Abstract:

Childhood obesity remains one of the most persistent public health and educational challenges in Spain. National surveillance systems such as ALADINO and PASOS have advanced understanding of prevalence and long-term trends; however, resulting interventions have predominantly targeted physiological aspects while overlooking the psychological determinants of adherence to healthy behaviors. Elements such as self-efficacy, enjoyment of movement, internal motivation, family support, and perceived stigma play a crucial role in children’s engagement with physical activity and healthy routines.

This study aims to identify and prioritize key psychological components that should be incorporated into national prevention programs through a two-round online Delphi process involving 20–25 experts in pediatrics, psychology, physical education, public health, and families. Experts will evaluate the importance and feasibility of 25 psychological elements grounded in the COM-B model and Self-Determination Theory. Consensus will be defined as an interquartile range ≤1.

Additionally, a clinical sub-study will be conducted in a pediatric obesity unit implementing 2–3 prioritized components (e.g., graded goal-setting, movement enjoyment strategies, structured family reinforcement). Outcomes will include wellbeing (KIDSCREEN-10), enjoyment (PACES-S), and weight-related self-stigma (WBIS-Y).

Expected results include consensus on approximately ten priority components and evidence of clinical feasibility, with anticipated improvements in wellbeing and reductions in self-stigma. This study aims to bridge the gap between epidemiological monitoring and the emotional needs of children with obesity, providing a practical roadmap for integrating validated psychological strategies into educational and clinical programs.

Keywords:

Childhood obesity, Delphi study, psychological factors, Self-Determination Theory, physical education, wellbeing, stigma, adherence, clinical implementation.