families, which should be considered in future obesity interventions.
New York University School of Medicine, New York, NY, USA Harvard University School of Public Health, Boston, MA, USA Lauren.E.Brown@mail.harvard.edu.
Lauren
L
Brown
Harvard Medical School, Boston, MA, USA.
Sarah-Bianca
SB
Dolisca
Harvard Medical School, Boston, MA, USA Boston Children's Hospital, Boston, MA, USA.
Jennifer K
JK
Cheng
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003469:Culture; D005190:Family; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010290:Parents; D063766:Pediatric Obesity / Q000628:therapy*; D010372:Pediatrics
barriers; facilitators; health-coaching; obesity; pediatric; qualitative research