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Brown CL, Skinner AC, Yin HS, Rothman RL, Sanders LM, Delamater AM, Ravanbakht SN, Perrin EM. Parental Perceptions of Weight During the First Year of Life. Acad Pediatr 2016; 16:558-64. [PMID: 27002214 PMCID: PMC4976024 DOI: 10.1016/j.acap.2016.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/08/2016] [Accepted: 03/11/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND More than half of parents underestimate their overweight child's weight; however, previous research focuses on children older than 2 years of age. The objective of this study was to assess whether parents of 2- to 12-month-old infants are able to accurately perceive their children's weight status. METHODS We performed a cross-sectional analysis of data collected from the Greenlight study, a cluster randomized obesity prevention trial, at 4 pediatric clinics serving diverse and low-income populations. Infants' length and weight were measured at well-child checks, and parents completed questionnaires including demographic characteristics and perception of their children's weight. Weight-for-length (WFL) percentile at the fifth to ≤95 was considered healthy weight and WFL percentile >95th was considered overweight. We used chi-squared tests to compare accuracy according to weight category and performed logistic regression analysis to assess accuracy at each time point. RESULTS Approximately 85% to 90% of infants (n = 853 at 2 months, n = 563 at 12 months) were at a healthy WFL at all measurement times, and parents of these infants were more likely to have an accurate perception of their child's weight (accuracy 89%-95%) than overweight children (accuracy 7%-26%; P < .001 across time points). Approximately 10% of healthy weight infants were perceived as underweight by their parents at all time points. At 12 months, mothers who were overweight were significantly more likely to underestimate their child's weight status (P = .008). CONCLUSIONS In our diverse and low-income sample, parents of overweight infants infrequently know that their infants are overweight. Future studies should examine how perception is related to feeding habits and weight status over time.
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Affiliation(s)
- Callie L. Brown
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Asheley C. Skinner
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - H. Shonna Yin
- Department of Pediatrics, School of Medicine/Bellevue Hospital Center, New York University, New York, NY
| | - Russell L. Rothman
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN
| | - Lee M. Sanders
- Department of Pediatrics, Center for Policy, Outcomes and Prevention, Stanford University, Stanford, CA
| | - Alan M. Delamater
- Department of Pediatrics, University of Miami School of Medicine, Miami, FL
| | - Sophie N. Ravanbakht
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Eliana M. Perrin
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
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Wright DR, Lozano P, Dawson-Hahn E, Christakis DA, Haaland WL, Basu A. Parental Predictions and Perceptions Regarding Long-Term Childhood Obesity-Related Health Risks. Acad Pediatr 2016; 16:475-481. [PMID: 26875508 PMCID: PMC4931970 DOI: 10.1016/j.acap.2016.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/02/2016] [Accepted: 02/06/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess how parents perceive long-term risks for developing obesity-related chronic health conditions. METHODS A Web-based nationally representative survey was administered to 502 US parents with a 5- to 12-year-old child. Parents reported whether their child was most likely to be at a healthy weight or overweight, and the probability that their child would develop hypertension, heart disease, depression, or type 2 diabetes in adulthood. Responses of parents of children with overweight and obesity were compared to those of healthy-weight children using multivariate models. RESULTS The survey had an overall response rate of 39.2%. The mean (SD) unadjusted parent predicted health risks were 15.4% (17.7%), 11.2% (14.7%), 12.5% (16.2%), and 12.1% (16.1%) for hypertension, heart disease, depression, and diabetes, respectively. Despite underperceiving their child's current body mass index class, parents of children with obesity estimate their children to be at greater risk for obesity-related health conditions than parents of healthy-weight children by 5 to 6 percentage points. Having a family history of a chronic disease, higher quality of care, and older parent age were also significant predictors of estimating higher risk probabilities. CONCLUSIONS Despite evidence that parents of children who are overweight may not perceive these children as being overweight, parents unexpectedly estimate greater future risk of weight-related health conditions for these children. Focusing communication about weight on screening for and reducing the risk of weight-related diseases may prove useful in engaging parents and children in weight management.
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Affiliation(s)
- Davene R Wright
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Wash.
| | | | - Elizabeth Dawson-Hahn
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Wash
| | - Dimitri A Christakis
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Wash
| | - Wren L Haaland
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Wash
| | - Anirban Basu
- Department of Pharmacy, University of Washington School of Pharmacy, Seattle, Wash
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Patiño-Villena B, Chirlaque MD, Salmerón D, González E, Navarro C. [Validity of anthropometric measurements and weight perceptions reported by relatives of children under 4 years old]. GACETA SANITARIA 2016; 30:300-3. [PMID: 27268022 DOI: 10.1016/j.gaceta.2016.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 03/21/2016] [Accepted: 03/30/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the validity of weight and height measurements reported by parents and the perception of their children's weight status in order to assess the prevalence of overweight children under 4 years old. METHODS Cross-sectional study. Anthropometric data was collected by self-report questionnaires completed by parents of children 3-45 months old: 1) information from paediatric check-ups (gold standard); 2) information reported from the home environment; and 3) data from individual perceptions. WHO standards were used. RESULTS Reported height was underestimated, thus reported weight/height and BMI/age were overestimated. Overweight prevalence according to paediatric check-ups was 18.6%, compared to 26.5% reported prevalence, showing a moderate concordance (Kappa: 0.47 [0.34-0.60]), 70% sensitivity and 84% specificity. Subjective perception was 11.2%, representing 30% sensitivity and 93% specificity. CONCLUSIONS The reported information has little validity for population-based studies, as height is underestimated and overweight status is not correctly perceived due to distortion of individual perception. Questionnaires must be validated and awareness raised among families.
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Affiliation(s)
| | - María Dolores Chirlaque
- Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Ciencias Socio-Sanitarias, Universidad de Murcia, Murcia, España
| | - Diego Salmerón
- Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Ciencias Socio-Sanitarias, Universidad de Murcia, Murcia, España
| | - Eduardo González
- Servicios Municipales de Salud, Ayuntamiento de Murcia, Murcia, España
| | - Carmen Navarro
- Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Ciencias Socio-Sanitarias, Universidad de Murcia, Murcia, España
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Health care providers' perceived barriers to and need for the implementation of a national integrated health care standard on childhood obesity in the Netherlands - a mixed methods approach. BMC Health Serv Res 2016; 16:83. [PMID: 26955883 PMCID: PMC4784354 DOI: 10.1186/s12913-016-1324-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2010, a national integrated health care standard for (childhood) obesity was published and disseminated in the Netherlands. The aim of this study is to gain insight into the needs of health care providers and the barriers they face in terms of implementing this integrated health care standard. METHODS A mixed-methods approach was applied using focus groups, semi-structured, face-to-face interviews and an e-mail-based internet survey. The study's participants included: general practitioners (GPs) (focus groups); health care providers in different professions (face-to-face interviews) and health care providers, including GPs; youth health care workers; pediatricians; dieticians; psychologists and physiotherapists (survey). First, the transcripts from the focus groups were analyzed thematically. The themes identified in this process were then used to analyze the interviews. The results of the analysis of the qualitative data were used to construct the statements used in the e-mail-based internet survey. Responses to items were measured on a 5-point Likert scale and were categorized into three outcomes: 'agree' or 'important' (response categories 1 and 2), 'disagree' or 'not important'. RESULTS Twenty-seven of the GPs that were invited (51 %) participated in four focus groups. Seven of the nine health care professionals that were invited (78 %) participated in the interviews and 222 questionnaires (17 %) were returned and included in the analysis. The following key barriers were identified with regard to the implementation of the integrated health care standard: reluctance to raise the subject; perceived lack of motivation and knowledge on the part of the parents; previous negative experiences with lifestyle programs; financial constraints and the lack of a structured multidisciplinary approach. The main needs identified were: increased knowledge and awareness on the part of both health care providers and parents/children; a social map of effective intervention; structural funding; task rearrangements; a central care coordinator and structural information feedback from the health care providers involved. CONCLUSIONS The integrated health care standard stipulate that the care of overweight or obese children be provided using an integrated approach. The barriers and needs identified in this study can be used to define strategies to improve the implementation of the integrated health care standard pertaining to overweight and obese children in the Netherlands.
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Bucher Della Torre S, Dudley-Martin F, Kruseman M. 'Croque&bouge': A feasible and acceptable programme for obesity prevention in preschoolers at risk and their parents. SAGE Open Med 2016; 3:2050312115574365. [PMID: 26770769 PMCID: PMC4679228 DOI: 10.1177/2050312115574365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 01/27/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To conceptualize and pilot test a programme of three workshops aiming to prevent the development of overweight in susceptible preschool children. METHODS Three workshops were conducted, targeting both parents and children. The curriculum for parents included discussions on feeding responsibilities, healthy eating, taste development, neophobia and physical activity recommendations. Children participated in various play activities with fruits and vegetables and read stories about hunger and satiety feelings. Recruitment was organized through paediatricians and child-care centres. Evaluation of the programme focused on feasibility, adequacy for children's age, parents' perception of impact and, for children, change of the ability to recognize and willingness to taste fruits and vegetables. RESULTS A total of 21 children and one of their parents participated in the programme. The programme was found to be feasible and adequate for the targeted community. Parents reported perceiving a positive impact of the intervention; however, this finding was not statistically significant. The major difficulty was identifying and recruiting families and engaging the parents in a discussion about weight. CONCLUSIONS This short programme aiming to improve parents' ability to offer healthy environment and promote healthy eating behaviour was feasible and acceptable for families with young children. When developing and implementing such programmes, close collaboration with paediatricians and other health providers should be sought in order to identify and reach children at risk of obesity and their family.
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Affiliation(s)
- Sophie Bucher Della Torre
- Nutrition and Dietetics Department, School of Health Professions - Geneva (HEdS-GE), University of Applied Sciences Western Switzerland (HES-SO), Carouge, Switzerland
| | - Fiona Dudley-Martin
- Nutrition and Dietetics Department, School of Health Professions - Geneva (HEdS-GE), University of Applied Sciences Western Switzerland (HES-SO), Carouge, Switzerland
| | - Maaike Kruseman
- Nutrition and Dietetics Department, School of Health Professions - Geneva (HEdS-GE), University of Applied Sciences Western Switzerland (HES-SO), Carouge, Switzerland
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56
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Vallejo M, Cortes-Rodríguez BA, Colin-Ramirez E. Maternal Underestimation of Child's Weight Status and Health Behaviors as Risk Factors for Overweight in Children. J Pediatr Nurs 2015; 30:e29-33. [PMID: 25764943 DOI: 10.1016/j.pedn.2015.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/19/2015] [Accepted: 02/21/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate children's risk of being overweight associated with maternal underestimation of weight status and health behaviors. RESULTS One hundred forty mother-child dyads were included. Children whose weight status was underestimated by their mothers were at greater risks of being overweight compared to those whose weigh status was correctly perceived (adjusted OR 2.31, 95% CI 1.11-4.81). Less television viewing time was associated with a 63% reduced risk of being overweight (adjusted OR .37, 95% CI .17-.83). CONCLUSIONS Maternal underestimation of weight status was common among overweight and normal-weight children, and it was associated with an increased children's risk of being overweight.
