1
|
Berge JM, Hazzard VM, Arlinghaus KR, Larson N, Hahn SL, Neumark-Sztainer D. Do parents engage in weight- and health-focused conversations with their emerging adult children and are there cross-sectional associations with weight and well-being outcomes? Prev Med 2024; 186:108066. [PMID: 39004315 DOI: 10.1016/j.ypmed.2024.108066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Research indicates harmful associations between parental weight-focused conversations and markers of pediatric health and well-being. However, little is known about the prevalence and consequences of parent conversations focused on weight or health behaviors (i.e., physical activity or nutrition) with emerging adult children. METHODS Data are from the 2018 follow-up survey of the population-based EAT 2010-2018 (Eating and Activity over Time) in cohort from Minneapolis-St. Paul, MN. Participants were emerging adults at follow-up with ages 18-26. Regression models adjusted for sociodemographic characteristics were conducted. RESULTS Over two-thirds (68%) of mothers and 44% of fathers engaged in weight-focused conversations with their emerging adult children; 25% of both parents reported engaging in conversations focused only on health behaviors; and 8% of mothers and 26% of fathers reported not engaging in either type of conversation. Health-focused conversations by both parents were associated with lower body mass index (BMI) and disordered eating behaviors, higher intake of fruit and vegetables, and psychosocial well-being in emerging adult children. Weight-focused conversations with both parents were associated with higher BMI and disordered eating behaviors in emerging adults. There were gender moderated associations of paternal conversations about weight and health with vegetable intake, binge eating, and depressive symptoms. DISCUSSION The high prevalence and negative health outcomes associated with weight-focused conversations coupled with the low prevalence and positive health outcomes associated with health-focused conversations by parents suggests the need for public health messaging and intervention development aimed at reducing parental weight talk with emerging adult children.
Collapse
Affiliation(s)
- Jerica M Berge
- University of Colorado Anschutz Medical Campus, Department of Family Medicine, and Adult and Child Center for Outsomes Research and Delivery Science (ACCORDS), Aurora, CO, USA.
| | - Vivienne M Hazzard
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Katherine R Arlinghaus
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Nicole Larson
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Samantha L Hahn
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Dianne Neumark-Sztainer
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| |
Collapse
|
2
|
Myntti WW, Parnell L, Valledor V, Chow CM. Adolescent-perceived parent-child negative body talk and disordered eating: Evidence for behavior-specific affective mediators. J Adolesc 2024; 96:1126-1136. [PMID: 38594877 DOI: 10.1002/jad.12323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION This study examined the mediating role of general negative affect and body-specific negative affect between the association between negative body talk occurring within the mother-daughter relationship and restrained and disinhibited disordered eating. METHODS Adolescent girls (N = 100; Mage = 14.25; 49.5% White) completed self-report measures of general negative affect (depression and anxiety), body-specific negative affect (body dissatisfaction), and perceptions of the frequency that negative body talk occurred in interactions with their mother (initiated by the mother or daughter) as part of a cross-sectional study. While the same set of questionnaires was administered to both mothers and daughters, only the data reported by the daughters were analyzed and included in this study. Data were gathered in the Ann Arbor/Ypsilanti area of Michigan, USA, around the year 2015. RESULTS Path analysis showed that general negative affect, but not body-specific negative affect, mediated the association from mother-daughter negative body talk to disinhibited eating behaviors (emotional and external eating). Conversely, body-specific negative affect, but not general negative affect, mediated the association from negative body talk to restrained eating behaviors. CONCLUSIONS Our findings suggest there are distinct affective mechanisms that mediate the relationship between mother-daughter negative body talk and restrained versus disinhibited eating behavior. Future work should continue to explicate the role of general and body-related negative affect in different eating behaviors.
Collapse
Affiliation(s)
- Warner W Myntti
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Lucas Parnell
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Valerie Valledor
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Chong Man Chow
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| |
Collapse
|
3
|
Smith ML, Brimhall AS, Didericksen KW, Jensen JF. Words matter: The role of family weight talk in anxiety and depression. JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:726-743. [PMID: 38605530 DOI: 10.1111/jmft.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
Family weight talk, in the forms of both family weight teasing and encouragement to diet, has been linked to numerous adverse outcomes, including increased disordered eating, unhealthy weight control behaviors, and body mass index. However, little is known about its role in mental health outcomes, especially for emerging adults. Utilizing structural equation modeling, we examined the role of family weight teasing (FWT) and parental encouragement to diet in anxiety and depression and explored body weight perception as a moderator within a sample of 292 emerging adults. Results indicated that FWT was significantly associated with increased anxiety and depression. No significant relationships were found between parental encouragement to diet and the outcome variables, and no group differences emerged across body weight perception. Findings of this pilot study can be used to inform future research to decrease family weight talk and improve psychosocial outcomes for emerging adults.
Collapse
Affiliation(s)
- Maggie L Smith
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Andrew S Brimhall
- Department of Human Development and Family Studies, East Carolina University, Greenville, North Carolina, USA
| | | | - Jakob F Jensen
- Department of Human Development and Family Studies, East Carolina University, Greenville, North Carolina, USA
| |
Collapse
|
4
|
Valledor V, Lawler J, Jefferson S, Chow CM. Attachment style to body dissatisfaction, restrained eating, and disordered eating in adolescent girls: Differential weight communication mediators. Appetite 2024; 198:107321. [PMID: 38555019 DOI: 10.1016/j.appet.2024.107321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/17/2024] [Accepted: 03/22/2024] [Indexed: 04/02/2024]
Abstract
Body dissatisfaction and eating behaviors are disproportionately elevated amongst adolescent girls. Family relationships represent a context in which adolescent girls' body image issues emerge. Thus, we integrated attachment and confirmation theories to examine whether weight related supportive messages (i.e., acceptance and challenge) mediated the relationship between attachment style (i.e., anxiety and avoidance) and body image outcomes (i.e., body dissatisfaction (BD), restrained eating (RE), and disordered eating (DE)). Acceptance refers to weight related support that is characterized by warmth and accepting messages; challenge refers to weight related support that is characterized by instrumental assistance and problem-solving messages. A sample of 106 adolescent girls, ages 11 to 21, completed self-report measures on attachment (Relationship Structures Questionnaire), acceptance and challenge (weight related Parental Behavior Questionnaire), body dissatisfaction (Eating Disorders Inventory), and eating behaviors (Dutch Eating Behavior Questionnaire; Eating Disorder Diagnostic Scale). Attachment anxiety directly related to all body image outcomes, whereas attachment avoidance only directly related to RE. Attachment avoidance only related to BD and DE indirectly through perceived acceptance. Those with high anxiety endorsed lower perceived challenge, whereas avoidant individuals endorsed lower perceived acceptance and challenge. We concluded that attachment dimension characteristics to be either hyperactivated regarding relationships (i.e., anxiety), or deactivated and distant (i.e., avoidance), are associated with how individuals perceive support, and in turn, are related to body image and eating behavior outcomes. Further, we clarify the differential roles of acceptance and challenge. Although both supportive, acceptance encompasses a layer of warmth that is more meaningful in body image, particularly for avoidantly attached individuals. By integrating qualities of attachment and supportive weight communication, we reveal that potential pathways of attachment to body image and eating behaviors.
Collapse
Affiliation(s)
- Valerie Valledor
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA.
| | - Jamie Lawler
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Stephen Jefferson
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Chong Man Chow
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| |
Collapse
|
5
|
Berge JM, Hazzard VM, Trofholz A, Hochgraf A, Zak-Hunter L, Miller L. Reported Intergenerational Transmission of Parent Weight Talk and Links with Child Health and Wellbeing. J Pediatr 2024; 270:114012. [PMID: 38494088 PMCID: PMC11176000 DOI: 10.1016/j.jpeds.2024.114012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To examine if intergenerational transmission of parent weight talk occurs, the contextual factors prompting weight talk, and whether parent weight talk is associated with child weight, dietary intake, psychosocial outcomes, and food parenting practices. STUDY DESIGN Children aged 5-9 years and their families (n = 1307) from 6 racial and ethnic groups (African-American, Hispanic, Hmong, Native American, Somali/Ethiopian, White) were recruited for a longitudinal cohort study through primary care clinics in Minneapolis/St. Paul, Minnesota from 2016 through 2019. Parents filled out surveys at 2 time points, 18 months apart. Adjusted regression models examined associations of interest. RESULTS Intergenerational transmission of parent weight talk was observed. In addition, significant associations were found between parent engagement in weight talk and higher weight status and poorer psychosocial outcomes in children 18 months later. Parent engagement in weight talk was also associated with more restrictive food parenting practices 18 months later. CONCLUSIONS Parents' exposure to weight talk as children increased the likelihood of engaging in weight talk with their own children and had harmful associations over time with parent restrictive feeding practices, child weight, and psychosocial wellbeing in children. Health care providers may want to consider both modeling positive health-focused conversations and educating parents about the potential harmful and long-lasting consequences of engaging in weight talk with their children.
Collapse
Affiliation(s)
- Jerica M Berge
- Department of Family Medicine and Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Vivienne M Hazzard
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Anna Hochgraf
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN
| | - Lisa Zak-Hunter
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Laura Miller
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| |
Collapse
|
6
|
Anastasiadou D, Tárrega S, Fornieles-Deu A, Moncada-Ribera A, Bach-Faig A, Sánchez-Carracedo D. Experienced and internalized weight stigma among Spanish adolescents. BMC Public Health 2024; 24:1743. [PMID: 38951859 PMCID: PMC11218352 DOI: 10.1186/s12889-024-19246-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 06/24/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Weight stigma has negative consequences for both physiological and psychological health. Studies on weight stigma in adolescence, particularly from general populations, are scarce in the Mediterranean area. The main aim of this study is to describe the prevalence of experienced and internalized weight stigma among a representative sample of adolescents from the Spanish city of Terrassa, and to determine its association with sociodemographic variables and weight status. METHODS Drawing on data from the initial assessment of a longitudinally funded project on weight stigma in adolescents, a cross-sectional survey-based study was conducted using random multistage cluster sampling. Weight stigma experiences, their frequency and sources, and weight bias internalization with the Modified Weight Bias Internalization Scale (WBISM) were assessed in a sample of 1016 adolescents. Adjusted odds ratios (AOR) between sociodemographic variables, weight status and having experienced weight stigma, and having reported high scores of WBISM (WBISM ≥ 4) were estimated by multiple logistic regression models. RESULTS The prevalence of weight-related stigma experiences was 43.2% in the sample (81.8 in adolescents with obesity) and the prevalence of high levels of weight bias internalization was 19.4% (50.7 in adolescents with obesity). Other kids and school were the most prevalent sources of weight stigma, with society and family being other significant sources of stigma reported by girls. A significantly higher risk of having experienced weight stigma was observed in girls (AOR = 2.6) and in older adolescents (AOR = 1.9). Compared to normal weight adolescents, all weight statuses showed higher risk, being 3.4 times higher in adolescents with underweight and reaching 11.4 times higher risk in those with obesity. Regarding high levels of weight bias internalization, girls had a risk 6.6 times higher than boys. Once again, a "J-shaped" pattern was observed, with a higher risk at the lowest and highest weight statuses. The risk was 6.3 times higher in adolescents with underweight, and 13.1 times higher in adolescents with obesity compared to those with normal weight. CONCLUSIONS Considering the high prevalence of experienced and internalized weight stigma among adolescents in Spain, especially in adolescents with obesity and girls, it seems important to implement preventive strategies in different settings and address all sources of stigma.
