#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

School-based obesity prevention for busy low-income families—Organisational and personal barriers and facilitators to implementation


Autoři: Åsa Norman aff001;  Gisela Nyberg aff001;  Anita Berlin aff003
Působiště autorů: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden aff001;  The Swedish School of Sport and Health Sciences, Stockholm, Sweden aff002;  Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0224512

Souhrn

Background

Little research has targeted multiple-level barriers and facilitators in school-based parental support programmes. This qualitative study aims to describe barriers and facilitators, at organisational and personal levels, that teachers and parents in disadvantaged settings in Sweden perceived as influencing the implementation of the Healthy School Start II (HSS II) intervention.

Methods

Data collection, analysis and interpretation were guided by the Consolidated Framework for Implementation Research (CFIR). Focus groups and interviews were conducted with 14 parents and ten teachers within the HSS II trial. Data were analysed using qualitative content analysis in a deductive step using the three CFIR domains–inner and outer setting, and personal characteristics–followed by an inductive analysis.

Results

The theme ‘being on the same page–getting burdened teachers and parents to work on common ground’ was found. Among teachers, barriers and facilitators were related to the structure of the schoolwork and curriculum, involvement from other staff and school management, the practical school workday, perception of high family needs but low parental interest, insufficient resources in the families, and teacher’s personal knowledge, interests, and opinions about health and food. For parents, barriers and facilitators were related to the perceived family needs and resources, parents’ health knowledge, consensus about healthy behaviours and ability to cooperate, and school involvement in health issues and the intervention.

Conclusion

Interventions should facilitate parents’ and teachers’ work on common ground, with activities suitable for a stressful and burdensome workday and everyday life. This could be achieved by integrating evidence-based practices within school routines, and including activities that are practicable despite parents’ stressful lives, and that increase parental consensus about promoting health. Strategies to increase involvement of parents in families with high needs are necessary. Also, this study suggests an expansion of the CFIR to capture the interface between different micro-level organisations, and account for several delivering/receiving organisations.

Klíčová slova:

Child health – Childhood obesity – Children – Parenting behavior – Physical activity – Schools – Socioeconomic aspects of health – Teachers


Zdroje

1. Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377(1):13–27. doi: 10.1056/NEJMoa1614362 28604169

2. Wang Y, Lim H. The global childhood obesity epidemic and the association between socio-economic status and childhood obesity. Int Rev Psychiatry. 2012;24(3):176–88. doi: 10.3109/09540261.2012.688195 22724639

3. Li X, Memarian E, Sundquist J, Zoller B, Sundquist K. Neighbourhood deprivation, individual-level familial and socio-demographic factors and diagnosed childhood obesity: a nationwide multilevel study from sweden. Obes Facts. 2014;7(4):253–63. doi: 10.1159/000365955 25096052

4. Lumeng JC, Taveras EM, Birch L, Yanovski SZ. Prevention of obesity in infancy and early childhood: a National Institutes of Health workshop. JAMA Pediatr. 2015;169(5):484–90. doi: 10.1001/jamapediatrics.2014.3554 25775180

5. Dietz WH, Economos CD. Progress in the control of childhood obesity. Pediatrics. 2015;135(3):e559–61. doi: 10.1542/peds.2014-2972 25667238

6. Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011(12):CD001871. doi: 10.1002/14651858.CD001871.pub3 22161367

7. Kader M, Sundblom E, Elinder LS. Effectiveness of universal parental support interventions addressing children’s dietary habits, physical activity and bodyweight: A systematic review. Prev Med. 2015;77:52–67. doi: 10.1016/j.ypmed.2015.05.005 25981555

8. Norman A, Nyberg G, Elinder LS, Berlin A. One size does not fit all-qualitative process evaluation of the Healthy School Start parental support programme to prevent overweight and obesity among children in disadvantaged areas in Sweden. BMC Public Health. 2016;16(1):37.

