Opinions from the experts: Experiences of adolescents with severe obesity participating in meal replacement therapy.

BACKGROUND: Meal replacement therapy (MRT) is a structured treatment that is effective for short-term weight reduction in adolescents with severe obesity. However, like other interventions, MRT response is variable. OBJECTIVE: The goal of the current study was to characterize the experience of adolescents with severe obesity participating in MRT. METHODS: Seventeen adolescents with severe obesity participated in semi-structured, individual interviews about their experience participating in MRT. The authors used a biopsychosocial model as the theoretical framework and data was analysed using Interpretive Phenomenological Analysis. A biopsychosocial model views an individual's health as a blend of biological characteristics, behavioural factors, and social conditions. RESULTS: Results showed that adolescents with severe obesity described three biopsychosocial factors that were central to their experience with MRT: (1) scheduling and planning, (2) social support and pressure, and (3) intrapersonal factors. Specifically, adolescents with severe obesity identified that planning ahead, social support, and intrapersonal changes (e.g. self-confidence) can promote engagement in MRT. On the other hand, unplanned schedule changes, social pressures, and different intrapersonal factors (e.g., taste preference) can make engagement challenging. CONCLUSIONS: Adolescents provided information on factors that supported or hindered their engagement in MRT, and themes were consistent with prior literature on health behaviour change. Overall, adolescents would recommend MRT to other teenagers who carry extra weight. Future research can use the rich information provided by adolescents with severe obesity to enhance and individualize treatment options.

Men's Reflections on Their Experiences of Gender-Based Violence.

Using Multicultural and Gender Case Conceptualization (MGCC) epistemology, the aim of this phenomenological study was to explore adult male victims' perceptions of gender and reflections on their experiences of gender-based violence (GBV). Data were analyzed using interpretative phenomenological analysis (IPA). Results indicated that, regardless of sexual orientation, participants experienced verbal and physical abuse due to their feminine gender expression, beginning in primary school and continuing through university and into the workplace. To reduce victimization, the men developed a range of strategies, such as policing their gender and avoiding social situations. The experiences of violence affected the participants' social relationships, choice of occupation, self-esteem, and ability to trust. However, after entering university, heterosexual, gay, and bisexual participants interpreted their experiences differently, whereby heterosexual participants linked the abuse to gender, and gay and bisexual participants viewed it as homophobia. As well, gay and bisexual participants found respite in the gay and bisexual communities, while heterosexual participants remained silent, isolated, and afraid to discuss their experiences. Implications for future research are discussed.

Evaluation of a community-based program for young boys at-risk of antisocial behaviour: results and issues.

OBJECTIVE: We assess the impact of a community-based intervention program for boys 6-11 years old at-risk of antisocial behaviour, and compare changes in behaviour and competence pre-post for intervention and wait-list comparison group. METHOD: Interested parents called for enrolment. Inclusion required police contact and/or clinical scores (T>69) on Child Behaviour Checklist (CBCL) or Teacher Report Form (TRF), no developmental delay and English speaking. The program included two core 12-week groups (children's, parents') and optional additional services. Twelve sessions (February 2002-December 2005) provide pre-post intervention data, boys waiting at least 6 months formed a comparison group (starting April 2005). Outcomes included CBCL and TRF behaviour scales (rule-breaking, aggression, conduct, total problems) and competence. Repeated measures analysis of variance was done. RESULTS: Pre-post outcome comparisons indicated improvements among all boys, with significant differences favouring intervention boys on CBCL behaviour scales, but not TRF outcomes. Effect sizes were small to medium. Persisting high post-behaviour levels, unmeasured variation in additional services, and other design and sampling issues are noted. CONCLUSIONS: More rigorously designed program evaluation is required.