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01.12.2012 | Study protocol | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Should I stay or should I go? Understanding families’ decisions regarding initiating, continuing, and terminating health services for managing pediatric obesity: the protocol for a multi-center, qualitative study

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Geoff DC Ball, Arnaldo Perez Garcia, Jean-Pierre Chanoine, Katherine M Morrison, Laurent Legault, Arya M Sharma, Rebecca Gokiert, Nicholas L Holt
Wichtige Hinweise

Competing interests

In relation to the present research, all authors are in agreement that they have no financial or non-financial interests to declare.

Authors’ contributions

GDCB conceived of the study and co-authored the first draft of the manuscript (with APG), APG co-authored the first draft of the manuscript (with GDCB), JPC assisted with study design as well as writing and editing the manuscript, KMM assisted with study design as well as writing and editing the manuscript, LL assisted with study design as well as writing and editing the manuscript, AMS assisted with study design as well as writing and editing the manuscript, RG assisted with study design as well as writing and editing the manuscript, NLH assisted with study design as well as writing and editing the manuscript. All authors have read and approved the final manuscript.

Abstract

Background

At least two million Canadian children meet established criteria for weight management. Due to the adverse health consequences of obesity, most pediatric weight management research has examined the efficacy and effectiveness of interventions to improve lifestyle behaviors, reduce co-morbidities, and enable weight management. However, little information is available on families’ decisions to initiate, continue, and terminate weight management care. This is an important knowledge gap since a substantial number of families fail to initiate care after being referred for weight management while many families who initiate care discontinue it after a brief period of time. This research aims to understand the interplay between individual, family, environmental, and systemic factors that influence families’ decisions regarding the management of pediatric obesity.

Methods/Design

Individual interviews will be conducted with children and youth with obesity (n = 100) and their parents (n = 100) for a total number of 200 interviews with 100 families. Families will be recruited from four Canadian multi-disciplinary pediatric weight management centers in Vancouver, Edmonton, Hamilton, and Montreal. Participants will be purposefully-sampled into the following groups: (i) Non-Initiators (5 families/site): referred for weight management within the past 6 months and did not follow-up the referral; (ii) Initiators (10 families/site): referred for weight management within the past 6 months and did follow-up the referral with at least one clinic appointment; and (iii) Continuers (10 families/site): participated in a formal weight management intervention within the past 12 months and did continue with follow-up care for at least 6 months. Interviews will be digitally recorded and analyzed using an ecological framework, which will enable a multi-level evaluation of proximal and distal factors that underlie families’ decisions regarding initiation, continuation, and termination of care. Demographic and anthropometric/clinical data will also be collected.

Discussion

A better understanding of family involvement in pediatric weight management care will help to improve existing health services in this area. Study data will be used in future research to develop a validated survey that clinicians working in pediatric obesity management can use to understand and enhance their own health services delivery.
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