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To explore the perceptions and experiences of caregivers of preschool children with weight issues referred from New Zealand's preschool check (the B4 School Check) to a healthy lifestyle programme. Second, to understand determinants of engagement with the programme for families post referral. Semi-structured focus groups and interviews were conducted with caregivers of preschool children referred from the national preschool check (the B4 School Check) to the Whānau Pakari healthy lifestyle programme. A purposeful sampling approach ensured the opinions of Māori (New Zealand's indigenous population) and non-Māori caregivers were included. Those who engaged and did not engage with the programme were included from across Taranaki (a semi-rural region of New Zealand). Focus groups and interviews were run separately for Māori and non-Māori participants. Thematic analysis yielded one sub-theme related to caregiver perceptions of weight: societal beliefs about childhood weight, and three sub-themes related to determinants of engagement: referral experience, competing life demands, and caregiver resistance to and motivation for accepting external support. A negative referral experience to Whānau Pakari often resulted in caregivers declining to engage with the programme. Themes were similar across both Māori and non-Māori caregivers. This study confirmed that caregiver perceptions influence their acceptance and management of their child's weight issues. The experience of the referral to a healthy lifestyle programme is important for determining future engagement, and is likely to be facilitated by providing improved training and support to health professionals around discussing childhood weight issues with caregivers of young children. [ABSTRACT FROM AUTHOR]

Summary: Objective: To determine whether 12‐month BMI SDS reductions persisted at 24 months in a multi‐disciplinary assessment and intervention program for children and adolescents with obesity, and whether secondary outcomes improved. Methods: This was a community‐based 12‐month RCT in Aotearoa/New Zealand. Eligible participants were aged 5 to 16 years with BMI ≥98th centile or BMI >91st centile with weight‐related comorbidities. The low‐intensity control received comprehensive home‐based baseline assessments and advice, and 6‐monthly follow‐up. The high‐intensity intervention received the same assessments and advice, but also weekly multidisciplinary sessions. Primary outcome was BMI SDS at 12 months. Secondary outcomes included cardiovascular and metabolic markers. Results: 121 participants (60% of participants at baseline) were assessed at 24 months. BMI SDS reduction at 12 months was lost at 24 months in the modified intention‐to‐treat analysis [Control −0.03 (95%CI −0.14, 0.09) and Intervention −0.02 (−0.12, 0.08); P =.93]. However, sweet drink intake was reduced, water intake increased, and there were improvements in cardiovascular fitness in the high‐intensity intervention. ≥70% attendance in the high‐intensity intervention resulted in a persistent BMI SDS reduction of −0.22 after 24 months (95%CI −0.38, −0.06). Conclusions: This trial was negative in terms of primary outcome at 24 months. However, high engagement led to sustained treatment effect, and there were multiple improvements in health measures. [ABSTRACT FROM AUTHOR]