Cultural adaptation of Healthy Dads, Healthy Kids: a weight management programme for fathers of primary school aged children

Problem

The Healthy Dads, Healthy Kids (HDHK) programme was developed in Australia to address weight management in fathers, within the context of their families, such that changes in their health behaviours would positively impact on their children (aged 4-11 years). However, it has not been tested in an ethnically diverse population. The aims of this study were: (i) to increase the cultural acceptability of the programme using theoretically informed adaptations so that it is accessible to the full ethnic, religious and socio-economic diversity of the UK population and (ii) to identify best practice, from the participant’s perspective, to increase attendance and limit attrition from fathers invited to HDHK.

Approach

Qualitative data collection with parents and grandparents from minority ethnic communities living in the West Midlands. Participants took part in focus groups (FGs) or semi-structured interviews exploring aspects of programme content, delivery and motivators for attendance. Topic guides theoretically guided discussions using Liu et al’s (2012) typology of health promotion intervention adaptation for minority ethnic groups (MEGs). Interviews and FGs were audio-recorded and transcribed clean verbatim. Thematic analysis of content, informed by the Framework approach, was used.

Findings

29 participants (14 fathers, 2 grandfathers, 13 mothers), of which 19 took part in one to one interviews and a further 10 took part in two focus groups (mothers only), were recruited from primary schools, community organisations and local businesses using research advocates (i.e. prominent community members promoting the study on behalf of the research team). Our sample was ethnically diverse, with seven White British participants and 21 from MEGs (Black Caribbean, Indian, Pakistani, and Bangladeshi). There was a preference for oral delivery from culturally competent facilitators in a group based format with content that encouraged co-physical activity with their children as opposed to altering their individual diet. Participants highlighted a need for consideration of the appropriateness of fathers and older daughters engaging in tactile games. Adaptations that could increase attendance from men were programme delivery times that accommodated shift work, using locations familiar to the community such as primary schools, facilitators from MEGs and/or fathers, as well as cultural representation in printed material. Fathers stated they would be more likely to participate if the programme was promoted as a father-child activity group rather than a weight loss service designed for men. Further, encouraging fathers to build social relationships with each other and learning to establish close relationships with their children by discussing parenting, could increase engagement.

Consequences

To increase cultural acceptability, weight management programmes for fathers from MEGs require cultural and gender concordance with regard to those delivering the intervention, content that focuses on the health and well-being of their families, with more ethnic representation in visual materials for participants.