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Affiliation(s)
- Maite Vallejo
- National Institute of Cardiology, Mexico City, Mexico
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57
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Shiely F, Ng HY, Berkery EM, Murrin C, Kelleher C, Hayes K. The association between weight perception and BMI: report and measurement data from the growing up in Ireland Cohort Study of 9-year olds. Int J Obes (Lond) 2015; 41:46-53. [PMID: 27671034 DOI: 10.1038/ijo.2016.162] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/05/2016] [Accepted: 08/07/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The gold standard for categorisation of weight status is clinically measured body mass index (BMI), but this is often not practical in large epidemiological studies. OBJECTIVES To determine if a child's weight perception or a mother's perception of a child's weight status is a viable alternative to measured height and weight in determining BMI classification. Secondary outcomes are to determine the influence of a mother's BMI on her ability to categorise the child's BMI and a child's ability to recognise his/her own BMI. METHODS Cross-sectional analysis of the growing up in Ireland cohort study, a nationally representative cohort of 8568 9-year-old children. The variables considered for this analysis are the child's gender, BMI (International Obesity Taskforce grade derived from measured height and weight) and self-perceived weight status, and the mother's weight perception of the child, BMI (derived from measured height and weight) and self-perceived weight status. Cohen's weighted-kappa was used to evaluate the strength of the agreement between pairwise combinations of the BMI variables. Cumulative and adjacent categories logistic regression were used to predict how likely a person rates themselves as under, normal or overweight, based on explanatory variables. RESULTS Mothers are more accurate at correctly classifying their child's BMI (κ=0.5; confidence intervals (CI) 0.38-0.51) than the children themselves (κ=0.25; CI 0.23-0.26). Overweight mothers are better raters of their child's BMI (κ=0.51; CI 0.49-0.54), compared with normal (κ=0.44; CI 0.41-0.47) or underweight mothers (κ=0.4; CI 0.22-0.58), regardless of whether the mother's BMI is derived from measured height and weight or self-perceived. The mother's perception of the child's weight status is not an influencing factor on the child's ability to correctly classify him/herself, but the child's self-perceived weight status influences the mother's ability to correctly classify the child. CONCLUSIONS A mother's BMI classification of her child is a viable alternative to BMI measurement in large epidemiological studies.
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Affiliation(s)
- F Shiely
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.,HRB Clinical Research Facility, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - H Y Ng
- School of Medicine, University College Cork, Brookfield Health Sciences Complex, Cork, Ireland
| | - E M Berkery
- Department of Mathematics and Statistics, University of Limerick, Plassey, Limerick, Ireland
| | - C Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - C Kelleher
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - K Hayes
- Department of Mathematics and Statistics, University of Limerick, Plassey, Limerick, Ireland
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Ek A, Chamberlain KL, Ejderhamn J, Fisher PA, Marcus C, Chamberlain P, Nowicka P. The More and Less Study: a randomized controlled trial testing different approaches to treat obesity in preschoolers. BMC Public Health 2015; 15:735. [PMID: 26231850 PMCID: PMC4522072 DOI: 10.1186/s12889-015-1912-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/08/2015] [Indexed: 01/13/2023] Open
Abstract
Background While obesity has been shown to be difficult to treat in school aged children and in adolescence, promising results have been detected for children who started treatment in early childhood. Yet knowledge on the effectiveness of structured early childhood obesity treatment programs is limited, preventing the widespread implementation of such programs. The main objective of this study is to evaluate the effectiveness of early treatment of childhood obesity with respect to treatment focus (parenting practices or lifestyle), length and intensity. The study will also examine the influence of gender, age, parental weight status, parenting practices, child behavior as well as parents’ socioeconomic status and child and parental psychosocial health on children’s weight status. Methods/design This is a parallel open label randomized controlled trial assessing two different behavioral treatment approaches offered in three conditions to families with children aged 4–6 years in Stockholm County, Sweden. Children (n = 180) identified as obese will be referred from primary child health care, school health care, and from outpatient pediatric clinics, and randomized to: 1) a standard treatment with focus on lifestyle, provided within the current healthcare system (n = 90); 2) a 10-session, 1.5 h/week group treatment with focus on parenting (n = 45); or 3) the same group treatment as 2) with additional follow-up sessions (n = 45). The primary study outcome is change in children’s body mass index standard deviation score (BMI SDS) one year post-baseline. Secondary outcomes include changes in children’s waist circumference, metabolic health, lifestyle patterns (Food Frequency Questionnaire), obesity-related child behaviors (Child Eating Behavior Questionnaire and Lifestyle Behavior Checklist, Problem Scale), parents’ general and feeding parenting practices (Communicating with Children and Child Feeding Questionnaire) and lifestyle-specific self-efficacy (Lifestyle Behavior Checklist, Confidence Scale), family functioning (Family Assessment Device), child and parental psychosocial health (Child Behavior Checklist and Beck’s Depression Inventory II). Discussion This study will facilitate a close examination of key components of treatment for obesity during early childhood and mechanisms of change. Results from this study will lead to better healthcare options for obesity treatment during early childhood and ultimately to the prevention of obesity later in life. Trial registration ClinicalTrials.gov NCT01792531 Registered February 14, 2013.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
| | | | - Jan Ejderhamn
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
| | - Philip A Fisher
- Oregon Social Learning Center, Eugene, OR, USA. philf@uoregon.\edu.,University of Oregon, Eugene, OR, USA. philf@uoregon.\edu
| | - Claude Marcus
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
| | | | - Paulina Nowicka
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
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Musaad SMA, Donovan SM, Fiese BH. Parental perception of child weight in the first two years-of-life: a potential link between infant feeding and preschoolers' diet. Appetite 2015; 91:90-100. [PMID: 25843938 DOI: 10.1016/j.appet.2015.03.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 03/25/2015] [Accepted: 03/27/2015] [Indexed: 02/02/2023]
Abstract
Approximately 23% of preschoolers are overweight or obese. Establishing a healthy dietary lifestyle at an early age can improve later child diet and body weight. This study examined the determinants of past infant feeding practices that do not follow standard feeding recommendations (breastfeeding for less than 6 months duration, cow's milk prior to the first year of age and solid foods at or before 4 months of age). It also examined the role of parental perception of child weight in the first 2 years-of-life on past infant feeding practices as well as current child diet and body weight. Families of 497 preschoolers aged 22-63 months (39.0 ± 8.2) were recruited from 30 child care centers in East-Central Illinois. Main findings indicate that past infant feeding practices were common and varied by socio-demographic factors including race/ethnicity, parental education and child gender. Children perceived as overweight in the first 2 years-of-life tended to breastfeed for lesser duration. Additionally, the majority (79.8%) of preschoolers who were classified as overweight using BMI percentile were perceived as non-overweight by the parent in the first 2 years-of-life. Mean daily total fatty/sugary food intake was higher among those perceived to be non-overweight in the first 2 years-of-life. These findings have identified parental perception of child weight in the first 2 years-of-life as a modifiable risk factor for unhealthy child diet and obesity among preschoolers.
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Affiliation(s)
- Salma M A Musaad
- Family Resiliency Center, Department of Human and Community Development, University of Illinois at Urbana-Champaign, 904 W. Nevada, MC-081, Urbana, IL 61801, USA.
| | - Sharon M Donovan
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Barbara H Fiese
- Family Resiliency Center, Department of Human and Community Development, University of Illinois at Urbana-Champaign, 904 W. Nevada, MC-081, Urbana, IL 61801, USA
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Gwozdz W, Sousa-Poza A, Reisch LA, Bammann K, Eiben G, Kourides Y, Kovács É, Lauria F, Konstabel K, Santaliestra-Pasias AM, Vyncke K, Pigeot I. Peer effects on obesity in a sample of European children. ECONOMICS AND HUMAN BIOLOGY 2015; 18:139-152. [PMID: 26115518 DOI: 10.1016/j.ehb.2015.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 05/05/2015] [Accepted: 05/07/2015] [Indexed: 06/04/2023]
Abstract
This study analyzes peer effects on childhood obesity using data from the first two waves of the IDEFICS study, which applies several anthropometric and other measures of fatness to approximately 14,000 children aged two to nine participating in both waves in 16 regions of eight European countries. Peers are defined as same-sex children in the same school and age group. The results show that peer effects do exist in this European sample but that they differ among both regions and different fatness measures. Peer effects are larger in Spain, Italy, and Cyprus--the more collectivist regions in our sample--while waist circumference generally gives rise to larger peer effects than BMI. We also provide evidence that parental misperceptions of their own children's weight goes hand in hand with fatter peer groups, supporting the notion that in making such assessments, parents compare their children's weight with that of friends and schoolmates.
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Affiliation(s)
- Wencke Gwozdz
- Department of Intercultural Communication and Management, Centre for Corporate Social Responsibility, Copenhagen Business School, Denmark.
| | - Alfonso Sousa-Poza
- Institute for Health Care & Public Management, University of Hohenheim, Fruwirthstr. 48, 70599, Stuttgart, Germany.
| | - Lucia A Reisch
- Department of Intercultural Communication and Management, Centre for Corporate Social Responsibility, Copenhagen Business School, Denmark.
| | - Karin Bammann
- Bremen Institute for Prevention Research and Social Medicine & Human and Health Sciences, University of Bremen, Bremen, Germany.
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, Public Health Epidemiology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Yiannis Kourides
- Research and Education Institute of Child Health, Strovolos, Cyprus.
| | - Éva Kovács
- Department of Paediatrics, Medical, University of Pécs, Pécs, Hungary.
| | - Fabio Lauria
- Institute of Food Science & Technology, National Research Council, Italy.
| | - Kenn Konstabel
- Institute of Psychology, Social Sciences and Education, University of Tartu, Estonia.
| | | | - Krishna Vyncke
- Department of Public Health, Medicine and Health Sciences, University Hospital, Ghent University, Ghent, Belgium.
| | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany; Institute of Statistics, Mathematics and Computer Science, University of Bremen, Bremen, Germany.
