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  • 1
    Online Resource
    Online Resource
    Participants’ and caregivers’ experiences of a multidisciplinary programme for healthy lifestyle change in Aotearoa/New Zealand: a qualitative, focus group study
    BMJ ; 2021
    In:  BMJ Open Vol. 11, No. 5 ( 2021-05), p. e043516-
    Details
    In: BMJ Open, BMJ, Vol. 11, No. 5 ( 2021-05), p. e043516-
    Abstract: Child and adolescent obesity continues to be a major health issue internationally. This study aims to understand the views and experiences of caregivers and participants in a child and adolescent multidisciplinary programme for healthy lifestyle change. Design Qualitative focus group study. Setting Community-based healthy lifestyle intervention programme in a mixed urban–rural region of Aotearoa/New Zealand. Participants Parents/caregivers (n=6) and children/adolescents (n=8) who participated in at least 6 months of an assessment and weekly session, family-based community intervention programme for children and adolescents affected by obesity. Results Findings covered participant experiences, healthy lifestyle changes due to participating in the programme, the delivery team, barriers to engagement and improvements. Across these domains, four key themes emerged from the focus groups for participants and their caregivers relating to their experience: knowledge-sharing, enabling a family to become self-determining in their process to achieve healthy lifestyle change; the importance of connectedness and a family-based programme; the sense of a collective journey and the importance of a nonjudgemental, respectful welcoming environment. Logistical challenges and recommendations for improvement were also identified. Conclusions Policymakers need to consider the experiences of participants alongside quantitative outcomes when informing multidisciplinary intervention programmes for children and adolescents affected by obesity. Trial registration number Australian New Zealand Clinical Trials Registry (ANZCTR):12611000862943; Post-results.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-043516
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2599832-8
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  • 2
    Online Resource
    Online Resource
    A Collaborative Indigenous–non-Indigenous Partnership Approach to Understanding Participant Experiences of a Community-Based Healthy Lifestyles Program
    SAGE Publications ; 2021
    In:  Qualitative Health Research Vol. 31, No. 8 ( 2021-07), p. 1404-1411
    Details
    In: Qualitative Health Research, SAGE Publications, Vol. 31, No. 8 ( 2021-07), p. 1404-1411
    Abstract: We describe the approach of an Indigenous–non-Indigenous research partnership in the context of a qualitative study which aimed to understand barriers and facilitators to engagement in a community-based healthy lifestyles program in Aotearoa/New Zealand. Informed by Kaupapa Māori research principles and by “Community-Up” research values, this collaborative approach between the mixed Māori–non-Māori research team effectively engaged with Māori and non-Māori families for in-depth interviews on participant experience, including with non-service users. “Community-Up” research principles allowed for a respectful process which upheld the mana (status, dignity) of the interview participants and the research team. Challenges included maintaining flexibility in our conceptions of ethnicity to reflect the complexity of modern family life in Aotearoa/New Zealand. We were committed to ongoing communication, awareness, and attention to the relationships that formed the basis of our research partnership, which allowed effective navigation of challenges and was critical to the study’s success.
