Factors | Quotations to illustrate the identified factors |
---|---|
Socio-political context | Â |
Norms and values in society | Â |
Weight-related | (–) ‘The norm about what is normal weight is changing. |
Children who have a healthy weight are now regarded as too lean’ | |
(–) ‘Parents don’t recognize their child being overweight, because there’s an increase in the number of fat children’ | |
Participation in programmes | (–) ‘It should be regarded as normal that parents participate in such a programme’ |
Severity of overweight problem | (–) ‘Overweight should get more attention in the media to make people aware that it’s an important health problem’ |
YHC organization | Â |
Task of YHC | (+) ‘Yes, absolutely! I think that no one else will call the parents to account for their child’s overweight’ |
(+) ‘Youth health care is the only place where you can find all those young children. There’s no other place to reach all children’ | |
(+) ‘We are partly responsible, but we’re not the only ones who are responsible. Primary schools have responsibilities as well, as they see what the children eat’ | |
Training | (–) ‘Extra skills training for professionals on the prevention of childhood overweight is needed in YHC’ |
Time | (–) ‘Of course you make time for it, but there’s not much time to discuss it, and a lot of other things have to be discussed as well during a consultation’ |
Resources | (–) ‘I think we don’t have enough resources’ |
Cooperation | Â |
Within the organization | (–) ‘Nurses should be more closely involved in the recruitment of overweight children’ |
 | (–) ‘Unfortunately, we nurses didn’t receive any information’ |
Between organizations | (–) ‘We think that we should first try to get all relevant stakeholders to agree’ |
 | (+) ‘The more consistent people from different organizations are in their message to parents, the higher the chance that we reach them’ |
 | (+) ‘The municipal health service is also involved in prevention of childhood obesity.’ |
 | (+) ‘It would be better if more organizations were involved. I mean general practitioners, schools, day-care centres’ |
The YHC professional | Â |
Attitude | Â |
Programme - specific outcome beliefs | (+) ‘I think it’s a very positive programme, because overweight is mainly an educational problem’ |
 | (+) ‘Yes, I think it’s a nice programme, although it’s intensive. It takes a lot of time for the parents’ |
Target group - specific outcome beliefs | (–) ‘I don’t know. I wonder whether parents see the need for it’ |
 | ‘I think a particular group does, but I don’t think that all parents see the relevance’ |
(+) ‘We do notice an increased need for parenting support’ | |
(–) ‘I think we all thought: how can we motivate these parents? from the very beginning’ | |
(–) ‘A lot of people feel uncomfortable when they hear their child is overweight. And that makes it hard for us’ | |
(–) ‘They’re not interested. They have no time for it’ | |
(–) ‘I think that one out of thirty people consciously want to change something’ | |
 | (–) ‘You notice that parents are very unresponsive’ |
Perceived responsibility | (+) ‘I feel responsible and want to discuss it with parents’ |
 | (+) ‘It’s a growing problem’ |
Perceived severity of problem | (–) ‘Obesity is just one of the areas of special interest. I can’t say it’s more important than other areas; it’s just one of them, although I take it very seriously!’ |
 | (–) ‘To be honest, I think that a lot of children between S1 and S2 are actually not too fat’ |
 | (–) ‘My experience is that the majority of the overweight children are just above the norm. When you look at that child, using your clinical judgement, I think those children are not overweight’ |
Need for prevention | (+) ‘Prevention of childhood obesity is really important, especially to prevent long-term risks’ |
 | (–) ‘I think that prevention of psychosocial problems is more important, but by that I mean severe problems like neglect’ |
Self – efficacy | (–) ‘I think it’s a complicated problem’ |
(–) ´Sometimes parents were very critical and started asking me a lot of questions, which I couldn´t answer. I felt uncomfortable´ | |
Skills | (–) ‘We’re not able to communicate the impact of the problem to the parents. We need more practice in communication skills’ |
(–) ‘I think we don’t have enough expertise about prevention of childhood obesity’ | |
Forgetting | (–) ‘I have to admit, I had forgotten it after a while’ |
The innovation | Â |
Relative advantage | ‘I think that the current protocol and the intervention can complement each other’ |
(+) ‘An advantage of the intervention is that professionals who are experienced in childhood obesity give the parents advice’ | |
(–) ‘I think that we’re already quite effective in our own approach’ | |
(+) ‘I think it’s a very positive programme, because overweight is mainly an educational problem’ | |
Observability | (–) ‘I would prefer to get more timely feedback on which parents participated and which ones didn’t’ |
Relevance for the client | (+) ‘I think that the programme is very useful for parents. Childhood overweight is a problem which is closely related to parenting’ |
Low frequency of use innovation | (–) ‘No, I didn’t see any children who were eligible for participation’ |
The parents | Â |
Awareness of child’s overweight | (–) ‘Parents are not aware of their child’s overweight’ |
Perceived severity of child’s overweight | (–) ‘Parents often don’t see their child’s overweight as a problem’ |
Resistance in discussing weight issues with parents | (–) ‘You clearly notice that parents are unresponsive’ |
(–) ‘You notice that when you mention the word ‘overweight’ to parents, you immediately perceive resistance’ | |
(–) ´Sometimes parents become angry when you continue to discuss overweight’ | |
Motivation to change behaviour | (–) ‘Parents are just not motivated to change their behaviour’ |
(–) ‘It’s difficult to approach parents for overweight prevention; they just don’t see the long-term advantages’ | |
Perceived responsibility | (–) ‘Parents don’t admit that they are themselves responsible for the weight of their child’ |
Willingness to cooperate in the intervention | (–) ‘Some parents want to reduce their child’s overweight themselves’ |
(–) ‘They mention that they are closely watching their child’s weight themselves and that they already know what to do about it’ | |
(–) ‘A lot of parents don’t have time for it. Or they don’t want to make time for it’ | |
Parent’s discomfort about the intervention | (–) ‘Parents think that it’s going too far to participate in an intervention’ |