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Table 3 Focus group and interview findings on perceptions regarding retention in 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

Retention
Most studies have real trouble getting the parents engaged and keeping them interested over time. (Researcher)
Barriers Enablers
Location Good experience for adolescents
I think it’s great if it can be more local, because I have broached it with some other parents before but either transport’s an issue or in trying to get off work and then get there after school, it’s a big ask. (School Health Nurse) I think anticipate that in any weight loss program, which is going to take months or years, people may well come in and out of it… If they see it is a good experience, if they see their teens happy, that’s probably something that’s going to really engage families. (Researcher)
Timing Fun and practical
Finding the time that actually works is very challenging. And it’s a barrier. (Researcher) It had to be fun, especially the adolescent sessions. It had to include fun, active games. They tended to bond more if you included those and when you look at the satisfaction questionnaires, they wanted more activity, as much activity as possible. (Researcher)
Commitment
The initial month or two is the hard part, because they’re going from nothing to exercising and always those first couple of months are hard. It’s hard for anyone. (Allied Health Professional)
Family involvement
Involving the family, is probably the most important thing that I see. Because it’s got to be a whole family change. Even if the particular teenager wants to do something, if the family’s not supporting that then it’s not going to go anywhere. (Allied Health Professional)
Social barriers
If you feel alone going there, that’s really bad. (Female Adolescent, Focus Group)
Use online components
Using electronic media too, that sort of validates it, if they’re getting reminders on their email or on their Facebook… even text messages. Maybe some online self-assessments- if they have something that they can go in and do their own little checklist and they get something back that says ‘oh you’re doing this now’ and prints some little graph for them about how they’re going. (Health Promotion Officer)
Good facilitators
It’s really important about the people that you employ…as much as it’s about their proficiency and level of organisation, is how they interact, you almost need those social skills, they’re so important. (Researcher)
Goal setting skills
One of the key aspects of goal setting is to make the goals realistic and achievable but also measureable. So that as they’re going along you can together assess whether in fact
Those goals are at any chance of being reached…because people want to be at the end. So if you can show them that they’ve had three steps forward and two steps back…but can still show them that they’ve made progress. That helps people stay engaged and have a sense of hope for change. (Psychologist)
Easy and rewarding for parents
 If the parent was coming along to that, the parent has got to get something out of it as well. That could be the exercise and all the same sort of things that you’re trying to do for the child. (Health Promotion Officer)