Collapse
Affiliation(s)
- Dimitra Anastasiadou
- Eating and Weight-Related Problems Unit, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
| | - Salomé Tárrega
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
- Department of Epidemiology and Methodology of Social and Health Sciences, Faculty of Health Sciences at Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic- UCC), Av. Universitària, 4-6, Manresa, 08242, Spain
- Research Group in Epidemiology and Public Health in the Digital Health context (Epi4Health), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Ctra. De Roda Núm. 70, Vic, 08500, Spain
| | - Albert Fornieles-Deu
- Eating and Weight-Related Problems Unit, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona Serra Húnter fellow, Edifici B. Campus de la UAB, 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
| | - Albert Moncada-Ribera
- Head of Community and Health Service, Social Rights Section, City Council of Terrassa, Ca. Torres Garcia 35, Terrassa, Barcelona, 08221, Spain
| | - Anna Bach-Faig
- Food Lab Research Group, Faculty of Health Sciences (2021 SGR 01357), Open University of Catalonia (UOC), Barcelona, 08018, Spain
| | - David Sánchez-Carracedo
- Eating and Weight-Related Problems Unit, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain.
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain.
| |
Collapse
|
7
|
Sjunnestrand M, Neuman N, Järvholm K, Ek A, Nordin K, Salas XR, Eli K, Nowicka P. "A balancing act": parents' longitudinal perspectives of weight-related discussions with their children following obesity treatment. BMC Public Health 2024; 24:1695. [PMID: 38918803 PMCID: PMC11202376 DOI: 10.1186/s12889-024-19195-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
Weight-related discussions during childhood may have long-lasting effects on children's body image and well-being. However, little is known about how parents frame these discussions with children who have undergone treatment for obesity. Our study aimed to explore how parents perceive weight-related discussions, several years after their children started obesity treatment. This qualitative study is part of the 4-year follow-up of the More and Less study, a randomized controlled trial examining the effectiveness of a parental support program as part of obesity treatment for preschool-aged children in Stockholm, Sweden. Semi-structured interviews were conducted with 33 parents (79% mothers, 48% with a university degree, 47% with foreign background) of 33 children (mean age 9.3 years (SD 0.7), 46% girls), transcribed and analyzed using realist informed thematic analysis. Three main themes, encompassing three subthemes were developed. Under the first theme, Parental attitudes and concerns, parents emphasized the importance of discussing weight and health behaviors with their children, yet found it challenging due to uncertainties about how to approach it safely and sensitively. A few parents found the conversation manageable, citing their own experiences of having overweight or their style of communication with the child as facilitating the conversation. Under the second theme, The significance of time and context, parents said they engaged in weight-related conversations with their children more frequently as the children matured, driven by their growing self-awareness. Parents also expressed how contextual factors, such as gender and the presence of others, shaped conversations. Parents perceived boys as more resilient, thus exposing them to more negative weight talk. The third theme, Navigating weight stigma, revealed how parents employed strategies such as nurturing their children's self-confidence, downplaying the significance of appearance and emphasizing health when discussing weight to shield their children from weight stigma. Taken together, we found that many parents need support to navigate weight-related discussions. Addressing weight stigma is part of children's obesity management process, as children may be bullied, teased, or experience discrimination in different social settings. More research is needed to explore how young children undergoing obesity treatment experience weight stigma and to understand gendered differences in these experiences.
Collapse
Affiliation(s)
- My Sjunnestrand
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
| | - Nicklas Neuman
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | | | - Anna Ek
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Karin Nordin
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Ximena Ramos Salas
- European Association for the Study of Obesity, United Kingdom and Bias 180, Ottawa, Canada
| | - Karin Eli
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| |
Collapse
|
8
|
Nebel-Schwalm MS. Family pressure and support on young adults' eating behaviors and body image: The role of gender. Appetite 2024; 196:107262. [PMID: 38368910 DOI: 10.1016/j.appet.2024.107262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/10/2024] [Accepted: 02/10/2024] [Indexed: 02/20/2024]
Abstract
Families play a key role in establishing eating habits of children, yet whether families continue to influence eating behaviors of young adults remains an open question. It is also not clear whether associations between family variables (i.e., support and pressure) are similar for adult sons and daughters regarding eating pathology. The present cross-sectional study examined family correlates on disordered eating, body satisfaction, and drive for muscularity. The aim was to examine the associations of family support and family pressure with eating pathology, and to determine whether gender moderated the associations. Among 365 undergraduates (Mage = 18.9 years, 62 % Caucasian, 48 % female), neither family pressure nor family support were significantly associated with the drive for muscularity, whereas both were associated with disordered eating, and family pressure was associated with body satisfaction. Gender moderated the relationship of family pressure and body satisfaction (p = 0.03) and, unexpectedly, the relationship of family support and disordered eating (p = 0.02). Contrary to prediction, family pressure had stronger associations with body satisfaction for men (i.e., men had a more robust association (beta = -0.31, p < .001) than women (beta = -0.19, p = 0.004)). For women, the relationship of family support and disordered eating was not significant (beta = 0.07, p = 0.452); but, was significant for men (beta = -0.25, p < .001). These findings suggest that family pressure and support are associated with eating pathology among young adults, and that in some instances the associations were larger for men, thus highlighting the importance of including men in eating pathology research. Pending replication, these results suggest that family attitudes, behaviors, and support may be necessary topics to address when designing prevention programs for young adults.
Collapse
|
9
|
Rancaño KM, Puhl R, Skeer M, Eliasziw M, Must A. Negative familial weight talk and weight bias internalization in a US sample of children and adolescents. Pediatr Obes 2024; 19:e13108. [PMID: 38375755 PMCID: PMC11006571 DOI: 10.1111/ijpo.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Negative familial weight talk may contribute to higher weight bias internalization in pre- and early adolescents (hereafter referred to as children) and may differ by gender, weight status, and race and ethnicity. OBJECTIVE Examine the relationship between negative familial weight talk and weight bias internalization and examine differences by gender, weight status, and race and ethnicity. METHODS We cross-sectionally analysed 5th-7th graders (10-15 years old) living in Massachusetts (n = 375, 52.3% girls, 21.3% BMI ≥85th percentile, 54.8% non-Hispanic White). Negative familial weight talk frequency during the past 3 months was self-reported and discretized as 'never,' 'occasionally' (1-9 times) and 'often' (>9 times); the Modified Weight Bias Internalization Scale assessed weight bias internalization. Generalized linear models estimated the relationship between negative familial weight talk and weight bias internalization and sub-analyses estimated the relationship across gender, weight status, and race and ethnicity. Results are summarized as ratios of means (RoM). RESULTS Children experiencing negative familial weight talk occasionally (RoM = 1.12, p = 0.024) and often (RoM = 1.48, p < 0.001) had significantly higher weight bias internalization than children who never experienced it. In sub-analyses, experiencing negative familial weight talk often was associated with higher weight bias internalization among girls (RoM = 1.66, p < 0.001), boys (RoM = 1.32, p = 0.007), children with BMI <85th percentile (RoM = 1.44, p = 0.007) and BMI ≥85th percentile (RoM = 1.39, p = 0.001), and non-Hispanic White children (RoM = 1.78, p < 0.001), but not Hispanic (RoM = 1.25, p = 0.085) or non-Hispanic Black children (RoM = 1.20; p = 0.31). CONCLUSIONS Frequent negative familial weight talk was associated with higher weight bias internalization across gender and weight status and in non-Hispanic White children only.
Collapse
Affiliation(s)
- Katherine M. Rancaño
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston MA, Boston, MA
| | - Rebecca Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Margie Skeer
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston MA, Boston, MA
| | - Misha Eliasziw
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston MA, Boston, MA
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston MA, Boston, MA
| |
Collapse
|
10
|
Lessard LM, Puhl RM, Foster GD, Cardel MI. Parent-Adolescent Weight Communication: Parental Psychosocial Correlates Among a Diverse National Sample. JOURNAL OF HEALTH COMMUNICATION 2024; 29:167-173. [PMID: 38230988 DOI: 10.1080/10810730.2023.2276797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Parental communication about body weight with their children is common across diverse families. The current study investigates how parents' feelings about their own bodies, beliefs about body weight, history of weight stigma, and weight-related characteristics contribute to the degree to which they talk about weight - both negatively and positively - with their adolescent children. The study sample was comprised of U.S. parents (N = 1936) from diverse racial/ethnic backgrounds with children aged 10-17 years old. Parents completed an online survey with measures assessing their frequency of engaging in negative and positive weight communication with their children, along with several relevant psychosocial factors (i.e. body satisfaction, experienced weight stigma, associative stigma, body appreciation, beliefs about weight controllability, weight bias internalization). Study findings paint a complex picture, including some psychosocial factors (e.g. weight bias internalization) that are related to both more frequent negative and positive weight communication. Notably, higher levels of associative stigma were related to more frequent negative parental weight comments, and less frequent positive weight socialization. Findings can inform healthcare professionals in raising parents' awareness about how their personal beliefs and feelings about their own weight and their child's weight can contribute to how they engage in communication about weight with their children.
Collapse
Affiliation(s)
- Leah M Lessard
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut, USA
| | - Rebecca M Puhl
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut, USA
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Gary D Foster
- WW International, Inc, New York, New York, USA
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michelle I Cardel
- WW International, Inc, New York, New York, USA
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
11
|
Pudney EV, Puhl RM, Halgunseth LC, Schwartz MB. An Examination of Parental Weight Stigma and Weight Talk Among Socioeconomically and Racially/Ethnically Diverse Parents. FAMILY & COMMUNITY HEALTH 2024; 47:1-15. [PMID: 37656801 DOI: 10.1097/fch.0000000000000384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Parental communication about body weight can influence children's emotional well-being and eating behaviors. However, little is known about the role of parental self-stigma concerning weight and social position variables (ie, race/ethnicity, income, and gender) in weight communication. This study examined how parents' self-stigmatization for their own weight (ie, weight bias internalization) and self-stigmatization for their child's weight (ie, affiliate stigma) relates to weight talk frequency with their children, and whether these associations vary across parental race/ethnicity, income, and gender. Parents (n = 408) completed a cross-sectional, online survey about their weight communication and self-stigmatization. Linear regression was used to examine the relationships among these variables, including interactions between the stigma variables and social position variables in predicting weight talk. Higher levels of weight bias internalization and affiliate stigma were strongly associated with increased parental weight talk frequency; parents who endorsed higher levels of internalized bias about their own weight expressed greater affiliate stigma for their child's weight, regardless of demographic characteristics or weight status. Associations between the stigma variables and weight talk outcomes were stronger among fathers and parents of higher income. Findings highlight the importance of considering weight stigma variables in parental weight communication research.
