Health  Vol.7 No.14 , December 2015
Put Yourself in My Shoes: Perspectives of Adolescents about What Makes an Obesity Intervention Effective
Abstract: Purpose: This study aims to investigate the adolescents’ perspectives about 1) the changing process promoted by a weight management program; 2) the factors which may act as facilitators and barriers to obesity management; 3) the strategies that should be included in order to design a successful weight management program. Methods: Data were collected by in-depth interviews and focus group discussions with 16 overweight adolescents, aged 12 - 18 years. Thematic analysis was used for analysing the data. Results: Findings suggest that attributions (internal and external), functions (barriers and facilitators) and perceptual changes (life and body and mind changes) play distinct roles in the changing process. Interactions recognized as high quality ones, acquisition of new knowledge and competencies and encouragement throughout the process, were identified as facilitators. Negative patterns of interaction, collection of anthropometric data and internal resistances, were identified as barriers. The relevance of developing systemic interventions including family and peers, and the use of Information and Communication Technologies were highlighted. Conclusion: This study aims to contribute for a deeper understanding of the factors and processes behind adherence to weight management. Implications for the design of future more effective strategies and implementation of appropriate interventions are discussed.
Cite this paper: Prioste, A. , Fonseca, H. , Sousa, P. , Gaspar, P. , Francisco, R. and do Céu Machado, M. (2015) Put Yourself in My Shoes: Perspectives of Adolescents about What Makes an Obesity Intervention Effective. Health, 7, 1833-1840. doi: 10.4236/health.2015.714201.

[1]   WHO World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic. Technical Report Series No. 894, World Health Organization, Geneva.

[2]   Fonseca, H., Matos, M.G., Guerra, A. and Pedro, J.G. (2009) Are Overweight and Obese Adolescents Different from Their Peers? International Journal of Pediatric Obesity, 4, 166-174.

[3]   Keating, C.L., Moodie, M.L. and Swinburn, B.A. (2011) The Health-Related Quality of Life of Overweight and Obese Adolescents—A Study Measuring Body Mass Index and Adolescent-Reported Perceptions. International Journal of Pediatric Obesity, 6, 434-441.

[4]   MacDonell, K., Ellis, D., Naar-King, S. and Cunningham, P. (2010) Predictors of Home-Based Obesity Treatment Efficacy for African American Youth Karen. Children’s Health Care, 39, 1-14.

[5]   Phillips, B.A., Gaudette, S., McCracken, A., Razzaq, S., Sutton, K., Speed, L., et al. (2012) Psychosocial Functioning in Children and Adolescents with Extreme Obesity. Journal of Clinical Psychology in Medical Settings, 19, 277-284.

[6]   Waters, E., de Silva-Sanigorski, A., Hall, B.J., Brown, T., Campbell, K.J., Gao, Y., et al. (2011) Interventions for Preventing Obesity in Children. Cochrane Database of Systematic Reviews, 7, Article ID: CD001871.

[7]   WHO (2006) European Charter on Counteracting Obesity. Report, Istanbul.

[8]   Sacher, P.M., Koltourou, M., Chadwick, P.M., Cole, T.J., Lawson, M.S., Lucas, A. and Singhal, A. (2010) Randomized Controlled Trial of the MEND Program: A Family-Based Community Intervention for Childhood Obesity. Childhood Obesity, 18, S62-S66.

[9]   Fonseca, H., Falcato, L., Carvalho, G.F., Martins, S. and Palmeira, A.L. (2015) The TOP Program: Treatment of Pediatric Obesity. Journal of Adolescent Health, 56, S106-S107.

[10]   Lopes, V.P., Gabbard, C. and Rodrigues, L.P. (2013) Physical Activity in Adolescents: Examing Influence of the Best Friend Dyad. Journal of Adolescent Health, 52, 752-756.

[11]   Sousa, P., Fonseca, H., Gaspar, P. and Gaspar, F. (2015) Controlled Trial of an Internet-Based Intervention for Overweight Teens (Next.Step): Effectiveness Analysis. European Journal of Pediatrics, 174, 1143-1157.

[12]   Reinehr, T., Widhalm, K., l’Allemand, D., Wiegand, S., Wabitsch, M., Holl, R.W., et al. (2009) Two-Year Follow-Up in 21,784 Overweight Children and Adolescents with Lifestyle Intervention. Obesity, 17, 1196-1199.

[13]   Sarwer, D.B. and Dilks, R.J. (2001) Invited Commentary: Childhood and Adolescent Obesity: Psychological and Behavioural Issues in Weight Loss Treatment. Journal of Youth and Adolescence, 41, 98-104.

