Obese children and adolescents are at risk of developing physical and medical problems and chronic diseases if the overweight continues in adulthood. Family interventions that address obesity issues are becoming increasingly common as family involvement is expected to create contextual coherence and thus increase the possibilities for sustainable weight loss. However, family involvement efforts are challenged by conflicting expectations and understandings of responsibilities within the family. In the FAIR-project we are currently doing research and development in three settings, described below.
Nordsjællands Hospital and 8 municipalities
This study investigates a family-based childhood obesity intervention, which is defined as a shared care project between the paediatric unit at Nordsjællands Hospital and 8 municipalities: Frederikssund, Fredensborg, Furesø, Gribskov, Halsnæs, Helsingør, Hillerød and Rudersdal. The intervention consists of an initial examination of the participating child at the paediatric unit at Nordsjællands Hospital and ensuing meetings with a health visitor on a regular basis (4-6 times a year) in the local municipality. Once a year there is a control visit at the paediatric unit. The health visitor passes on information from the meetings in the municipality to the hospital.
The study explores how the participating families experience the encounter with the paediatric unit and the health visitor and how the intervention influences their daily life.
A central part of the obesity intervention is a standardised chart with several changing points, which the families are expected to comply with to achieve and maintain a healthier lifestyle. An objective of the study is therefore to study how families negotiate these changing points. Furthermore, the study explores the different levels of family-involvement.
Design and methods
The study uses semi-structured family interviews with 20-25 participating families. Family interviews make it possible to get insight into the relatively hidden dynamics of family life. The target group consist of families with children at 11 years or older.
This pre-study will produce knowledge about family dynamics and the potentials and barriers for positive family involvement in weight management processes. The study will be a starting point for developing an intervention in a collaboration between Steno and the paediatrics unit at Nordsjællands Hospital.
Næstved Hospital and municipality
Næstved Municipality and the paediatric outpatient clinic, at Næstved Hospital have developed a family-based intervention targeting obesity in childhood and adolescence. All families are enrolled in the project for two years. The first year is the primary intervention-year and consists of 14 counselling sessions at the paediatric outpatient clinic with various health professionals (e.g. nurses, dieticians, health visitors and psychologists). In the first year of intervention the families additionally attend a 12-week health education course in the municipality, where the families participate in sessions on healthy eating, physical activity, family-life and psychology. The second year of intervention is the follow-up year where the families attend four family-counselling sessions at the paediatric outpatient clinic. The intervention is based on a positive and empowerment inspired approach.
Design and methods
The study focuses on how the families experience their participation in a family-based obesity intervention and how they manage lifestyle changes when implementing them at home. The study is based on a qualitative approach with in-depth semi-structured family-interviews. The family-interviews consist of two or three family members and are done in the families’ homes. A dialogue tool has been developed to motivate the children to be actively involved in the family-interviews. A phenomenology-hermeneutic methodology is applied and Systematic Text Condensation is used when analysing the data.
The study has produced a master’s thesis and the overall findings will be implemented in future obesity approaches in Næstved. Steno will follow the implementation process closely.
In Guldborgsund Municipality there is a relatively high prevalence of pre-school children with overweight or emerging overweight. Steno Diabetes Center and Guldborgsund Municipality have entered into a partnership on a research and development project to identify challenges, opportunities and potentials in families with overweight pre-school children, and to develop and feasibility-test an intervention targeting the entire family in order to achieve weight control and simultaneously well-being of children and their families.
Design and methods
The project will employ a Design Based Research approach in order to develop the intervention in close collaboration with families and local professionals. Data will be collected in participatory workshops.
The project will develop a family-based intervention with the aim of reducing the number of overweight children starting school. The intervention will also focus on maintaining or establishing well-being and positive involvement in the families.