Open Access Study protocol

Should I stay or should I go? Understanding families’ decisions regarding initiating, continuing, and terminating health services for managing pediatric obesity: the protocol for a multi-center, qualitative study

Geoff DC Ball1*, Arnaldo Perez Garcia1, Jean-Pierre Chanoine2, Katherine M Morrison3, Laurent Legault4, Arya M Sharma5, Rebecca Gokiert6 and Nicholas L Holt7

Author affiliations

1 8B, Pediatric Centre for Weight and Health, Edmonton General Continuing Care Centre, 11111 Jasper Ave, Edmonton, AB, T5K0L4, Canada

2 Room K4-212, Endocrinology and Diabetes Unit, British Columbia's Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H3V4, Canada

3 Department of Pediatrics & Population Health Research Institute, McMaster University, Hamilton, HSC 3A59, 1200 Main St. W, Ontario, L8N3Z5, Canada

4 2300 rue Tupper, Montréal, Québec, H3H1P3, Canada

5 406 CSC Royal Alexandra Hospital, Edmonton, AB, T5H3V9, CANADA

6 Community-University Partnership, University of Alberta, Room 2-281 Enterprise Square, 10230 Jasper Avenue, Edmonton, AB, T5J4P6, Canada

7 Faculty of Physical Education and Recreation, University of Alberta, P3-20S Van Vliet Centre, Edmonton, AB, T6G2H9, Canada

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Citation and License

BMC Health Services Research 2012, 12:486  doi:10.1186/1472-6963-12-486

Published: 31 December 2012



At least two million Canadian children meet established criteria for weight management. Due to the adverse health consequences of obesity, most pediatric weight management research has examined the efficacy and effectiveness of interventions to improve lifestyle behaviors, reduce co-morbidities, and enable weight management. However, little information is available on families’ decisions to initiate, continue, and terminate weight management care. This is an important knowledge gap since a substantial number of families fail to initiate care after being referred for weight management while many families who initiate care discontinue it after a brief period of time. This research aims to understand the interplay between individual, family, environmental, and systemic factors that influence families’ decisions regarding the management of pediatric obesity.


Individual interviews will be conducted with children and youth with obesity (n = 100) and their parents (n = 100) for a total number of 200 interviews with 100 families. Families will be recruited from four Canadian multi-disciplinary pediatric weight management centers in Vancouver, Edmonton, Hamilton, and Montreal. Participants will be purposefully-sampled into the following groups: (i) Non-Initiators (5 families/site): referred for weight management within the past 6 months and did not follow-up the referral; (ii) Initiators (10 families/site): referred for weight management within the past 6 months and did follow-up the referral with at least one clinic appointment; and (iii) Continuers (10 families/site): participated in a formal weight management intervention within the past 12 months and did continue with follow-up care for at least 6 months. Interviews will be digitally recorded and analyzed using an ecological framework, which will enable a multi-level evaluation of proximal and distal factors that underlie families’ decisions regarding initiation, continuation, and termination of care. Demographic and anthropometric/clinical data will also be collected.


A better understanding of family involvement in pediatric weight management care will help to improve existing health services in this area. Study data will be used in future research to develop a validated survey that clinicians working in pediatric obesity management can use to understand and enhance their own health services delivery.

Obesity; Pediatric; Treatment; Family; Qualitative; Attrition; Health services