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Table 2 Descriptive characteristics of the 15 studies included in the qualitative synthesis

From: Overweight and obese adolescents: what turns them off physical activity?

Study number/Author/Country/Recruitment setting

Aims and fit to the systematic review

Design/method of data collection

Population characteristics

1. Lee et al. (2009) [25], Taiwan, primary schools in Taipei City

·To explore viewpoints on exercise and reasons for not exercising among obese preadolescents in the precontemplation stage

Not explicit, semi-structured focus group discussions

N = 11, Boys & girls, aged 11–13 years, BMI – not specificed (obese) according to Taiwan’s Department of Health Executive Yuan (2002)

·To identify key motivators for encouraging overweight or obese children to engage in, or increase regular exercise

Fit: focus on reasons for non participation in exercise

2. Thomas & Irwin (2009) [26], Canada, physician’s office, cross-cultural learners’ centre, YMCA, girl guides leader, neighbour, mother

·To assess overweight and obese adolescents’ perceptions of the meaning of “healthy body weight”, facilitators and barriers to healthy body weight attainment, and program components they believed would effectively enhance and support health body weight behaviours.

Not explicit, semi-structured one-on-one in-depth interviews

N = 11, Boys & girls, aged 14–16 years, overweight (BMI > 85th percentile) or obese by self report (BMI > 95th percentile according to the Centres for Disease Control and Prevention (2000)

Fit: from the perspective of barriers to “healthy body weight” attainment

3. Trout & Graber (2009) [27], United States, weight loss camp from the Midwestern US

·To explore the overweight students’ experiences in and perceptions of physical education

Not explicit, one-on-one open-ended interviews and follow-up telephone interviews

N = 12, Boys & girls, aged 13–18 years, BMI > 85th percentile (overweight) according to the Centres for Disease Control and Prevention

Fit: experiences of physical education classes

4. Griffiths & Page (2008) [28], United Kingdom, Care of Children with Obesity Clinic, Royal Hospital for Children

·To extend our understanding of weight-relation victimisation experiences of obese young people and how, in particular, this impacts on peer relationships

Fit: from the perspective of victimisation and peer relationships

Interpretive Phenomenological Analysis, semi-structured in-depth interviews

N = 5, Girls, aged 12–18 years, BMI > 95th percentile (obese) according to Cole, Freeman & Preece (1995)

Fit: from the perspective of victimisation and peer relationships

5. Daley et al. (2008) [29], United Kingdom, community & children’s hospital for evaluation of obesity

·To explore obese adolescents’ experiences of participation in an exercise intervention

Not explicit, semi-structured interviews

N = 25, Boys & girls, aged 11–16 years, BMI > 98th percentile (obese) according to Cole, Freeman & Preece (1995)

Fit: qualitative study nested within a RCT focusing on experiences of intervention

6. Curtis (2008) [30], United Kingdom, community-based obesity intervention programme

·To explore the experiences of young people with obesity within the secondary school environment in relation to areas of concern prioritised by the Health School Program

Not explicit, focus groups & one semi-structured interview

N = 18, Boys & girls, aged 10–17 years, BMI – not specified (obese)

Fit: experiences of secondary school generally

7. Boyington et al. (2008) [31], United States, hospital based paediatric diabetes screening & prevention program

·To explore cultural attitudes & perceptions toward body image, food, and physical activity among a sample of overweight African American girls

Not explicit, semi-structured group interviews

N = 12, Girls, aged 12–18 years, BMI – not specified (screened as overweight)

Fit: from the perspective of general cultural attitudes relating to body image, food & exercise

8. Alm et al. (2008) [32], United States, subset of participants involved in Teenways pilot project

·To explore the reasons for weight management

·To identify barriers & facilitators of reaching behaviour goals

Not explicit, semi-structured interviews

N = 18, Boys & girls, 13–16 years, BMI > 95th percentile (obese) – which index not specified.

·To identify barriers & facilitators of reaching behaviour goals

·To investigate the role of a motivational behaviour coach in goal-setting among obese Bronx adolescents in a weight management program

Fit: from the perspective of achieving behaviour goals in a weight management program

9. Bodiba et al. (2008) [33], South Africa, the University of Limpopo – Turfloop Campus

·To explore adolescents’ attitudes, feelings and needs regarding their body mass

Not explicit, semi-structured focus group interviews

N = 75, Girls, 17–19 years, no BMI criteria but BMI > 25 kg/m2 classed as overweight according to Senekal (1988)

·To identify social limitations encountered by female adolescents as a result of their body mass

·To investigate feelings in relation to the societal emphasis on weight loss

·To explore relationship between body mass & self-concept

·To identify whether there are differences in self-concept between female adolescents with low, average and high BMI

Fit: from the perspective of self concept in relation to social context

10. Langley (2006) [34], United States, wellness program run at local recreation centre

·To understand the factors influencing PA participation for middle school girls who are overweight or at-risk for overweight

Not explicit, focus groups & reflective journals

N = 17, Girls, aged 11–13 years, BMI > 85th percentile (overweight) according to CDC (2000)

·To examine the effects of a recreation centre’s wellness program on PA levels and the determinants of PA participation in middle school girls who are overweight

Fit: focus on physical activity barriers by one research question

11. Wills et al. (2006) [35], United Kingdom, schools and youth groups in areas within Eastern Scotland

·To discover whether, & how, weight and body size infiltrate other areas of teenagers’ everyday lives

Not explicit, semi-structured interviews

N = 36, Boys & girls, 13–14 years, Normal weight to obese (BMI > 30) according to Cole et al. (2000)

·To discover how these issues are experienced & perceived

·To discover whether medical definitions of fatness are reflected in young peoples’ discursive concerns

Fit: from the perspective of body image perceptions among teenagers, stratified by weight status

12. Smith (2000) [36], United States, National Association to Advance Fat Acceptance (NAAFA) and community

·To learn about adults’ experiences as obese adolescents

Grounded Theory and Symbolic Interactionism, semi-structured interviews

N = 24, Boys & girls, aged 25–40 years reflecting back on their experiences as obese adolescents

·To review literature related to the areas of childhood obesity, physical attractiveness, discrimination, and stigma

Fit: from the perspective of weight salience

13. Neumark-Sztainer et al. (1999) [37], United States, urban public high school

·To gather descriptions of experiences related to body & self-image from overweight adolescent girls to understand how they view themselves & relate to their social context

Not explicit, semi- structured interviews

N = 50, Girls, aged 14–20 years, BMI > 85th percentile (overweight) according to Himes & Dietz (1994)

·To compare experiences related to self-image/body image, among African-American & Caucasian overweight girls

Fit: from perspective of self-image

14. Neumark-Sztainer, Story & Faibisch (1998) [10], United States, urban high schools

·To explore how African-American and Caucasian adolescent girls describe weight-related stigmatisation experiences and their response to these experiences

Not explicit, semi-structured interviews

N = 50, Girls, aged 15–17 years, BMI > 85th percentile (overweight) according to Himes & Dietz (1994)

Fit: from the perspective of stigmatisation

15. Smith & Perkins (2008) [38], United States, recently completed nutrition & exercise program supported by the American Academy of Pediatrics

·To explicate the meaning of being overweight for adolescents attending a medical clinic for weight reduction

Phenomenology, story path/conversation

N = 3, Boys & girls, aged 16–18 years,

 41 < BMI < 49

Fit: from the perspective of mental health

  1. BMI body mass index, RCT randomised controlled trial, PA physical activity.