Collapse
Affiliation(s)
- Ellen V Pudney
- Department of Pediatrics, Division of Community Health & Research, Eastern Virginia Medical School, Norfolk (Dr Pudney); Department of Human Development & Family Sciences, University of Connecticut, Storrs, and Rudd Center for Food Policy & Health, University of Connecticut, Hartford (Drs Puhl and Schwartz); and Department of Human Development & Family Studies, Michigan State University, East Lansing (Dr Halgunseth)
| | | | | | | |
Collapse
|
12
|
White HJ, Sharpe H, Plateau CR. Family body culture, disordered eating and mental health among young adult females during COVID-19. Eat Behav 2023; 51:101792. [PMID: 37647687 DOI: 10.1016/j.eatbeh.2023.101792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023]
Abstract
Different family interactions related to body weight and shape may co-occur and represent a broader 'family body culture'. This may be important in the context of COVID-19 due to a heightened focus on body weight/shape, and many young adults living back with their families. This study aimed to, first, explore relationships between different family body-related interactions to assess the presence of a family body culture, and second, explore relationships between aspects of family body culture, disordered eating and mental health among young adult females during the COVID-19 pandemic. Participants were 233 females aged 18-25 years who completed measures of family body culture (family fat talk; family weight concern; family weight teasing), disordered eating, anxiety and depression. Results showed all aspects of family body culture were significantly, positively related. Engaging in fat talk with family members (self fat talk) was a key correlate of disordered eating, anxiety and depression. Family concern with weight was also significantly associated with disordered eating. Findings suggest that among some families there is a more problematic family body culture with a greater importance placed on body weight and shape through various body-related interactions. Additionally, findings highlight two key aspects of family body culture related to disordered eating and wellbeing among young adult females. Specifically, vocalising critical remarks about one's own body when with family and an environment that may indirectly communicate a high importance of body weight and shape (e.g., via dieting). These should be considered in future family interventions to support healthy eating behaviours.
Collapse
Affiliation(s)
- Hannah J White
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Helen Sharpe
- School of Health in Social Science, University of Edinburgh, Teviot Place, EH8 9AG Edinburgh, UK.
| | - Carolyn R Plateau
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| |
Collapse
|
13
|
Rancaño KM, Lawrence SE. Health Consequences of Familial Negative Weight Talk Across the Spectrum of Gender Diversity. Curr Nutr Rep 2023; 12:581-593. [PMID: 37837600 DOI: 10.1007/s13668-023-00501-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE OF REVIEW To synthesize differences in familial negative weight talk and health-related correlates across gender identities and to highlight gaps relevant to the unique experiences and health correlates of boys and transgender and gender diverse youth. RECENT FINDINGS Most of the studies included in this review observed no difference by gender in familial negative weight talk health correlates. Gender biases in existing measures, however, may have contributed to underreporting of health correlates in boys. Moreover, transgender and gender diverse youth are severely underrepresented in this research. Future research should consistently examine effect modification across gender identities and include measures that are specific to the weight-based concerns and experiences of boys and transgender and gender diverse youth.
Collapse
Affiliation(s)
- Katherine M Rancaño
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave, Boston, MA, 02111, USA.
| | | |
Collapse
|
14
|
Trofholz A, Hochgraf AK, Tschida L, Berge JM. Understanding Weight Talk in Racially/Ethnically Diverse Homes: A Qualitative Analysis With Parents. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:721-733. [PMID: 37656096 PMCID: PMC10591964 DOI: 10.1016/j.jneb.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To explore weight talk in the homes of racially/ethnically diverse immigrant/refugee children and their families. DESIGN Qualitative interviews were conducted with parents of young children. SETTING Twin Cities, Minnesota. PARTICIPANTS Parents from 150 families (25 families each from White, Black, Latino, Hmong, Native American, and Somali households) were recruited from primary care clinics. Eligibility criteria included: participating parent lived with a child aged 5-7 years, shared a meal with this child at least daily, and had another child living in the home. MAIN OUTCOME MEASURES Weight talk (ie, weight-related conversations, teasing), intergenerational transmission of weight talk. ANALYSIS Qualitative content analysis using Nvivo software. RESULTS Themes were found for each of our 4 research questions. Themes included: (1) parents experienced weight talk in their own homes growing up; (2) parents believed their community or culture influenced weight talk in their home; (3) parents described different ways of approaching weight talk, including not discussing weight, being direct about weight, and playful teasing; and (4) parents described various strategies for addressing concerns about their children's weight. CONCLUSIONS AND IMPLICATIONS Results suggested weight and health were salient issues for racially/ethnically diverse parents. Further research is needed to investigate why some parents engage in weight teasing, what prompts weight teasing, and the differences between weight- and health-focused conversations to identify potential targets for intervention. Recommendations for health providers working with families with young children, such as training using nonstigmatizing language, are discussed.
Collapse
Affiliation(s)
- Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN.
| | - Anna K Hochgraf
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Lauren Tschida
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| |
Collapse
|
15
|
Dahill LM, Morrison NMV, Touyz S, Mitchison D, Bussey K, Mannan H, Hay P. An exploration of how adolescents experience and reason their parents' comments on their weight, shape, and eating. J Adolesc 2023; 95:1488-1504. [PMID: 37464918 DOI: 10.1002/jad.12221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Disordered eating among adolescents is of increasing concern given associated physical and mental health sequelae. Cognitions underlying disordered eating are formed in childhood and adolescence. Parents are a significant presence during this period, so it is critical to understand how they influence their adolescent's eating cognitions and behaviors. METHODS Qualitative analysis using interpretative phenomenological analysis (IPA) methodology was employed to consider the lived experiences of 10 Australian adolescents (14-19 years), 60% female, as they engaged with their parents in a range of weight, shape, and eating communications. RESULTS Our inductive IPA revealed three key themes representing adolescents' experiences and meaning-making: Parents as Influencers-adolescents acknowledged parents are influencers (objects) within a wider context of community and cultural norms (symbols) and can be protective for peer influence on body image ideals; Expression and Perception-the "what" (weight-talk as an object) and the "how" (objects as independent influences) of gendered parental communication related to health and fitness ideals and illustrated diverse interpretations of both verbal and non-verbal expression; and Fertile Soil and Maturity-the adolescent's characteristics and context influence perceptions of communication, a fear of deviating from norms, and an overarching focus on being "healthy" yet not always knowing what that was. Perception of bidirectional communication also offered valuable insights into potential dangers through family loyalty and in-group permissions. CONCLUSIONS Findings highlight implications for the nuanced influence of parental communication and illustrate the pivotal role of parents within the bioecosystem of adolescent development.
Collapse
Affiliation(s)
- Lucy M Dahill
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Natalie M V Morrison
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Stephen Touyz
- University of Sydney Inside Out, Camperdown, New South Wales, Australia
- Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- University of Technology Sydney, Broadway, New South Wales, Australia
| | - Kay Bussey
- Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Haider Mannan
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- South West Sydney Local Health District, Camden and Campbelltown Hospitals, Campbelltown, New South Wales, Australia
| |
Collapse
|
16
|
Lessard LM, Puhl RM, Foster GD, Cardel MI. Parental Communication About Body Weight and Adolescent Health: The Role of Positive and Negative Weight-Related Comments. J Pediatr Psychol 2023; 48:700-706. [PMID: 37377019 DOI: 10.1093/jpepsy/jsad040] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE Research has consistently documented adverse effects of parent weight-related comments on adolescent health. However, little empirical attention has focused on isolating the impact of weight-related comments from mothers versus fathers, and the valence of their comments. The present study examined the extent to which positive and negative weight-related comments from mothers and fathers are related to adolescent health and wellbeing, and whether these associations differ according to adolescent sociodemographic characteristics. METHODS Data were collected from a diverse sample of 2032 U.S.-based adolescents aged 10-17 years (59% female; 40% White, 25% Black or African American, 23% Latinx). Online questionnaires assessed perceived frequency of negative and positive weight-related comments from mothers and fathers, as well as four indicators of adolescent health and wellbeing: depression, unhealthy weight control behaviors, weight bias internalization (WBI), and body appreciation. RESULTS More frequent negative weight-related comments from parents were associated with poorer adolescent health and wellbeing, while positive comments contributed to lower levels of WBI and body appreciation; these associations were documented regardless of whether mothers or fathers were the source of such comments, and considerable consistency was demonstrated across adolescent sociodemographic characteristics. CONCLUSION Findings highlight differences in adolescent health based on how parents discuss their body weight (i.e., negatively or positively), and similarity in associations regardless of whether mothers or fathers are the source of weight communication. These findings reiterate the importance of efforts to educate parents on ways to engage in supportive communication about weight-related health with their children.
Collapse
Affiliation(s)
- Leah M Lessard
- Rudd Center for Food Policy and Health, University of Connecticut, USA
| | - Rebecca M Puhl
- Rudd Center for Food Policy and Health, University of Connecticut, USA
- Department of Human Development and Family Sciences, University of Connecticut, USA
| | - Gary D Foster
- WW International, Inc, USA
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, USA
| | - Michelle I Cardel
- WW International, Inc, USA
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, USA
| |
Collapse
|
17
|
Chen J, Liu K, Zhang J, Liu S, Wang Y, Cao R, Peng X, Han M, Han H, Yao R, Fu L. Parental Pressure on Child Body Image, BMI, Body Image Dissatisfaction Associated with Eating Disorders in School-Age Children in China: A Path Analysis. Psychol Res Behav Manag 2023; 16:3247-3258. [PMID: 37609642 PMCID: PMC10440685 DOI: 10.2147/prbm.s418535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/05/2023] [Indexed: 08/24/2023] Open
Abstract
Background Children's eating behaviors, body shape and body image cognition may be more susceptible to the influence of their parents, but these influences may be weakened with age. There may be different association pathways between parental pressure on children's body image (PPCBI), body mass index (BMI), body image dissatisfaction (BID) and eating disorders (EDs) among children and adolescents at different developmental stages. Methods The stratified cluster sampling method (Stratified by grade, and took the classes as clusters) was used to select 486 students aged 8-15 years in two 9-year schools. Children's body height, weight, testicular volume and breast development were measured. PPCBI, BID, and EDs were investigated using the Appearance-related Social Stress Questionnaire, Body Size Questionnaire (BID-14), and EDI-1 scale, respectively. Results The boys before puberty initiation had significantly higher EDs score (182.3±50.8) than girls before puberty initiation (164.1±58.1) (P<0.05). There were significant association pathways of PPCBI→BMI→BID→EDs and PPCBI→BID→EDs in boys before puberty initiation (β=0.035, P<0.01; β=0.059, P<0.01), in boys after puberty initiation (β=0.032, P<0.01; β=0.175, P<0.001), and in girls after puberty initiation (β=0.026, P<0.01; β=0.172, P<0.001). There was a positive association pathway of PPCBI→EDs in boys before puberty initiation (β=0.30, P<0.001) and PPCBI→BID→EDs in girls before puberty initiation (β=0.176, P<0.01). Conclusion Parental pressure on children's body image may positively associate with children's eating disorders through BMI and body image dissatisfaction in boys and girls after puberty initiation and directly associate with eating disorders in boys before puberty initiation; however, it may indirectly associate with eating disorders only through BID in girls before puberty initiation.
Collapse
Affiliation(s)
- Jiaoyan Chen
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Keke Liu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Juan Zhang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Songhui Liu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Yuanyuan Wang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Ruiyao Cao
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Xingwang Peng
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Mei Han
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Hui Han
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Rongying Yao
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Lianguo Fu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| |
Collapse
|
18
|
Baber F, Gillison FB, Grey EB. The acceptability of evidence-informed guidance for parents in talking to their children about weight. BMC Public Health 2023; 23:1357. [PMID: 37452306 PMCID: PMC10349501 DOI: 10.1186/s12889-023-16267-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 07/08/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Many parents express concern about the impact of talking to children about weight on their self-esteem and wellbeing. The aim of this study was to explore the perceived relevance, utility and acceptability of new guidance for parents on talking to children about weight, developed to apply theory, evidence and expert advice into practice. METHODS For this qualitative study, parents and public health practitioners (PHPs) were recruited from ten local authorities in England, through the National Child Measurement Programme between June and September 2021. Participants were sent a copy of the guidance document and took part in an interview approximately one week later. Interviews were transcribed verbatim and explored using thematic analysis. RESULTS 12 parents and 15 PHPs took part, and were similar in their responses reporting the guidance to be acceptable, relevant and helpful. Theme 1 explored how the guidance reduced perceptions of stigma and blame through the perspective and tone that was adopted. Theme 2 explored how the guidance could provide reassurance and increase confidence as a result of case study examples, and specific tips and advice. Theme 3 explored the extent to which participants perceived the advice to be realistic and how it could fit with existing PHP practice. Suggestions for improvement included adapting for relevance for lower income families and providing separate advice for parents of older and younger children. CONCLUSIONS The guidance was perceived as relevant and needed; it showed potential to reduce parents' negative affect and concerns, and improve confidence around talking to children about weight.
