Influence of parenting styles in the context of adolescents' energy balance-related behaviors: Findings from the FLASHE study

Association between Parental Feeding Styles and Excess Weight, and Its Mediation by Diet, in Costa Rican Adolescents

Background. Whereas parental feeding styles (PFS) influence children’s diet, less is known about this relationship in adolescents. Methods. A cross-sectional study in 686 Costa Rican adolescents (13–18 years) evaluated 4 validated PFS scores: healthy eating verbal encouragement; scolding; directly controlling diet; instrumental/emotional. Diet was evaluated through 3-day food records, deriving a Traditional Costa Rica Adolescents Diet Score (TCRAD). Excess weight (EW) measured by BMI was dichotomized following standards. Regression-based mediation analysis estimated the overall and sex-stratified odds ratios of EW for natural direct (NDE), natural indirect (NIE), and total effects (TE) of the pathway PFS→TCRAD→EW. Results. A one-unit increase in the direct control PFS score was associated with higher EW odds overall [(TE: 1.55; 95% CI: 1.04–2.31; p-value = 0.033), (NDE: 1.52; 95% CI: 1.02–2.27; p-value = 0.039)], and in boys [(TE: 2.13; 95% CI: 1.04–4.38; p-value = 0.039), (NDE: 2.10; 95% CI: 1.03–4.31; p-value = 0.042)]. Non-significant mediation by TCRAD was observed for the healthy eating verbal encouragement PFS overall (p-value = 0.06). Associations for the instrumental/emotional and scolding PFS were not significant. Conclusions. Direct diet control from parents may contribute to adolescents’ excess weight, particularly among boys. Parents encouraging healthy eating might support adolescents’ healthy weight through a healthy diet. Longitudinal research should clarify the association between PFS and diet-related outcomes among diverse adolescents.

Adolescents' proxy reports on obesity-related parenting practices: factorial validity and reliability across four behavioral domains

Background

Adolescents’ energy balance behaviors are precursors to obesity shaped by the practices or strategies that many parents implement. Although key stakeholders to their families, adolescents are rarely considered to report on these obesity-related parenting practices. The aim of this study is to assess the factorial and predictive validity of adolescents’ proxy-report of parents’ obesity-related parenting across four behavioral domains.

Methods

This study used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) study. This study tests whether adolescents’ proxy reports about their parents’ obesity-related parenting are significantly associated with parents’ responses on their own obesity-related parenting, as well as whether these reports are significantly associated to parent-adolescent energy balance behaviors. Factorial validity was assessed using linear regression and Confirmatory Factor Analysis (CFA), whereas predictive validity was assessed using Actor-Partner Interdependence Modeling (APIM).

Results

Regression results indicated that adolescents’ proxy report is significantly associated with parents’ report of their own parenting in all four domains (β = .59—.71; p < 0.05). CFA results indicated a final factor structure that loaded significantly onto hypothesized obesity-related parenting domains (β > .30) in both adolescents and parents. APIM results indicated that both parent- (β = .32; p < 0.05) and adolescent-(β = .21; p < 0.05) reported obesity parenting for fruit and vegetable consumption were associated with their own fruit and vegetable intake. In addition, adolescent-reported physical activity parenting was significantly associated with adolescent physical activity (β = 0.23; p < 0.05). Regarding partner effects, only parent-reported parenting for fruit and vegetable consumption were significantly associated with adolescent intake of fruit and vegetables (β = 0.15, p < 0.05) and adolescent-reported physical activity parenting was significantly associated with parental physical activity (β = 0.16, p < 0.05). Neither adolescent nor parent reported parenting were significantly associated with screen time or junk food intake outcomes. Each final obesity-related parenting scale had good internal consistency (a = .74-.85).

Conclusions

We found that adolescent- and parent-reported obesity-related parenting were significantly associated, while adolescent-reported parenting were more explanatory of fruit and vegetable intake and physical activity than parent-reported parenting. These findings suggest that adolescent proxy reports may be a valid source of information on obesity-related parenting.

Gender-based eating norms, the family environment and food intake among Costa Rican adolescents

OBJECTIVE

To examine the association between family environment variables (parenting styles, family meal atmosphere), gender-based stereotypes and food intake in Latin American adolescents.

DESIGN

Structural equation modelling applied to cross-sectional data, 2017.

SETTING

Urban and rural sites of San José, Costa Rica.

PARTICIPANTS

n 813; 13-18 years old.

