Adolescent and Parent Attitudes about Obesity and Behavior Change

Objective: The community served by the South Bronx Health Center for Children and Families has among the highest rates of obesity in NYC. SBHCCF created Starting Right, a multi-component pediatric obesity program integrated into its primary care practice. This qualitative study explored adolescent and parent attitudes about obesity and behavior change to enhance provider-patient communication and inform program development.

Methods: Four focus groups with 23 participants (11 overweight adolescents, 12 parents) were conducted to explore obesity, nutrition and exercise-related topics. A preliminary analysis of transcripts was conducted to identify codes and emerging themes. A formal analysis using qualitative analysis software will be performed based on the code list.

Results: Several themes emerged: 1. Obesity and nutrition are emotionally charged issues for all participants: parents feel guilty limiting/changing kids' diets; teens are concerned with body image and self-esteem. 2. Health risks of obesity are not a primary motivator for behavior change except when family or friends develop obesity-related conditions. 3. Finances, time, and environment are major barriers to healthy changes in diet and activity. 4. Intensive provider involvement and detailed guidance are important motivators for behavior change.

Conclusions: Emotional, financial and environmental factors all impact adolescents' and families' ability to make changes in lifestyle. Long-term health risks have limited relevance for adolescent participants. Families look to providers for motivation and education to make healthy behavior changes. As practitioners, it's important to provide intensive follow-up. Providers should also advocate for public policy changes that will improve the environment of the community served.