9. Langford R, Bonell C, Jones H, Campbell R. Obesity prevention and the Health promoting Schools framework: essential components and barriers to success. Int J Behav Nutr Phys Act. 2015;12:15. doi: 10.1186/s12966-015-0167-7 25885800

10. Cui Z, Seburg EM, Sherwood NE, Faith MS, Ward DS. Recruitment and retention in obesity prevention and treatment trials targeting minority or low-income children: a review of the clinical trials registration database. Trials. 2015;16(1):564.

11. Bergström H, Sundblom E, Elinder L, Norman A, Nyberg G. Managing implementation of a parental support programme for obesity prevention in the school context–The importance of creating commitment in an overburdened work situation, a qualitative study. Under revision in Primary Prevention.

12. Weihrauch-Blüher S, Kromeyer-Hauschild K, Graf C, Widhalm K, Korsten-Reck U, Jödicke B, et al. Current Guidelines for Obesity Prevention in Childhood and Adolescence. Obes Facts. 2018;11(3):263–76. doi: 10.1159/000486512 29969778

13. Howard-Drake EJ, Halliday V. Exploring primary school headteachers’ perspectives on the barriers and facilitators of preventing childhood obesity. Journal of public health (Oxford, England). 2016;38(1):44–52.

14. van den Berg V, Salimi R, de Groot RHM, Jolles J, Chinapaw MJM, Singh AS. "It’s a Battle… You Want to Do It, but How Will You Get It Done?": Teachers’ and Principals’ Perceptions of Implementing Additional Physical activity in School for Academic Performance. Int J Env Res Public Health. 2017;14(10):1160.

15. Bergstrom H, Haggard U, Norman A, Sundblom E, Schafer Elinder L, Nyberg G. Factors influencing the implementation of a school-based parental support programme to promote health-related behaviours—interviews with teachers and parents. BMC Public Health. 2015;15:541. doi: 10.1186/s12889-015-1896-x 26051650

16. Christian D, Todd C, Davies H, Rance J, Stratton G, Rapport F, et al. Community led active schools programme (CLASP) exploring the implementation of health interventions in primary schools: headteachers’ perspectives. BMC Public Health. 2015;15:238-. doi: 10.1186/s12889-015-1557-0 25886398

17. Nyberg G, Sundblom E, Norman A, Elinder LS. A healthy school start—parental support to promote healthy dietary habits and physical activity in children: design and evaluation of a cluster-randomised intervention. BMC Public Health. 2011;11:185. doi: 10.1186/1471-2458-11-185 21439049

18. Nyberg G, Sundblom E, Norman A, Bohman B, Hagberg J, Elinder LS. Effectiveness of a universal parental support programme to promote healthy dietary habits and physical activity and to prevent overweight and obesity in 6-year-old children: the healthy school start study, a cluster-randomised controlled trial. PLoS One. 2015;10(2):e0116876. doi: 10.1371/journal.pone.0116876 25680096

19. Nyberg G, Norman A, Sundblom E, Zeebari Z, Elinder LS. Effectiveness of a universal parental support programme to promote health behaviours and prevent overweight and obesity in 6-year-old children in disadvantaged areas, the Healthy School Start Study II, a cluster-randomised controlled trial. Int J Behav Nutr Phys Act. 2016;13(1):4.

20. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50. doi: 10.1186/1748-5908-4-50 19664226

21. Patton MQ. Qualitative research and evaluation methods. Fourth ed. Thousand Oaks, CA: Sage Publications Inc; 2015.

22. Bandura A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall, Inc; 1986.

23. von Haartman F SE, Schafer Elinder L. Föräldrastöd till hälsosamma matvanor och fysisk aktivitet—en kunskapsöversikt (Parental support for healthy dietary habits and physical activity—a review). Stockholm: Karolinska Institutets folkhälsoakademi 2009.

24. Miller WR, Rollnick S. Motivational interviewing: Helping people change (3rd edition). New York, NY: Guilford Press; US; 2013.

