title: Recommendations From Parents to Improve Health Services for Managing Pediatric Obesity in Canada.
abstract: Although parents are uniquely positioned to offer first-hand insights that can be used to improve health services for managing pediatric obesity, their perspective is underexplored. Our objective was to characterize parents' recommendations for enhancing tertiary-level health services for managing pediatric obesity in Canada.
  
  
  
  Semistructured, one-on-one interviews were conducted with parents of children who initiated treatment at 1 of 4 Canadian tertiary-level, multidisciplinary weight management clinics. Parent perspectives were elicited regarding the strengths and weaknesses of the health services they received as well as areas for potential improvement. Interviews were audio-recorded and transcribed verbatim. We used qualitative description as the methodological framework and manifest content analysis as the analytical strategy.
  
  
  
  Parents (n = 65; 88% female; 72% Caucasian; 74% with at least some postsecondary education; 52% >$50,000 CDN household income) provided a range of recommendations that were organized according to health care: 1) accessibility, 2) content, and 3) delivery. The most common recommendations included increasing scheduling options (44%; n = 29), tailoring services to families' needs and circumstances (29%; n = 19), placing greater emphasis on physical activity (29%; n = 19), altering program duration (29%; n = 19), incorporating interactive elements (25%; n = 16), information provision (25%; n = 16), and providing services at sites closer to participants' homes (24%; n = 15).
  
  
  
  Parents' recommendations to enhance health services for managing pediatric obesity concerned modifiable factors related to accessibility, content, and delivery of care. Further research is needed to evaluate whether implementing suggested recommendations improves clinically relevant outcomes including attrition, quality of care, and success in weight management.
authors.affiliation: Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Melissa
authors.initials: M
authors.lastname: Tremblay
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Arnaldo J
authors.initials: AJ
authors.lastname: Perez
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Rasquinha
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Jillian L S
authors.initials: JL
authors.lastname: Avis
authors.affiliation: Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Morrison
authors.affiliation: Endocrinology and Diabetes Unit, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Chanoine
authors.affiliation: Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
authors.forename: Laurent
authors.initials: L
authors.lastname: Legault
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Holt
authors.affiliation: Community-University Partnership, Faculty of Extension, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Gokiert
authors.affiliation: Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Arya M
authors.initials: AM
authors.lastname: Sharma
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. Electronic address: gdball@ualberta.ca.
authors.forename: Geoff D C
authors.initials: GD
authors.lastname: Ball
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002170:Canada; D002648:Child; D002662:Child Health Services / Q000592:standards*; D015444:Exercise; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D010348:Patient Care Team; D010353:Patient Education as Topic; D063766:Pediatric Obesity / Q000628:therapy*; D058996:Quality Improvement; D063128:Tertiary Health Care; D013997:Time Factors
keywords: health services; obesity; parent; pediatric; qualitative research