Harnessing mothers’ strengths to THRIVE in obesity prevention efforts: A qualitative study.

Infancy is a critical period for preventing obesity and health disparities. This study reports on the acceptability of a responsive parenting obesity prevention intervention (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). Eleven of 32 (34.4%) mothers participated in a 45-60 minute focus group (three groups, 3-5 participants each). Sessions utilized a semi-structured interview guide, were transcribed verbatim, and analyzed according to a thematic analytic approach. Four themes emerged: (1) Lived Experience (e.g., lived experience as a mother, navigating systemic and healthcare-related barriers, and context that shaped personal experiences with THRIVE); (2) Therapeutic Processes and Cultural Responsiveness (e.g., an appreciation of families' strengths and values by the THRIVE interventionist that facilitated engagement with THRIVE); (3) Tailored Strategy Implementation (e.g., implementation of THRIVE skills and strategies by families and how strategies were adapted or tailored to meet families' needs); (4) Future Improvements to THRIVE (e.g., proposed strategies for increased attention to DEIA and reducing participant burden). 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 suggested ways to decrease burden and increase access.