Acceptability and non-compliance in a family-led weight-management programme for obese Pacific children.

Objective: To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children. Design: Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme. Setting: New Zealand. Subjects: Forty-two parents/primary caregivers of obese children who were randomised in the intervention weight-management programme. Results: Programmatic factors that enhanced retention included: simultaneous delivery to both children and parents as participants; delivery of the programme in small group settings at local community venues; enabling trustworthy and accountable relationships; providing resources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals; and day and time scheduling. Suggested programme improvements included having ethnic-specific Island-language delivery and practical sessions like cooking classes and shopping expeditions at local food stores. The research found that unpredictable external life crises like extended family deaths, a change in job shift, family illnesses (both acute and those requiring chronic management) and long-term family visitations affected participation and momentum. A loss of momentum through managing life crises was often difficult to overcome for participants, leading them to drop out of the weight-management programme. Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time. Conclusions: In order for weight-management programmes to be effective, participants must be able to complete them. Identifying factors that predict participation and attrition may serve as a basis for programme improvement.