    Type of Medium: Online Resource
    ISSN: 1049-7323 , 1552-7557
    URL: Article
    DOI: 10.1177/1049732321998640
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2010333-5
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  • 3
    Online Resource
    Online Resource
    Challenges of making healthy lifestyle changes for families in Aotearoa/New Zealand
    Cambridge University Press (CUP) ; 2021
    In:  Public Health Nutrition Vol. 24, No. 7 ( 2021-05), p. 1906-1915
    Details
    In: Public Health Nutrition, Cambridge University Press (CUP), Vol. 24, No. 7 ( 2021-05), p. 1906-1915
    Abstract: The objective of the current study was to identify challenges of making and sustaining healthy lifestyle changes for families with children/adolescents affected by obesity, who were referred to a multicomponent healthy lifestyle assessment and intervention programme in Aotearoa/New Zealand (NZ). Design: Secondary qualitative analysis of semi-structured interviews. Setting: Taranaki region of Aotearoa/NZ. Participants: Thirty-eight interviews with parents/caregivers ( n 42) of children/adolescents who had previously been referred to a family-focused multidisciplinary programme for childhood obesity intervention, who identified challenges of making healthy lifestyle changes. Participants had varying levels of engagement, including those who declined contact after their referral. Results: Participant-identified challenges included financial cost, impact of the food environment, time pressures, stress, maintaining consistency across households, independence in adolescence, concern for mental health and frustration when not seeing changes in weight status. Conclusions: Participants recognised a range of factors that contributed towards their ability to make and sustain change, including factors at the wider socio-environmental level beyond their immediate control. Even with the support of a multidisciplinary healthy lifestyle programme, participants found it difficult to make sustained changes within an obesogenic environment. Healthy lifestyle intervention programmes and families’ abilities to make and sustain changes require alignment of prevention efforts, focusing on policy changes to improve the food environment and eliminate structural inequities.
    Type of Medium: Online Resource
    ISSN: 1368-9800 , 1475-2727
    URL: Article
    DOI: 10.1017/S1368980020003699
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2016337-X
    SSG: 21
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  • 4
    Online Resource
    Online Resource
    What affects programme engagement for Māori families? A qualitative study of a family‐based, multidisciplinary healthy lifestyle programme for children and adolescents
    Wiley ; 2021
    In:  Journal of Paediatrics and Child Health Vol. 57, No. 5 ( 2021-05), p. 670-676
    Details
    In: Journal of Paediatrics and Child Health, Wiley, Vol. 57, No. 5 ( 2021-05), p. 670-676
    Abstract: It is important that intervention programmes are accessible and acceptable for groups most affected by excess weight. This study aimed to understand the barriers to and facilitators of engagement for Māori in a community‐based, assessment‐and‐intervention healthy lifestyle programme (Whānau Pakari). Methods Sixty‐four in‐depth, home‐based interviews were conducted with past service users. Half of these were with families with Māori children and half with non‐Māori families. The interviews were thematically analysed with peer debriefing for validity. Results Māori families experienced barriers due to racism throughout the health system and society, which then affected their ability to engage with the programme. Key barriers included the institutionalised racism evident through substantial structural barriers and socio‐economic challenges, the experience of interpersonal racism and its cumulative impact with weight stigma, and internalised racism and beliefs of biological determinism. Responses to these barriers were distrust of health services, followed by renewed engagement or complete disengagement. Participants identified culturally appropriate care as that which was compassionate, respectful, and focused on relationship building. Conclusions While Whānau Pakari is considered appropriate due to the approach of the delivery team, this is insufficient to retain some Māori families who face increased socio‐economic and structural barriers. Past instances of weight stigma and racism have enduring effects when re‐engaging with future health services, and inequities are likely to persist until these issues are addressed within the health system and wider society.
