Lack of funds, staffing problem hinder program for kids with obesity

Several barriers on the system and organizational levels disrupt the continuous implementation of SmartMoves, an evidence-based intensive health behaviour and lifestyle treatment (IHBLT) program, for children with obesity, a study has shown.

“The increasing prevalence of and inequities in childhood obesity demand improved access to effective treatment,” the authors said.

Key informants were surveyed and interviewed regarding their experiences acquiring and implementing SmartMoves in this study. The authors then analysed and integrated the survey findings and themes from interviews using the constant comparative method. 

Participants from 16 sites (53 percent) completed the survey, and 12 from 10 sites completed the interviews. Eleven sites (63 percent) implementing the SmartMoves had differences in both the use of training opportunities/materials and fidelity to the components of the program.

In interviews, implementation of SmartMoves was enabled by partnerships, obesity programming, and organizational priorities.

Seven sites discontinued the program even before the COVID-19 pandemic. Based on the interviews, the most common barriers to implementation/sustainment of SmartMoves were lack of funds and insufficient staffing. Some interviewees also mentioned competing demands and the program’s fit with population as additional challenges.

“Adequate funding could enable sufficient staffing and training to promote fidelity to the intervention's core functions and adaptation to fit local populations/context,” the authors said. 

The SmartMoves curriculum used in Bright Bodies, a proven-effective IHBLT, was disseminated to more than 30 sites in the US from 2003 to 2018, according to the authors.