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. 2025 Jun 4;25(1):2089.
doi: 10.1186/s12889-025-23381-0.

Family weight management in rural U.S. communities: a mixed methods study of parent and child perspectives

Alyssa Button  1   2 , Denise Holston  3 , Jamila Freightman  3 , Katherine Seals  3 , Matthew Helie  3   4 , Elizabeth Bankhead  2 , Deirdre Harrington  5 , Peyton Murray  2 , Amanda Staiano  6
Affiliations

Family weight management in rural U.S. communities: a mixed methods study of parent and child perspectives

Alyssa Button et al. BMC Public Health. .

Abstract

Background: Effective treatments are available to address the rising prevalence of childhood obesity in the U.S. Families in rural communities face unique barriers to accessing and engaging in these programs. This study evaluated interests and considerations for behavioral health programming to treat child obesity in rural southern U.S.

Methods: Rural counties with high prevalence of adult obesity (> 40%) were selected for recruitment following interviews with community partners and agents, in accordance with the Hexagon Tool framework. Researchers collaborated with extension agents and communities to recruit parents (n = 33) and children (n = 15) for cross-sectional focus groups and parent surveys (n = 295). The survey was adapted from questions on The Knowledge, Attitudes and Practices Scale, The Behavioral Information Preference Scale, and The Health Information National Trends Survey. Parent focus group data was analyzed using inductive reasoning, and content analysis was used for child focus group data. Descriptive statistics were used to interpret survey results.

Results: Parent surveys (18-54 years, 50% male) indicated concern for childhood overweight and obesity (129/295 responses), as well as great interest in health education (153/295). Responses indicated high acceptability of digital (184-193/295) and group-class (192/295) formats for programming and accessing information. During focus groups, parents (≥ 18 years, 94% female) identified structural barriers including lack of resources as limitations for participation. Children (M = 10.5 ± 1.3 years, 60% boys) identified improving overall health and athleticism as desired outcomes.

Conclusions: Families living in rural settings desire programming for childhood obesity treatment. Researchers and community leaders can build capacity and utilize existing resources to implement programs.

Keywords: Community health; Family weight management; Lifestyle treatment; Pediatrics; Rural.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures in this study were approved by the Pennington Biomedical Research Center Institutional Review Board (FWA#00006218) in accordance with the declaration of Helsinki. Informed adult consent, informed consent obtained from the parents or legal guardians of any participating child under the age of 16, and child assent were collected. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References

    1. Hampl SE, Hassink SG, Skinner AC et al. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatr. 2023. - PubMed
    1. Skinner AC, Staiano AE, Armstrong SC, et al. Appraisal of clinical care practices for child obesity treatment. Part I: interventions. Pediatr. 2023;151(2):e2022060642. - PubMed
    1. Epstein LH, Wilfley DE, Kilanowski C, et al. Family-Based behavioral treatment for childhood obesity implemented in pediatric primary care: A randomized clinical trial. JAMA. 2023;329(22):1947–56. 10.1001/jama.2023.8061. - PMC - PubMed
    1. Davison GM, Monocello LT, Lipsey K, Wilfley DE. Evidence base update on behavioral treatments for overweight and obesity in children and adolescents. J Clin Child Adolesc Psychol. 22023;52(5):589–603. 10.1080/15374416.2023.2251164. - PMC - PubMed
    1. King JE, Jebeile H, Garnett SP, Baur LA, Paxton SJ, Gow ML. Physical activity based pediatric obesity treatment, depression, self-esteem and body image: A systematic review with meta-analysis. Ment Health Phys Acty. 2020;19:100342. 10.1016/j.mhpa.2020.100342.

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