25. Annual report on child health care (In Swedish: Barnhälsovårdens årsrapport). Stockholm: Stockholm County Council; 2013.

26. Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G. Indicators of socioeconomic position (part 1). J Epidemiol Community Health. 2006;60(1):7–12. doi: 10.1136/jech.2004.023531 16361448

27. Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G. Indicators of socioeconomic position (part 2). J Epidemiol Community Health. 2006;60(2):95–101. doi: 10.1136/jech.2004.028092 16415256

28. Ministry of Employment Sweden. Urban Development Areas (In Swedish: Urbana utvecklingsområden. Statistisk uppföljning utifrån sju indikatorer). Stockholm; 2012. Contract No.: Dnr A2012/4115/IU.

29. Krueger RA. Focus Groups: a Practical Guide for Applied Research, 2nd ed. Thousand Oaks, CA: SAGE Publications, Inc; 1994.

30. Kitzinger J. Qualitative research. Introducing focus groups. BMJ. 1995;311(7000):299–302. doi: 10.1136/bmj.311.7000.299 7633241

31. Morse JM. Critical Analysis of Strategies for Determining Rigor in Qualitative Inquiry. 2015;25(9):1212–22.

32. Lincoln YS, Guba EG. Naturalistic inquiry. Beverly Hills, Calif.: Sage; 1985.

33. Krippendorff K. Content Analysis, An Introduction to Its Methodology. Third ed. Thousand Oaks, CA: SAGE Publications, Inc.; 2013.

34. Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–15. doi: 10.1111/j.1365-2648.2007.04569.x 18352969

35. Norman A, Berlin A, Sundblom E, Elinder LS, Nyberg G. Stuck in a vicious circle of stress. Parental concerns and barriers to changing children’s dietary and physical activity habits. Appetite. 2014;87C:137–42.

36. Perry RA, Daniels LA, Bell L, Magarey AM. Facilitators and Barriers to the Achievement of Healthy Lifestyle Goals: Qualitative Findings From Australian Parents Enrolled in the PEACH Child Weight Management Program. J Nutr Educ Behav. 2017;49(1):43–52.e1. doi: 10.1016/j.jneb.2016.08.018 27780669

37. Yung TK, Lee A, Ho MM, Keung VM, Lee JC. Maternal influences on fruit and vegetable consumption of schoolchildren: case study in Hong Kong. Matern Child Nutr. 2010;6(2):190–8. doi: 10.1111/j.1740-8709.2009.00198.x 20624214

38. Cason-Wilkerson R, Goldberg S, Albright K, Allison M, Haemer M. Factors influencing healthy lifestyle changes: a qualitative look at low-income families engaged in treatment for overweight children. Childhood obesity (Print). 2015;11(2):170–6.

39. May C, Chai LK, Burrows T. Parent, partner, co-parent or partnership? The need for clarity as family systems thinking takes hold in the quest to motivate behavioural change. Children (Basel, Switzerland). 2017;4(4).

40. Kirk MA, Kelley C, Yankey N, Birken SA, Abadie B, Damschroder L. A systematic review of the use of the Consolidated Framework for Implementation Research. Implementation Science. 2016;11(1):72.

41. Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge, Mass.: Harvard Univ. Press; 1979.

42. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88. doi: 10.1177/1049732305276687 16204405


Článek vyšel v časopise

PLOS One


2019 Číslo 11
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

plice
INSIGHTS from European Respiratory Congress
nový kurz

Současné pohledy na riziko v parodontologii
Autoři: MUDr. Ladislav Korábek, CSc., MBA

Svět praktické medicíny 3/2024 (znalostní test z časopisu)

Kardiologické projevy hypereozinofilií
Autoři: prof. MUDr. Petr Němec, Ph.D.

Střevní příprava před kolonoskopií
Autoři: MUDr. Klára Kmochová, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#