© The Author 2011. Published by Oxford University Press. All rights reserved.
For permissions, please e-mail: firstname.lastname@example.org.
Parents’ views and experiences of childhood obesity
management in primary care: a qualitative study
Katrina M Turnera,*, Chris Salisburyaand Julian P H Shieldb
aAcademic Unit of Primary Health Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39
Whatley Road, Bristol BS8 2PS andbDepartment of Clinical Science at South Bristol, Bristol Royal Hospital for Children and
University of Bristol, Upper Maudlin Street, Bristol BS2 8AE, UK.
*Correspondence to Katrina M Turner, Academic Unit of Primary Health Care, School of Social and Community Medicine,
University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS; E-mail: Katrina.Turner@bristol.ac.uk
Received 6 March 2011; Revised 7 September 2011; Accepted 27 October 2011.
Background. Primary care has been viewed as an appropriate setting for childhood obesity
management. Little is known about parents’ views and experiences of obesity management
within this clinical setting. These views and experiences need to be explored, as they could affect
Objective. To explore parents’ views and experiences of primary care as a treatment setting for
Methods. In-depth interviews were held with 15 parents of obese children aged 5–10 years, to
explore their views and experiences of primary care childhood obesity management. Parents
were contacted via a hospital-based childhood obesity clinic, general practices and Mind, Exer-
cise, Nutrition ... Do it! (MEND) groups based in Bristol, England. The interviews were audio-
taped transcribed verbatim and analysed thematically.
Results. Parents viewed primary care as an appropriate setting in which to treat childhood
obesity but were reluctant to consult due to a fear of being blamed for their child’s weight and
a concern about their child’s mental well-being. They also questioned whether practitioners
had the knowledge, time and resources to effectively manage childhood obesity. Parents varied
in the extent to which they had found consulting a practitioner helpful, and their accounts
suggested that GPs and school nurses offer different types of support.
Conclusions. Parents need to be reassured that practitioners will address their child’s weight in
a non-judgemental sensitive manner and are able to treat childhood obesity effectively. A mul-
tidisciplinary team approach might benefit a child, as different practitioners may vary in the type
of care they provide.
Keywords. Child health, obesity, parents, primary health care, qualitative research.
Childhood obesity is one of the most serious public
health challenges of the 21st century, affecting chil-
dren in both developed and developing countries.1In
2009, 14.4% of children in England aged 2–10 years
were classed as obese.2Some researchers and advisory
bodies view primary care as an appropriate setting in
which to manage childhood obesity.3–7To date, very
few researchers have assessed parents’ views and ex-
periences of primary care childhood obesity manage-
ment. Parents’ views need to be assessed as parental
involvement is fundamental to successful management.8
In addition, their views and experiences will influence
the extent to which practitioner advice is sought and
could affect the practitioner–parent relationship once
treatment has started.
The limited research that has been conducted with
parents has focused mainly on their experiences of
a specific intervention or clinic.8–12To our knowledge,
only Taveras et al.3and Edmunds13have assessed pa-
rents’ experiences of obesity management in primary
care. Taveras et al.’s US study employed a quantitative
survey approach. Most of the parents surveyed re-
ported they had been satisfied with the care they had
received. However, 13% of parents reported they had
received too little advice and 17% rated the advice
given as poor or fair. Edmunds’s UK study involved
a more detailed insight. Descriptions of how practi-
tioners had managed consultations suggested that
while some practitioners had been helpful, others had
been dismissive, unsure of how to help or had blamed
the parent for the child’s weight. Edmunds’s study
Family Practice 2012; 29:476–481
Advance Access publication on 24 November 2011
by guest on December 26, 2015
5National Institute for Health and Clinical Excellence (NICE).
Obesity: Guidanceon the Prevention, Identification, Assessment
and Management of Overweight and Obesity in Adults and
Children. Clinical Guideline 43. London: NICE, 2006.
6National Health and Medical Research Council (NHMRC). Clin-
ical Practice Guidelines for the Management of Overweight
and Obesity in Adults, Children and Adolescents—A Guide
for General Practitioners. Canberra: NHMRC, 2003.
7Scottish Intercollegiate Guidelines Network (SIGN). Management
of Obesity in Children and Young People. A National Clinical
Guideline. Edinburgh: SIGN, 2003.
8Barlow SE, Ohlemeyer CL. Parent reasons for nonreturn to a pedi-
9Owen SE, Sharp DJ, Shield JP, Turner KM. Children’s and pa-
rents’ views and experiences of attending a childhood obesity
clinic: a qualitative study. Prim Health Care Res Dev 2009;
10Stewart L, Chapple J, Hughes AR, Poustie V, Reilly JJ. Parents’
study. Arch Dis Child 2008; 93: 35–9.
11Stewart L, Chapple J, Hughes AR, Poustie V, Reilly JJ. The use of
behavioural change techniques in the treatment of paediatric
obesity: qualitative evaluation of parental perspectives on
treatment. J Hum Nutr Diet 2008; 21: 464–73.
12Dixey R, Rudolf M, Murtagh J. WATCH IT: obesity management
for children: a qualitative exploration of the views of parents.
Int J Health Promot Educ 2006; 44: 131–7.
13Edmunds LD. Parents’ perceptions of health professionals’ re-
sponse when seeking help for their overweight children. Fam
Pract 2005; 22: 287–92.
14BBC news. Obesity ‘Link to Same-Sex Parent’. 12 July 2009.
http://news.bbc.co.uk/1/hi/health/8144376.stm (accessed on
11 February 2011).
life/Pages/Default.aspx (accessed on 11 March 2011).
16Weaver M. Treat Childhood Obesity as Act of Neglect, Say
medicineandhealth1 (accessed on 3 March 2011).
17MEND. http://www.mendprogramme.org/ (accessed on 15 Novem-
18Department of Health. National Standards, Local Action. Health
and Social Care Standards and Planning Framework, 2005/
06–2007/08. London: Department of Health, 2004.
19Ritchie J, Spencer L. Qualitative data analysis for applied policy
research. In Bryman A, Burgess RG (eds). Analyzing Qualita-
tive Data, London: Routledge, 1994, pp. 173–94.
20De La OA, Jordan KC, Ortiz K et al. Do parents accurately per-
ceive their child’s weight status? J Pediatr Health Care 2009;
21Jeffery AN, Voss LD, Metcalf BS et al. Parents’ awareness of over-
weight in themselves and their children: cross-sectional study
with a cohort (EarlyBird 21). BMJ 2005; 330: 23–4.
22Jain A, Sherman SN, Leigh A et al. Why don’t low-income mothers
worry about their preschoolers being overweight? Pediatrics
2001; 107: 1138–46.
23Turner KM, Shield J, Salisbury C. Practitioners’ views on manag-
ing childhood obesity in primary care: a qualitative study.
Br J Gen Pract 2009; 59: 856–62.
24Department of Health. Obesity Care Pathway and Your Weight,
Your Health. London: Department of Health, 2006.
Parents’ views of primary care childhood obesity management
by guest on December 26, 2015