    Type of Medium: Online Resource
    ISSN: 1034-4810 , 1440-1754
    URL: Issue
    URL: Article
    DOI: 10.1111/jpc.v57.5
    DOI: 10.1111/jpc.15309
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2007577-7
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  • 5
    Online Resource
    Online Resource
    “It's more personal if you can have that contact with a person”: Qualitative study of health information preferences of parents and caregivers of children with obesity in New Zealand
    Hindawi Limited ; 2022
    In:  Health & Social Care in the Community Vol. 30, No. 5 ( 2022-09)
    Details
    In: Health & Social Care in the Community, Hindawi Limited, Vol. 30, No. 5 ( 2022-09)
    Type of Medium: Online Resource
    ISSN: 0966-0410 , 1365-2524
    URL: Issue
    URL: Article
    DOI: 10.1111/hsc.v30.5
    DOI: 10.1111/hsc.13756
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
    detail.hit.zdb_id: 2006277-1
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  • 6
    Online Resource
    Online Resource
    Survey of Barriers and Facilitators to Engagement in a Multidisciplinary Healthy Lifestyles Program for Children
    Elsevier BV ; 2020
    In:  Journal of Nutrition Education and Behavior Vol. 52, No. 5 ( 2020-05), p. 528-534
    Details
    In: Journal of Nutrition Education and Behavior, Elsevier BV, Vol. 52, No. 5 ( 2020-05), p. 528-534
    Type of Medium: Online Resource
    ISSN: 1499-4046
    URL: Article
    DOI: 10.1016/j.jneb.2019.10.010
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2095185-1
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  • 7
    Online Resource
    Online Resource
    The Impact of a Family-Based Assessment and Intervention Healthy Lifestyle Programme on Health Knowledge and Beliefs of Children with Obesity and Their Families
    MDPI AG ; 2022
    In:  Nutrients Vol. 14, No. 20 ( 2022-10-18), p. 4363-
    Details
    In: Nutrients, MDPI AG, Vol. 14, No. 20 ( 2022-10-18), p. 4363-
    Abstract: Objective: To determine the impact of a family-based assessment-and-intervention healthy lifestyle programme on health knowledge and beliefs of children and families affected by obesity. Second, to compare the health knowledge of the programme cohort to those of a national cohort in Aotearoa/New Zealand (NZ). Design: This mixed-methods study collected health knowledge and health belief data in a questionnaire at baseline and 12-, 24-, and 60-month follow-up assessments. Health knowledge over time was compared with baseline knowledge and with data from a nationally representative survey. A data-driven subsumption approach was used to analyse open-text responses to health belief questions across the study period. Setting: Taranaki region, a mixed urban–rural setting in NZ. Participants: Participants (caregiver/child dyads) from the Whānau Pakari randomised trial. Results: A greater proportion of the cohort correctly categorised foods and drinks as healthy or unhealthy at 12 months compared to baseline for most questionnaire items. Retention of this health knowledge was evident at 24- and 60-month follow-ups. More than twice as many participants correctly reported physical activity recommendations at follow-up compared to baseline (p 〈 0.001). Health knowledge of participants was similar to the national survey cohort at baseline, but surpassed it at 12 and 24 months. Participant beliefs around healthy lifestyles related to physical functioning, mental and emotional wellbeing, and enhancement of appearance, and gained greater depth and detail over time. Conclusions: This study demonstrates the important role that community-level healthy lifestyle programmes can have in knowledge-sharing and health promotion.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu14204363
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518386-2
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  • 8
    Online Resource
    Online Resource
    Health system barriers to accessing care for children with weight issues in New Zealand: An interview-based study
    SAGE Publications ; 2021
    In:  Journal of Health Services Research & Policy Vol. 26, No. 4 ( 2021-10), p. 234-241
    Details
    In: Journal of Health Services Research & Policy, SAGE Publications, Vol. 26, No. 4 ( 2021-10), p. 234-241
    Abstract: To identify barriers created and maintained by the health system affecting engagement in a family-based multidisciplinary healthy lifestyle programme for children and adolescents in New Zealand. Methods We conducted 64 semi-structured interviews with participants of the programme (n = 71) with varying levels of engagement, including those who declined contact after their referral. Half the interviews were with families with Māori children, allowing for appropriate representation. Interviews were analysed using thematic analysis. Results Five health system factors affecting engagement were identified: the national policy environment, funding constraints, lack of coordination between services, difficulty navigating the health system, and the cost of primary health care. Conclusions Engaging with a health system that creates and maintains substantial barriers to accessing services is difficult, affecting programme engagement, even where service-level barriers have been minimised. Lack of access remains a crucial barrier to improved health outcomes for children and their families experiencing childhood obesity in New Zealand. There is a need for comprehensive approaches that are accompanied by a clear implementation strategy and coordinated across sectors.
