Boundaries and Bridges to Adolescent Obesity Prevention: Identifying Parent, School Personnel and Student Engagement Strategies in High Schools in Southern Appalachia

Background. Childhood obesity rates remain high in Appalachia. Effective strategies are needed to engage parents, school personnel and students in obesity prevention efforts in the region, particularly among programs targeting older adolescents.   

Methods. During 2013-2014, focus groups and interviews were conducted with parents (n=39), school personnel (n=38) and high school students (n=21) in 6 counties across rural Southern Appalachia to explore strategies to engage these stakeholders collectively in obesity prevention efforts. The transcripts were analyzed using thematic network analysis.   

Results. Seven engagement mechanisms emerged: (1) environmental supports, (2) policy initiatives, (3) parent/student-centered programming, (4) targeted communications, (5) collaboration to leverage local resources, (6) rewards-based health promotion strategies and (7) cultural norms as barriers and facilitators to change. Participants had differing views on the influence of each factor, but expressed frustration with the “one size fits all” approach to programming that fails to account for the unique needs of their schools. Participants also expressed the need for programming and supports designed to personalize information and engage stakeholders as agents of change. Among high school students, parents remain key stakeholders. Opportunities to promote discourse between parents, school personnel and students are needed to ensure support of school health programming and to create a shared vision for health transformation.

Conclusions. This study identifies potential ways to promote parent, school personnel and student involvement in obesity prevention efforts. Strategies will need to be individually tailored to families and school settings. Parents and school personnel can then facilitate and support changes within their adolescents.