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Parkinson KN, Jones AR, Tovee MJ, Ells LJ, Pearce MS, Araujo-Soares V, Adamson AJ. A cluster randomised trial testing an intervention to improve parents' recognition of their child's weight status: study protocol. BMC Public Health 2015; 15:549. [PMID: 26068921 PMCID: PMC4465009 DOI: 10.1186/s12889-015-1882-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 05/28/2015] [Indexed: 11/26/2022] Open
Abstract
Background Parents typically do not recognise their child’s weight status accurately according to clinical criteria, and thus may not take appropriate action if their child is overweight. We developed a novel visual intervention designed to improve parental perceptions of child weight status according to clinical criteria for children aged 4–5 and 10–11 years. The Map Me intervention comprises age- and sex-specific body image scales of known body mass index and supporting information about the health risks of childhood overweight. Design This cluster randomised trial will test the effectiveness of the Map Me intervention. Primary schools will be randomised to: paper-based Map Me; web-based Map Me; no information (control). Parents of reception (4–5 years) and year 6 (10–11 years) children attending the schools will be recruited. The study will work with the National Child Measurement Programme which measures the height and weight of these year groups and provides feedback to parents about their child’s weight status. Before receiving the feedback, parents will complete a questionnaire which includes assessment of their perception of their child’s weight status and knowledge of the health consequences of childhood overweight. The control group will provide pre-intervention data with assessment soon after recruitment; the intervention groups will provide post-intervention data after access to Map Me for one month. The study will subsequently obtain the child height and weight measurements from the National Child Measurement Programme. Families will be followed-up by the study team at 12 months. The primary outcome is any difference in accuracy in parental perception of child weight status between pre-intervention and post-intervention at one month. The secondary outcomes include differences in parent knowledge, intention to change lifestyle behaviours and/or seek advice or support, perceived control, action planning, coping planning, and child weight status at 12 month follow-up. Discussion The Map Me tool has potential to make a positive impact on children’s health at a population level by introducing it into current intervention programmes to improve accuracy of parental perception of child’s weight status. This trial will inform the action of researchers, educators, health professionals and policy makers. Trial registration Current Controlled Trials ISRCTN91136472. Registered 3 May 2013
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Affiliation(s)
- Kathryn N Parkinson
- Institute of Health & Society, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK. .,Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.
| | - Angela R Jones
- Institute of Health & Society, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK. .,Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.
| | - Martin J Tovee
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
| | - Louisa J Ells
- Health and Social Care Institute, Teesside University, Middlesbrough, UK.
| | - Mark S Pearce
- Institute of Health & Society, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK.
| | - Vera Araujo-Soares
- Institute of Health & Society, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK.
| | - Ashley J Adamson
- Institute of Health & Society, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK. .,Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.
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Parry L, Saxena S, Christie D. Addressing an overweight child and an unaware parent in the general practice consultation. LONDON JOURNAL OF PRIMARY CARE 2015; 3:42-4. [PMID: 25949617 DOI: 10.1080/17571472.2010.11493295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Revised: 01/19/2010] [Accepted: 02/01/2010] [Indexed: 10/23/2022]
Abstract
KEY MESSAGES General practitioners (GPs) can play a key role in tackling the current obesity epidemic, especially helping parents who may not realise that their child is overweight. In a ten-minute consultation, a GP should: explore a parent's ideas, concerns and expectations about food and exercise and build a picture of the home environmentexclude medical causes of overweight and plot height and weight on a growth chartoffer practical strategies and achievable goals, agree follow up and involve the multidisciplinary team for support. WHY THIS MATTERS TO ME Childhood obesity is a global epidemic that has significant impact on the physical and psychological health and development of children, and often persists into adulthood where the health sequelae are well known. Parents are key players in putting healthy living advice into practice but our recent systematic review showed that parents are poor at recognising overweight in their own children. We believe GPs are key to providing health promotion for this group. However, to approach this sensitive subject requires one to have confidence and skills at one's fingertips and we hope this guide can provide these.
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Affiliation(s)
- Lauren Parry
- GP Trainee ST2, King's College Hospital NHS Foundation Trust, Lambeth and Southwark PCT, London, UK
| | - Sonia Saxena
- General Practitioner and Honorary Consultant in Primary Care, Department of Primary Care and Social Medicine, Imperial College London and Hammersmith and Fulham PCT, London, UK
| | - Deborah Christie
- Consultant Clinical Psychologist and Honorary Reader in Paediatric and Adolescent Psychology, University College Hospital NHS Trust, Child and Adolescent Psychological Services, London, UK
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Lloyd A. National child measurement programme: does it work? Perspect Public Health 2015; 135:128-9. [DOI: 10.1177/1757913914566546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Jeffery AN, Metcalf BS, Hosking J, Mostazir MBA, Voss LD, Wilkin TJ. Awareness of body weight by mothers and their children: repeated measures in a single cohort (EarlyBird 64). Child Care Health Dev 2015; 41:434-42. [PMID: 24912623 DOI: 10.1111/cch.12167] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mothers often do not realize when their child is overweight. We aimed to compare mothers' perceptions of children's weight before and during puberty, and to explore factors at 7 years predicting recognition of overweight at 16 years. METHODS Mothers of 237 children (136 boys) from the EarlyBird study estimated their own weight category and that of their child aged 7 years and 16 years. The children estimated their own weight category at 16 years. Annual measures: body mass index standard deviation score (BMIsds), per cent fat, physical activity. Pubertal development assessed by age at peak height velocity (APHV). MATERNAL MEASURES: BMI, education, socio-economic status. RESULTS At 7 years 21% of girls and 16% of boys were overweight or obese, rising to 27% and 22% respectively at 16 years. The accuracy of the mother's perception of her child's weight category improved from 44% at 7 years to 74% at 16 years, but they were less able to judge overweight in sons than daughters. The mothers' level of concern about overweight was greater for girls than boys, and increased for girls (52% mothers of overweight/obese girls were worried at 7 years, 62% at 16 years), but remained static in the boys (42% vs. 39%). Over 80% of the youngsters realized when they were overweight, but 25% normal-weight girls also classed themselves as overweight. Only BMI predicted a mother's ability to correctly perceive her child's weight. Neither her awareness, nor concern, about the child's weight at 7 years had any impact on the trajectory of the child's BMI from 7 years to 16 years. CONCLUSIONS Parents are central to any successful weight reduction programme in their children, but will not engage while they remain ignorant of the problem. Crucially, any concern mothers may have about their child's excess weight at 7 years appears to have no impact on subsequent weight change.
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Affiliation(s)
- A N Jeffery
- Institute of Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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Large proportions of overweight and obese children, as well as their parents, underestimate children’s weight status across Europe. The ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project. Public Health Nutr 2015; 18:2183-90. [DOI: 10.1017/s136898001400305x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo investigate the magnitude and country-specific differences in underestimation of children’s weight status by children and their parents in Europe and to further explore its associations with family characteristics and sociodemographic factors.DesignChildren’s weight and height were objectively measured. Parental anthropometric and sociodemographic data were self-reported. Children and their parents were asked to comment on children’s weight status based on five-point Likert-type scales, ranging from ‘I am much too thin’ to ‘I am much too fat’ (children) and ‘My child’s weight is way too little’ to ‘My child’s weight is way too much’ (parents). These data were combined with children’s actual weight status, in order to assess underestimation of children’s weight status by children themselves and by their parents, respectively. Chi-square tests and multilevel logistic regression analyses were conducted to examine the aims of the current study.SettingEight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.SubjectsA school-based survey among 6113 children aged 10–12 years and their parents.ResultsIn the total sample, 42·9 % of overweight/obese children and 27·6 % of parents of overweight/obese children underestimated their and their children’s weight status, respectively. A higher likelihood for this underestimation of weight status by children and their parents was observed in Eastern and Southern compared with Central/Northern countries. Overweight or obese parents (OR=1·81; 95 % CI 1·39, 2·35 and OR=1·78, 95 % CI 1·22, 2·60), parents of boys (OR=1·32; 95 % CI 1·05, 1·67) and children from overweight/obese (OR=1·60; 95 % CI 1·29, 1·98 and OR=1·76; 95 % CI 1·29, 2·41) or unemployed parents (OR=1·53; 95 % CI 1·22, 1·92) were more likely to underestimate children’s weight status.ConclusionsChildren of overweight or obese parents, those from Eastern and Southern Europe, boys, younger children and children with unemployed parents were more likely to underestimate their actual weight status. Overweight or obese parents and parents of boys were more likely to underestimate the actual weight status of their children. In obesity prevention such underestimation may be a barrier for behavioural change.
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Oldham M, Robinson E. Visual weight status misperceptions of men: Why overweight can look like a healthy weight. J Health Psychol 2015; 21:1768-77. [PMID: 25609407 DOI: 10.1177/1359105314566257] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Overweight men often underestimate their weight status. Here, we examine whether underestimation occurs when visually judging the weight status of men and whether exposure to heavier body weights may be a cause of visual underestimation of male weight status. Participants systematically underestimated the weight status of overweight and obese men (Study 1) and participants reporting more frequent exposure to heavy male body weights were most likely to underestimate (Study 2). Experimental exposure to different body weights influenced underestimation of weight status (Study 3). Frequent exposure to heavier body weights may cause visual underestimation of the weight status of overweight men.
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Eli K, Howell K, Fisher PA, Nowicka P. "A little on the heavy side": a qualitative analysis of parents' and grandparents' perceptions of preschoolers' body weights. BMJ Open 2014; 4:e006609. [PMID: 25500371 PMCID: PMC4265138 DOI: 10.1136/bmjopen-2014-006609] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Parents' difficulties in perceiving children's weight status accurately pose a barrier for family-based obesity interventions; however, the factors underlying weight misinterpretation still need to be identified. This study's objective was to examine parents and grandparents' perceptions of preschoolers' body sizes. Interview questions also explored perceptions of parental responsibility for childhood obesity and appropriate contexts in which to discuss preschoolers' weights. DESIGN Semistructured interviews, which were videotaped, transcribed and analysed qualitatively. SETTING Eugene and the Springfield metropolitan area, Oregon, USA PARTICIPANTS: Families of children aged 3-5 years were recruited in February-May 2011 through advertisements about the study, published in the job seekers' sections of a classified website (Craigslist) and in a local newspaper. 49 participants (22 parents and 27 grandparents, 70% women, 60% with overweight/obesity) from 16 low-income families of children aged 3-5 years (50% girls, 56% with overweight/obesity) were interviewed. RESULTS There are important gaps between clinical definitions and lay perceptions of childhood obesity. While parents and grandparents were aware of their preschoolers' growth chart percentiles, these measures did not translate into recognition of children's overweight or obesity. The participants spoke of obesity as a problem that may affect the children in the future, but not at present. Participants identified childhood obesity as being transmitted from one generation to the next, and stigmatised it as resulting from 'lazy' parenting. Parents and grandparents avoided discussing the children's weights with each other and with the children themselves. CONCLUSIONS The results suggest that clinicians should clearly communicate with parents and grandparents about the meaning and appearance of obesity in early childhood, as well as counteract the social stigma attached to obesity, in order to improve the effectiveness of family-based interventions to manage obesity in early childhood.
