Building space for children's voices: The added value of participatory and creative approaches for child-centred integrated obesity care

Background: Paediatric obesity is increasing across the globe. In search for solutions, it is important to engagechildren, as they have their own unique perspectives on what it means to be a child with obesity within their sociocultural context. Though this is increasingly acknowledged, the question remains how to meaningfully engage children in paediatric obesity care as they are often in an unequal position in relation to adults.
Aim: In this study, we reflect on what can be learned from a participatory research approach to improve
child-centred paediatric obesity care.
Design and methods: We reflect on four years of participatory research with children and care professionals to understand the mechanisms that facilitated child participation within the research process. Secondly, we reflect on how these lessons relate to care practices. We conducted qualitative content analysis on the data gathered, including interviews, observations and working sessions with children and care professionals.
Results: We identified three elements that facilitated child participation: (1) adopting a participatory attitude, (2) connecting to children's living environment and (3) doing activities together. This helped to build trustingrelationships and gain in-depth understanding of what works well and why.
Conclusion: Our findings underscore the significance of building communicative spaces where children's voices can be articulated at their own pace, about issues of their own choice, based on their own experiences. Practical implications: Working together with children as knowledgeable partners in paediatric obesity care can improve care delivery and provide solutions that better reflect their everyday realities and needs.