Reasons for (non)participating in a telephone-based intervention program for families with overweight children

Franziska Alff, Jana Markert, Silke Zschaler, Ruth Gausche, Wieland Kiess, Susann Blüher, Franziska Alff, Jana Markert, Silke Zschaler, Ruth Gausche, Wieland Kiess, Susann Blüher

Abstract

Objective: Willingness to participate in obesity prevention programs is low; underlying reasons are poorly understood. We evaluated reasons for (non)participating in a novel telephone-based obesity prevention program for overweight children and their families.

Method: Overweight children and adolescents (BMI>90(th) percentile) aged 3.5-17.4 years were screened via the CrescNet database, a representative cohort of German children, and program participation (repetitive computer aided telephone counseling) was offered by their local pediatrician. Identical questionnaires to collect baseline data on anthropometrics, lifestyle, eating habits, sociodemographic and psychosocial parameters were analyzed from 433 families (241 participants, 192 nonparticipants). Univariate analyses and binary logistic regression were used to identify factors associated with nonparticipation.

Results: The number of overweight children (BMI>90(th) percentile) was higher in nonparticipants than participants (62% vs. 41.1%,p<0.001), whereas the number of obese children (BMI>97(th) percentile) was higher in participants (58.9% vs.38%,p<0.001). Participating girls were younger than boys (8.8 vs.10.4 years, p<0.001). 87.3% and 40% of participants, but only 72.2% and 24.7% of nonparticipants, respectively, reported to have regular breakfasts (p = 0.008) and 5 regular daily meals (p = 0.003). Nonparticipants had a lower household-net-income (p<0.001), but higher subjective physical wellbeing than participants (p = 0.018) and believed that changes in lifestyle can be made easily (p = 0.05).

Conclusion: An important reason for nonparticipation was non-awareness of their child's weight status by parents. Nonparticipants, who were often low-income families, believed that they already perform a healthy lifestyle and had a higher subjective wellbeing. We hypothesize that even a low-threshold intervention program does not reach the families who really need it.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Main reasons for nonparticipation given…
Figure 1. Main reasons for nonparticipation given by parents from a defined list.
Multiple answers were possible.