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Affiliation(s)
- Karin Eli
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
| | - Kyndal Howell
- Department of Psychology, University of Oregon, Eugene, USA
| | | | - Paulina Nowicka
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
- Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Law C, Cole T, Cummins S, Fagg J, Morris S, Roberts H. A pragmatic evaluation of a family-based intervention for childhood overweight and obesity. PUBLIC HEALTH RESEARCH 2014. [DOI: 10.3310/phr02050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BackgroundChildhood overweight is unequally distributed by ethnicity and socioeconomic circumstances. Weight management interventions are moderately effective under research conditions. We evaluated the Mind, Exercise, Nutrition, Do it! (MEND) 7–13 programme, a multicomponent family-based intervention for children aged 7–13 years who are overweight or obese. The programme was tested in a randomised controlled trial (RCT) and then delivered at scale under service conditions.ObjectivesThe aims of this study were to describe the characteristics of children who take part in MEND, when implemented at scale and under service conditions; assess how the outcomes associated with participation in MEND vary with the characteristics of children (sex, socioeconomic circumstances and ethnicity), MEND centres (type of facility, funding source and programme group size) and areas where children live (in relation to area-level deprivation and the obesogenic environment); examine the cost of providing MEND, per participant, to the NHS and personal social services, including how this varies and how variation in cost is related to variation in outcome; evaluate the salience and acceptability of MEND to those who commission it, those who participate in full, those who participate but drop out and those who might benefit but do not take up the intervention; and investigate what types of costs, if any, are borne by families (and by which members) when participating in MEND, and in sustaining a healthy lifestyle afterwards.Data and methodsWe compared the sociodemographic characteristics of all children referred to MEND (‘referrals’,n = 18,289), those who started the programme (‘starters’,n = 13,998) and those who completed it (‘completers’,n = 8311) with comparable overweight children in England. Associations between participant, programme and neighbourhood characteristics and change in body mass index (BMI) and other outcomes associated with participation in MEND 7–13 were estimated using multilevel models. Economic costs were estimated using published evaluations in combination with service data. We used qualitative methods to explore salience and acceptability to commissioners (n = 27 interviews) and families (n = 23 family interviews and eight individual interviews), and costs to families.FindingsLess than 0.5% of children eligible for MEND were referred to, participated in or completed the programme. Compared with the MEND-eligible population, proportionally more MEND 7–13 starters and completers were girls, Asian or from families with a lone parent, and lived in social or private rented rather than owner-occupied accommodation, in families where the primary earner was unemployed, and in urban and deprived areas. Compared with the MEND-eligible population, proportionally less MEND 7–13 starters and completers were white or from ‘other’ ethnic groups. Having started the programme, boys and participants who were psychologically distressed, lived in socioeconomically deprived circumstances, or attended large groups or groups whose managers had delivered several programmes were less likely to complete the programme.Multilevel multivariable models showed that, on average, BMI reduced by 0.76 kg/m2over the period of the programme (10-week follow-up). BMI reduced on average in all groups, but the reduction was greater for boys, as well as children who were of higher baseline BMI, younger, white or living in less socioeconomically deprived circumstances, and for those who attended more sessions and participated in smaller programmes. BMI reductions under service and RCT conditions were of a similar order of magnitude. Reported participant self-esteem, psychological distress, physical activity and diet improved overall and were also moderated by participant-, family-, neighbourhood- and programme-level covariates.Based on previous studies the cost per programme was around £4000. The mean cost per starter is £463 and the mean cost per completer is £773. The estimated costs varied according to costs associated with local programmes and MEND Central (the organisation which sells MEND interventions to commissioners and delivery partners), and the number of participants per programme.Commissioners liked the fact that the programme was evidence-informed, involved families and was ‘implementation-ready’. However, recruitment and retention of families influenced their view on the extent to which the programme offered value for money. They wanted longer-term outcome data and had concerns in relation to skills for delivery to diverse populations with complex health and social needs.At least one individual in every family felt that participation in MEND had been beneficial, but few had managed long-term change. Most families had self-referred via the mother on the basis of weight concerns and/or bullying and anxiety about the transition to secondary school. Exercising with others of a similar build, tips for parents and cooking lessons for children were all valued. Less positively, timings could be difficult for parents and children, who reported competing after-school activities, and feeling tired and hungry. Getting to venues was sometimes difficult. Although families described liking the facilitators who delivered the programme, concerns were expressed about their skills levels. Engagement with the behaviours MEND recommends was challenging, as were the family dynamics relating to support for participants. The costs families mostly associated with the programme were for higher quality food or ‘treats’, time and transport costs, and the emotional cost of making and maintaining changes to lifestyle behaviours generally unsupported by the wider environment.ConsiderationsFurther research should focus on the sustainability, costs (including emotional costs to families) and cost-effectiveness of behaviour change. However, weight management schemes are only one way that overweight and obese children can be encouraged to adopt healthier lifestyles. We situate this work within a social model of health with reference to inequalities, obesogenic environments, a lifecourse approach and frameworks of translational research.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Catherine Law
- Institute of Child Health, University College London, London, UK
| | - Tim Cole
- Institute of Child Health, University College London, London, UK
| | - Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - James Fagg
- Institute of Child Health, University College London, London, UK
| | - Stephen Morris
- Department of Applied Health Research, University College London, London, UK
| | - Helen Roberts
- Institute of Child Health, University College London, London, UK
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Black MM, Hager ER. Commentary: Pediatric obesity: systems science strategies for prevention. J Pediatr Psychol 2014; 38:1044-50. [PMID: 24013965 DOI: 10.1093/jpepsy/jst071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Pediatric obesity is a major public health problem that undermines the physical and mental health of children and increases their risk for adult obesity and other chronic illnesses. Although health care providers, including pediatric psychologists, have implemented prevention programs, effects have been minimal, with no solid evidence of sustainable programs. METHODS A systems science framework that incorporates the multiple interacting factors that influence pediatric obesity may be useful in guiding prevention. RESULTS The National Prevention Strategy provides recommendations that can be incorporated into systems science designs, including (1) Healthy and Safe Environments, (2) Clinical and Community Preventive Services, (3) Empowering People, and (4) Elimination of Health Disparities. In addition, our recommendation is that future obesity prevention programs target early in life (pre-pregnancy through toddlerhood) and use multilevel multidisciplinary designs. CONCLUSIONS The benefits of preventing pediatric obesity extend from the health and well-being of individual children to the economic security of the nation.
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Gillespie J, Midmore C, Hoeflich J, Ness C, Ballard P, Stewart L. Parents as the start of the solution: a social marketing approach to understanding triggers and barriers to entering a childhood weight management service. J Hum Nutr Diet 2014; 28 Suppl 1:83-92. [PMID: 24866275 DOI: 10.1111/jhn.12237] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Childhood obesity is a sensitive subject and barriers exist with respect to accessing weight management programmes. Social marketing insight gathering provides an opportunity to understand behaviours and address these challenges. This project gained insight into the views of parents/carers on triggers and barriers to entering a childhood weight management service. METHODS Participants were identified from the public using marketing recruitment. Four focus groups were conducted with parents of school aged children (n = 27) by an experienced interviewer. Twenty two mothers, three fathers and two grandmothers participated, with half describing their child as overweight. Groups discussed health behaviours; attitudes to health messages and weight issues; and motivations, benefits and barriers with respect to accessing weight management services. Discussions were taped and transcribed. Themes were identified using framework analysis of content matrix data analysis. RESULTS Participants were aware of healthy lifestyle messages, although the ability to implement these was variable. Triggers to seeking help included bullying, health concerns and inability to participate in school activities. Barriers included feeling a lack of control, desire to avoid conflict and no proven case that weight was a problem. Parents wished to be given information regarding their child's weight by a trusted person. The Internet and word of mouth were identified as methods of recruitment into a weight management service, with a focus on fitness, fun and friendliness and being free-of-charge. CONCLUSIONS Insight gathering can be used to establish parental/carer opinion regarding engaging in childhood weight management services. A fun, friendly programme that is free of charge appealed to parents. Local community involvement around normalising child weight issues may boost referrals into child healthy weight interventions.
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Wang LDL, Lam WWT, Wu JTK, Fielding R. Chinese new immigrant mothers' perception about adult-onset non-communicable diseases prevention during childhood. Health Promot Int 2014; 30:929-41. [PMID: 24842077 DOI: 10.1093/heapro/dau029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Many non-communicable diseases (NCDs) are largely preventable via behaviour change and healthy lifestyle, which may be best established during childhood. This study sought insights into Chinese new immigrant mothers' perceptions about adult-onset NCDs prevention during childhood. Twenty-three semi-structured interviews were carried out with new immigrant mothers from mainland China who had at least one child aged 14 years or younger living in Hong Kong. Interviews were audio taped, transcribed and analysed using a Grounded Theory approach. The present study identified three major themes: perceived causes of adult NCDs, beliefs about NCDs prevention and everyday health information practices. Unhealthy lifestyle, contaminated food and environment pollution were perceived as the primary causes of adult NCDs. Less than half of the participants recognized that parents had responsibility for helping children establish healthy behaviours from an early age to prevent diseases in later life. Most participants expressed helplessness about chronic diseases prevention due to lack of knowledge of prevention, being perceived as beyond individual control. Many participants experienced barriers to seeking health information, the most common sources of health information being interpersonal conversation and television. Participants' everyday information practice was passive and generally lacked awareness regarding early prevention of adult-onset NCDs. Updated understanding of this issue has notable implications for future health promotion interventions.
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Affiliation(s)
- Linda Dong Ling Wang
- Health Behaviour Research Group, Division of Behavioural Health, School of Public Health, The University of Hong Kong, Hong Kong
| | - Wendy Wing Tak Lam
- Health Behaviour Research Group, Division of Behavioural Health, School of Public Health, The University of Hong Kong, Hong Kong
| | - Joseph Tsz Kei Wu
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong, Hong Kong
| | - Richard Fielding
- Health Behaviour Research Group, Division of Behavioural Health, School of Public Health, The University of Hong Kong, Hong Kong
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Concern about Child Weight among Parents of Children At-Risk for Obesity. HEALTH BEHAVIOR AND POLICY REVIEW 2014; 1:197-208. [PMID: 25364770 DOI: 10.14485/hbpr.1.3.4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study investigated the relationship between parental concern about child weight and weight-related child behaviors, parenting practices, and household characteristics. METHODS Parent-child dyads (N=421) enrolled in a randomized, controlled obesity prevention trial were evaluated at baseline. RESULTS Parental concern regarding child weight was associated with greater use of restrictive and monitoring feeding practices and lower total child energy intake. CONCLUSIONS Parents expressing greater concern about child weight were more likely to report engaging in strategies to regulate their child's dietary intake, some of which may inadvertently have negative consequences. Intervention strategies that activate parental concern about child weight should include guidance and support for engaging in feeding practices that support healthful child eating patterns and growth.
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Gillison F, Beck F, Lewitt J. Exploring the basis for parents' negative reactions to being informed that their child is overweight. Public Health Nutr 2014; 17:987-97. [PMID: 24060095 PMCID: PMC10282330 DOI: 10.1017/s1368980013002425] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 07/30/2013] [Accepted: 08/02/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Increasing parental awareness of childhood obesity is an important part of tackling the issue. However, parents' negative reactions to being informed that their children are overweight or obese can hinder their engagement with relevant services. The present study aimed to develop a deeper understanding of why parents react negatively, to help commissioners and service providers design services that are more acceptable to them. DESIGN Open, qualitative responses to a survey were collected using a postal questionnaire. Responses were analysed using content analysis. SETTING One local authority in south-west England. SUBJECTS The sample frame included all parents receiving letters informing them that their child was overweight (91st-98th centile) or very overweight (98th-100th centile) through the UK National Child Measurement Programme in 2012. RESULTS Forty-five of 313 eligible parents (14 %) responded to the survey, of whom forty-three rejected either to the judgement that their child was overweight and/or being provided with this feedback. Primary reasons for objection included: lack of trust in the measures used, lack of belief that being overweight is important for children's health (relative to a healthy lifestyle), and fear that discussing weight with children will trigger eating disorders. In addition, parents' responses suggested that they considered receiving this feedback to be a criticism of their parenting skills. CONCLUSIONS Overall, three areas for improving communication with parents were suggested: tailoring letters; providing information about the importance of weight independently of lifestyle; and addressing parents' concerns about the risks of talking to children about their weight.
