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一项针对太平洋肥胖儿童的家庭主导体重管理计划的可接受性与不依从性

Acceptability and non-compliance in a family-led weight-management programme for obese Pacific children.

作者信息

Teevale Tasileta, Taufa Seini, Percival Teuila

机构信息

1Pacific Development Office,Academic Services Division,University of Otago,PO Box 56,Dunedin 9054,New Zealand.

2Pacific Health Section,School of Population Health, Faculty of Medical & Health Sciences,University of Auckland,Auckland,New Zealand.

出版信息

Public Health Nutr. 2015 Oct;18(14):2625-33. doi: 10.1017/S1368980014003255. Epub 2015 Feb 4.

Abstract

OBJECTIVE

To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children.

DESIGN

Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme.

SETTING

New Zealand.

SUBJECTS

Forty-two parents/primary caregivers of obese children who were randomised in the intervention weight-management programme.

RESULTS

Programmatic factors that enhanced retention included: simultaneous delivery to both children and parents as participants; delivery of the programme in small group settings at local community venues; enabling trustworthy and accountable relationships; providing resources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals; and day and time scheduling. Suggested programme improvements included having ethnic-specific Island-language delivery and practical sessions like cooking classes and shopping expeditions at local food stores. The research found that unpredictable external life crises like extended family deaths, a change in job shift, family illnesses (both acute and those requiring chronic management) and long-term family visitations affected participation and momentum. A loss of momentum through managing life crises was often difficult to overcome for participants, leading them to drop out of the weight-management programme. Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time.

CONCLUSIONS

In order for weight-management programmes to be effective, participants must be able to complete them. Identifying factors that predict participation and attrition may serve as a basis for programme improvement.

摘要

目的

探讨影响太平洋肥胖儿童家庭主导式体重管理项目参与度和退出率的因素。

设计

在为期8周的体重管理项目结束时进行定性研究,采用双语深度访谈。

地点

新西兰。

研究对象

42名肥胖儿童的父母/主要照顾者,他们被随机分配到干预性体重管理项目中。

结果

提高留存率的项目因素包括:儿童和父母同时作为参与者参与项目;在当地社区场所以小组形式开展项目;建立可信赖且负责的关系;提供前往项目场所的交通资源,并通过定期电话/短信跟进强化项目目标;以及安排合适的日期和时间。建议的项目改进措施包括提供特定族裔的岛语授课内容,以及开展烹饪课程和当地食品店购物考察等实践课程。研究发现,诸如大家庭成员去世、工作班次变动、家庭疾病(包括急性病和需要长期治疗的疾病)以及长期家庭访客等不可预测的外部生活危机影响了参与度和进展。因应对生活危机而导致进展受阻,参与者往往难以克服,从而导致他们退出体重管理项目。大多数退出的参与者更愿意推迟项目参与,希望日后能重新参与未来的项目。

结论

为使体重管理项目有效,参与者必须能够完成项目。识别预测参与度和退出率的因素可为项目改进提供依据。

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