A qualitative examination of contributing factors and treatment considerations for pediatric obesity among parents of rural preschoolers.

The primary purpose of this study was to gather qualitative information related to contributors of pediatric obesity in rural preschoolers, as well as potential changes to obesity interventions that could help promote the health and well-being of children and families in this population. Qualitative focus groups were conducted with 17 parents (all mothers, 19-26 years old [M = 24.7]) of children 2-5 years old with obesity. All study participants resided within a rural area (in a town or county with a population <20,000) and focus groups were held near their homes. Six primary themes were identified through framework analysis of focus group data: (a) limited access to healthy food options in grocery stores and restaurants; (b) challenges with providing recreational alternatives to screen time, especially those that promote physical activity; (c) severely limited access to weight-management services; (d) comfort and acceptability of telemedicine and other technological advancements for behavioral health services; (e) endorsement of the belief that parents are the primary agents of change for preschoolers' health behaviors and weight status; and (f) general time management difficulties, which limit the feasibility of traditional face-to-face interventions and have a negative impact on their child's sleep duration. These themes are discussed in detail, and put into the context of potential changes that could be made to current obesity intervention options for preschoolers living in rural communities. These include using telemedicine to increase reach, considering parent-only interventions, and incorporating behavioral sleep medicine intervention components.