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Affiliation(s)
- Fiona Gillison
- Department for Health, University of Bath, Bath BA2 7AY, UK
| | - Fay Beck
- Department for Health, University of Bath, Bath BA2 7AY, UK
| | - Joanna Lewitt
- NHS Bath & North East Somerset, PCT Headquarters, St Martin's Hospital, Bath, UK
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Predictors of health-related behaviour change in parents of overweight children in England. Prev Med 2014; 62:20-4. [PMID: 24518007 PMCID: PMC3995088 DOI: 10.1016/j.ypmed.2014.02.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 12/17/2013] [Accepted: 02/02/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Providing parents with information about their child's overweight status (feedback) could prompt them to make lifestyle changes for their children. We assessed whether parents of overweight children intend to or change behaviours following feedback, and examined predictors of these transitions. METHODS We analysed data from a cohort of parents of children aged 4-5 and 10-11 years participating in the National Child Measurement Programme in five areas of England, 2010-2011. Parents of overweight children (body mass index ≥91st centile) with data at one or six months after feedback were included (n=285). The outcomes of interest were intention to change health-related behaviours and positive behaviour change at follow-up. Associations between respondent characteristics and outcomes were assessed using logistic regression analysis. RESULTS After feedback, 72.1% of parents reported an intention to change; 54.7% reported positive behaviour change. Intention was associated with recognition of child overweight status (OR 11.20, 95% CI 4.49, 27.93). Parents of older and non-white children were more likely to report behaviour changes than parents of younger or white children. Intention did not predict behaviour change. CONCLUSIONS Parental recognition of child overweight predicts behavioural intentions. However, intentions do not necessarily translate into behaviours; interventions that aim to change intentions may have limited benefits.
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Gerards SMPL, Gubbels JS, Dagnelie PC, Kremers SPJ, Stafleu A, de Vries NK, Thijs C. Parental perception of child's weight status and subsequent BMIz change: the KOALA birth cohort study. BMC Public Health 2014; 14:291. [PMID: 24678601 PMCID: PMC3983903 DOI: 10.1186/1471-2458-14-291] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 03/24/2014] [Indexed: 11/15/2022] Open
Abstract
Background Parents often fail to correctly perceive their children’s weight status, but no studies have examined the association between parental weight status perception and longitudinal BMIz change (BMI standardized to a reference population) at various ages. We investigated whether parents are able to accurately perceive their child’s weight status at age 5. We also investigated predictors of accurate weight status perception. Finally, we investigated the predictive value of accurate weight status perception in explaining children’s longitudinal weight development up to the age of 9, in children who were overweight at the age of 5. Methods We used longitudinal data from the KOALA Birth Cohort Study. At the child’s age of 5 years, parents filled out a questionnaire regarding child and parent characteristics and their perception of their child’s weight status. We calculated the children’s actual weight status from parental reports of weight and height at ages 2, 5, 6, 7, 8, and 9 years. Regression analyses were used to identify factors predicting which parents accurately perceived their child’s weight status. Finally, regression analyses were used to predict subsequent longitudinal BMIz change in overweight children. Results Eighty-five percent of the parents of overweight children underestimated their child’s weight status at age 5. The child’s BMIz at age 2 and 5 were significant positive predictors of accurate weight status perception (vs. underestimation) in normal weight and overweight children. Accurate weight status perception was a predictor of higher future BMI in overweight children, corrected for actual BMI at baseline. Conclusions Children of parents who accurately perceived their child’s weight status had a higher BMI over time, probably making it easier for parents to correctly perceive their child’s overweight. Parental awareness of the child’s overweight as such may not be sufficient for subsequent weight management by the parents, implying that parents who recognize their child’s overweight may not be able or willing to adequately manage the overweight.
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Affiliation(s)
- Sanne M P L Gerards
- Department of Health Promotion, and NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
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Laurent JS. A qualitative exploration into parental recognition of overweight and obesity in pre-adolescents: a process of discovery. J Pediatr Health Care 2014; 28:121-7. [PMID: 23419505 DOI: 10.1016/j.pedhc.2012.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/12/2012] [Accepted: 12/17/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The purpose of this study is to describe influential factors as parents become aware that their pre-adolescent is overweight/obese. METHODS A grounded theory approach was used, and 17 parents of obese pre-adolescents were interviewed. RESULTS Within the concept of discovery ("How did you come to realize your pre-adolescent was overweight or obese?"), five central themes emerged. The theme of predisposition emerged as most parents believed there was some type of predisposition for their pre-adolescent to be overweight/obese. Parents avoided using the words overweight, obese, or fat to describe their pre-adolescent's body habitus, thus leading to the theme "husky build." "Compared to others" was identified as a theme since most parents described how they compared their overweight pre-adolescent with other pre-adolescents. The health care provider emerged as a theme because the role of the health care provider played a pivotal role in the discovery process for parents. Finally, parental buy-in involved acceptance that their pre-adolescent was overweight and recognition that this status signaled a problem and a potential health threat for their pre-adolescent. DISCUSSION Parents do not rely solely on visual cues. Several factors are involved in the awareness process of parents whose pre-adolescents are clinically obese. The input from the health care provider played a significant role.
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Abstract
BACKGROUND AND OBJECTIVE Parental perceptions of their children's weight play an important role in obesity prevention and treatment. The objective of this study was to determine the proportion of parents worldwide who underestimate their children's weight and moderators of such misperceptions. METHODS Original studies published to January 2013 were chosen through literature searches in PUBMED, PSYCHINFO, and CINAHL databases. References of retrieved articles were also searched for relevant studies. Studies were published in English and assessed parental perceptions of children's weight and then compared perceptions to recognized standards for defining overweight based on anthropometric measures. Data were extracted on study-level constructs, child- and parent-characteristics, procedural characteristics, and parental underestimates separately for normal-weight and overweight/obese samples. Pooled effect sizes were calculated using random-effects models and adjusted for publication bias. Moderators were explored using mixed-effect models. RESULTS A total of 69 articles (representing 78 samples; n = 15,791) were included in the overweight/obese meta-analysis. Adjusted effect sizes revealed that 50.7% (95% confidence interval 31.1%-70.2%) of parents underestimate their overweight/obese children's weight. Significant moderators of this effect included child's age and BMI. A total of 52 articles (representing 59 samples; n = 64,895) were included in the normal-weight meta-analysis. Pooled effect sizes indicated that 14.3% (95% confidence interval 11.7%-17.4%) of parents underestimate their children's normal-weight status. Significant moderators of this effect included child gender, parent weight, and the method (visual versus nonvisual) in which perception was assessed. CONCLUSIONS Half of parents underestimated their children's overweight/obese status and a significant minority underestimated children's normal weight. Pediatricians are well positioned to make efforts to remedy parental underestimates and promote adoption of healthy habits.
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Affiliation(s)
- Alyssa Lundahl
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska
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Tarasenko YN, Rossen LM, Schoendorf KC. Children's, their guardians', and health care professionals' perceptions of child overweight in relation to children's weight loss attempts. Am J Health Promot 2014; 29:e73-81. [PMID: 24459998 DOI: 10.4278/ajhp.130410-quan-165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine accuracy of children's, their guardians', and health care professionals' (HCPs') perceptions of child overweight and obesity, the degree of agreement between their perceptions, and relationships with weight loss attempts among overweight or obese children. DESIGN Cross-sectional study using 2005-2010 National Health and Nutrition Examination Survey. SETTING United States. SUBJECTS Out of 4691 children and adolescents, ages 8 to 15 years, 16.4% were overweight (body mass index [BMI] percentiles 85-94.99) and 19.3% were obese (BMI percentiles ≥95). MEASURES Age and sex-specific BMI percentiles; responses of adult proxies (guardians) on whether they considered their child overweight and whether an HCP had ever told them that their child was overweight; responses of children and adolescents on their self-perceived weight status and whether they were trying to lose weight; children's and guardians' socio-demographic characteristics. ANALYSIS Weighted percentages; sensitivities and Cohen's kappas; adjusted prevalence ratios. RESULTS Children, their guardians, and HCPs underestimated child's actual overweight or obesity status. Little agreement existed between overweight or obese children, their parents, and HCPs on whether these children were overweight or obese. Overweight and obese children perceived as such by themselves, their guardians, and HCPs were 88% and 32%, respectively, more likely to attempt weight loss based on multivariable analyses. CONCLUSION Accurate and shared perceptions of adiposity in children and adolescents between children themselves, their guardians, and HCPs are positively associated with weight loss attempts among overweight or obese children in the United States.
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79
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Regber S, Mårild S, Johansson Hanse J. Barriers to and facilitators of nurse-parent interaction intended to promote healthy weight gain and prevent childhood obesity at Swedish child health centers. BMC Nurs 2013; 12:27. [PMID: 24308289 PMCID: PMC4175109 DOI: 10.1186/1472-6955-12-27] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 11/29/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Overweight and obesity in preschool children have increased worldwide in the past two to three decades. Child Health Centers provide a key setting for monitoring growth in preschool children and preventing childhood obesity. METHODS We conducted semi-structured interviews with 15 nurses working at Child Health Centers in southwest Sweden in 2011 and 2012. All interviews were tape recorded and transcribed verbatim and imported to QSR N'Vivo 9 software. Data were analyzed deductively according to predefined themes using content analysis. RESULTS Findings resulted in 332 codes, 16 subthemes and six main themes. The subthemes identified and described barriers and facilitators for the prevention of childhood obesity at Child Health Centers. Main themes included assessment of child's weight status, the initiative, a sensitive topic, parental responses, actions and lifestyle patterns. Although a body mass index (BMI) chart facilitated greater recognition of a child's deviant weight status than the traditional weight-for-height chart, nurses used it inconsistently. Obesity was a sensitive topic. For the most part, nurses initiated discussions of a child's overweight or obesity. CONCLUSION CHCs in Sweden provide a favorable opportunity to prevent childhood obesity because of a systematic organization, which by default conducts growth measurements at all health visits. The BMI chart yields greater recognition of overweight and obesity in children and facilitates prevention of obesity. In addition, visualization and explanation of the BMI chart helps nurses as they communicate with parents about a child's weight status. On the other hand, inconsistent use and lack of quality assurance regarding the recommended BMI chart was a barrier to prevention, possibly delaying identification of overweight or obesity. Other barriers included emotional difficulties in raising the issue of obesity because it was perceived as a sensitive topic. Some parents deliberately wanted overweight children, which was another specific barrier. Concerned parents who took the initiative or responded positively to the information about obesity facilitated prevention activities.