[14]   Ahern, D., Phalen, J., Le, L. and Goldman, R. (2007) Childhood Obesity Prevention and Reduction: Role of eHealth. Health e-Technologies Initiative, Boston.

[15]   Sousa, P., Fonseca, H., Gaspar, P. and Gaspar, F. (2013) Internet-Based Intervention Programme for Obese Adolescents and Their Families (Next.Step): Research Protocol of a Controlled Trial. Journal of Advanced Nursing, 70, 904-914.

[16]   Patton, M.Q. (1990) Qualitative Evaluation and Research Methods. Sage, Thousand Oaks.

[17]   Richards, L. (2009) Handling Qualitative Data: A Practical Guide. 2nd Edition, Sage Publications, Inc., London.

[18]   Braun, V. and Clarke, V. (2006) Using Thematic Analysis in Psychology. Qualitative Research in Psychology, 3, 77-101.

[19]   Murtagh, J., Dixey, R. and Rudolf, M. (2006) A Qualitative Investigation into the Three Levels and Barriers to Weight Loss in Children: Opinions of Obese Children. Archives of Disease in Childhood, 91, 920-923.

[20]   Pierce, J.W. and Wardle, J. (1997) Cause and Effect Beliefs and Self-Esteem of Overweight Children. Journal of Child Psychology and Psychiatry, 38, 645-650.

[21]   Amiri, P., Ghofranipour, F., Ahmadi, F., Montazeri, A., Jalali-Farahani, S. and Rastegarpour, A. (2011) Barriers to a Health Lifestyle among Obese Adolescents: A Qualitative Study from Iran. International Journal of Public Health, 56, 181-189.

[22]   Roach, J.B., Yadrick, M.K., Johnson, J.T., Boudreaux, L.J., Forsythe, W.A. and Billon, W. (2003) Using Self-Efficacy to Predict Weight Loss among Young Adults. Journal of the American Dietetic Association, 103, 1357-1359.

[23]   Story, M.T., Neumark-Stzainer, D.R., Sherwood, N.E., Holt, K., Sofka, D., Trowbridge, F.L. and Barlow, S. (2002) Management of Child and Adolescent Obesity: Attitudes, Barriers, Skills, and Training Needs among Health Care Professionals. Pediatrics, 110, 210-214.

[24]   Saelens, B.E., Lozano, P. and Scholz, K. (2013) A Randomized Clinical Trial Comparing Delivery of Behavior Pediatric Obesity Treatment Using Standard and Enhanced Motivational Approaches. Journal of Pediatric Psychology, 38, 954-964.

[25]   Kitzmann, K.M. and Beech, B.M. (2006) Family-Based Interventions for Pediatric Obesity: Methodological and Conceptual Challenges from Family Psychology. Journal of Family Psychology, 20, 175-189.

[26]   Wrotniak, B.H., Epstein, L.H., Paluch, R.A. and Roemmich, J.N. (2004) Parent Weight Change as a Predictor of Child Weight Change in Family-Based Behavioral Obesity Treatment. Archives of Pediatrics and Adolescent Medicine, 158, 342-347.

[27]   Hood, M.Y., Moore, L.L., Sundarajan Ramamurti, A., Singer, M., Cupples, L.A. and Ellison, R.C. (2000) Parental Eating Attitudes and the Development of Obesity in Children. The Framingham Children’s Study. International Journal of Obesity, 24, 1319-1325.

[28]   Smith, K.L., Straker, L.M., McManus, A. and Fenner, A.A. (2014) Barriers and Enablers for Participation in Healthy Lifestyle Programs by Adolescents Who Are Overweight: A Qualitative Study of the Opinions of Adolescents, Their Parents and Community Stakeholders. BMC Pediatrics, 14, 53.

[29]   An, J.Y., Hayman, L.L., Park, Y.S., Dusaj, T.K. and Ayres, C.G. (2009) Web-Based Weight Management Programs for Children and Adolescents: A Systematic Review of Randomized Controlled Trial Studies. Advances in Nursing Science, 32, 222-240.

[30]   Hamel, L.M. and Robbins, L.B. (2013) Computer- and Web-Based Interventions to Promote Healthy Eating among Children and Adolescents: A Systematic Review. Journal of Advanced Nursing, 69, 16-30.

[31]   Tracy, S.J. (2013) Qualitative Research Methods. Wiley-Black Well, West Sussex.