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