Collapse
Affiliation(s)
- Fran Baber
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Fiona B Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Elisabeth B Grey
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
19
|
Berge JM, Trofholz A, Danner C, Brandenburg D, Pusalavidyasagar S, Loth K. Weight- and Health-focused Conversations in Racially/Ethnically Diverse Households With and Without a Child with Overweight/Obesity. STIGMA AND HEALTH 2023; 8:139-149. [PMID: 37274810 PMCID: PMC10234617 DOI: 10.1037/sah0000268] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Studies indicate parent conversations focused on child weight, shape, or size are associated with unhealthy child weight and weight-related behaviors, whereas health-focused conversations are not. Little research has examined what these types of conversations sound like, how parents respond to them, and whether households with or without a child with overweight/obesity approach these conversations differently. This study used qualitative data to identify the weight- and health-focused conversations occurring in racially/ethnically diverse households. Children ages 5-7 and their families (n=150) from six racial/ethnic groups (i.e., African American, Hispanic, Hmong, Native American, Somali, White) participated in this mixed-methods study. Results showed that parents from households with and without a child with overweight/obesity engaged in similar weight- and health-focused conversations (qualitative themes = focus on growth; health consequences of having overweight/obesity; focus on dietary intake and physical activity; being direct about weight, shape or size; mixing weight- and health-focused conversations). In addition, findings showed that parents also engaged in different types of weight- and health focused conversations depending on whether the household had a child with overweight/obesity (qualitative themes = weight-based teasing; critiquing own weight) or without overweight/obesity (qualitative themes = differences in body shape and size are the norm; focus on modeling rather than talking). Results may be useful for informing public health interventions and for health care providers working with parents regarding weight- and health-focused conversations occurring in home environments of diverse children.
Collapse
Affiliation(s)
- Jerica M. Berge
- University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN
| | - Amanda Trofholz
- University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN
| | - Christine Danner
- University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN
| | - Dana Brandenburg
- University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN
| | - Snigdhasmrithi Pusalavidyasagar
- University of Minnesota Medical School, Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Minneapolis, MN
| | - Katie Loth
- University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN
| |
Collapse
|
20
|
Nelson JD, Trojanowski PJ, Aarnio-Peterson CM, Fischer S, Adams L, Matthews A. Caregiver and adolescent intuitive eating behavior: associations with weight change during family-based treatment for anorexia nervosa. Eat Weight Disord 2023; 28:32. [PMID: 36964787 PMCID: PMC10039824 DOI: 10.1007/s40519-023-01557-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 12/13/2022] [Indexed: 03/26/2023] Open
Abstract
PURPOSE Intuitive eating (IE) is an adaptive eating construct for which little research exists in eating disorder (ED) samples. IE is negatively correlated with disordered eating behaviors in healthy adolescents and adults, and similar associations have been found in adults with EDs. This study aims to examine IE in a treatment seeking sample of adolescents and their caregivers to understand the role of IE in weight gain during FBT. METHODS Descriptive statistics and bivariate correlations were calculated in a sample of 47 pairs of adolescent patients and their caregivers who initiated outpatient FBT at a large academic medical center. Analyses examined associations between caregiver and adolescent IE on the Intuitive Eating Scale (IES), change in percent expected body weight (%EBW) by session 4 and end of treatment (EOT), clinical impairment, and ED pathology. RESULTS Significant correlations were found between aspects of adolescent IE, ED symptoms, and clinical impairment. Caregiver IES scores (Reliance on Hunger and Satiety Cues, Body-Food Choice Congruence, IES Total) were negatively related to adolescent ED symptoms (EDE-Q Weight Concerns, EDE-Q Shape Concerns, EDE-Q Global) at baseline. Caregiver IE (Eating for Physical Rather than Emotional Reasons) was positively associated with adolescent weight gain at FBT session 4 and EOT, even when statistically adjusting for gender and initial level of care. CONCLUSION Study results were consistent with past research indicating adolescent IE is negatively associated with ED behaviors, cognitions, and impairment. This study is the first to provide evidence that caregiver IE is positively associated with adolescent weight gain in FBT and is the first to provide evidence that caregiver IE is negatively related to adolescent ED symptoms. Future research should examine adolescent and caregiver IE throughout FBT to understand the role of IE in treatment response. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
Collapse
Affiliation(s)
- Jillian D Nelson
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
| | - Paige J Trojanowski
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | - Claire M Aarnio-Peterson
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah Fischer
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | - Leah Adams
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | - Abigail Matthews
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
21
|
Dahill LM, Hay P, Morrison NMV, Touyz S, Mitchison D, Bussey K, Mannan H. Associations between Parents' Body Weight/Shape Comments and Disordered Eating Amongst Adolescents over Time-A Longitudinal Study. Nutrients 2023; 15:1419. [PMID: 36986150 PMCID: PMC10059676 DOI: 10.3390/nu15061419] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Parents are key influencers of adolescents' attitudes on weight, shape, and eating, and make more positive than negative comments, with negative comments most impactful. This study examined prospective unique associations of parental positive and negative comments in a community sample of adolescents with paediatric psychosocial quality of life (PED-QoL), Eating Disorder Weight/Shape Cognitions (EDEQ-WS), BMI percentile, and Psychological Distress (K10) scales. Data were from 2056 adolescents from the EveryBODY study cohort. Multiple regressions were conducted for the impacts of parental positive and negative comments on four dependent variables at one year after controlling for their stage of adolescence (early, middle, late). Multiple imputation and bootstrapping were used for handling missing data and violations of normality. Results indicated that positive maternal comments on eating were associated with increased EDCs and better quality of life at one year. Paternal positive weight shape comments were associated with a decrease in psychological distress, but positive eating comments saw a decrease in quality of life. Findings highlight the nuances of parental comments and how these are perceived and interpreted, and could alert health care workers and family practitioners who have weight, shape, and eating conversations to be aware of the potential influence of their communication.
Collapse
Affiliation(s)
- Lucy M. Dahill
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
- South West Sydney Local Health District, Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia
| | - Natalie M. V. Morrison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
| | - Stephen Touyz
- School of Psychology and Inside Out Institute, University of Sydney, Sydney, NSW 2006, Australia;
- Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
- Centre for Emotional Health, Macquarie University, North Ryde, NSW 2109, Australia;
| | - Kay Bussey
- Centre for Emotional Health, Macquarie University, North Ryde, NSW 2109, Australia;
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
| |
Collapse
|
22
|
Briatico D, Reilly KC, Tucker P, Irwin JD, Johnson AM, Pearson ES, Bock DE, Burke SM. Using the RE-AIM framework to evaluate the feasibility of a parent-focused intervention targeting childhood obesity. Pilot Feasibility Stud 2023; 9:38. [PMID: 36915150 PMCID: PMC10009980 DOI: 10.1186/s40814-023-01248-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 01/16/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Childhood obesity remains a serious public health concern. Community-based childhood obesity treatment interventions have the potential to improve health behaviors and outcomes among children, but require thorough evaluation to facilitate translation of research into practice. The purpose of the current study was to determine the feasibility of a community-based, parent-focused childhood obesity intervention ("C.H.A.M.P. Families") using the RE-AIM framework, an evaluation tool for health interventions. METHODS A single-group, non-randomized, repeated measures feasibility study was conducted. Participants (n = 16 parents/caregivers of 11 children with obesity) completed a 13-week parent-focused education intervention. The intervention consisted of three main components: (a) eight group-based (parent-only) education sessions; (b) eight home-based (family-centered) activities; and (c) two group-based follow-up support sessions for parents and children. The five dimensions of RE-AIM-reach, effectiveness, adoption, implementation, and maintenance-were assessed using various measures and data sources (e.g., child, parent/caregiver, costing, census) obtained throughout the study period. Outcome variables were measured at baseline, mid-intervention, post-intervention, and at a 6-month follow-up. RESULTS Overall, the C.H.A.M.P. Families intervention reached approximately 0.09% of eligible families in London, Ontario. Despite the small number, participants were generally representative of the population from which they were drawn, and program participation rates were high (reach). Findings also suggest that involvement in the program was associated with improved health-related quality of life among children (effectiveness/individual-level maintenance). In addition, the intervention had high fidelity to protocol, attendance rates, and cost-effectiveness (implementation). Lastly, important community partnerships were established and maintained (adoption/setting-level maintenance). CONCLUSIONS Based on a detailed and comprehensive RE-AIM evaluation, the C.H.A.M.P. Families intervention appears to be a promising parent-focused approach to the treatment of childhood obesity. TRIAL REGISTRATION ISRCTN Registry, Study ID ISRCTN 10752416 . Registered 24 April 2018.
Collapse
Affiliation(s)
- Daniel Briatico
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Kristen C Reilly
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Patricia Tucker
- Faculty of Health Sciences, Western University, London, Ontario, Canada.,Children's Health Research Institute, Lawson Health Research Institute, London, Canada
| | - Jennifer D Irwin
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Andrew M Johnson
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Erin S Pearson
- Faculty of Health and Behavioural Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Dirk E Bock
- Children's Health Research Institute, Lawson Health Research Institute, London, Canada.,Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,Office for Child and Adolescent Medicine, Windisch, Aargau, Switzerland
| | - Shauna M Burke
- Faculty of Health Sciences, Western University, London, Ontario, Canada. .,Children's Health Research Institute, Lawson Health Research Institute, London, Canada.
| |
Collapse
|
23
|
Evans EH, Tovée MJ, Hancock PJB, Cornelissen PL. How do looking patterns, anti-fat bias, and causal weight attributions relate to adults' judgements of child weight? Body Image 2023; 44:9-23. [PMID: 36413890 DOI: 10.1016/j.bodyim.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022]
Abstract
Prevailing weight-normative approaches to health pressure adults to visually categorise children's weight, despite little understanding of how such judgements are made. There is no evidence this strategy improves child health, and it may harm children with higher weights. To understand decision-making processes and identify potential mechanisms of harm we examined perceptual and attitudinal factors involved in adults' child weight category judgements. Eye movements of 42 adults were tracked while categorizing the weight of 40 computer-generated images of children (aged 4-5 & 10-11 years) varying in size. Questionnaires assessed child-focused weight bias and causal attributions for child weight. Participants' eye movement patterns resembled those previously reported for adult bodies. Categorisation data showed a perceptual bias towards the 'mid-range' category. For higher weight stimuli, participants whose category judgements most closely matched the stimulus's objective weight had higher child-focused anti-fat bias and weaker genetic attributions for child weight - i.e,. adults who 'label' higher weight in children in line with BMI categories report more stigmatising beliefs about such children, suggesting a possible mechanism of harm. Overall, adults' judgements reflect both unalterable perceptual biases and potentially harmful attitudinal factors, calling into question the feasibility and appropriateness of public health efforts to promote visual child weight categorisation.
