title: Factors influencing healthy lifestyle changes: a qualitative look at low-income families engaged in treatment for overweight children.
abstract: BACKGROUND
  Childhood obesity disproportionately affects low-income minority populations, yet there is a paucity of literature about effective interventions in this population. This study sought to understand the experience of low-income majority Hispanic families engaged in obesity treatment.
  
  
  METHODS
  We conducted six focus groups (2=English, 4=Spanish) with families who completed a community-based, family-oriented obesity treatment program, using standard qualitative focus group interview methods. Transcripts were recorded, transcribed, and analyzed for thematic content. Two coders using the software program ATLAS.ti (v.7.0; Scientific Software Development GmbH, Berlin, Germany) coded each transcript independently; reflexive team analysis with three study team members was used to reach a consensus.
  
  
  RESULTS
  Participants (n=37) indicated high program satisfaction. Parents reported buying less junk/fast food, increased consumption of fruits and vegetables, preparing and eating more meals as a family, and increasing their families' physical activity (PA). Four barrier and facilitator themes emerged. Barrier themes were time and financial cost, parent's lack of time and energy, influence of family members, and challenges regarding physical environment. Facilitator themes were skill building around healthy eating and parenting, family involvement, and long-term health concerns. Unanticipated findings, parents reported, were that changes resulted in children sleeping better, feeling happier, and less irritability.
  
  
  CONCLUSIONS
  Despite low-income families experiencing barriers to lifestyle changes to manage obesity, they made positive dietary changes and increased PA by learning specific skills and including the whole family in those changes. Additionally, some unexpected benefits were noted, including improved sleep, less irritability, and children appearing happier. Future studies should consider using these parent-identified outcomes as secondary measures of program effectiveness.
authors.affiliation: 1 Children's Outcomes Research Program, The Children's Hospital , Aurora, CO.
authors.forename: Rochelle
authors.initials: R
authors.lastname: Cason-Wilkerson
authors.forename: Shauna
authors.initials: S
authors.lastname: Goldberg
authors.forename: Karen
authors.initials: K
authors.lastname: Albright
authors.forename: Mandy
authors.initials: M
authors.lastname: Allison
authors.forename: Matthew
authors.initials: M
authors.lastname: Haemer
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration*; D015444:Exercise / Q000523:psychology*; D005196:Family Therapy; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009042:Motivation; D016487:Parenting; D010290:Parents / Q000193:education / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D063766:Pediatric Obesity / Q000191:economics / Q000517:prevention & control* / Q000523:psychology; D011203:Poverty; D036301:Qualitative Research; D014481:United States / Q000453:epidemiology