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Affiliation(s)
- Susann Regber
- Nordic School of Public Health NHV, Box 12 133, Gothenburg SE- 402 42, Sweden
- Department of Public Health and Community Medicine, Public Health Epidemiology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Staffan Mårild
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Johansson Hanse
- Nordic School of Public Health NHV, Box 12 133, Gothenburg SE- 402 42, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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Cloutier MM, Lucuara-Revelo P, Wakefield DB, Gorin AA. My Weight Ruler: a simple and effective tool to enhance parental understanding of child weight status. Prev Med 2013; 57:550-4. [PMID: 23872428 DOI: 10.1016/j.ypmed.2013.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 07/08/2013] [Accepted: 07/09/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare caregiver identification and understanding of body mass index percentile (BMI%) using the CDC Growth Chart and a newly adapted BMI ruler ("My Weight Ruler"). METHOD Between October 2009 and March 2010, eight focus groups with 27 low-income, minority caregivers with children 2-4 years of age were conducted to choose a meaningful tool to explain child weight status. A within-subject experiment comparing identification and interpretation of 2 BMI% plots (50th and 97th%) using the CDC Growth Chart and the selected tool was performed in February 2012 with 251 primary caregivers of children 2-4 years in a primary care clinic. RESULTS Caregivers chose the "BMI Ruler" a tool used in Arkansas, recommended culturally-responsive descriptors of weight status and renamed it "My Weight Ruler". 92% of caregivers reported having previously been explained the CDC Growth Chart; 37% correctly identified both plots. In contrast, 92% of caregivers correctly identified both plots on the My Weight Ruler and many interpreted the 97th% plot as a health risk and need to change behavior. CONCLUSION My Weight Ruler is a simple, easily understood tool of weight status for low-income, minority primary caregivers and could enhance parental knowledge and understanding of child weight status.
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Affiliation(s)
- Michelle M Cloutier
- Department of Pediatrics, University of Connecticut Health Care Center, 263 Farmington Avenue, Farmington, CT 06030, USA; Children's Center for Community Research, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA.
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81
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Rossen LM, Tarasenko YN, Branum AM, Simon AE, Schoendorf KC. Abdominal adiposity and caregiver recall of healthcare provider identification of child overweight in the United States, 2001-2010. Child Obes 2013; 9:418-26. [PMID: 24028562 PMCID: PMC4655875 DOI: 10.1089/chi.2013.0051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND A minority of overweight or obese children are identified as such by a healthcare provider (HCP). The aim of this study was to examine characteristics of caregiver-reported HCP identification of overweight or obesity and whether it is associated with children's waist circumference (WC). METHODS This was an observational study using a nationally representative sample of 14,694 children (2-15 years of age) from the 2001-2010 National Health and Nutrition Examination Survey. Proxy respondents (i.e., caregivers) for 4906 overweight or obese (BMI≥85th percentile) children reported whether an HCP had ever told them that their child was overweight. Multi-variable logistic regression analyses were used to examine associations between reported HCP identification of overweight and child sociodemographic and anthropometric characteristics. RESULTS Over 75% of caregivers of overweight or obese children did not recall being notified of their child's weight status by an HCP, though this proportion has decreased over the past decade. A significant WC by weight status interaction indicated abdominal adiposity was positively associated with reported HCP identification for obese children, but not for overweight children. CONCLUSIONS Lower levels of reported HCP identification were observed for overweight children, compared to obese children; among obese children, those with lower levels of abdominal adiposity were less likely to be identified as overweight by an HCP, according to caregivers. Reasons for this finding remain unclear. Providers may be relying on a child's appearance, rather than universally screening all patients for overweight. Additionally, a variety of parent and provider characteristics may influence weight-related communications and caregiver recall of such information.
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Affiliation(s)
- Lauren M. Rossen
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
| | - Yelena N. Tarasenko
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD,Department of Health Policy and Management and the Department of Epidemiology, Georgia Southern University, Jiann-Ping Hsu College of Public Health, Statesboro, GA
| | - Amy M. Branum
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
| | - Alan E. Simon
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
| | - Kenneth C. Schoendorf
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
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82
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Childhood overweight/obesity and pediatric asthma: the role of parental perception of child weight status. Nutrients 2013; 5:3713-29. [PMID: 24064571 PMCID: PMC3798930 DOI: 10.3390/nu5093713] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 08/13/2013] [Accepted: 09/04/2013] [Indexed: 01/31/2023] Open
Abstract
Childhood obesity and asthma are on the rise in the U.S. Clinical and epidemiological data suggest a link between the two, in which overweight and obese children are at higher risk for asthma. Prevention of childhood obesity is preferred over treatment, however, in order to be receptive to messages, parents must perceive that their child is overweight. Many parents do not accurately assess their child’s weight status. Herein, the relation between parental perceptions of child weight status, observed body mass index (BMI) percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. Out of the children with asthma or food allergy that were classified as overweight/obese by BMI percentiles, 93% were not perceived as overweight/obese by the parent. Mean scores for concern about child weight were higher in children with both asthma and food allergy than either condition alone, yet there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. In summary, parents of children with asthma or food allergy were less likely to recognize their child’s overweight/obese status and their feeding practices did not differ from those without asthma and food allergy.
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83
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Abstract
BACKGROUND Several studies have addressed mothers' perceptions of their children's weight status; however, there is no investigation on Portuguese children (a country with one of the highest levels of children's overweight and obesity in Europe). The aim of this study was to quantify maternal misclassification of child weight status in a sample of Portuguese children aged 9 to 12 years, according to gender, family income, and maternal weight status, education level and age. METHODS Data were collected in a school-based study (school year 2009/2010) in northern Portugal with 499 urban children (236 girls; 47.3%). Body mass index was calculated from measurements of height and weight [body mass (kg)/height (m(2))]. Mothers' perceptions of child's weight status, age, height and weight were accessed by a questionnaire. Children's age, gender and socio-economic status were extracted from the schools' administrative record systems. Cohen's Kappa was used to analyse the misperceptions and the agreement between children's objectively measured weight status and mothers' perception of their child's weight status. RESULTS The prevalence of underweight, overweight and obesity in children was 4.6%, 25.5% and 6.4%, respectively. A proportion of 65.2% of underweight and 61.6% of overweight/obese children were misclassified by their mothers. For the majority of variables presented, the values of agreement were fair (k ranged from 0.257 to 0.486), but were statistically significant. Significant differences in the percentages of mothers who correctly classified their children's weight status were only found among the most educated in the overweight/obese group and among the normal-weight mothers in the underweight group. CONCLUSIONS Many mothers do not properly recognize their children's weight status and frequently underestimate their children's body size.
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Affiliation(s)
- L Lopes
- Research Centre on Child Studies, CIEC, Institute of Education, University of Minho, Braga, Portugal.
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84
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Parkinson KN, Drewett RF, Jones AR, Adamson AJ. Mothers' judgements about their child's weight: distinguishing facts from values. Child Care Health Dev 2013; 39:722-7. [PMID: 23039117 DOI: 10.1111/cch.12000] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mothers' responses to questionnaire items assessing their child's weight status typically do not correspond to conventional clinical classifications based on body mass index (BMI). From this observation health professionals infer that mothers do not recognize overweight in their child. But the questions used have generally confounded factual judgements with values, so it is not clear whether the mothers are making factual errors, or differ from professionals in their values. METHODS Cross-sectional study of population-based birth cohort at 6-8 years and their mothers (n = 540). An objective BMI matching task was used to determine the accuracy of mothers' recognition of their child's weight. Mothers matched their child to sex- and age-specific images of children of known BMI ranging from very thin to obese, and chose a descriptor of their child's weight of the kind used in previous research. RESULTS Mothers tended to underestimate their child's BMI on the matching task. Matching errors significantly predicted mothers' description of their child's weight; those who overestimated their child's BMI on the matching task were more likely to say their child was overweight, while those who underestimated it were less likely to, independently of their child's actual BMI. CONCLUSIONS Educational programmes aimed at parents of young primary school children need to address separately the factual and the evaluative components of their assessment of child weight.
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Affiliation(s)
- K N Parkinson
- Institute of Health and Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.
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85
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Aldhafiri FK, McColl JH, Reilly JJ. Prevalence of being underweight and overweight and obesity at diagnosis in UK patients with childhood acute lymphoblastic leukaemia 1985-2002. J Hum Nutr Diet 2013; 27:76-9. [DOI: 10.1111/jhn.12112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - J. H. McColl
- School of Mathematics and Statistics; University of Glasgow; Glasgow UK
| | - J. J. Reilly
- Physical Activity for Health Group; School of Psychological Sciences and Health; University of Strathclyde; Glasgow UK
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86
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Binkin N, Spinelli A, Baglio G, Lamberti A. What is common becomes normal: the effect of obesity prevalence on maternal perception. Nutr Metab Cardiovasc Dis 2013; 23:410-416. [PMID: 22212600 DOI: 10.1016/j.numecd.2011.09.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 09/09/2011] [Accepted: 09/12/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND AIMS This analysis investigates the poorly-known effect of local prevalence of childhood obesity on mothers' perception of their children's weight status. METHODS AND RESULTS In 2008, a national nutritional survey of children attending the third grade of elementary school was conducted in Italy. Children were measured and classified as underweight, normal weight, overweight and obese, using the International Obesity Task Force cut-offs for body mass index (BMI). A parental questionnaire included parental perception of their child's weight status (underweight, normal, a little overweight and a lot overweight). Regions were classified by childhood obesity prevalence (<8%, 8-12%, ≥13%). The association between incorrect maternal perception and regional obesity prevalence, and maternal and child characteristics were examined using bivariate and logistic regression analyses. Complete data were available for 37 590 children, of whom 24% were overweight and 12% obese. Mothers correctly identified the status of 84% of normal weight, 52% of overweight and 14% of obese children. Among overweight children, factors associated with underestimation of the child's weight included lower maternal education (adjusted odds ratio, aOR, 1.9; 95% confidence interval (CI) 1.6-2.4), residence in a high-obesity region (aOR 2.2; 95% CI 1.9-2.6), male gender (aOR 1.4; 95% CI 1.2-1.6) and child's BMI. CONCLUSION Higher regional obesity prevalence is associated with lower maternal perception, suggesting that what is common has a greater likelihood of being perceived as normal. As perception is a first step to change, it may be harder to intervene in areas with high-obesity prevalence where intervention is most urgent.
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Affiliation(s)
- N Binkin
- National Centre for Epidemiology, Surveillance, and Health Promotion, Istituto Superiore di Sanità (National Institute of Health), Viale Regina Elena 299, 00161 Rome, Italy.