    Type of Medium: Online Resource
    ISSN: 1355-8196 , 1758-1060
    URL: Article
    DOI: 10.1177/13558196211016011
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2039416-0
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  • 9
    Online Resource
    Online Resource
    Determining barriers and facilitators to engagement for families in a family-based, multicomponent healthy lifestyles intervention for children and adolescents: a qualitative study
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 9 ( 2020-09), p. e037152-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 9 ( 2020-09), p. e037152-
    Abstract: Recruitment and retention in child and adolescent healthy lifestyle intervention services for childhood obesity is challenging, and inequalities across social groups are persistent. This study aimed to understand the barriers and facilitators to engagement in a multicomponent assessment-and-intervention healthy lifestyle programme for children and their families, based in the home and community. Design Qualitative interview-based study of past users (n=76) of a family-based multicomponent healthy lifestyle programme in a mixed urban–rural region of New Zealand. Semistructured, home-based interviews were conducted and thematically analysed with peer debriefing for validity. Participants Families were selected through stratified random sampling to include a range of levels of engagement, including those who declined their referral, with equal numbers of interviews with Indigenous and non-Indigenous families. Results Three interactive and compounding determinants were identified as influencing engagement in Whānau Pakari: acute and chronic life stressors, societal norms of weight and body size and historical experiences of healthcare. These determinants were present across societal, system and healthcare service levels. A negative referral experience to Whānau Pakari often resulted in participants declining further input or disengaging from the programme. A fourth domain, respectful and compassionate healthcare, was identified as a mitigator of these three themes, facilitating participant engagement despite previous negative experiences. Conclusions While participant engagement in healthy lifestyle programmes is affected by determinants which appear to operate outside immediate service provision, the programme is an opportunity to acknowledge past instances of stigma and the wider challenges of healthy lifestyle change. The experience of the referral to Whānau Pakari is important for setting the scene for future engagement in the programme. Respectful, compassionate care is critical to enhanced retention in multidisciplinary healthy lifestyle programmes and ongoing engagement in healthcare services overall.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-037152
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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  • 10
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    Online Resource
    Changes in referral patterns for weight in association with the preschool Raising Healthy Kids target
    CSIRO Publishing ; 2022
    In:  Journal of Primary Health Care Vol. 14, No. 4 ( 2022-10-28), p. 310-317
    Details
    In: Journal of Primary Health Care, CSIRO Publishing, Vol. 14, No. 4 ( 2022-10-28), p. 310-317
    Abstract: Introduction The ‘Raising Healthy Kids (RHK) health target’ recommended that children identified as having obesity [body mass index (BMI) ≥98th centile] through growth screening at the B4 School Check (B4SC) be offered referral for subsequent assessment and intervention. Aim To determine the impact of the ‘RHK health target’ on referral rates for obesity in Aotearoa New Zealand (NZ). Methods A retrospective audit was undertaken of 4-year-olds identified to have obesity in the B4SC programme in Taranaki and nationally in 2015–19. Key outcomes were: ‘RHK health target’ rate [proportion of children with obesity for whom District Health Boards (DHBs) applied the appropriate referral process] ; Acknowledged referral rate (proportion of children with a referral for obesity whose referral was acknowledged by DHBs); and Declined referral rate (proportion of children offered a referral for obesity who declined their referral). Results Data were audited on 266 448 children, including 7464 in Taranaki. ‘RHK health target’ rates increased markedly between 2015–16 and 2016–17 following the health target implementation (NZ: 34–87%; P  〈  0.0001, Taranaki: 21–68%; P  〈  0.0001). Acknowledged referral rates also increased post-target nationally (56–90%; P  〈  0.0001), and remained high in Taranaki over the 4-year period (ranging from 89 to 99%). However, there were notably high Declined referral rates across NZ (26–31%) and in Taranaki (although variable: 38–69%). Discussions The ‘RHK health target’s’ focus on referral rather than intervention uptake limited the policy’s impact on improving preschool obesity. Future policy should focus on ensuring access to multidisciplinary intervention programmes across NZ to support healthy lifestyle change.
    Type of Medium: Online Resource
    ISSN: 1172-6156
    URL: Article
    DOI: 10.1071/HC22076
    Language: English
    Publisher: CSIRO Publishing
    Publication Date: 2022
    detail.hit.zdb_id: 2572943-3
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