Collapse
Affiliation(s)
- Elizabeth H Evans
- Department of Psychology, Durham University, Durham, United Kingdom.
| | - Martin J Tovée
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | | | - Piers L Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
24
|
Hawking MKD, Dezateux C, Swinglehurst D. Weighing up the future: a meta-ethnography of household perceptions of the National Child Measurement Programme in England. CRITICAL PUBLIC HEALTH 2023. [DOI: 10.1080/09581596.2023.2169599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
| | - Carol Dezateux
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Deborah Swinglehurst
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| |
Collapse
|
25
|
Baker JH, Temes E, Bohon C, Derenne J, Duvall A, Steinberg D. Enhanced Family-Based Treatment for an Adolescent With Binge-Eating Disorder: A Case Report. COGNITIVE AND BEHAVIORAL PRACTICE 2023. [DOI: 10.1016/j.cbpra.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
|
26
|
Puhl RM, Lessard LM, Pudney EV, Foster GD, Cardel MI. Motivations for engaging in or avoiding conversations about weight: Adolescent and parent perspectives. Pediatr Obes 2022; 17:e12962. [PMID: 36350198 DOI: 10.1111/ijpo.12962] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Little is known about parent and adolescent motivations for engaging in weight communication. OBJECTIVES To assess parent and adolescent motivations for engaging in, or avoiding, weight communication, and whether these reasons differed across sex, race/ethnicity, weight, and engagement in weight management. METHODS Independent samples of parents (N = 1936) and unrelated adolescents (N = 2032) completed questionnaires assessing their agreement with different reasons they engage in, or avoid, parent-adolescent weight communication, using 7-point Likert scales (strongly-disagree to strongly-agree). RESULTS Parents, irrespective of sex, race/ethnicity, and child's weight status, expressed stronger motivations for engaging in weight communication in order for their child to feel good about his/her weight and body size compared to being motivated because a health professional raised their child's weight as a concern. Adolescent motivations for weight communication with parents stemmed from health concerns and worry about their weight; avoidance stemmed from feeling embarrassed, upset, or not wanting to obsess about weight. Differences emerged across sex and race/ethnicity but were most pronounced by weight status and weight management. CONCLUSION Parents and adolescents have different motivations for engaging in or avoiding weight communication. Protecting adolescents' emotional wellbeing and body esteem are viewed as reasons for both engaging in or avoiding weight communication.
Collapse
Affiliation(s)
- Rebecca M Puhl
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut, USA.,Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Leah M Lessard
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut, USA
| | - Ellen V Pudney
- Department of Pediatrics, Division of Community Health and Research, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Gary D Foster
- WW International, Inc., New York, New York, USA.,Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michelle I Cardel
- WW International, Inc., New York, New York, USA.,Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
27
|
Duan C, Lian S, Yu L, Niu G, Sun X. Photo Activity on Social Networking Sites and Body Dissatisfaction: The Roles of Thin-Ideal Internalization and Body Appreciation. Behav Sci (Basel) 2022; 12:bs12080280. [PMID: 36004851 PMCID: PMC9404895 DOI: 10.3390/bs12080280] [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: 07/13/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 11/24/2022] Open
Abstract
Objective: According to sociocultural theory, media is associated with detrimental effects on body image. Due to the popularity of social networking sites (SNS) and the prevalence of body image disturbance among young women, the association between them is worth further exploration. This study examined the relationship between photo activity on SNS and body dissatisfaction (BD) and the roles of thin-ideal internalization (TII) and body appreciation (BA) in this relation. Materials and Methods: A total of 746 Chinese female undergraduate students (mean age 20.34 ± 1.47 years) completed a questionnaire measuring SNS photo activity, TII, BD, and BA. Results: (1) Photo activity on SNS was positively associated with BD (r = 0.10, p < 0.01), and TII could mediate this relation (β = 0.07, 95% CI = [0.04, 0.10]). (2) Both the direct effect of SNS photo activity on BD (β = −0.08, p < 0.05) and the mediating effect of TII (β = −0.09, p < 0.01) were moderated by BA. Specifically, these associations were more pronounced for students with lower BA. Conclusion: People exposed to ideal photos or images can shape women’s body image perception via TII, whether in the age of traditional media or the Internet, and BA did not buffer the effect of ideal photos on internalization. Our findings could provide practical suggestions for rational photo activity on SNS and the intervention for BD.
Collapse
Affiliation(s)
- Changying Duan
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
- School of Psychology, Central China Normal University, Wuhan 430079, China
| | - Shuailei Lian
- College of Education and Sport Sciences, Yangtze University, Jingzhou 434023, China
| | - Li Yu
- School of Psychology, Central China Normal University, Wuhan 430079, China
| | - Gengfeng Niu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
- School of Psychology, Central China Normal University, Wuhan 430079, China
- Beijing Normal University Collaboration Innovation Center, Central China Normal University Branch, Wuhan 430079, China
- Correspondence: (G.N.); (X.S.)
| | - Xiaojun Sun
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
- School of Psychology, Central China Normal University, Wuhan 430079, China
- Beijing Normal University Collaboration Innovation Center, Central China Normal University Branch, Wuhan 430079, China
- Correspondence: (G.N.); (X.S.)
| |
Collapse
|
28
|
Trofholz AC, Tate A, Telke S, Loth KA, Buchanan GJ, Berge JM. Associations Between Weight Talk and Biopsychosocial Outcomes in Children from Racially/Ethnically Diverse Households. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 32:31-43. [PMID: 36824477 PMCID: PMC9943526 DOI: 10.1007/s10826-022-02351-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 06/18/2023]
Abstract
Weight talk in the home-parents talking to their children about their weight, shape or size-has been associated with many negative health outcomes in children and adolescents, although the majority of research has been with adolescents. This study explored associations between weight talk in the home and a broad range of child biopsychosocial outcomes (e.g., weight status, diet quality, psychological well-being, peer problems), in addition to child sex and race/ethnicity. Parents of 5-7 year old children from six racial/ethnic groups (White, African American, Hmong, Latino, Native American, Somali) (n=150) completed an online survey and completed 24-hour dietary recalls on the child. Additionally, anthropometric measurements were taken on the 5-7 year old child and parent. Over one-third of parents reported engaging in weight talk with their child. Overall, weight talk was associated with child weight status, but not with child diet quality. The presence of weight talk differed by race/ethnicity and child weight status. Most psychological (e.g., emotional problems) and social (e.g., peer problems) outcomes differed significantly by race/ethnicity with the following pattern: (1) no significant associations between weight talk and biopsychosocial outcomes were found for Hmong and Latino children; (2) a negative association (e.g., less healthy functioning) was found for African American and Somali children; (3) a positive association (e.g., healthier functioning) was found for Native American children. Future research should investigate why psychological and social outcomes differ by race/ethnicity in children experiencing weight talk. This study confirms the need to develop best practices for helping parents concerned about their child's weight to talk to children in a healthful way.
Collapse
Affiliation(s)
- Amanda C Trofholz
- Department of Family Medicine and Community Health at the University of Minnesota, Minneapolis, MN, USA
| | - Allan Tate
- College of Public Health, University of Georgia, Athens, GA
| | - Susan Telke
- Department of Family Medicine and Community Health at the University of Minnesota, Minneapolis, MN, USA
| | - Katie A Loth
- Department of Family Medicine and Community Health at the University of Minnesota, Minneapolis, MN, USA
| | - Gretchen J Buchanan
- Department of Family Medicine and Community Health at the University of Minnesota, Minneapolis, MN, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health at the University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
29
|
Grey EB, Atkinson L, Chater A, Gahagan A, Tran A, Gillison FB. A systematic review of the evidence on the effect of parental communication about health and health behaviours on children's health and wellbeing. Prev Med 2022; 159:107043. [PMID: 35405179 DOI: 10.1016/j.ypmed.2022.107043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/07/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022]
Abstract
Parents report feeling unsure how best to talk with their children about sensitive health topics and may avoid such conversations; yet if children have questions or concerns about their health, talking to a parent could enhance their health and wellbeing. We investigated the effects of parental communications about health and health behaviours on children's health and wellbeing, and explored what strategies can encourage parents to communicate about health. We conducted a systematic review and narrative synthesis of research published between January 2008 and April 2020 from five databases. Of 14,007 articles identified, 16 met inclusion criteria focusing on five topics: diet and weight (n = 5), body image (n = 2), sexual health (n = 7), physical activity (n = 1) and bullying (n = 1). Positive child outcomes were associated with positive general parent-child communication characterised by warmth, openness and allowing children choice. Conversely, hostility, negative and inconsistent messaging were associated with poorer outcomes. Interventions to increase parent-child communication could be classified as providing single directive messages, media campaigns or intensive support. Single messages increased communication frequency; media campaigns and intensive interventions showed mixed outcomes. No differences in outcomes were found according to child's gender or socio-economic status. Generally, parents were less confident in initiating, rather than continuing, conversations and were more likely to initiate conversations when they felt they had good topic knowledge. While the relatively small, diverse sample limits the strength of these findings, this review provides provisional support for approaches to promote positive parent-child communication about health that are associated with better child health and wellbeing.
Collapse
Affiliation(s)
- E B Grey
- Department for Health, University of Bath, Bath BA2 7AY, UK.
| | - L Atkinson
- School of Psychology, Aston University, Birmingham B4 7ET, UK
| | - A Chater
- Institute for Sport and Physical Activity Research (ISPAR), Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK
| | - A Gahagan
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, UK
| | - A Tran
- UK Health Security Agency, Department of Health and Social Care, Noble House, 17 Smith Square, London SW1P 3HX, UK
| | - F B Gillison
- Department for Health, University of Bath, Bath BA2 7AY, UK
| |
Collapse
|
30
|
Puhl RM, Lessard LM, Foster GD, Cardel MI. A Comprehensive Examination of the Nature, Frequency, and Context of Parental Weight Communication: Perspectives of Parents and Adolescents. Nutrients 2022; 14:nu14081562. [PMID: 35458124 PMCID: PMC9032323 DOI: 10.3390/nu14081562] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 02/01/2023] Open
Abstract
Research suggests that many parents make comments about their child’s weight, which is associated with negative adolescent health outcomes. Gaps in this literature include an underrepresentation of fathers, limited knowledge regarding positive versus negative parental weight comments and differences across race/ethnicity, and adolescent preferences for parental weight communication. The present study addressed these research gaps through a comprehensive investigation of two diverse samples of U.S. parents (n = 1936) and adolescents (n = 2032), who completed questionnaires about their experiences and perspectives of parental weight communication. Positive weight comments from parents were more frequent than negative comments, though both were commonly reported across sex, race/ethnicity, and weight status. In general, boys, fathers, Latino/a parents and adolescents, and adolescents with a high BMI and/or engaged in weight management reported more frequent parental weight-talk. Parent–adolescent weight communication occurred both in-person and digitally, and across daily life contexts. Although the majority of parents communicated positive messages of body diversity and respect, 44% and 63% of adolescents said they never want their mothers and fathers, respectively, to talk about their weight. Adolescents were offered circumstances that would increase their comfort level in having these conversations. Findings have implications for health professionals working with families to promote supportive health communication at home.
