title: Parent and child perceptions of school-based obesity prevention in England: a qualitative study.
abstract: BACKGROUND
  Schools are key settings for childhood obesity prevention, and the location for many intervention studies. This qualitative study aims to explore parent and child experiences of the WAVES study obesity prevention intervention, in order to gain understanding of the mechanisms by which the intervention results in behaviour change, and provide context to support interpretation of the main trial results.
  
  
  METHODS
  Focus groups were held with 30 parents and 62 children (aged 6-7 years) from primary schools in the West Midlands, UK. Data analysis (conducted using NVivo 10) was guided by the Framework Approach.
  
  
  RESULTS
  Three over-arching themes were identified: 'Impact', 'Sustainability' and 'Responsibilities', under which sub-themes were determined. Participants were supportive of the school-based intervention. Parental involvement and the influential role of the teacher were seen as key ingredients for success in promoting consistent messages and empowering some parents to make positive behavioural changes at home. Parents recognised that whilst they held the primary responsibility for obesity prevention in their children, they faced a number of barriers to healthier lifestyles, and agreed that schools have an important role to play.
  
  
  CONCLUSIONS
  This study enabled us to better understand aspects of the WAVES study intervention programme that have the potential to initiate positive behaviour changes in families, and indicated that a combination of pathways influenced such changes. Pathways included: increasing capability through improving knowledge and skills of children and parents; increasing motivation through parental empowerment and role modelling; and the direct provision of opportunities to lead healthier lifestyles. Strategies to sustain behaviour changes, and the school role in supporting these, are important considerations.
authors.affiliation: Institute of Applied Health Research, Public Health building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. j.l.clarke@bham.ac.uk.
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Clarke
authors.affiliation: Institute of Applied Health Research, Public Health building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. t.l.griffin.1@bham.ac.uk.
authors.forename: Tania L
authors.initials: TL
authors.lastname: Griffin
authors.affiliation: Institute of Applied Health Research, Public Health building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. e.r.lancashire@bham.ac.uk.
authors.forename: Emma R
authors.initials: ER
authors.lastname: Lancashire
authors.affiliation: Institute of Applied Health Research, Public Health building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. p.adab@bham.ac.uk.
authors.forename: Peymane
authors.initials: P
authors.lastname: Adab
authors.affiliation: Institute of Applied Health Research, Public Health building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. j.m.parry.1@bham.ac.uk.
authors.forename: Jayne M
authors.initials: JM
authors.lastname: Parry
authors.affiliation: Institute of Applied Health Research, Public Health building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. m.j.pallan@bham.ac.uk.
authors.forename: Miranda J
authors.initials: MJ
authors.lastname: Pallan
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002648:Child; D004739:England; D005260:Female; D017144:Focus Groups; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D009042:Motivation; D016487:Parenting; D010290:Parents; D063766:Pediatric Obesity / Q000517:prevention & control*; D010465:Perception; D036301:Qualitative Research; D012572:School Health Services; D012574:Schools