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Table 2 Themes and exemplar meaning units reflecting lifestyle (i.e., dietary and physical activity) adherence post-program

From: Perceptions of a family-based lifestyle intervention for children with overweight and obesity: a qualitative study on sustainability, self-regulation, and program optimization

Theme

Exemplar Meaning Unit

Diet (Success)

“The way I cook now, I reduce the amount of oil in cooking, reduce what they call it, the portion or the size.” (generally healthier choices)

“I used to bring full cream milk, you know, for the small kids. Now I’m just bringing low fat. I used to bring white bread and whole meal, now I’m bringing the whole meal only. I don’t bring white bread at all.” “He still has snacks but now, he has different snacks, like fruit salad with yogurt, and he likes it.” “They are looking for more vegetables instead now, and eating more vegetables now.” “I started drinking a lot more water instead of lemonade.” “I know I always feel hungry at night, so I now normally eat apples. Before that I always had cookies but now I don’t.” (healthier substitutions)

“If I like see a packet of chips, I turn it around, and then see the nutrition label. For chips, I look at the salt, and then for like lollies, it’s like sugar, I really just look for everything, cause they’re full of everything. (nutrition resources, tip, and skills) (child)

“Things like how to cut down on carbs, and we learnt how to read the labels, and even still to this day, they still do it. With my son, he’s become very observant. When we go shopping he’s like, “Ma, this is not good, it’s got that much sugar”. He’s just more conscious now, and he goes through the labels.” (nutrition resources, tips, and skills)

Diet (Challenges)

“We made a bit of a WhatsApp group for sharing ideas, which we haven’t actually connected, we were going to, but I suppose everyone got busy. We have got a Facebook group now, but we haven’t really talked during this holiday, probably cause everyone’s away or something.” (conflicting priorities)

Physical Activity (Success)

“The program gave us these pamphlets with different things you could do. Crossfit was one of them. So, I’m doing Crossfit once a week now.” “I was allowed to ride to school afterwards, and at first, I took the short way, but now, I always go the long way.” (continued positive attitudes and engagement)

Physical Activity (Challenges)

“I think it’s [physical activity] dropped off, because in the program we were setting goals, like their physical activity goal every week. It was set up from the start and you had to do it for about a month, so they were pushing. Now that’s gone, my son doesn’t do that anymore.” (loss of structure)

“The problem is like, we give excuses, I’m busy, I’ve got something, I can’t do it today, today I’m tired, always making excuses.” (loss of structure)

“Like mixed martial arts, self-defence physical activity, you do your own stuff, and you never get kids get left out. They do stuff together, but no kids get left out because they’re the slowest or fattest or shortest or tallest. That worked for us, we don’t feel like he’s getting left out, where in soccer and stuff they get left out. It’s about finding something that they want to do, and enjoy, get accepted. If groups were more inclusive, that would be good.” (stigma / exclusion in community activity)

“Some of the community sports are too expensive. We have 3 kids, and it’s too expensive to put them in there.” (cost)