The Process of Change in Patterns of Daily Occupations among Parents of Children with Obesity - Time use, family characteristics and factors related to change

This thesis provides new insights into parents’ patterns of daily occupations. It proceeds from the basis of an occupational perspective on family life, using an occupational lens to understand how, when and where individuals spend their time. In recent decades, lifestyles have changed worldwide and the transition into an increasingly sedentary lifestyles is a major health concern, the origins which can be traced to childhood. The overall aim of this thesis was to explore the shared patterns of daily occupations among parents of preschool-age children with obesity, and to investigate whether it was possible for parents to change the amount of time they spent with their children and the parents’ occupational value over the course of a one-year intervention. Factors related to any change in the parents’ time use as well as any change in the children’s BMI z-score, were also investigated. The first study had a qualitative approach. This study investigated the usefulness of the time-geographical diary method in facilitating reflections on how patterns of daily occupations occur and change over time. The diary method enabled the participants to reflect on and become aware of changes relevant to explaining their reasons for engaging in daily occupations in the way that they did. The second study had a quasi-experimental design in the context of a one-year intervention within the framework of an RCT and consisted of three papers. In Paper II, daily occupations among parents of children with obesity were investigated. Four main family types were identified, the shared patterns of daily occupations differed between each type in terms of the division of household work, paid work and the amount of time spent together as a family. In Paper III an increase over time was seen in the time parents spent together with their children and the parents’ perceived occupational value, along with a subsequent decrease in the children’s BMI. In Paper IV, factors associated with changes in the parents’ time use during the intervention turned out to be the parents’ finances and satisfaction with everyday occupations as well as the parents’ BMI and low sense of control at inclusion. The fathers’ perceptions of occupational values, education and their subjective health, and the mothers’ high sense of control and subjective health explained 67% of the variance in the children’s change in BMI. The findings may lead to a greater understanding of how parents shared patterns of daily occupations are shaped within the family. Together with the contributing factors for predicting change, this should be addressed in the context of the family in order to create further knowledge regarding the development of family-based interventions with an aim of child health promotion