Participant engagement with a UK community-based preschool childhood obesity prevention programme: a focused ethnography study

Burton, Wendy; Twiddy, Maureen; Sahota, Pinki; Brown, Julia; Bryant, Maria

Abstract

© 2019 The Author(s). Background: Children's centres in the UK provide a setting for public health programmes; offering support to families living in the most disadvantaged areas where obesity prevalence is at its highest. Health, Exercise and Nutrition in the Really Young (HENRY) is an eight-week obesity prevention programme currently delivered in children's centres across the UK. However, low participant engagement in some local authorities threatens its potential reach and impact. This study aimed to explore the factors influencing participant engagement with HENRY to describe where local intervention may support engagement efforts. Method: A focused ethnography study was undertaken in five children's centres delivering HENRY across the UK. One hundred and ninety hours of field observations, 22 interviews with staff (commissioners, HENRY co-ordinators, managers and facilitators) and six focus groups (36 parents), took place over five consecutive days in each centre. The Consolidated Framework for Implementation Research (CFIR) was used to guide the observations and analysis of the data. Results: Three overarching themes described the factors influencing participant engagement with HENRY: local authority decision making around children's centre programmes; children's centre implementation of HENRY; and the participant experience of HENRY. The results indicate that factors influencing participant engagement with public health programmes begin at the commissioning body level, influencing children's centre implementation and subsequently the experience of participants. Local authority funding priorities and constraints influence availability of places and who these places are offered to, with funding often targeted towards those deemed most at need. This was perceived to have a detrimental effect on participant experience of the programme. Conclusion: In summary, participant engagement is affected by multiple factors, working at different levels of the children's centre and local authority hierarchy, most of which are at play even before participants decide whether or not they choose to enrol and maintain attendance. For programmes to achieve their optimal reach and impact, factors at the commissioning and local implementation level need to be addressed prior to addressing participant facing issues.

Citation

Burton, W., Twiddy, M., Sahota, P., Brown, J., & Bryant, M. (2019). Participant engagement with a UK community-based preschool childhood obesity prevention programme: a focused ethnography study. BMC public health, 19(1), Article 1074. https://doi.org/10.1186/s12889-019-7410-0

• Journal Article Type: Article
• Acceptance Date: Jul 31, 2019
• Online Publication Date: Aug 8, 2019
• Publication Date: Aug 9, 2019
• Deposit Date: Oct 28, 2019
• Publicly Available Date: Oct 28, 2019
• Journal: BMC Public Health
• Print ISSN: 1471-2458
• Electronic ISSN: 1471-2458
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Issue: 1
• Article Number: 1074
• DOI: https://doi.org/10.1186/s12889-019-7410-0
• Keywords: Children’s centres; Ethnography; Public health; Engagement; Obesity; Prevention
• Public URL: https://hull-repository.worktribe.com/output/2344495
• Publisher URL: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7410-0#additional-information
• Additional Information: Received: 31 October 2018; Accepted: 31 July 2019; First Online: 8 August 2019; : Approved by University of Leeds School of Medicine Research Ethics Committee. Consent for the ethnographical observations to take place was provided by participating children’s centres and local authority leads. Written informed consent was provided by all participants of interviews and focus groups.; : Not applicable.; : The authors declare that they have no competing interests.