Weight Management Engagement for Teens From Low-Income Backgrounds: Qualitative Perspectives From Adolescents and Caregivers

Katherine E Darling; Jennifer Warnick; Kate M Guthrie; Melissa Santos; Elissa Jelalian

doi:10.1093/jpepsy/jsad008

Weight Management Engagement for Teens From Low-Income Backgrounds: Qualitative Perspectives From Adolescents and Caregivers

J Pediatr Psychol. 2023 Jul 20;48(7):593-601. doi: 10.1093/jpepsy/jsad008.

Authors

Katherine E Darling^{1

2}, Jennifer Warnick^{1

2}, Kate M Guthrie^{2

3}, Melissa Santos⁴, Elissa Jelalian^{1

2}

Affiliations

¹ Weight Control and Diabetes Research Center, The Miriam Hospital, USA.
² Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA.
³ Center for Behavioral and Preventive Medicine, The Miriam Hospital, USA.
⁴ Division of Pediatric Psychology, Connecticut Children's, USA.

Abstract

Objective: Adolescents from low-income backgrounds are at increased risk for obesity and related negative health outcomes. Furthermore, these adolescents have less access to, and success in, weight management (WM) programs. This qualitative study sought to better understand engagement in a hospital-based WM program from the perspective of adolescents and caregivers at different levels of program initiation and engagement.

Methods: Qualitative interviews were conducted with 55 participants (29 adolescents and 26 caregivers). This included: (a) those that were referred to, but never initiated, WM treatment (non-initiators); (b) those that prematurely disengaged from treatment (drop-outs); and (c) those that had ongoing participation in treatment (engaged). Data were analyzed using applied thematic analysis.

Results: Related to program initiation, participants across all groups (including adolescents and caregivers) noted that they did not have a full understanding of the scope or goals of the WM program following initial referral. In addition, many participants identified misperceptions of the program (e.g., perceptions of a screening visit as compared to an intensive program). Both caregivers and adolescents identified caregivers as drivers of engagement, with adolescents often hesitant about participation in the program. However, engaged adolescents found the program valuable and sought ongoing participation following caregiver initiation.

Conclusions: When considering initiation and engagement in WM services for adolescents at highest risk, healthcare providers should provide more detailed information concerning WM referrals. Future research is needed to improve adolescent perception of WM, especially for adolescents from low-income backgrounds, which could increase initiation and engagement for this population.

Keywords: adolescent; engagement; low-income; obesity; weight management.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Adolescent
Caregivers*
Humans
Obesity
Poverty*
Qualitative Research
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding