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Why do parents discontinue health services for managing paediatric obesity? A multi-centre, qualitative study
Jasmine Dhaliwal1, Arnaldo J Perez1, Nicholas L Holt2
1Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Canada.
Insights
Parents discontinued pediatric weight management due to family issues, logistical barriers, and health service concerns. Addressing these factors may improve child obesity treatment retention and outcomes.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Behavioral Science
Background:
- Childhood obesity is a growing public health concern requiring effective, long-term management strategies.
- Tertiary-level paediatric weight management programs offer specialized care but face challenges with patient retention.
- Understanding reasons for discontinuing care is crucial for improving program effectiveness and patient outcomes.
Purpose of the Study:
- To explore the multifaceted reasons why parents discontinue tertiary-level care for their children's weight management.
- To identify key factors contributing to attrition in paediatric obesity treatment programs.
Main Methods:
- A qualitative study involving semi-structured individual interviews with parents (n=29) of adolescents (10-17 years) who had discontinued care.
- Participants were recruited from three Canadian tertiary-level paediatric weight management centers.
- Data were analyzed using inductive manifest content analysis to identify recurring themes.
Main Results:
- Parents cited three primary categories of reasons for discontinuing care: family factors (e.g., perceived lack of progress, low motivation), logistical factors (e.g., cost, distance, scheduling), and health services factors (e.g., unmet expectations, limited services).
- Specific barriers included children's lack of motivation, financial costs, scheduling conflicts, and dissatisfaction with the perceived scope of services offered.
- The majority of interviewed parents were female (89.7%), Caucasian (75.9%), and had higher education levels (79.3%).
Conclusions:
- Attrition from tertiary paediatric weight management is influenced by a complex interplay of family, logistical, and health service-related factors.
- Future research should investigate interventions targeting these identified barriers to enhance family retention in care.
- Improving retention rates is essential for achieving better long-term health outcomes for children with obesity.
Objective:
To explore parents' reasons for discontinuing tertiary-level care for paediatric weight management.
Methods:
Participants were parents of 10-17year olds (body mass index [BMI] ≥85th percentile) who were referred for paediatric weight management. Parents were recruited from three Canadian sites (Vancouver, BC; Edmonton, AB; Hamilton, ON) and were eligible if their children attended at least one clinical appointment and subsequently discontinued care. Data were collected using semi-structured individual interviews that were digitally recorded, transcribed, and analysed using an inductive manifest content analysis.
Results:
Parents (n=29) of children [mean age: 14.7±1.8years; mean BMI percentile: 98.9±1.6; n=17 (58.6%) boys] were primarily female (n=26; 89.7%), Caucasian (n=22; 75.9%), and had a university degree (n=23; 79.3%). Reasons for discontinuing care were grouped into three categories: (i) family factors (e.g., perceived lack of progress, lack of family support, children's lack of motivation), (ii) logistical factors (e.g., monetary costs, distance, scheduling), and (iii) health services factors (e.g., unmet expectations of care, perceived limited menu of services, no perceived need for further support).
Conclusions:
A range of multi-level factors influenced attrition from tertiary-level paediatric weight management. Our data suggest that experimental research is needed to examine whether addressing reasons for attrition can enhance families' retention in care and ultimately improve health outcomes for children living with obesity.
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