Caregivers' perceived importance of topics for managing pediatric obesity and their expectations and preferences regarding family navigation: a convergent mixed-methods study

PURPOSE: To examine caregivers' perceived importance of topics regarding pediatric obesity management (POM) and explore their expectations and preferences regarding family navigation (FN). DESIGN AND METHODS: In this cross-sectional, mixed-methods study, caregivers of 6-to-17-year-olds with a BMI ≥ 97th percentile completed a survey to assess their perceived importance of topics regarding POM, including knowledge and skill needs regarding healthier food/drinks, physical activity/exercise, family support/behaviour, and weight management goals. A sub-set completed individual interviews to explore their expectations and preferences regarding FN for POM. From 2022 to 2024, data collection occurred at two POM clinics in Calgary and Mississauga, Canada, within a randomized controlled trial. To examine differences between caregivers' knowledge and skill needs, the paired t-test or Wilcoxon test was used. Inductive/manifest content analysis was used to analyze interview data, with convergent mixed methods used to integrate quantitative and qualitative data. RESULTS: Overall, 108 caregivers completed the survey; data analysis included interviews with 52 caregivers. Survey data showed that caregivers' knowledge needs exceeded skill needs for healthier food/drinks, physical activity/exercise, and total knowledge/skills (all p < 0.01). Caregivers attended clinic appointments seeking support to change behaviours; however, competing commitments limited their ability to attend regularly. Participants preferred to meet navigators more often than monthly, both as a family and parent only, and expected navigators to serve as facilitators and supporters to identify available community resources. CONCLUSIONS: Caregivers reported that FN could support families in accessing community resources and connect them with medical and healthcare providers to promote behaviour change and improve their children's mental health. PRACTICE IMPLICATIONS: Caregivers expect to receive support to overcome barriers that reduce access to health services for managing pediatric obesity in clinics. Interventions that include family navigators as facilitators and supporters to help families in addressing barriers can enhance pediatric obesity management engagement in clinic appointments.