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Table 3 Enablers, barriers and resources for parent engagement in health behaviour change

From: Study protocol of a parent-focused child feeding and dietary intake intervention: the feeding healthy food to kids randomised controlled trial

Enablers of parent engagement in behavioural change Barriers to engaging parents in behavioural change
· Collaborative, whole of agency approach · Delayed response to identification of issues
· Recognition of mutual expertise · Feelings of isolation or victimisation
· Belief that parents are trying their best · Fear of being labelled a ‘bad parent’
· Target various stages of readiness to change · Fear of failure
· Importance of ‘engaging’ parents · Parents unaware of consequences of behaviours
· Multi component strategies, multiple referral methods · Parents ambivalent to change own behaviours
· Low level interventions for simple behavioural change · Inadequate time allowance between exposure and expected adoption of health behaviour change
· Encourage authoritative parenting  
· Normalise parenting support  
Enablers of optimal child feeding and childhood nutrition Perceived barriers to optimal child feeding (parent cited)
· Role modelling healthy eating habits · Lack of information about overcoming fussy eating Inadequate communication about nutrition from childcare Impact of food marketing Poor food availability and confusion about food labelling
· Involvement of children in food preparation
· Availability of reputable resources in the public domain
· Early intervention and a theoretical basis for programs · Food used as a reward despite parent knowledge
· Universal interventions for less severe needs, · Perceived lack of appropriate nutrition resources
· Parents receptive to/capable of behavioural change · Need for ‘one stop shop’
· Targeting parenting skills in addition to nutrition · Need for user friendly resources related to healthy eating
· Programs that encourage authoritative parenting styles, with or without a nutrition or child feeding focus
· Multifaceted and community wide programs  
Effective health education resource/strategy components Ineffective health education resource/strategy components
· Educational home visits or telephone education · Printed materials of limited value
· ‘Parents as teachers’ model · Didactic approach to teaching
· Resources that are socially and culturally appropriate · Lack of consideration for adult learning principles
· Educational resources need to be reading age appropriate · Poor training of educators to work parents in paediatrics
· Web resources to replace face-to-face education · Resources not appropriate for target group
· Ensure ample ‘dosage’ of technology resources  
· Use of internet for rural participants  
· Optimal balance of regulation, legislation and education