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Table 2 Focus group and interview findings on perceptions regarding recruitment to a community-based healthy lifestyle program

From: Barriers and enablers for participation in healthy lifestyle programs by adolescents who are overweight: a qualitative study of the opinions of adolescents, their parents and community stakeholders

Recruitment
We’ve had a lot of interest but it’s getting those families to actually register…and still wanting to attend (Allied Health Professional)
Barriers Enablers
Adolescents are often embarrassed about having to attend Advertising needs to sell the message and promote it widely
Teenagers often don’t want to go, because they’re very anxious they might see someone they know. Teenagers are already dealing with enormous bullying and other issues; to ask them to do something that they’re concerned may actually make their life worse is going to turn them off the project. (Researcher) It comes down to selling it really well and selling it as a healthy lifestyle thing, rather than a weight loss group. (Allied Health Professional)
Message needs to be positive and not associated with being overweight
From a youth development perspective, it’s really important that the young people are interested in doing it, there’s a whole lot of stigma attached to identifying yourself as overweight or obese. (Local Council)
Overweight has become normalised
I think they’re in denial a lot of these parents…often the parents are overweight, the kids are overweight, the dog’s overweight, the cat’s overweight. (School Health Nurse)
Program needs to be free
The Government should see fit to subsidise something like this alright, ‘cause they keep talking about ‘we’ve gotta do something about the obesity of our children’. If they’re not going to put the money forward, then there’s… I mean I work two jobs just to try and make ends meet, I don’t sort of have the extra money to spend on stuff like this’. (Parent)
Reluctance to refer and lack of expertise in health professionals
Our experience is even paediatricians have had families come to them concerned but the family has been told ‘oh no they’re ok’ when they are clearly overweight, well into the overweight range. (Researcher)  
Lack of current services  
The older people in the community are actually well catered for, but younger kids aren’t and I think seriously there is a huge gap because kids are just getting so overweight and they’re not fit. (Allied Health Professional)  
Broader social barriers  
The only way you’re going to get them in is if it’s for free. The only way they’re going to keep coming back is if it’s for free. You’re not going to get a kid in a low socioeconomic family saying yep we’re going to put up the money for this kid [to access a program like CAFAP]. (Local Council)