RESULTS

Data suggest direct associations between gender-based stereotypes and intake of fruits and vegetables (FV) (β = 0·20, P < 0·05), unhealthy foods (fast food (FF)) (β = -0·24, P < 0·01) and ultra-processed foods (β = -0·15, P < 0·05) among urban girls; intake of legumes among rural girls (β = 0·16, P < 0·05) and intake of sugar-sweetened beverages (SSB) among rural boys (β = 0·22, P < 0·05). Family meal atmosphere was associated with legume intake (β = 0·19, P <·05) among rural girls. Authoritative parenting style was associated with FV intake (β = 0·23, P < 0·05) among urban boys and FF intake (β = 0·17, P < 0·05) among urban girls. Authoritarian parenting style was associated with FV consumption (β = 0·19, P < 0·05) among rural boys, and with SSB and FF consumption (β = 0·21, P < 0·05; β = 0·14, P < 0·05, respectively) among urban girls.

CONCLUSIONS

Findings are the first to describe the complex family environment and gender-based stereotypes within the context of a Latin American country. They emphasise the need for culturally relevant measurements to characterise the sociocultural context in which parent-adolescent dyads socialise and influence food consumption.

Influence of paternal general parenting on Latino early adolescents' energy balance-related behaviours and interactions with behaviour-specific parenting practices

OBJECTIVE

To investigate the influence of general parenting dimensions on adolescents' energy balance-related behaviours (EBRB) and its interactions with behaviour-specific parenting practices based on Darling and Steinberg's contextual model of parenting style.

DESIGN

Multiple linear regression analyses and the Hayes PROCESS procedure to analyse self-reported cross-sectional survey data.

SETTING

In-person survey.

PARTICIPANTS

Latino early adolescents and their fathers (n 225 dyads) recruited using convenience sampling from metropolitan areas of north-central USA.

RESULTS

Both paternal parenting dimensions of warmth and autonomy granting were positively associated with adolescents' fruit intake, vegetable intake and physical activity. Coercive control was positively associated with adolescents' sugary drink intake and sweets/salty snack intake. These associations were predominantly mediated by the parenting practices of setting expectations/allowances, role modelling, and managing availability and accessibility for corresponding EBRB. After adjusting for parenting practices, paternal warmth was inversely associated with adolescents' screen time, paternal autonomy was positively associated with sugary drink intake, and both paternal warmth and autonomy granting were positively associated with adolescents' fast food intake. In addition, positive associations between fathers' parenting practices and adolescents' sugary drink intake were significantly stronger among those who perceived high v. low levels of paternal warmth and autonomy granting.

CONCLUSIONS

Paternal warmth and autonomy granting showed mixed effects on adolescents' EBRB, and coercive control showed undesirable relationships with adolescents' dietary intake via interactions with behaviour-specific parenting practices. Lifestyle intervention programmes for Latino adolescents need to consider incorporating paternal parenting education components.

Associations between Psychosocial Variables, Availability of Physical Activity Resources in Neighborhood Environment, and Out-of-School Physical Activity among Chinese Adolescents

This study aimed to evaluate the relationship between psychosocial variables (peer support, parental support, autonomous motivation, and controlled motivation), availability of physical activity resources in a neighborhood environment, and out-of-school moderate to vigorous physical activity (MVPA) among Chinese adolescents. The questionnaire of Family Life, Activity, Sun, Health, and Eating (FLASHE) Study was used to collect information on demographics, socioeconomic status, psychosocial variables, available physical activity resources in the neighborhood environment, and minutes of out-of-school MVPA. ANOVA analysis and multiple regression analysis were performed. The mean age of the 3833 adolescents included in our analysis was 14.7 years old (SD = 1.7). Peer support (b = 9.35, 95% CI: 7.55–11.15), autonomous motivation (b = 6.46, 95% CI: 4.09–8.82), parental support (b = 3.90, 95% CI: 1.75–6.07), and availability of physical activity resources in neighborhood environment (b = 3.18, 95% CI: 1.99–4.36) were significantly associated with out-of-school MVPA (p < 0.05). Controlled motivation was insignificantly related to minutes of out-of-school MVPA. Boys spent more time on out-of-school MVPA than girls (p < 0.001) and had a high level of peer support, parental support, and motivation (p < 0.05). Our findings suggest that interventions targeting the out-of-school MVPA among Chinese adolescents should focus on the psychosocial variables and neighborhood environment.

