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Från deltagande till delaktighet inom övervikt- och fetmaprevention riktad till barn: -En scopingstudie
Halmstad University, School of Health and Welfare.
2019 (Swedish)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [sv]

Förekomsten av övervikt och fetma hos barn ökar i världen trots insatser. Studier visar att förebyggande interventioner för barn och unga har blygsam effekt. Deltagarbaserad forskning har visat sig vara ett sätt att hitta hållbara lösningar inom hälsointerventioner. Övergripande kunskap saknas dock om hur deltagandet för barn och vuxna kan tillämpas inom deltagarbaserade övervikt- och fetmainterventioner riktade till barn. Syftet med denna studie var att kartlägga deltagandet inom deltagarbaserad övervikt- och fetmaprevention riktad till barn. Hur tillämpas deltagande inom deltagarbaserad övervikt- och fetmaprevention? I vilken utsträckning deltar barnen? 

 

En litteraturbaserad design användes enligt Arksey och O’Malley’s ramverk för scoping review, som innebär fem steg; identifiera forskningsfrågan, identifiera relevanta studier, val av studier, kartläggning av data samt samla in, summera och rapportera resultat. Studier till resultatet samlades in från databaserna Medline, Academic Search Elite, Cinahl och Scopus samt via manuella sökningar.  Inklusionkriterier var peer-reviewed, empiriska studier med fokus på interventioner mot förebyggande av övervikt/fetma för barn och unga (0–18 år) samt med en deltagande ansats med föräldrar, barn eller samhälle. Studier på annat språk än engelska eller svenska, som inte fokuserade på förebyggande interventioner mot övervikt/fetma för barn och som inte tydligt definierat studien som deltagarbaserad exkluderades. Sökningen resulterade initialt i 995 artiklar. Urvalsprocessen med vidare granskning resulterade slutligen i 34 studier som inkluderades i denna studie. Graden av delaktighet analyserades vidare med Shier’s Modell, som innebär 5 steg; 1. barn blir lyssnade på, 2. barn stöds i att uttrycka sina åsikter, 3. barns åsikter beaktas, 4. barn är involverade i beslutsprocessen, 5. barn delar makt och ansvar för att ta beslut”. 

 

Resultatet visade att de flesta interventioner skedde i skolan. Både föräldrar, barn, lärare och samhället involverades i olika grad och inom olika metoder. Flera studier rapporterade dock deltagandet bristfälligt. I 12 studier exkluderades barn som deltagare. När barn deltog var det ofta äldre barn i tonåren. Vid analys av barns deltagande med Shier’s Modell var flest studier inom steg 4 (deltagande i beslut, n= 7) och steg 3(konsultation, n=7) följt av steg 5 (delat ansvar och makt, n=6).

Framtida forskning bör fokusera på att mer utförligt beskriva den deltagande processen, involvera yngre barn samt undersöka hur barn upplever sitt deltagande, för att skapa ett meningsfullt deltagande. Prevention för övervikt och fetma kräver innovativa lösningar och fokus inom framtida studier bör vara på att öppna upp för deltagande genom en deltagande utgångspunkt, att skapa möjligheter genom tillräckliga resurser och passande metoder samt att inkludera deltagandet som en inbyggd policy genom arbetsprocessen.

Abstract [en]

The prevalence of overweigth and obesity in children is increasing in the world despite efforts. Studies show that preventive interventions for children and young people have a modest effect. Participatory research has proven to be a way to find sustainable solutions in health interventions. However, there is no comprehensive 

knowledge on how participation for children and adults can be applied within participant-based obesity interventions targeting children.The purpose of this study was to map participation in participant-based obesity prevention targeting children. How is participation in participant-based obesity prevention applied? To what extent do the children participate?

 

A literature-based design was used according to Arksey and O’Malley’s scoping review framework, which involves five steps; identifying the research issue, identifying relevant studies, selecting studies, charting data, and collecting, summarizing and reporting results. Studies for the results were collected from the databases Medline, Academic Search Elite, Cinahl and Scopus as well as through manual searches. Inclusion criteria were peer-reviewed, empirical studies focusing on interventions to prevent obesity for children and adolescents (0–18 years) and with a participatory approach with parents, children or society. Studies in languages ​​other than English or Swedish, studies which did not focus on preventive interventions against obesity for children and studies that did not clearly define the study as participant-based, were excluded. The search initially resulted in 995 articles. The selection process with further examination finally resulted in 34 studies that are included in this study. The degree of participation was further analyzed with Shier's Model, which involves 5 steps; 1. children are listened to, 2. children are supported in expressing their opinions, 3. children's opinions are taken into account, 4. children are involved in the decision-making process, 5. children share power and responsibility in making decisions

 

The result showed that most interventions took place in school. Both parents, children, teachers and society were involved to varying degrees and within different methods. Several studies reported the participation poorly. In 12 studies, children were excluded as participants. When children participated, they were often older, in their teens. When analyzing children´s participation with Shiers’s Model, most studies were in step 4 (participation in decisions, n=7) and step 3 (consultation, n= 7) followed by step 5 (shared responsibility and power, n=6).

 

Future research should focus on more fully describing the participatory process, involving younger children and examining how children experience their participation, in order to create meaningful participation. Prevention for obesity requires innovative solutions and the focus of future studies should be on opening up for participation through a participatory starting point, creating opportunities through adequate resources and appropriate methods, and including participation as an embedded policy through the work process.

 

Place, publisher, year, edition, pages
2019. , p. 55
Keywords [en]
Children, intervention, obesity prevention, participatory research, scoping review
Keywords [sv]
Barn, deltagarbaserad forskning, fetmaprevention, intervention, scopingstudie
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hh:diva-41306OAI: oai:DiVA.org:hh-41306DiVA, id: diva2:1381655
Subject / course
Health and lifestyle
Educational program
Master's Programme in Health and Lifestyle, 120 credits
Supervisors
Examiners
Available from: 2020-01-02 Created: 2019-12-25 Last updated: 2020-01-02Bibliographically approved

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