Collapse
Affiliation(s)
- Rebecca M. Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT 06269, USA
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, CT 06103, USA;
- Correspondence:
| | - Leah M. Lessard
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, CT 06103, USA;
| | - Gary D. Foster
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
- WW International, Inc., New York, NY 10010, USA;
| | - Michelle I. Cardel
- WW International, Inc., New York, NY 10010, USA;
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32611, USA
| |
Collapse
|
31
|
Norton L, Parkinson J, Harris N, Darcy M, Hart L. Parental Food Communication and Child Eating Behaviours: A Systematic Literature Review. Health Promot J Austr 2022; 34:366-378. [PMID: 35363899 DOI: 10.1002/hpja.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/21/2022] [Accepted: 03/29/2022] [Indexed: 11/08/2022] Open
Abstract
AIM To review current evidence for parental food communication practices and their association with child eating behaviours. METHODS The PRISMA framework guided the reporting of the review; registered with Prospero in July 2020 (blinded for peer review). Eligible studies were critically appraised using the Joanna Briggs Institute tools. Only quantitative studies that included a parental measure of food communication and a child measure of eating behaviour were included. RESULTS From 11063 articles 23 were eligible for synthesis. The vast majority (82%) of studies used observational cross-sectional designs. Three involved observing parent-child dyads, with the remainder using questionnaires. Two quasi-experimental designs tested interventions and two randomised control trial were reported. The majority of measures assessing parental food communication were subscales of larger questionnaires. The Caregiver's Feeding Style Questionnaire (CFSQ) was the most direct and relevant measure of parental food communication. Findings of reviewed studies highlighted that "how" parents communicate about food appears to impact child eating behaviours. Using child-centred communication provided promising outcomes for positive child eating behaviours, while parental "diet" communication was found to be associated with poorer dietary outcomes in children. CONCLUSIONS Food communication research is in its infancy. However, evidence for the importance of parents' child-focused food communication is emerging, providing a focus for future research and interventions. SO WHAT?: Given the gaps in our understanding about prevention of disordered eating, there is a significant opportunity to explore what food communication strategies may assist parents to communicate about food in a positive way.
Collapse
|
32
|
Exploring associations between positive and negative valanced parental comments about adolescents' bodies and eating and eating problems: a community study. J Eat Disord 2022; 10:43. [PMID: 35331338 PMCID: PMC8953043 DOI: 10.1186/s40337-022-00561-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a time of rapid emotional and physical development when foundational self-concepts (including beliefs about one's weight and shape) are established. Parents are key influencers of adolescent beliefs and behaviours. This study aimed to investigate associations between perceived positive and negative parental comments on weight/shape and eating, with sons' and daughters' psychological distress and eating disorder cognitions (EDCs). METHODS A representative mixed-sex sample of 2204 Australian adolescents (12-19 years) from the EveryBODY Study completed an online survey exploring eating behaviours, psychological wellbeing and experiences of parental comments regarding weight, shape and eating behaviours. RESULTS Correlation analyses revealed that adolescents' reports of perceived positive parental comments on shape/weight were significantly associated with lower psychological distress and EDCs only for daughters. All perceived negative parental comments on shape/weight or eating were associated with greater psychological distress and EDCs for both sons and daughters. In the final model of the regression analysis, only perceived parental negative shape/weight and maternal negative eating comments, adolescent stage and biological sex were significantly associated with EDCs. When known contributors such as BMI percentile and psychological distress were included in the regression model, adolescent stage and perceived negative paternal comments were no longer significantly associated with EDCs. CONCLUSIONS Overall, results show perceived negative comments were associated with poorer adolescent mental health, both their specific EDCs and general distress. Findings highlight the importance of raising awareness of potential negative impacts within family systems of comments around weight/shape and eating in these key formative years. Trial Registration The study was approved by the Macquarie University Human Research Ethics Committee (HREC 5201600312) and the New South Wales Department of Education.
Collapse
|
33
|
Trofholz A, Hersch D, Norderud K, Berge JM, Loth K. Changes to the home food environment and parent feeding practices during the COVID-19 pandemic: A qualitative exploration. Appetite 2022; 169:105806. [PMID: 34798223 PMCID: PMC8594079 DOI: 10.1016/j.appet.2021.105806] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 12/29/2022]
Abstract
The COVID-19 pandemic brought about many changes that potentially altered the home food environment, which has been associated with child eating patterns and dietary intake. There is also some evidence that changes due to the COVID-19 pandemic are associated with health behaviors in children, such as an increased intake of high-calorie snack food. The current study aimed to more deeply understand how the COVID-19 pandemic affected the home food environment of meal and snack time routines and parent feeding practices within families of young children. Data for this study are taken from the Kids EAT! Study, a racially/ethnically diverse cohort of families with 2-5 year old children. Qualitative interviews were conducted by phone and video conference with mothers (n = 25) during August/September 2020 and were coded using a hybrid deductive/inductive analysis approach. This allowed coders to identify themes using the interview questions as an organizational template (deductive) while also allowing unique themes to emerge from the qualitative data (inductive). Three overarching themes emerged with multiple sub-themes: 1) Mothers were more directive in the types of food and amounts of food eaten by children; 2) Mothers had less rules around mealtimes; 3) Mothers had increased meal responsibilities. When faced with a change in a structured schedule and increased stress-such as occurred with the COVID-19 pandemic, parents may benefit from advice on how to manage parent feeding practices, including tips on appropriate limit setting, establishing a schedule and routines, and improving accessibility of healthful snacks. Lessons learned during the COVID-19 pandemic may have relevance to other time periods when families face disruptions to routine and during other times of transition.
Collapse
Affiliation(s)
- Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Derek Hersch
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Kristin Norderud
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
34
|
Feragen KJB, Myhre A, Stock NM. "Will You Still Feel Beautiful When You Find Out You Are Different?": Parents' Experiences, Reflections, and Appearance-Focused Conversations About Their Child's Visible Difference. QUALITATIVE HEALTH RESEARCH 2022; 32:3-15. [PMID: 34596475 PMCID: PMC8739583 DOI: 10.1177/10497323211039205] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
To investigate parents' reflections and experiences of having a child born with an appearance-altering condition, interviews with 33 parents of children born with rare craniofacial conditions were analyzed using inductive thematic analysis. Three themes emerged: "Managing emotions: A dynamic process," "Through another lens: External reminders of difference," and "Awareness of difference: Approaching the child." Findings suggest that although parents learned to accept and love their child's visible difference, external factors such as appearance-altering surgery and other people's reactions activated difficult emotions in parents. Parents struggled to decipher whether and when to raise appearance-related issues with their child, and how this could be done without distressing the child. Anticipatory guidance that facilitates positive appearance-focused conversations both within and outside the home seems to be needed. Parenting skills could also be strengthened by preparing parents for social reactions to the child's visible difference, and their child's changed appearance following surgery.
Collapse
|
35
|
Bauer KW, Branch JM, Appugliese DP, Pesch MH, Miller AL, Lumeng JC, Kaciroti N. Emerging Ideas Brief Report. How Do Low-Income Mothers Talk to Children About Weight and Body Shape? FAMILY RELATIONS 2021; 70:1477-1484. [PMID: 34955577 PMCID: PMC8694111 DOI: 10.1111/fare.12550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Identify mothers' perceptions of how they talk about weight and body shape with their children and examine how approaches vary by mother and child characteristics. BACKGROUND Youth who report that their parents talk with them about their weight experience poor health. However, very little is known about the content of these conversations. METHOD Mothers and their 6- to 11-year-old children (N = 188 dyads) participated in a mixed-methods study. Themes in mothers' responses to the interview question "How do you talk to your child about weight or body shape?" were identified, and latent class analysis was used to characterize patterns of weight and shape talk. RESULTS Seven themes of weight and shape talk were identified, including talking about "Healthy Habits" (39.9%), "Avoids Weight and Body Talk" (21.8%), and tells "Cautionary Tales" (18.6%). Three patterns emerged from themes: talk to promote health, avoid talking about weight and shape, and talk to build children's self-esteem. Mothers of children with obesity were more likely to talk to promote health versus other patterns. CONCLUSION The content of family conversations about weight and shape is diverse. IMPLICATIONS FOR EMERGING IDEAS Future research is needed to understand the impacts of specific ways parents talk about weight and shape.
Collapse
|
36
|
Norton L, Parkinson J, Harris N, Hart LM. What Factors Predict the Use of Coercive Food Parenting Practices among Mothers of Young Children? An Examination of Food Literacy, Disordered Eating and Parent Demographics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910538. [PMID: 34639838 PMCID: PMC8508140 DOI: 10.3390/ijerph181910538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/29/2021] [Accepted: 10/07/2021] [Indexed: 12/04/2022]
Abstract
Parents have the most significant influence on the development of young children’s eating patterns. Understanding what parental factors best predict specific negative feeding practices is important for designing preventive interventions. We examined the relationship between parents’ use of coercive food parenting practices (pressure to eat and restriction) and parents’ disordered eating, food literacy, Body Mass Index (BMI) and socio-economic status (SES). Adult mothers, with a mean age of 33 years, at least one child aged between 6 months and 5 years and living in Australia (n = 819) completed an online questionnaire. Regression models were used to examine predictors of pressure to eat and restriction, respectively. Although the amount of variance accounted for by the models was small, maternal eating disorder symptoms were found to be the most important predictor of coercive food parenting practices. This finding has implications for early nutrition education, which has traditionally focused heavily on nutrition literacy. Parental disordered eating may be a more important preventive target and thus including behavioral strategies for positive feeding practices may better assist mothers in promoting positive eating habits with their children, rather than traditional approaches that aim to increase nutrition literacy.
Collapse
Affiliation(s)
- Lyza Norton
- Department of Social Marketing, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia;
- Correspondence:
| | - Joy Parkinson
- Department of Social Marketing, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia;
| | - Neil Harris
- Department of Public Health, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia;
| | - Laura M. Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3010, Australia;
| |
Collapse
|
37
|
Loth KA, Lebow J, Uy MJA, Ngaw SM, Neumark-Sztainer D, Berge JM. First, Do No Harm: Understanding Primary Care Providers' Perception of Risks Associated With Discussing Weight With Pediatric Patients. Glob Pediatr Health 2021; 8:2333794X211040979. [PMID: 34514059 PMCID: PMC8427925 DOI: 10.1177/2333794x211040979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022] Open
Abstract
Many health care providers struggle with if- and how-to discuss weight with their pediatric patients. This study used one-on-one interviews with primary care providers (n = 20) to better understand their: (1) perception of risks associated with talking about weight with pediatric patients, (2) commitment to adhering to best practices of pediatric weight management, and (3) approaches to mitigate perceived risks. Providers felt concerned that discussing weight with children during clinic visits may have unintended negative impacts. Despite perceived risks, providers continued regular BMI screening and weight-focused conversations, but took care with regard to language and approach with the goal of mitigating perceived risks. Findings suggest that pediatric primary care providers perceive that engaging in weight-related discussions with their patients has the potential to lead to negative, unintended consequences. Future research is needed to understand if weight-focused conversations should be avoided altogether or if there are approaches that can effectively mitigate risks.
