ESPE Abstracts

Background: Whilst recent systematic reviews have suggested potential benefits to exercise interventions on metabolic outcomes for children and young people (CYP) living with obesity, there is a lack of studies examining the qualitative experiences of CYP as to exercise provision within obesity services. It is reported that weight stigma has a negative impact on self-esteem which may be a barrier to participating in physical activity. We describe the experiences of CYP under the care of a tertiary weight management service, and their parents, who attended a group exercise programme. In addition, barriers to participation in group exercise are explored.

Methods: 220 patients aged 2-17 years old, with mean body mass index (BMI) SDS 3.40 (SD 0.72), are under the care of the tertiary weight management service. All patients aged 7-14 years (n = 157) were invited to participate, at no cost, in a group exercise programme run by an external provider (“Gymrun”) comprising 12 weekly sessions lasting 45 minutes each. 29 (18%) took up a place and retention of participants was 86%. At the end of the programme, families were invited to undertake semi-structured telephone interviews about their experiences with clinical psychologists from the weight management team. Additionally, all families who declined the programme (n = 128) were asked to complete a feedback questionnaire regarding barriers to participation.

Results: Thirteen parents and four CYP participated in interviews following the activity programme. The following four main themes emerged, i) feelings of anxiety due to not knowing what to expect, ii) the importance of celebrating success, iii) inclusivity and iv) noticing change. Psychological and physical benefits of participation were described, including increased motivation to be active, increased confidence, strength and fitness and feeling more positive. 22 families who declined to take part in the activity programme completed questionnaires (17% response rate). Common barriers for non-participation included time to travel (55%), distance from home (50%), cost of travel (32%), timing of sessions (27%) and uncertainty about what to expect (18%). 54% reported not having been provided with enough information about the programme.

Conclusions: This group-based activity-program for CYP living with obesity was associated with positive perceptions from the families who attended. Motivation derived from taking part, may support making other lifestyle changes, and potentially improve long-term health outcomes. Barriers to participation (over 80% declining the offer), such as location, timing of sessions and providing sufficient information about the programme, will inform the design of future activity programmes.