Objective:
Infancy is a critical period for preventing obesity and health disparities. This study reports on the acceptability of a responsive parenting obesity prevention intervention (Teaching Healthy Responsive parenting during Infancy to promote Vital growth and rEgulation [THRIVE]) delivered via integrated behavioral health in a pediatric primary care setting. Intervention participants were invited to participate in a focus group on the acceptability of THRIVE and suggestions for refinement with particular attention to cultural responsiveness and diversity, equity, inclusion, and accessibility (DEIA).
Method:
Eleven of 32 (34.4%) mothers participated in a 45–60-min focus group (three groups, three to five participants each). Sessions utilized a semi-structured interview guide, were transcribed verbatim, and analyzed according to a thematic analytic approach.
Results:
Four themes emerged: (a) lived experience (e.g., lived experience as a mother, navigating systemic and healthcare-related barriers, and context that shaped personal experiences with THRIVE); (b) therapeutic processes and cultural responsiveness (e.g., an appreciation of families’ strengths and values by the THRIVE interventionist that facilitated engagement with THRIVE); (c) tailored strategy implementation (e.g., implementation of THRIVE skills and strategies by families and how strategies were adapted or tailored to meet families’ needs); and (d) future improvements to THRIVE (e.g., proposed strategies for increased attention to DEIA and reducing participant burden).
Conclusions:
Conducting qualitative research prior to Phase 2–3 trials is vital to ensuring the interventions developed, implemented, and tested are not only empirically based but also culturally responsive, attentive to DEIA, acceptable, and relevant. Mothers provided valuable insights surrounding participation in THRIVE, highlighting important DEIA elements of THRIVE and suggesting ways to decrease the burden and increase access.
Implications for Impact Statement
The present focus group study examined the acceptability and perceived effectiveness of a strengths-based obesity prevention intervention delivered in integrated primary care. Mothers identifying as Black or African American were also asked to provide feedback on cultural responsiveness or how the study team, intervention, and procedures valued diversity and cultural factors. This is an important but often overlooked step in intervention development; thus, this study demonstrates the importance of attending to the “voice of the customer,” particularly those with intersecting and diverse identities (i.e., Black mothers), in clinical research.
