Adolescents' involvement in decision-making for pediatric weight management: A multi-centre, qualitative study on perspectives of adolescents and health care providers.

Abstract

To explore adolescents' and health care providers' (HCPs) perspectives on adolescents' involvement in decision-making within multidisciplinary clinical care for pediatric weight management. In this multi-centre, qualitative description study, we purposefully recruited 13-17-year-olds with overweight or obesity and HCPs from two pediatric weight management clinics in Edmonton and Ottawa, Canada. Participants completed one-on-one, in-person, semi-structured interviews (adolescents) or focus groups (HCPs), which were audio-recorded, transcribed verbatim, and managed using NVivo 11. Data were analyzed by two independent researchers using inductive thematic analysis and the congruent methodological approach for group interactions. A total of 19 adolescents and 16 HCPs participated. Three themes were identified in relation to adolescents' decision-making for weight management, including (i) conditions for adolescent involvement, (ii) preferences for adolescent involvement, and (iii) extent of parental involvement. Although adolescents and HCPs positively valued adolescents' involvement in making decisions regarding their weight and health, the extent to which adolescents wished to be involved in the decision-making process varied between individuals and families. HCPs are encouraged to include adolescents and families in their health services delivery, including consulting individually with adolescents and tailoring care to their expectations regarding decision-making.