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Socioenvironmental Barriers
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i. School-Related Issues
“If you look at this group…and the overall challenge with children today, eating disorders and being overweight, there just seems to be a real lack of focus on it in the school system.” (Participant 10, male) “Sometimes they’ll come back [and] they haven’t touched their vegetables or anything in their lunch, and when we challenge them on it it’s like we didn’t have enough time.” (Participant 2, male) “I think they might have gym once or twice a week [at school], and with no actual focus on what to eat, how to eat.” (Participant 2, male)
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ii. Social Pressures and the Food Environment
“You have to make the best decisions when you’re around the table and there’s a buffet, and Grandma made something, Great Aunt made something … so have a typical strategy that works best for you, cause you don’t want to feel that now you have limited yourself or restricted yourself, and now that becomes another forbidden fruit for you and for the family, it’s hard.” (Participant 11, female) “With my kids, no sugary drinks. When they go to parties and everyone is having juice or pop it’s a, ‘Why can’t we have carbonated beverages, Mom?’, or like when the nephews and nieces come over and they have pop for breakfast.” (Participant 11, female) “We are really competing against food science and some of the brightest and best food scientists out there you know. It does not take fifteen times for a snack food to appeal to a kid. It is like an addictive drug, it really is … how do you compete against that?” (Participant 3, male)
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iii. Lack of Flexible and Cost-Effective Programming for Children
“… one of [the] things is cost for a lot of families. If you’ve already got your kids in a lot of activities and then your kids want to go out and do things. Everything costs money, right?” (Participant 9, female) “Everything is so structured and monetarized now too, it’s a struggle. People think they need to go to these places to go do physical activity. It is a mindset and it doesn’t have to be that way.” (Participant 10, male) “I wanted a program like a nice supportive activity where I could drop her off once a week…. Where they do nice, structured, physical activities with a lot of other kids… Like a recreational but hard physical activity. Something that will make them sweat because I don’t want to put her into all the competitive stuff.” (Participant 12, female)
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iv. Stigma and Bullying
“It was hard for him [my son] to understand why the kids at school called him fat…so it’s kind of trying to help explain that stuff to him.” (Participant 6, male) “The problem that my son is facing is mental health…. He feels he is isolated because he is not able to relate to others and he has used the word ‘bullying’ quite often…. He hasn’t missed school or pretended to be sick because he doesn’t want to go, his friends still play with him, but he does not feel like he belongs.” (Participant 11, female) “There’s lot of blame and guilt that comes with your child who is overweight and you feel like everyone walking around and looks at you, [thinking] she’s not thin and no wonder her child’s not thin.” (Participant 1, female)
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v. Geographical and Seasonal Issues
“It’s tougher now too as we get into the winter.” (Participant 2, male) “Especially now when it’s dark at five, like shower, bed time, let’s go.” (Participant 11, female) “He’s had such a struggle always and we’ve been trying to reach out to get help, but it’s so hard. We live in a small community, about an hour away from here, but this was the closest that we could really get help.” (Participant 6, male)
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Time Constraints
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“Barring going into a restaurant, to find a quick option when you are like off to a game or something like that, it is impossible” (Participant 10, male) “I have been paying for the Y for six years … I only do the summer camps, because I finish work by 5:30–6 o’clock and there is no way I can get anywhere.” (Participant 11, female) “Getting your kids and family fed so you can get to the rest of the life…. You rush them through to get everything done, we are going back and forth from activity to home. You might have 10 or 15 min at home so you don’t have time to prep a great meal for your family…. Our lives are really busy; we’re gone every day of the week.” (Participant 9, female) “Sometimes you know you shouldn’t be doing this, but you have 5 min or 10 min to get supper ready and get to whatever it is you have to do. I work sometimes 14-h days.” (Participant 8, male) “She [my daughter] could play in the park for 9 or 10 h if you let her. It’s just, I’ve got her two days a week and if we go play at the park for 6–7 h then I’m going to get absolutely nothing done. So as much as I would love to let her just go, there are other things I have to do.” (Participant 8, male) “There’s so many things. Some days you get home from work and you had a plan, but there is no way, it’s just is not happening. For me it is all about dinners…I don’t meal prep, I don’t have time on weekends, I don’t do any of that so I get home and then I start making the dinners. Like [that’s] what really holds us back from doing anything.” (Participant 12, female) “A barrier to nutrition is again, time management.” (Participant 3, male)
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Parenting Issues
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i. Protecting Children’s Feelings
“She [my daughter] is a very confident girl, and she sees herself as very pretty and she’s very popular. She’s got tons of friends, but I think the moment those words come out of my mouth, that she thinks I look at her differently…I feel like it could shatter her.” (Participant 12, female) “We didn’t talk a lot about the program to my daughter and I have … a bit of anxiety. I didn’t want to say why I sought it out. I didn’t want to say that… and whatever confidence they have, you don’t want to change that.” (Participant 4, female) “She has the most self-confidence … my biggest hope is that it stays…. She’s having fun and she’s enjoying it, and is keeping it positive. That is the part that I like, that I want to keep.” (Participant 7, female)
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ii. Setting Appropriate Boundaries
“It’s hard to say absolutely no screens ever, all day until Friday, until the weekend.” (Participant 5, female) “You don’t want it to feel like, ‘No, you can’t have this. No you cannot have this.’” (Participant 11, female) “It’s hard ‘cause you’re giving your kid withdrawals, like ‘No, you can’t do what everyone else is doing’” (Participant 3, male)
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iii. Difficulties Associated with Relaying Program Content to Children
“I go home and she doesn’t listen to me. She would listen to someone else standing in front of the room talking to everyone. She would be more likely to get something out of that, than me retelling what we learned because I’m Mom and I don’t know that much.” (Participant 4, female) “Parents don’t carry as much weight as the experts. Everything we took away from here was delivered by the parent. But if it’s not being delivered by Mom and Dad, it would be less [of a] chore.” (Participant 2, male)
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