Intersectionality between parenting styles, area of residence and gender on food group consumption among Costa Rican adolescents

Little is known about how parenting styles can influence the adolescent's consumption of sugar-sweetened beverages (SSB), fruits and vegetables (FV) and beans in Latin America. This study uses hierarchical moderated regression models to examine such association by area of residence, sex of the parent and of the adolescent in Costa Rica. Results showed that fathers' authoritarian style was significantly associated with lower intake of sugar-sweetened beverages (SSB) among boys (b = -0.163, p = 0.050), but not girls (b = 0.097, p = 0.114) while mother's authoritarian style was associated with lower SSB intake among girls (b = -0.138, p = 0.031), but not boys (b = 0.159, p = 0.059). Fathers' authoritative style was associated with higher consumption of fruits and vegetables (FV) among boys in rural areas (b=0.440, p= 0.017), but this association was not significant for girls (b=-0.033, p= 0.800) in rural areas or for either gender in urban areas. Parenting styles of the mothers' and fathers' were not significantly associated with Costa Rican adolescent bean consumption, in general or for any of the subgroups. Findings suggest an intersectionality in the effects of parentchild interactions by child and parent sex, cultural and geographic context, and the eating behaviors examined.

Perceptions of Family-Level Social Factors That Influence Health Behaviors in Latinx Adolescents and Young Adults at High Risk for Type 2 Diabetes

Given that health behaviors occur within the context of familial social relationships, a deeper understanding of social factors that influence health behaviors in Latinx families is needed to develop more effective diabetes prevention programming. This qualitative study identified perceived family-level social factors that influence health behaviors in Latinx adolescents (12–16 years; N = 16) and young adults (18–24 years; N = 15) with obesity and explored differences in perceptions across sex and age. Participants completed an in-depth interview that was recorded, transcribed, and coded using thematic content analysis. Emergent themes central to health behaviors included: perceived parental roles and responsibilities, perceived family social support for health behaviors, and familial social relationships. Mom’s role as primary caregiver and dad’s role as a hard worker were seen as barriers to engaging in health behaviors among adolescent females and young adults, males and females. Adolescents perceived receiving more support compared to young adults and males perceived receiving more support compared to females. Health behaviors in both age groups were shaped through early familial social interactions around physical activity. These insights suggest that traditional gender roles, social support, and social interaction around health behaviors are critical components for family-based diabetes prevention programs in high-risk Latinx youth and young adults.

Factors Affecting Adolescents' Screen Viewing Duration: A Social Cognitive Approach Based on the Family Life, Activity, Sun, Health and Eating (FLASHE) Survey

The pervasiveness of prolonged screen viewing (SV) in adolescence is of significant concern given its well-documented implications with various health outcomes. Based on Social Cognitive Theory (SCT), this study explored how a wide range of individual, environmental, and behavioral factors correlate with adolescents' SV duration. The study used adolescents' self-reported data from the cross-sectional Family Life, Activity, Sun, Health and Eating (FLASHE) study implemented by the National Cancer Institute (NCI). Findings indicated that adolescents' SV duration were different across various age and ethnic groups. It was positively associated with emotion regulation and negatively connected with self-efficacy in limiting screen time. Compared to un-authoritative parenting style, authoritative parenting had an advantage in curbing adolescents' screen use. General media susceptibility strongly correlated with SV duration. Perception of peers' behaviors (descriptive norm) and how peers would react adversely (injunctive norm) were both connected with SV duration. SV duration was negatively connected with physical activity whereas positively linked with sedentary behavior. Theoretical and practical implications were outlined, as well as limitations and directions for future research.

Individual parental conversations with non-birthing parents

Aim:

The aim of this study was to describe Child Health Service (CHS) nurses’ experiences with conducting individual parental conversations (IPCs) with non-birthing parents.

Background:

CHS nurses in Sweden mainly focus on monitoring a child’s physical and mental development and the mothers’ health in order to support their parenthood. The assignment of the CHS includes identifying dysfunctional social relationships in a family and strengthening responsive parenting. An imbalance arises within the family when someone in the family suffers from illness, which could have a negative effect on the whole family’s health and well-being.

Methods:

An inductive, descriptive qualitative study design was used to describe and to gain an understanding of the CHS nurses’ experiences. Data were collected in 13 interviews, and a qualitative content analysis was performed.

Findings:

The analysis of interviews with CHS nurses resulted in two main categories, each with three subcategories. The main categories are: working for equality and applying a family focus, and dealing with challenges in the developing assignment. The IPCs stimulate the CHS nurses to work for more equality and to apply a family focus, which can be a way of strengthening the families’ health and the children’s upbringing. Developing the CHS nurses’ assignment can be a challenge that appears to entail positive outcomes for CHS nurses, while also generating the need for CHS nurses to receive supervision to find ways to improve their approach and practice.