Table 3

Challenges of engaging parents, children and healthcare professionals with the service

Difficulties engaging parents
Talking about the weight of a child can be highly emotive for parents.“It’s difficult with parents sometimes to explain to them that what they are doing at home is probably not the best thing for their child. That’s quite difficult you know, that’s their baby that’s their child and they don’t want to hear anything negative.” (INT 19)
Parents often find it difficult to accept that their child is overweight.“Parents often see their children as normal weight when they are in fact overweight and we know people often will refer to children who are a normal weight as a bit skinny.” (INT 5)
Parents often do not recognise the role they need to play in engaging in the service as part of a ‘family intervention’ to improve their child’s BMI centile.“So we say it has to be a family intervention. But they don’t always see it that way. They just want the child to lose the weight and don’t acknowledge their role in being the providers’ food and the environment they grow up in.” (INT 11)
Difficulties engaging children
Engaging children with the service could be challenging.“there is a lot of issues around recruitment and retentions with tier two services for children and also there’s a great difficulty with actually the secondary aged children to get them sort of accessing services.” (INT 2)
Difficulties engaging healthcare professionals
Healthcare professionals can find it difficult to bring up weight status of a child with a parent.“I think there’s definitely issues there from what I’ve heard about professionals bringing things up with families.” (INT 4)
Some healthcare professionals fail to recognise overweight or obese children.“The GP will look at the child and say, it’s just puppy fat, they’ll grow out of it.” (INT 5)
“We even get some out of school nurses say ‘well, they’re only just into the overweight category’. You know, the child is really athletic, they’re really muscular.” (INT 11)
Lack of GP engagement.“GP’s still struggle to engage with it.” (INT 10)
“GPs, locally they tend not to refer.” (INT 6)
  • BMI, body mass index; GP, general practitioner.