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87
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Jay M, Stepney C, Wijetunga NA, Akinrinade G, Dorsey K, Bruzzese JM. Accuracy of weight perception among urban early adolescents with uncontrolled asthma and their caregivers. Ann Behav Med 2013; 45:239-48. [PMID: 23355113 PMCID: PMC3602231 DOI: 10.1007/s12160-012-9452-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Obesity is associated with poor asthma outcomes; weight loss improves such outcomes. Inaccurate recognition of obesity may impede weight control. PURPOSE We examined perception of weight by early adolescents with uncontrolled asthma and their caregivers, and tested the relationship between medical visit frequency and accuracy of perceived weight status. METHODS A total of 373 adolescents and their caregivers reported the adolescent's height/weight and weight perception; caregivers reported healthcare utilization. We measured height/weight. Logistic regression modeled accuracy of weight perception. RESULTS A total of 43.7 % of the overweight/obese adolescents and caregivers accurately perceived weight status. BMI percentile [odds ratio (OR) = 1.19, confidence interval (CI) = 1.10-1.28] and total medical visits (OR = 1.18, CI = 1.05-1.33) were associated with higher accuracy in caregivers. Total medical visits (OR = 0.84, CI = 0.74-0.96) was associated with lower accuracy in adolescents. CONCLUSIONS Accurate perception of weight status was poor for overweight adolescents with uncontrolled asthma and their caregivers. Frequent medical visits were associated with improved caregivers' but not adolescents' perceptions.
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Affiliation(s)
- Melanie Jay
- NYU School of Medicine, Division of General Internal Medicine, New York, NY
| | | | - N. Ari Wijetunga
- Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
| | - Grace Akinrinade
- NYU School of Medicine, Dept. of Child and Adolescent Psychiatry, New York, NY
| | - Karen Dorsey
- Yale University, School of Medicine, Dept. of Pediatrics, New Haven, CT
| | - Jean-Marie Bruzzese
- NYU School of Medicine, Dept. of Child and Adolescent Psychiatry, New York, NY
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Regber S, Novak M, Eiben G, Bammann K, De Henauw S, Fernández-Alvira JM, Gwozdz W, Kourides Y, Moreno LA, Molnár D, Pigeot I, Reisch L, Russo P, Veidebaum T, Borup I, Mårild S. Parental perceptions of and concerns about child's body weight in eight European countries--the IDEFICS study. Pediatr Obes 2013; 8:118-29. [PMID: 23001999 DOI: 10.1111/j.2047-6310.2012.00093.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 06/19/2012] [Accepted: 07/17/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate parental perceptions of and concern about child's body weight and general health in children in a European cohort. DESIGN Cross-sectional multi-centre study in eight European countries. PARTICIPANTS 16,220 children, ages 2-9 years. METHODS Parents completed a questionnaire regarding children's health and weight and concern about overweight and underweight. Objective children's weight categories from the International Obesity Task Force were used. Logistic regression models were utilized to identify predictors of accurate weight perception. RESULTS Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, with important exceptions. About one-third of the total indicated concern about underweight, paradoxically most often parents of children in the overweight or obesity categories. In 63%, parents of children in the overweight category marked 'proper weight'. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR] = 7.2, 95% confidence interval [CI] 6.1-8.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.3-6.0) in Northern Europe and 3.4 (95% CI 2.7-4.2) in Central Europe. CONCLUSION Parents of children categorized as being overweight or obese systematically underestimated weight. Parents differed regionally regarding accurate weight perception and concern about overweight and underweight.
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Affiliation(s)
- S Regber
- Nordic School of Public Health NHV, Gothenburg, Sweden.
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Aljunaibi A, Abdulle A, Nagelkerke N. Parental weight perceptions: a cause for concern in the prevention and management of childhood obesity in the United Arab Emirates. PLoS One 2013; 8:e59923. [PMID: 23555833 PMCID: PMC3608558 DOI: 10.1371/journal.pone.0059923] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 02/19/2013] [Indexed: 11/18/2022] Open
Abstract
Parental participation is a key factor in the prevention and management of childhood obesity, thus parental recognition of weight problems is essential. We estimated parental perceptions and their determinants in the Emirati population. We invited 1541 students (grade 1-12; 50% boys) and their parents, but only 1440 (6-19 years) and their parents consented. Of these, 945 Emirati nationals provided data for analysis. Anthropometric and demographic variables were measured by standard methods. CDC BMI percentile charts for age and sex were used to classify children's weight. Parental perception of their children's weight status (underweight, normal, and overweight/obese) was recorded. Logistic regression analyses were used to identify independent predictors of parental perceptions of children's weight status. Of all parents, 33.8% misclassified their children's' weight status; underestimating (27.4%) or overestimating (6.3%). Misclassification was highest among parents of overweight/obese children (63.5%) and underweight (55.1%) children. More importantly, parental perceptions of their children being overweight or obese, among truly overweight/obese children, i.e. correct identification of an overweight/obese child as such, were associated with the true child's BMI percentile (CDC) with an OR of 1.313 (95% CI: 1.209-1.425; p<0.001) per percentile point, but not age, parental education, household income, and child's sex. We conclude that the majority of parents of overweight/obese children either overestimated or, more commonly, underestimated children's weight status. Predictors of accurate parental perception, in this population, include the true children's BMI, but not age, household income, and sex. Thus, parents having an incorrect perception of their child's weight status may ignore otherwise appropriate health messages.
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Affiliation(s)
- Abdulla Aljunaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Abdishakur Abdulle
- Department of Internal Medicine, College of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Nico Nagelkerke
- Department of Community Medicine; College of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
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90
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Campbell M, Bryson HE, Price AMH, Wake M. Childhood obesity in secondary care: national prospective audit of Australian pediatric practice. Acad Pediatr 2013; 13:168-76. [PMID: 23498083 DOI: 10.1016/j.acap.2012.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 12/10/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE In many countries, pediatricians offer skilled secondary care for children with conditions more challenging than can readily be managed in the primary care sector, but the extent to which this sector engages with the detection and management of obesity remains largely unexplored. This study aimed to audit the prevalence, diagnosis, patient, and consultation characteristics of obesity in Australian pediatric practices. METHODS This was a national prospective patient audit in Australia. During the course of 2 weeks, members of the Australian Paediatric Research Network prospectively recorded consecutive outpatient consultations by using a brief standardized data collection form. Measures included height, weight, demographics, child and parent health ratings, diagnoses, referrals, investigations, and consultation characteristics. We compared the prevalence of pediatrician-diagnosed and measured obesity (body mass index ≥95th percentile) and top-ranked diagnoses, patient, and consultation characteristics in (a) obese and nonobese children, and (b) obese children with and without a diagnosis. RESULTS A total of 198 pediatricians recorded 5466 consultations with 2-17 year olds, with body mass index z-scores calculated for 3436 (62.9%). Of the 12.6% obese children, only one-third received an "overweight/obese" diagnosis. Obese children diagnosed as overweight/obese were heavier, older, and in poorer health than those not diagnosed and incurred more Medicare (government-funded health system) cost and referrals. CONCLUSIONS Obesity is infrequently clinically diagnosed by Australian pediatricians and measurement practices vary widely. Further research could focus on supporting and normalizing clinical obesity activities from which pediatricians and parents could see clear benefits.
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Affiliation(s)
- Michele Campbell
- Centre for Community Child Health, Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Hudson E, McGloin A, McConnon A. Parental weight (mis)perceptions: factors influencing parents' ability to correctly categorise their child's weight status. Matern Child Health J 2013; 16:1801-9. [PMID: 22139047 DOI: 10.1007/s10995-011-0927-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study investigates parents' ability to correctly classify their child's weight status. The influence of parent and child socio-demographic and lifestyle factors on parental misclassification of their child's weight status is explored. A representative sample of Irish children (aged 5-12 (n = 596) years, aged 13-17 years (n = 441)) and their parents (n = 1885) were recruited to participate in a national dietary survey. Parental perceptions of their child's weight and their own weight were measured. Anthropometric measurements (weight and height) were objectively measured for parents and children. Body Mass Index (BMI) scores were derived and categorised as normal, overweight or obese using standard references. Over 80% of parents of overweight boys and 79.3% of parents of overweight girls reported their child's weight was fine for his/her height and age. Furthermore, 44.4% of parents of obese boys and 45.3% of parents of obese girls felt their child's weight was fine for their height and age. Parents were significantly less likely to be correct about their sons' weight status and more likely to be correct the older the child. Parents were over 86% less likely to be correct about their child's weight if their child was overweight and approximately 59% less likely to be correct if the child was obese, compared to parents of normal weight children. This research suggests that parents are failing to recognise overweight and obesity in their children with factors such as parental weight status, child's age and gender influencing this.
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Affiliation(s)
- Eibhlin Hudson
- School of Economics, Finance and Marketing, RMIT University, Melbourne, Australia
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92
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Latzer Y, Stein D. A review of the psychological and familial perspectives of childhood obesity. J Eat Disord 2013; 1:7. [PMID: 24999389 PMCID: PMC4081713 DOI: 10.1186/2050-2974-1-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 01/11/2013] [Indexed: 12/31/2022] Open
Abstract
Childhood obesity is on the rise in both industrialized and developing countries. The investigation of the psychosocial aspects of childhood obesity has been the focus of long- standing theoretical and empirical endeavor. Overweight in children and adolescents is associated with a host of psychological and social problems such as reduced school and social performance, less favorable quality of life, societal victimization and peer teasing, lower self-and body-esteem, and neuropsychological dysfunctioning. Whereas community samples of obese youngsters usually do not show elevated psychopathology, clinically-referred overweight children show elevated depression, anxiety, behavior problems, attention deficit hyperactivity disorder and disordered eating. Parents' perceptions of their child's overweight highly influence the well-being of obese children and the way in which they perceive themselves. THE PRESENT REVIEW PAPER AIMS TO BROADEN THE SCOPE OF KNOWLEDGE OF CLINICIANS ABOUT SEVERAL IMPORTANT PSYCHOSOCIAL AND FAMILIAL DIMENSIONS OF CHILDHOOD OBESITY: the psychosocial functioning, self and body esteem and psychopathology of overweight youngsters, the influence of children's perceptions of overweight, including those of the obese children themselves on their well being, and the influence of parental attitudes about weight and eating on the psychological condition of the obese child.