References

    1. Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. 2010;375:1737–1748.
    1. Blüher S, Meigen C, Gausche R, Keller E, Pfäffle R, et al. Age-specific changes in obesity prevalence in German children over a 10 year period. Int J Pediatr Obes. 2011;6(2–2):e199–206.
    1. Baker JL, Olsen LW, Sorensen TI. Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med. 2007;357:2329–2337.
    1. Nyberg G, Ekelund U, Yucel-Lindberg T, Modeér T, Marcus C. Differences in metabolic risk factors between normal weight and overweight children. Int J Pediatr Obes. 2011;6(3–4):244–252.
    1. Singh A, Mulder C, Twisk J, van Mechelen W, Chinapaw M. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9(5):474–488.
    1. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;25; 337(13):869–873.
    1. Epstein L, Valoski A, Wing R, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol. 1994;13(5):373–383.
    1. Shepherd J, Harden A, Rees R, Brunton G, Garcia J, et al. Young people and healthy eating: a systematic review of research on barriers and facilitators. Health Educ Res. 2006;21:239–257.
    1. Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;(1):CD001872.
    1. Golan M. Parents as agents of change in childhood obesity – from research to practice. Int J Pediatr Obes. 2006;1(2):66–76.
    1. Spoth R, Redmond C. Research on Family Engagement in Preventive Interventions: Toward Improved Use of Scientific Findings in Primary Prevention Practice. J Prim Prevent. 2000;21(2):267–284.
    1. Stewart L, Chapple J, Hughes AR, Poustie V, Reilly JJ. Parents' journey through treatment for their child's obesity: a qualitative study. Arch Dis Childhood. 2008;93(1):35–39.
    1. Finne E, Reinehr T, Schaefer A, Winkel K, Kolip P. Overweight children and adolescents-is there a subjective need for treatment? Int J Public Health. 2009;54(2):112–116.
    1. Jansen W, Brug J. Parents often do not recognize overweight in their child, regardless of their socio-demographic background. Eur J Public Health. 2006;16:645–647.
    1. Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, et al. Percentiles of body mass index in children and adolescents evaluated from different regional German cohorts. Monatsschr Kinderheilkd. 2001;149(8):807–818.
    1. Meigen C, Keller A, Gausche R, Kromeyer-Hauschild K, Blüher S, et al. Secular trends in body mass index in German children and adolescents: a cross-sectional data analysis via CrescNet between 1999 and 2006. Metabolism. 2008;57(7):934–949.
    1. Cole TJ, Green PJ. Smoothing reference centile curves: The lms method and penalized likelihood. Statistics in Medicine. 1992;11(10):1305–1319.
    1. World Health Organization. Physical Status. The Use and Interpretation of Anthropometry. Report of a WHO Expert Commitee. Technical Report Series no. 854. Geneva: WHO; 1995.
    1. Kurth BM, Kamtsiuris P, Holling H, Schlaud M, Dolle R, et al. The challenge of comprehensively mapping children's health in a nation-wide health survey: design of the German KiGGS-Study. BMC Public Health. 2008;8:196.
    1. Schwarzer R. Self-efficacy in the adoption and maintenance of health behaviours: Theoretical approaches and a new model. In: Schwarzer R, editor. Self-efficacy: Thought control of action. Washington DC: Hemisphere; 1992. pp. 217–242.
    1. Ravens-Sieberer U, Bullinger M. Assessing health-related quality of life in chronically ill children with the German KINDL: first psychometric and content analytical results. Qual Life Res. 1998;7(5):399–407.
    1. Magarey AM, Perry RA, Baur LA, Steinbeck KS, Sawyer M, et al. A Parent-Led Family-Focused Treatment Program for Overweight Children Aged 5 to 9 Years: The PEACH RCT. Pediatrics. 2011;127:214–222.
    1. Beckman H, Hawley S, Bishop T. Application of Theory-Based Health Behavior Change Techniques to the Prevention of Obesity in Children. J Pediatr Nurs. 2006;21(4):266–275.
    1. Heinberg LJ, Kutchman EM, Berger NA, Lawhun SA, Cuttler L, et al. Parent involvement is associated with early success in obesity treatment. Clin Pediatr (Phila) 2010;49:457–465.
    1. Wake M, Nicholson JM, Hardy P, Smith K. Preschooler obesity and parenting styles of mothers and fathers: Australian national population study. Pediatrics. 2007;120(6):e1520–1527.
    1. Heinrichs N, Bertram H, Kuschel A, Hahlweg K. Parent recruitment and retention in a universal prevention program for child behaviour and emotional problems: barriers to research and program participation. Prev Sci. 2005;6(4):275–286.
    1. Warschburger P, Kröller K. Maternal perception of weight status and health risks associated with obesity in children. Pediatrics. 2009;124(1):e60–68.
    1. Rhee KE, De Lago CW, Arscott-Mills T, Mehta SD, Davis RK. Factors associated with parental readiness to make changes for overweight children. Pediatrics. 2005;116(1):e94–101.
    1. Rudolph H, Blüher S, Falkenberg C, Neef M, Körner A, et al. Perception of body weight status: a case control study of obese and lean children and adolescents and their parents. Obes Facts. 2010;3(2):83–91.
    1. Timperio A, Salmon J, Ball K, Baur LA, Telford A, et al. Family physical activity and sedentary environments and weight change in children. Int J Pediatr Obes. 2008;3(3):160–167.
    1. Plachta-Danielzik S, Landsberg B, Johannsen M, Lange D, Muller MJ. Determinants of the prevalence and incidence of overweight in children and adolescents. Public Health Nutr. 2010;26:1–12.
    1. Danielzik S, Pust S, Landsberg B, Müller MJ. First lessons from the Kiel Obesity Prevention Study (KOPS). Int J Obes. 2005;29(s2):78–83.
    1. Benton D. Role of parents in the determination of the food preferences of children and the development of obesity. Int J Obes Relat Metab Disord. 2004;28(7):858–869.
    1. Toschke AM, Thorsteinsdottir KH, von Kries R for the GME Study Group. Meal frequency, breakfast consumption and childhood obesity. Int J Pediatr Obes. 2009;4(4):242–248.
    1. Sonneville KR, La Pelle N, Taveras EM, Gillman MW, Prosser LA. Economic and other barriers to adopting recommendations to prevent childhood obesity: results of a focus group study with parents. BMC Pediatr. 2009;9:81.
    1. Beyerlein A, Toschke AM, Schaffrath Rosario A, von Kries R. Risk factors for obesity: further evidence for stronger effects on overweight children and adolescents compared to normal-weight subjects. PLoS One. 2011;6(1):e15739.
    1. Huybrechts I, De Bourdeaudhuij I, Buck C, De Henauw S. Environmental factors: Opportunities and barriers for physical activity and healthy eating among children and adolescents. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2010;53(7):716–724.
    1. Hamzaid H, Talib RA, Azizi NH, Maamor N, Reilly JJ, et al. Quality of life of obese children in Malaysia. Int J Pediatr Obes. 2011;6(5–6):450–454.
    1. Williams JW, Canterford L, Hesketh KD, Hardy P, Waters EB, et al. Changes in body mass index and health related quality of life from childhood to adolescence. Int J Pediatr Obes. 2011;6(2–2):e442–448.
    1. Huffman FG, Kanikireddy S, Patel M. Parenthood-a contributing factor to childhood obesity. Int J Environ Res Public Health. 2010;7(7):2800–2810.
    1. Pott W, Albayrak O, Hebebrand J, Pauli-Pott U. Treating childhood obesity: family background variables and the child's success in a weight-control intervention. Int J Eat Disord. 2009;42(3):284–289.
    1. Eakin EG, Lawler SP, Vandelanotte C, Owen N. Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med. 2007;32(5):419–434.
    1. Schwarz P, Greaves C, Lindström J, Yates T, Davies M. Nonpharmacological interventions for the prevention of type 2 diabetes mellitus. Nat Rev Endocrinol. 2012;Jan 17 doi: .
    1. Lindström J, Neumann A, Sheppard K, Gilis-Januszewska A, Greaves C, et al. Take action to prevent diabetes-the IMAGE toolkit for the prevention of type 2 diabetes in Europe. Horm Metab Res. 2010;42;(Suppl 1):S37–55.
    1. Paulweber B, Valensi P, Lindström J, Lalic NM, Greaves CJ, et al. A European evidence-based guideline for the prevention of type 2 diabetes. Horm Metab Res. 2010;42;(Suppl 1):S3–36.

Source: PubMed

3
Abonnieren