Collapse
Affiliation(s)
- Katie A. Loth
- University of Minnesota Medical School, Minneapolis, MN, USA
| | | | | | | | | | - Jerica M. Berge
- University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
38
|
Lessard LM, Puhl RM. Adolescents' Exposure to and Experiences of Weight Stigma During the COVID-19 Pandemic. J Pediatr Psychol 2021; 46:950-959. [PMID: 34313727 PMCID: PMC8344898 DOI: 10.1093/jpepsy/jsab071] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has increased attention to the proliferation of pediatric obesity amidst significant changes in weight-related health functioning (e.g., compromised physical activity, limited food access, increased stress). The present cross-sectional study investigated adolescents' feelings about their bodies and perceived changes in weight stigma from peers, parents, and social media during the pandemic. METHODS Four hundred fifty-two adolescents (11-17 years old) completed an online survey during the Fall of 2020. Measures assessed perceived changes in exposure to weight stigmatizing social media content (stress eating jokes, weight gain memes) and experiences of weight stigma (weight-based bullying, teasing, hurtful comments) by parents and peers, as well as body dissatisfaction, during the COVID-19 pandemic. Weight status and gender were examined as individual difference variables. RESULTS The majority (53%) of adolescents reported increased exposure to at least one form of weight stigmatizing social media content during the pandemic. Additionally, pandemic-related increases in body dissatisfaction were prevalent (41%), especially among girls with higher body mass index (≥85th percentile; 67%). On average, the extent to which adolescents experienced weight-based mistreatment from parents and peers remained consistent with their pre-pandemic experiences. CONCLUSIONS Overall, these findings highlight changes in the social messages that adolescents receive about their bodies, as well as their subjective body satisfaction, during the pandemic. Results underscore the need for healthcare providers and mental health professionals to be aware of the potential rise in weight stigma during the pandemic, and encourage families and schools to engage in supportive, rather than stigmatizing, weight-related communication with youth.
Collapse
Affiliation(s)
- Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut
| | - Rebecca M Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut
- Department of Human Development & Family Sciences, University of Connecticut
| |
Collapse
|
39
|
Lampe EW, Abber SR, Forman EM, Manasse SM. Guidelines for caregivers and healthcare professionals on speaking to children about overweight and obesity: a systematic review of the gray literature. Transl Behav Med 2021; 10:1144-1154. [PMID: 33044530 DOI: 10.1093/tbm/ibaa012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Caregivers and healthcare professionals (HPs) are increasingly concerned about childhood obesity. A critical consideration of caregivers and HPs is discussing weight status without provoking disordered eating. Given the complexity of these interacting concerns, major health advocacy groups have independently published guidelines for having conversations with children about overweight/obesity. The current investigation represented the first-ever systematic review of these guidelines to analyze their content, consistency, actionability, or scientific support. To conduct a systematic review, the authors performed a web-based search using the terms parent/HP, guidelines, child, and overweight/obesity that identified 59 guidelines on childhood obesity broadly, of which 13 provided explicit direction on how the caregiver or HP should approach a conversation about overweight with a child. Within these 13 guidelines, nine topic domains were identified: attitude modeling (covered by 31% of guidelines), behavior modeling (61%), dietary recommendations (54%), physical activity (46%), body acceptance and self-esteem (69%), conversation advice (92%), contact with HP (46%), talking about "weight" versus "overall health" (54%) and external factors (e.g., bullying, media) (54%). Although guidelines presented similar content, several inconsistencies in recommendations emerged. Notably, only three of the 13 guidelines referenced any scholarly sources and only a small minority of advice was actionable by caregivers or HPs. It is evident that guidelines for caregivers and HPs on speaking to children about obesity offer inconsistent advice, minimally based on empirical evidence. Future guidelines should aim to unify their messages for caregivers and HP and be better supported by empirical data.
Collapse
Affiliation(s)
- Elizabeth W Lampe
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA.,Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Sophie R Abber
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA.,Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA.,Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA
| |
Collapse
|
40
|
Abdin S, Heath G, Welch RK. Health professionals' views and experiences of discussing weight with children and their families: A systematic review of qualitative research. Child Care Health Dev 2021; 47:562-574. [PMID: 33565647 DOI: 10.1111/cch.12854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/23/2020] [Accepted: 02/03/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Healthcare professionals are ideally placed to discuss weight management with children and families to treat and prevent childhood obesity. The aim of this review was to collect and synthesize primary research evidence relating to health professional's views and experiences of discussing weight with children and their families. METHODS Systematic searches were conducted using the following databases: MEDLINE (OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE (OVID), PsycINFO (OVID) and Healthcare Management Information Consortium (HMIC). Twenty-six full text qualitative studies published in English Language journals since inception to October 2019 were included. Papers were quality assessed and synthesized using an inductive thematic analysis approach. RESULTS Data analysis generated five themes: sensitivity of the issue, family-professional relationships, whole systems approach, professional competency and sociocultural context. CONCLUSION Supporting behaviour change through discussion of healthy weight with children and families is an important part of the health professional's role. Tailored information for professionals, including resources and training, facilitates them to confidently talk to children and families about weight prioritized within interventions. The success of such interventions requires commitment from a range of professionals to ensure healthy weight is tackled through a whole system approach.
Collapse
Affiliation(s)
- Shanara Abdin
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, Bristol, UK.,Public Health and Wellbeing, City of Wolverhampton Council, Wolverhampton, UK
| | - Gemma Heath
- Department of Psychology, University of Wolverhampton, Wolverhampton, UK
| | - Richard K Welch
- Public Health and Wellbeing, City of Wolverhampton Council, Wolverhampton, UK
| |
Collapse
|
41
|
Cox JS, Searle AJ, Hinton EC, Giri D, Shield JPH. Perceptions of non-successful families attending a weight-management clinic. Arch Dis Child 2021; 106:377-382. [PMID: 33139347 DOI: 10.1136/archdischild-2020-319558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/25/2020] [Accepted: 09/15/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study seeks to understand family's perceptions of their care at a paediatric weight management service, with a view to informing service improvement. DESIGN A qualitative service review conducted via semistructured interviews with parents (n=11) and children (n=3) who attended the clinic. The recruitment was open to all, but those who were not succeeding in their weight-loss goals self-selected to participate. Self-Determination Theory was used as a framework to explore families' experiences of the clinic. SETTING Recruitment occurred during clinical appointments and interviews were conducted over the phone in the days following the appointments. PATIENTS The service sees paediatric patients with a body mass index >99th percentile, with comorbidities or safeguarding concerns. INTERVENTIONS The clinic's service includes appointments typically every 2 months, with a multidisciplinary team including consultant endocrinologists, a dietician, a clinical psychologist, a social worker and a clinical nurse specialist. MAIN OUTCOME MEASURES Families' feedback on the multi-disciplinary team (MDT) clinic, and their perceptions of how improvements could be made. RESULTS Families perceive a lack of autonomy, competency and feel a lack of connectivity both in their lives broadly and within their experience at the clinic. CONCLUSIONS Interventions in families struggling with weight improvements should see the clinical team placing more emphasis on working alongside parents to develop young people's sense of self-determination. Expectations must be set that success originates from changes outside of clinical appointments and that the clinical team is in place to support the family's development of sustainable, self-determined lifestyle habits.
Collapse
Affiliation(s)
- Jennifer S Cox
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| | - Aidan J Searle
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| | - Elanor C Hinton
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| | - Dinesh Giri
- Department of Paediatric Endocrinology, Bristol Royal Hospital for Children, Bristol, UK.,Department of Translational Health Sciences, University of Bristol, Bristol, UK
| | - Julian P H Shield
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| |
Collapse
|
42
|
Dahill LM, Touyz S, Morrison NMV, Hay P. Parental appearance teasing in adolescence and associations with eating problems: a systematic review. BMC Public Health 2021; 21:450. [PMID: 33676473 PMCID: PMC7936414 DOI: 10.1186/s12889-021-10416-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 02/09/2021] [Indexed: 01/29/2023] Open
Abstract
Background The adolescent years see significant physical and emotional development that lay foundations for patterns of behaviour that can continue into adult life, including the shaping of eating behaviours. Given parents are key socio-environmental drivers and influencers of adolescent behaviours around physical health and wellbeing, it is critical to consider if specific forms of parental communication are potentially contributing to the associated emotional difficulties experienced in the adolescent years. The aim of this research was to systematically review the myriad of literature pertaining to the prevalence of parental weight or appearance-based teasing and adolescent eating problems to examine how the scientific and clinical community currently understands the relationship between these domains. Methods A systematic search of the literature, using the SCOPUS, APA PsycINFO, Medline, CINAHL databases, reference lists and Google Scholar, was undertaken to identify relevant literature for parental teasing and problem eating in adolescents aged 10–19 years, published between January 1980 to October 2020, in English or French. Results Six studies met criteria for inclusion, all were cross-sectional studies and two included additional prospective data. Although parents were not the most common perpetrators of teasing, often subsidiary to that of peers and siblings, the influence and impact of parental teasing remained significant, and in some cases, appeared to interact with sibling-based teasing. This teasing was associated with problem eating behaviours for adolescents. Conclusions There is evidence in the literature to suggest the existence of an association between ‘eating problems’ amongst adolescents and exposure to parental appearance or weight teasing. Parents are unlikely to be aware of the perception or impact of the words they use or the wider influence these words may have. Future research should employ representative longitudinal designs to develop a greater understanding of the relationships between parental communications around their adolescent’s appearance or weight and how that communication is perceived by adolescents within complex family processes. Trial registration PROSPERO 2018 CRD42018109623. Prospectively registered 15th October 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10416-5.
Collapse
Affiliation(s)
- Lucy M Dahill
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Stephen Touyz
- Department of Psychology, University of Sydney, Sydney, Australia
| | - Natalie M V Morrison
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, Australia
| |
Collapse
|
43
|
Tommerup K, Smith AD, Evans EH, Croker H, Steptoe A, Tovee MJ, Fildes A, Llewellyn C. The acceptability and feasibility of using a 3D body size scale to initiate conversations about weight in toddlerhood: a mixed-methods study. Pediatr Obes 2021; 16:e12715. [PMID: 32820620 DOI: 10.1111/ijpo.12715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health Care Professionals struggle to initiate conversations about overweight in toddlerhood. A novel 3D body size scale (3D BSS) may facilitate engagement with this topic during pediatric appointments. OBJECTIVES To explore barriers and facilitators to using the 3D BSS through a mixed-methods design. METHODS For the qualitative phase, parents of toddlers (n = 38) participated in semi-structured interviews introducing the 3D BSS of 4-5-year-old children. For the quantitative phase, pre- and post-interview questionnaires were administered to ascertain the acceptability of the 3D BSS. RESULTS Parents rated the 3D BSS as "very" (n = 20, 52.6%) to "moderately" (n = 12, 31.6%) acceptable. Thematic analysis revealed four barriers to acceptability: i) the sensitive nature of child weight, ii) the belief that weight does not determine health, iii) the visual normalisation of overweight and iv) the need to account for individual variation in growth patterns. However, these barriers could be overcome through three facilitators: i) the provision of expert guidance ii) the value of simple tools, and iii) tailoring conversations to familial needs. CONCLUSIONS Parents considered the 3D BSS an acceptable visual resource to discuss child weight during routine appointments. However, the acceptability of the tool was conditional on a sensitive, collaborative, and tailored delivery approach.