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Affiliation(s)
- Yael Latzer
- Faculty of Social Welfare & Health Sciences, Haifa University, Haifa, Israel
- Eating Disorders Clinic, Psychiatric Division, Rambam Medical Center, Haifa, Israel
| | - Daniel Stein
- Pediatric Psychosomatic Department, the Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer, affiliated with The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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93
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Rietmeijer‐Mentink M, Paulis WD, van Middelkoop M, Bindels PJ, van der Wouden JC. Difference between parental perception and actual weight status of children: a systematic review. MATERNAL & CHILD NUTRITION 2013; 9:3-22. [PMID: 23020552 PMCID: PMC6860751 DOI: 10.1111/j.1740-8709.2012.00462.x] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
An increasing number of children worldwide are overweight, and the first step in treating obesity is to identify overweight. However, do parents recognise overweight in their child and which factors influence parental perception? The aim of the present review is to systematically study differences between parental perception and the actual weight status of children. Medline, EMbase, CINAHL and PsychINFO were searched. After screening 2497 abstracts and 106 full texts, two reviewers independently scored the methodological quality of 51 articles (covering 35 103 children), which fulfilled the inclusion criteria. The primary outcome parameters were sensitivity and specificity of parental perception for actual weight status of their child. The methodological quality of the studies ranged from poor to excellent. Pooled results showed that according to objective criteria 11 530 children were overweight; of these, 7191 (62.4%) were incorrectly perceived as having normal weight by their parents. The misperception of overweight children is higher in parents with children aged 2-6 years compared with parents of older children. Sensitivity (correct perception of overweight) of the studies ranged from 0.04 to 0.89, while specificity (correct perception of normal weight) ranged from 0.86 to 1.00. There were no significant differences in sensitivity or specificity for different cut-off points for overweight, or between newer and older studies. Therefore we can conclude that parents are likely to misperceive the weight status of their overweight child, especially in children aged 2-6 years. Because appropriate treatment starts with the correct perception of overweight, health care professionals should be aware of the frequent parental misperception of the overweight status of their children.
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Affiliation(s)
| | - Winifred D. Paulis
- Department of General PracticeErasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | | | - Patrick J.E. Bindels
- Department of General PracticeErasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | - Johannes C. van der Wouden
- Department of General PracticeErasmus MCUniversity Medical CenterRotterdamThe Netherlands
- Department of General Practice and Elderly Care MedicineEMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamThe Netherlands
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94
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95
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Guagliano JM, Rosenkranz RR. Physical activity promotion and obesity prevention in Girl Scouts: Scouting Nutrition and Activity Program+. Pediatr Int 2012; 54:810-5. [PMID: 22672146 DOI: 10.1111/j.1442-200x.2012.03681.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND A previous version of Scouting Nutrition and Activity Program (SNAP) resulted in greater physical activity (PA) during troop meetings, but no impact on girls' body mass index (BMI) or overall PA. The purpose of this study was to evaluate the effects of a 6-month intervention that coupled the evidence-based program SNAP with a channel of communication to parents using health report cards. METHODS Thirty-two Girl Scouts (mean age = 9.5, SD = 1.4 years) received the SNAP+ intervention. Girls were measured before and after the intervention on body composition, BMI, and 7-day step counts. Troop leaders were trained to implement an interactive obesity-prevention curriculum. Parents received health report cards designed to provide personalized information about their daughters' PA and weight status. RESULTS The full sample of participants took more steps per day after the intervention (mean difference = 1741, P= 0.007). Results showed that lower values for body fat percentage (P= 0.620), BMI percentile (P= 0.100) and BMI z-scores (P= 0.055) at intervention end were not statistically significant. In the subsample of girls at risk for overweight and obesity, there were lower values for BMI z-score (P= 0.010), BMI percentile (P= 0.027), and body fat percentage (P= 0.053). CONCLUSIONS From this preliminary study, the SNAP+ intervention appears to be effective for Scout-based promotion of PA, and for the prevention of overweight and obesity in at-risk Girl Scouts, but further evaluation through a fully powered randomized controlled trial is warranted.
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Affiliation(s)
- Justin M Guagliano
- School of Science and Health, University of Western Sydney, Sydney, Australia
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96
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Nickelson J, Bryant CA, McDermott RJ, Buhi ER, Debate RD. A modified obesity proneness model predicts adolescent weight concerns and inability to self-regulate eating. THE JOURNAL OF SCHOOL HEALTH 2012; 82:560-571. [PMID: 23151118 DOI: 10.1111/j.1746-1561.2012.00737.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The prevalence of obesity among high school students has risen in recent decades. Many high school students report trying to lose weight and some engage in disordered eating to do so. The obesity proneness model suggests that parents may influence their offspring's development of disordered eating. This study examined the viability of a modified obesity proneness model in a high school population. METHODS Cross-sectional survey data from a random cluster sample of 1533 students in grades 9-12 from a Florida school district were analyzed using structural equation modeling. Variables included adolescents' weight concerns; inability to self-regulate eating; and perceptions about maternal comments about adolescents' weight, restrictive feeding practices, and maternal weight-related concern and values. RESULTS All the model's originally proposed relationships were statistically significant, for example perceived maternal weight comments were associated with adolescents' weight concerns (β = 0.64; p < .0001), and perceived maternal restrictive feeding practices were associated with adolescents' inability to self-regulate eating (β = 0.22; p < .001). CONCLUSION Some points of intervention should be subjected to empirical study. These interventions should give mothers guidance about appropriate feeding practices and discourage mothers from making weight-related comments to their offspring. Together, as 1 component of a multilevel intervention, these behaviors may help prevent disordered eating and obesity.
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Affiliation(s)
- Jen Nickelson
- Department of Health Science, University of Alabama, Box 870311, Tuscaloosa, AL 35487-0311, USA.
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97
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Guo X, Zheng L, Li Y, Yu S, Sun G, Yang H, Zhou X, Zhang X, Sun Z, Sun Y. Differences in lifestyle behaviors, dietary habits, and familial factors among normal-weight, overweight, and obese Chinese children and adolescents. Int J Behav Nutr Phys Act 2012; 9:120. [PMID: 23031205 PMCID: PMC3522535 DOI: 10.1186/1479-5868-9-120] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2011] [Accepted: 09/25/2012] [Indexed: 12/21/2022] Open
Abstract
Background Pediatric obesity has become a global public health problem. Data on the lifestyle behaviors, dietary habits, and familial factors of overweight and obese children and adolescents are limited. The present study aims to compare health-related factors among normal-weight, overweight, and obese Chinese children and adolescents. Methods We conducted a cross-sectional study consisted of 4262 children and adolescents aged 5–18 years old from rural areas of the northeast China. Anthropometric measurements and self-reported information on health-related variables, such as physical activities, sleep duration, dietary habits, family income, and recognition of weight status from the views of both children and parents, were collected by trained personnel. Results The prevalence rates of overweight and obesity were 15.3 and 6.4%, respectively. Compared to girls, boys were more commonly overweight (17.5% vs. 12.9%) and obese (9.5% vs. 3.1%). Approximately half of the parents with an overweight or obese child reported that they failed to recognize their child’s excess weight status, and 65% of patients with an overweight child reported that they would not take measures to decrease their child’s body weight. Obese children and adolescents were more likely to be nonsnackers [odds ratio (OR): 1.348; 95% confidence interval (CI): 1.039–1.748] and to have a family income of 2000 CNY or more per month (OR: 1.442; 95% CI: 1.045–1.99) and less likely to sleep longer (≥7.5 h) (OR: 0.475; 95% CI: 0.31–0.728) than the normal-weight participants. Conclusions Our study revealed a high prevalence of overweight and obesity in a large Chinese pediatric population. Differences in sleep duration, snacking, family income, and parental recognition of children’s weight status among participants in different weight categories were observed, which should be considered when planning prevention and treatment programs for pediatric obesity.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, People's Republic of China
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98
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Skinner AC, Steiner MJ, Perrin EM. Self-reported energy intake by age in overweight and healthy-weight children in NHANES, 2001-2008. Pediatrics 2012; 130:e936-42. [PMID: 22966024 PMCID: PMC3457623 DOI: 10.1542/peds.2012-0605] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Variation in energy intake by weight status at different ages may explain inconsistencies in previous research on energy intake and obesity. Therefore, our objective was to determine the relationship between reported daily energy intake and categorized weight status across childhood. METHODS We examined dietary reports of children ages 1 to 17 years by using the National Health and Nutrition Examination Survey, 2001-2008 (N = 12648). Using measured height and weight, we categorized weight status based on weight-for-length percentile (age <2 years) or BMI percentile (ages 2-17 years) using current recommendations. Dietary intake was reported by using the repeatedly validated automated multiple pass method, a detailed 2-day 24-hour recall. We used ordinary least squares regression to examine the interactions of age and weight category on total energy intake, controlling for gender, race, ethnicity, and income. RESULTS Weight status and age both have positive associations with self-reported energy intake. However, the interaction between weight and age demonstrates a negative effect throughout childhood, such that young obese/overweight children reported consuming significantly more calories and obese/overweight adolescents reported consuming fewer calories than their same-age healthy-weight peers. CONCLUSIONS In a nationally representative cross-sectional sample, overweight and obese girls older than 7 years and boys older than 10 years reported consuming fewer daily calories than their healthy-weight peers. One explanation for this would be that increased energy intake in early childhood is related to the onset of obesity, but other mechanisms, such as differences in energy expenditure, may contribute more to maintaining obese/overweight status through adolescence.
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Affiliation(s)
- Asheley Cockrell Skinner
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics in the School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
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99
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Parents' Awareness of Their Fifth Graders' Weight Status in Rural South Dakota. TOP CLIN NUTR 2012. [DOI: 10.1097/tin.0b013e31826f8ff8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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100
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Hager ER, Candelaria M, Latta LW, Hurley KM, Wang Y, Caulfield LE, Black MM. Maternal perceptions of toddler body size: accuracy and satisfaction differ by toddler weight status. ACTA ACUST UNITED AC 2012; 166:417-22. [PMID: 22566540 DOI: 10.1001/archpediatrics.2011.1900] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To examine (1) accuracy of maternal perceptions of toddler body size; (2) factors associated with accuracy of toddler body size; and (3) how maternal satisfaction relates to accuracy/toddler body size. DESIGN Cross-sectional. SETTING Low-income community sample from suburban Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)/urban pediatric clinics. PARTICIPANTS Two hundred eighty-one mother-toddler dyads (toddlers: 54.1% male; mean age, 20.2 months; 70.8% African American; 8.5% underweight [<15th weight-for-length percentile]; and 29.2% overweight [≥85th weight-for-length percentile]). MAIN EXPOSURE Measured anthropometry (mother/toddler) and demographics. OUTCOME MEASURE Validated toddler silhouette scale (accuracy and satisfaction). RESULTS Nearly 70% of mothers were inaccurate in assessing their toddler's body size. Compared with mothers of healthy-weight toddlers, mothers of underweight toddlers were 9.13 times more likely to be accurate (95% CI, 2.94-28.36) and mothers of overweight toddlers were 87% less likely to be accurate (95% CI, 0.05-0.33); accuracy did not differ by toddler age, sex, or race or mother's education or weight status. More than 70% of all mothers and 81.7% of mothers of overweight toddlers were satisfied with their toddler's body size. Accurate mothers of underweight toddlers were less likely to be satisfied than accurate mothers of healthy-weight toddlers (30.0% vs 76.8%; P < .001). CONCLUSIONS Mothers of overweight toddlers had inaccurate perceptions of their toddler's body size and were highly satisfied, suggesting a view of heavy toddlers as normative. Mothers of underweight toddlers had accurate perceptions yet were dissatisfied, suggesting recognition of their child as outside the norm. Because inaccurate perceptions begin early in toddlerhood, pediatric providers should help improve families' understanding of healthy body size. Future studies should examine how satisfaction and accuracy relate to parenting behaviors.
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Affiliation(s)
- Erin R Hager
- Division of Growth and Nutrition, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.
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