Providers' Involvement of Blended Families in Pediatric Weight Management Programs

Introduction: Family based interventions are the standard for pediatric weight management programs (PWMPs), yet the details of how to involve additional family members, when youth are part of blended families (i.e., step families) or reside in multiple households is not well understood. The objective of this study is to describe how providers involve blended families and multiple households in PWMPs. Method: A cross-sectional exploratory survey was conducted of providers at PWMPs in the United States and Canada. The survey questions included had both multiple choice and open-ended responses. Univariate analyses were conducted. Results: 71 providers participated, representing 47 centers/clinics. The majority (96%) reported assessing multiple households, most often during the medical history. Providers reported including the primary caretakers at all known residences (59%), but not immediate family members beyond the primary caretakers. Providers reported adapting dietary (88%) and physical activity (77%) recommendations to accommodate multiple households. The most frequent adaptations included the goals at each family/household, adjustments on a per family basis or based on family resources, and making materials available to all family members. The most frequent challenges in extending treatment plans to multiple households included one caretaker/household not willing to participate or being present at visits, and inconsistency between households. Despite providers reporting that they assess multiple households, they did not have a formal interview template or form to use in assessments (27%). Discussion: Providers recognize the challenges and complexity that blended families present with in obesity treatment. Further research is need to increase provider assessment and involvement of blended families and the extension of goals and treatment plans to multiple homes.