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Table 2 The structure of the main themes, their sub-themes and the codes that make up the sub-themes

From: Is children’s weight a public health or a private family issue? A qualitative analysis of online discussion about National Child Measurement Programme feedback in England

Main theme Sub-theme Code
1) Sources of legitimate feedback ‘Parents know what is best for their child and do not need outside input’ Result is wrong (child is not overweight)
  External input in inappropriate/unnecessary
Feelings (shock, fury, upset, angry, annoyed)
Parenting failure, perceiving being told off
More factors need to be considered (family background, lifestyle, puberty)
Interventions should target other aspects of children’s life (school, neighbourhood)
Parent identity
Some parents need a reminder Feedback letter is gentle/friendly reminder
Overweight is perceived as the new normal in children, it became harder to notice a weight problem
Letter contains useful advice and weight loss programmes
Parents can be blind/biased in relation to their child and need an objective opinion
It is better to intervene early (in childhood) than struggling with weight in adulthood
The initial emotional harm to children is less than the overall harm of living excess weight
BMI is a reliable tool for weight, appropriate for population level
Health or educational professional identity
2) Intrusion versus intervention ‘Nanny state’ Distrust in government collecting this data
  The state intrudes into family life
Nanny state (the state telling people what to do)
Concerns about anonymity and confidentiality of children’s data
The measurements should not be done in schools (perception of schools being behind the programme)
Evidence based policy …how can that be wrong?’ The NHS needs statistical data to plan services locally and nationally
Treating health problems due to excess weight costs the NHS money
Participating is important for everyone for the sample to be representative
Overweight in childhood can lead to overweight and health problems in adulthood
Data collecting does not link to individual children, but is used for population statistics
3) Weight obsession versus weight discussion Unhealthy weight obsession Over-emphasising the importance of weight is wrong
  Measurements lead to discussing weight and upset children
Discussing weight will lead to 'complexes' or even eating disorders
BMI charts are one-size-fits-all and idealise a slim body shape
Emotional harm on children is worse than being overweight
Parents will deal with real problems when they arise (i.e. childhood overweight is not real problem)
Parents’ own history of childhood weight complexes and/or eating disorders
Healthy weight discussion Weight is natural part of life and discussing it will not do harm
Parents themselves decide whether they conduct healthy discussion about weight
Weight is not important in relation to an ideal appearance but in relation to health
Measurements are done sensitively and results not discussed with children to avoid harm
The BMI chart allows for a wide range of normal, and is not trying to fit different shapes into the same size