Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Burke, Shauna M.

Abstract

The overarching purpose of this dissertation was to investigate the role of parents as agents of change in the treatment of childhood obesity and the promotion of children’s health behaviours. In order to achieve this purpose, four studies were conducted. The purpose of Study 1 was to explore parents’ perceptions of nutritional literacy, as well as their needs for nutritional literacy information, supports, and resources at familial and community levels. Next, Study 2 described the theoretical components and model used in the development and implementation of a parent-focused childhood overweight and obesity intervention (i.e., C.H.A.M.P. Families). The purpose of Study 3 was to investigate the impact of the C.H.A.M.P. Families program on: (a) children’s standardized body mass index (BMI-z); and (b) parental self-efficacy for promoting children’s health behaviours. Finally, the aim of Study 4 was to explore parents’ perspectives of their experiences in and the influence of C.H.A.M.P. Families, as well as their recommendations related to future paediatric overweight and obesity treatment interventions.

The findings presented in Study 1 showed that parents perceived nutritional literacy as having an understanding of nutrition and healthy eating, as well as having the skills to translate such knowledge into practice. All participants agreed that nutritional literacy was important, and the majority believed that it could be improved within their families. With regard to the resources parents identified as needing to enhance nutritional literacy in their families, professional advice, practical skills, kid-friendly recipes, and environmental information were identified. Food regulation, accessible community programming, and school-based policies and curriculum were the needs identified at the community level. In Study 2, the “C.H.A.M.P. Families” intervention was described in detail. This 13-week parent-focused program involved eight group-based (parent-only) educations delivered to parents of children aged 6-14 years with overweight or obesity (i.e., body mass index equal to or greater than the 85th percentile for age and sex). The program also included eight home-based (family) activities and two group-based (family) follow-up support sessions. In addition to a description of the intervention and feasibility analyses, Study 2 detailed the use of the unique theoretical framework that integrated evidence-based group dynamics principles and motivational interviewing techniques within the broader context of Social Cognitive Theory. Several practical examples related to the application of specific theoretical constructs and evidence-based strategies within a parent-focused paediatric obesity interventions were presented. In Study 3, the results demonstrated that the C.H.A.M.P. Families intervention had a small, positive effect on both parental self-efficacy for promoting child health behaviours and child BMI-z, from baseline to post-intervention. However, the results also showed that these improvements were not maintained at the 6-month follow-up. Finally, findings from Study 4 showed that C.H.A.M.P. Families was well-received by parents. Parents highlighted several positive outcomes for children and families and underscored specifically the importance of the group environment, content and materials, and additional program components (e.g., home visits). Many participants also noted important socioenvironmental and personal barriers related to health behaviour changes for themselves and their child(ren), and recommended that future programs emphasize greater child involvement and additional information and strategies.

Available for download on Sunday, March 01, 2020

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