Collapse
Affiliation(s)
- Kristiane Tommerup
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | - Andrea D Smith
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | | | - Helen Croker
- Great Ormond Street Institute of Child Health, Faculty of Population Health Sciences, University College London (UCL), London, UK
| | - Andrew Steptoe
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | - Martin J Tovee
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, UK
| | - Clare Llewellyn
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| |
Collapse
|
44
|
Chau S, Oldman S, Smith SR, Lin CA, Ali S, Duffy VB. Online Behavioral Screener with Tailored Obesity Prevention Messages: Application to a Pediatric Clinical Setting. Nutrients 2021; 13:223. [PMID: 33466705 PMCID: PMC7828782 DOI: 10.3390/nu13010223] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity prevention involves promoting healthy eating and physical activity across all children. Can we leverage technology to feasibly survey children's health behaviors and deliver theory-based and user-tailored messages for brief clinical encounters? We assessed the acceptability and utility of an online pediatric-adapted liking survey (PALS) and tailored messages among children receiving non-urgent care in a pediatric emergency department (PED). Two hundred and forty-five children (average age = 10 years, racially/ethnically diverse, 34% overweight/obese from measured indices, 25% of families reporting food insecurity) and their parents/caregivers participated. Each reported the child's activity and behaviors using the online PALS and received two to three messages tailored to the responses (aligned with elaboration likelihood and transtheoretical models) to motivate behavioral improvements or reinforce healthy behaviors. Most children and parents (>90%) agreed the PALS was easy to complete, encouraging thought about their own/child's behaviors. The child's PALS responses appeared reasonable (fair-to-good child-parent intraclass correlations). Most children and parents (≥75%) reported the tailored messages to be helpful and favorable for improving or maintaining the targeted behavior. Neither message type (motivating/reinforcing) nor favorability responses varied significantly by the child's weight or family's food security status. In summary, children and parents found the PALS with tailored messages acceptable and useful. The message types and responses could help focus brief clinical encounters.
Collapse
Affiliation(s)
- Sarah Chau
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (S.C.); (S.O.); (S.A.)
| | - Samantha Oldman
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (S.C.); (S.O.); (S.A.)
| | - Sharon R. Smith
- CT Children’s Medical Center, University of CT School of Medicine, Hartford, CT 06269-1101, USA;
| | - Carolyn A. Lin
- Communications Department, University of CT, Storrs, CT 06269-1101, USA;
| | - Saba Ali
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (S.C.); (S.O.); (S.A.)
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (S.C.); (S.O.); (S.A.)
| |
Collapse
|
45
|
Prevalence of Parental Comments on Weight/Shape/Eating amongst Sons and Daughters in an Adolescent Sample. Nutrients 2021; 13:nu13010158. [PMID: 33418994 PMCID: PMC7825281 DOI: 10.3390/nu13010158] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Reports suggest that 12–76% of adolescents have experienced parental comments regarding their weight/shape and/or eating behaviours. Parents may engage in conversations about weight/shape and eating out of concern, even without any ill intent; however, the associations of these comments with subsequent problematic psychosocial and eating behaviours are evidenced. Therefore, an in-depth understanding of the content and prevalence of such comments is needed. To date, adolescent-reported prevalence estimates have not included differentiation between mother or father and sons or daughters, nor have they considered eating-focussed comments. This study considered the prevalence of positive and negative parental commentary regarding weight/shape and eating with a focus on parental origin. A total of 2287 Australian male and female adolescents participated via a self-report survey. Adolescents reported frequent positive comments on weight/shape and on eating, most commonly maternal positive comments on weight/shape (78%; 95% CI 77–80). Daughters reported significantly more maternal comments on weight/shape (positive and negative) as well as more negative eating comments from mothers than did sons. Sons reported significantly more negative weight/shape comments from fathers than did daughters. Some negative comments increased significantly with age. These findings support a notable prevalence of reported parental weight/shape and eating comments directed at their offspring, particularly from mothers.
Collapse
|
46
|
Klupt KA, Oreskovich SM, Bernard-Genest J, Patel BP, Chu L, Dettmer E, Walsh CM, Strom M, McPherson AC, Strub J, Steinberg A, Steinegger C, Hamilton JK. Careful conversations: an educational video to support parents in communicating about weight with their children. BMC Pediatr 2020; 20:397. [PMID: 32838762 PMCID: PMC7446051 DOI: 10.1186/s12887-020-02284-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/09/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Parents may struggle to initiate healthy weight-related conversations with their children. Educational videos may be an effective tool for improving parents' knowledge and self-efficacy on this topic. The aim of this pilot study was to develop an educational video to assist parents in weight-related conversations with their child, and to assess changes in parents' self-efficacy on this topic. METHODS Video development was based on a scoping review and semi-structured interviews with parents. Respondent demographics and user satisfaction were assessed at pre- and post- video, and 4-6 months later. Self-efficacy scores were compared between parent groups based on weight concerns over time. RESULTS Fifty-seven parents participated in the video questionnaires, and 40 repeated measures 4-6 months later. Significant improvements in self-efficacy in "raising the issue of weight" and "answering questions or concerns" were found after watching the video (p ≤ 0.002) compared to baseline, and scores 4-6 months post baseline remained slightly elevated, but non-significant. Parents with concerns about their child being overweight had significantly lower perceived self-efficacy scores compared to parents with no concerns about their child's weight (p = 0.031). The video was found to be positively received and of relevance to parents across a number of different domains. CONCLUSION(S) Preliminary findings suggest an educational video about initiating weight-related conversations may be an effective tool for increasing parents' perceived self-efficacy in the short term. Further work is needed to validate findings in a randomized controlled trial, and with diverse parent populations. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03664492 . Registered 10 September 2018 - Retrospectively registered.
Collapse
Affiliation(s)
- Kody A Klupt
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Stephan M Oreskovich
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Julie Bernard-Genest
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada.,Centre Mère-Enfant Soleil du Centre hospitalier universitaire de Québec, Université Laval, 2705 Boulevard Laurier, Québec City, Québec, G1V4G2, Canada
| | - Barkha P Patel
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Lisa Chu
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Elizabeth Dettmer
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Catharine M Walsh
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Michele Strom
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, East York, Toronto, Ontario, M4G1R8, Canada.,Dalla Lana School of Public Health & Rehabilitation Sciences Institute, University of Toronto, 155 College St, Toronto, Ontario, M5T3M7, Canada
| | - Jonah Strub
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Alissa Steinberg
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Cathleen Steinegger
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Jill K Hamilton
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada.
| |
Collapse
|
47
|
Robinson E, Daly M, Sutin A. Association of parental identification of child overweight and mental health problems during childhood. Int J Obes (Lond) 2020; 44:1928-1935. [PMID: 32398752 DOI: 10.1038/s41366-020-0587-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Public health policies attempt to increase parental identification of child overweight and obesity. The objective of the present research was to determine the cross-sectional, prospective and longitudinal associations between parental identification of child overweight and child mental health problems. METHODS We made use of two cohort studies of Australian (Longitudinal Study of Australian Children, LSAC) and Irish children (Growing up in Ireland Study, GUI) that measured parental identification of child overweight and child mental health problems. Participant included 6502 (LSAC) and 7503 (GUI) children (49% female) and their parents. Child mental health problems were measured using child, parent and teacher-reported Strengths and Difficulties Questionnaires (SDQ) at ages 9/10 years old to 12/13 years old. In all analyses we controlled for child Z-BMI. RESULTS In LSAC children whose parents identified them as being overweight at age 10 experienced worse mental health at age 10 (β = 0.21, SE = 0.04) and age 12 (β = 0.13, SE = 0.04) than children whose parents failed to identify them as overweight. In GUI children whose parents identified them as being overweight at age 9 experienced worse mental health at age 9 (β = 0.20, SE = 0.04) and age 13 (β = 0.22, SE = 0.04). In LSAC parental identification of child overweight at age 10 did not significantly predict changes in mental health problems from age 10 to 12 (β = -0.02, SE = 0.03). In GUI parental identification of child overweight was predictive of increases in mental health problems from age 9 to 13 (β = 0.08, SE = 0.03). CONCLUSIONS Parental identification of child overweight and obesity is associated with worse child mental health, independent of child body weight. Parents should be aware of the potential stigma and mental health difficulties associated with labelling a child as overweight.
Collapse
Affiliation(s)
- Eric Robinson
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool, UK.
| | - Michael Daly
- Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling, UK.,UCD Geary Institute, University College Dublin, Dublin, Ireland.,Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Angelina Sutin
- Florida State University College of Medicine, Tallahassee, FL, USA
| |
Collapse
|
48
|
Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, Momin SR, Welsh JA, Woo JG, Haycraft E. Caregiver Influences on Eating Behaviors in Young Children: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2020; 9:e014520. [PMID: 32389066 PMCID: PMC7660848 DOI: 10.1161/jaha.119.014520] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self‐regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self‐regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self‐regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self‐regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community‐based care providers.
Collapse
|
49
|
Albright CA, Pratt KJ, Martin SB, Hulshult H, Brown CL, Lewis KH, Skelton JA. Family members' experiences with adult participation in weight management programs: Triadic perspectives from patients, partners and children. Clin Obes 2020; 10:e12354. [PMID: 31965733 PMCID: PMC9107074 DOI: 10.1111/cob.12354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/25/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Spouses are known to influence the outcomes of an individual's attempt at weight loss, but little is known about the broader influence of, and on, the family. The objectives were to explore: (a) the effects of an adult weight management program on the family and (b) family factors that help or hinder patient weight loss. METHODS A qualitative design was employed to explore triadic family members' experiences of patient participation in a weight management program. Semi-structured interviews were conducted with patients, partners and children (ages 7-18). Questions included support for patient participation and weight loss, dietary choices, meal preparation, physical activity routines, the home-food environment, communication about health and family dynamics. Thematic analysis was used, where codes and categories of codes were then grouped together to create themes and subthemes. RESULTS Nineteen triadic interviews were conducted (57 total). Seven themes emerged, including four related to Outcomes (objective 1): (a) shift in family dynamics, (b) family behaviour change, (c) child observations of family change, (d) indirect benefit to partner; and three related to Process (objective 2): (e) level of accountability, (f) patient perception of support and (g) support is essential and flexible. CONCLUSIONS Future research and clinical applications from these themes should seek to determine the positive behaviour change that was evident in the families that were interviewed, where the culmination of family interactions, expectations and concurrent partner weight loss indicates the potential longevity of weight management programs beyond patients' own participation.
Collapse
Affiliation(s)
| | - Keeley J. Pratt
- Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
| | - Sarah B. Martin
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Callie L. Brown
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristina H. Lewis
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph A. Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
50
|
Rodgers RF, Wertheim EH, Damiano SR, Paxton SJ. Maternal influences on body image and eating concerns among 7- and 8-year-old boys and girls: Cross-sectional and prospective relations. Int J Eat Disord 2020; 53:79-84. [PMID: 31479170 DOI: 10.1002/eat.23166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Little is known regarding maternal influences on the body image and eating concerns of young children. The current study aimed to examine the cross-sectional and longitudinal relationships between maternal comments about their child's weight and shape and eating, and mothers' own body dissatisfaction and disordered eating on one hand, and their children's body esteem and disordered eating behaviors on the other. METHOD Children, n = 244 of the fifth wave, aged 7 years (58% female), and n = 194 of the sixth wave, aged 8 years (57% female), of the longitudinal Children's Body Image Development Study, in Melbourne, Australia were included. Mothers completed measures of body dissatisfaction, dietary restraint, and comments and concerns regarding their children's weight and eating behaviors. They also reported on their children's disordered eating behaviors. Children's body esteem was assessed through a child interview. RESULTS Findings revealed cross-sectional and prospective bivariate relationships between maternal comments and disordered eating behaviors among both boys and girls. Similar patterns of relationships emerged between maternal body dissatisfaction and lower child body esteem. CONCLUSION Findings highlight the importance of conducting prevention within the family environment from a young age, and targeting both direct communication as well as parental body image and eating behaviors.
Collapse
Affiliation(s)
- Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Eleanor H Wertheim
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Stephanie R Damiano
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|