title: Why do families enrol in paediatric weight management? A parental perspective of reasons and facilitators.
abstract: BACKGROUND
  Few children with obesity who are referred for weight management end up enroled in treatment. Factors enabling enrolment are poorly understood. Our purpose was to explore reasons for and facilitators of enrolment in paediatric weight management from the parental perspective.
  
  
  METHODS
  Semi-structured interviews were conducted with parents of 10- to 17-year-olds who were referred to one of four Canadian weight management clinics and enroled in treatment. Interviews were audio-recorded and transcribed verbatim. Manifest/inductive content analysis was used to analyse the data, which included the frequency with which parents referred to reasons for and facilitators of enrolment.
  
  
  RESULTS
  In total, 65 parents were interviewed. Most had a child with a BMI ≥95th percentile (n = 59; 91%), were mothers (n = 55; 85%) and had completed some post-secondary education (n = 43; 66%). Reasons for enrolment were related to concerns about the child, recommended care and expected benefits. Most common reasons included weight concern, weight loss expectation, lifestyle improvement, health concern and need for external support. Facilitators concerned the referral initiator, treatment motivation and barrier control. Most common facilitators included the absence of major barriers, parental control over the decision to enrol, referring physicians stressing the need for specialized care and parents' ability to overcome enrolment challenges.
  
  
  CONCLUSIONS
  Healthcare providers might optimize enrolment in paediatric weight management by being proactive in referring families, discussing the advantages of the recommended care to meet treatment expectations and providing support to overcome enrolment barriers.
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
authors.forename: A J
authors.initials: AJ
authors.lastname: Perez
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
authors.forename: J L S
authors.initials: JL
authors.lastname: Avis
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada.
authors.forename: N L
authors.initials: NL
authors.lastname: Holt
authors.affiliation: Community-University Partnership, Faculty of Extension, University of Alberta, Edmonton, AB, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Gokiert
authors.affiliation: Endocrinology and Diabetes Unit, British Columbia Children's Hospital, Vancouver, BC, Canada.
authors.forename: J-P
authors.initials: JP
authors.lastname: Chanoine
authors.affiliation: Department of Pediatrics, Faculty of Medicine, McGill University, Montréal, QC, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Legault
authors.affiliation: Department of Pediatrics and Population Health Research Institute, Faculty of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: K M
authors.initials: KM
authors.lastname: Morrison
authors.affiliation: Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, AB, Canada.
authors.forename: A M
authors.initials: AM
authors.lastname: Sharma
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
authors.forename: G D C
authors.initials: GD
authors.lastname: Ball
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002170:Canada / Q000453:epidemiology; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D018579:Patient Selection; D063766:Pediatric Obesity / Q000517:prevention & control / Q000523:psychology*; D012017:Referral and Consultation; D061217:Weight Reduction Programs
keywords: content analysis; decision-making; health behaviour; obesity; paediatrics; parent