Examining the experiences of implementing a lifestyle intervention for overweight and obese children An interview study on the barriers and enhancers when implementing an intervention program in Norwegian municipalities

Abstract

Background: Childhood obesity is one of the 21st century’s most serious public health challenges. In Norway, health nurses are obligated to record children’s body mass and children who are classified as overweight or obese should be offered a follow up through lifestyle programs. There has been a lack of such lifestyle programs, however, some municipalities have implemented intervention programs to support overweight and obese children and their families’ lifestyle changes. Aim: To examine how a lifestyle intervention focusing on promoting healthy lifestyle habits in overweight and obese children and their families in three different Norwegian municipalities was implemented and conducted. The intervention focused on physical activity, diet and individual guidance. Important enhancers and barriers related to the implementation process were identified. Methods: In depth interviews were conducted with representatives (n=5) involved in the implementation process in three different municipalities. All interviews were recorded digitally, transcribed verbatim and analysed using systematic text condensation. Results: An initiator to establish agreements in the municipality council was identified as an important enhancer in the implementation. Barriers in the implementation were related to the cooperation between the program facilitators, municipal council and the health nurses. Resistance from the participating children’s parents and a lack of program founding were also identified as barriers. There was a lack of structured evaluations of the intervention programs. The intervention programs components were identified as important focus areas, including connection to local community, physical activity sessions, diet courses, individual counselling and involvement of the entire family. Conclusion: Involvement of a determined individual with strong sense of commitment seems essential for implementing such intervention programs. For future work, better strategies to involve health nurses and how they should approach the families are needed. Thorough program evaluation should be conducted to examine the intervention program’s effect, why they were successful or not, and to ensure future funding.