Background and significance: Young women are difficult to recruit to weight management trials (WMT). Limited research has explored these challenges. This study aimed to examine barriers and enablers influencing WMT participation by young obese women.
Methods: Young (18-35y) women with obesity (BMI >30-40kg/m2) were recruited to 90 min focus groups (3-5 participants/group) to discuss barriers and enablers influencing participation in WMT. Participants were required to have undertaken at least two previous serious weight loss attempts. Discussion was recorded and transcribed verbatim. Recruitment continued until thematic saturation occurred with qualitative content analysis conducted using NVivo.
Major findings: Eight groups (5 urban; 3 regional) including 27 women (16 urban; 11 regional) were conducted. Age and BMI was (mean±SD) 29.2±5.8y and 36.0±2.8 kg.m-2 respectively. Barriers were psychological, physical or program-related. Strong psychological barriers included, feeling stigmatised about obesity, especially the fear of judgement by health professionals/researchers (or other participants) as well as the challenge of overcoming the denial of needing to lose weight. Physical barriers included the time commitment, other participation costs and access (transport/parking). Perceived program barriers included the lack of WMT tailoring to younger women and the need to eat specific foods. Financial incentives were a strong enabler. Advertising other WMT benefits (health, fitness, well-being) rather than weight loss and use of private (toilet door, e-mail, e-newsletters, social media and websites with self-assessment of eligibility) rather than public advertising (noticeboards or flyers) was viewed positively. The words obesity, BMI or weight loss were identified as deterrents to participation.
Conclusions: Young women feel vulnerable to weight stigma and this is a barrier to WMT participation. Tailoring content to age-stage and considering time and access barriers was viewed as important. Positive health messages, financial incentives, self-eligibility assessment and ‘private’ advertising emerged as valuable recruitment strategies.
Research supported by Meat and Livestock Australia