Childhood obesity: Understanding the user perspective to inform prevention and treatment strategies
As a result of increasing prevalence in childhood obesity, it is now at the forefront of policy agendas. To date, however, there is a paucity of evidence in the UK, relating to the behavioural and environmental factors which influence diet and physical activity from the user perspective. Using the social-ecological framework, the principle aim of this thesis was to obtain the user perspective to identify priorities for action to inform prevention and treatment strategies for childhood obesity. A series of qualitative studies were carried out to determine the views of professionals, parents and children. In addition, a family based intervention for childhood obesity was evaluated.\ud There was congruence in the findings across all studies. Poor diet and physical inactivity were identified as the main causes of obesity. Cost, availability, a lack of\ud knowledge on portion sizes and food labels, a lack of appropriate facilities for activity and an unsupportive environment emerged as the main barriers. Across the studies, parents were consistently purported to be a contributor and a potential solution to childhood obesity. In terms of interventions, cookery courses which provide parents with practical information were deemed crucial. In addition, the development of a training programme for health care professionals on childhood obesity was identified as a priority. Children identified the use of the media and the internet as mechanisms with which to engage with children. With regard to the family based intervention, there was a significant decrease (p<0.05) in BMI and a significant increase in self-esteem (/?<0.05)\ud post intervention. Although it is likely that the intervention had an effect, these findings warrant further investigation. In summary, this thesis provides a comprehensive insight to childhood obesity from the user perspective. Whilst change needs to occur to reduce the wider environmental barriers, equally parents are responsible for childhood obesity. However, there needs to\ud be a concerted effort from health care professionals to ensure that parents have the necessary skills and knowledge to change behaviour.
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