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Kettle J, Marshman Z. Dimensions of young children's toothbrushing resistance: A qualitative content analysis of discussions on the online parenting forum Mumsnet. Int J Paediatr Dent 2024; 34:485-493. [PMID: 38158629 DOI: 10.1111/ipd.13149] [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: 04/18/2023] [Revised: 11/27/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Young children's resistant behaviour is a barrier to parental-supervised brushing. Discussions on online parenting forums offer an insight into parental experiences, behaviour and attitudes. Analysing these discussions also demonstrates how dental advice is represented and potentially resisted. AIM To analyse how young children's toothbrushing resistance is discussed on an online parenting forum. DESIGN Qualitative content analysis of threads on toothbrushing resistance retrieved from the UK parenting forum Mumsnet. RESULTS A search was carried out on Mumsnet in April 2022. Overall, 204 relevant threads were identified and analysed. A coding frame was developed. Posters interacted by discussing their experiences of resistance, asking for advice, making suggestions and being both supportive and critical. Thirty-seven strategies for addressing resistance were identified. Discussions reflected attitudes and concerns relating to young children and toothbrushing resistance, including the idea brushing should be 'non-negotiable'. A key issue was the acceptability of physical force or restraint to achieve adequate brushing. Posters invoked dental authority to support their views. CONCLUSION Understanding how toothbrushing resistance is discussed on a parenting forum helps establish what information and advice is shared, and highlights attitudes and concerns that shape how this problem is approached.
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Affiliation(s)
- Jennifer Kettle
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Gutiérrez-González E, Andreu-Ivorra B, Rollán-Gordo A, Tejedor-Romero L, Sánchez-Arenas F, García-Solano M. Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: results of the ALADINO study. An Pediatr (Barc) 2024; 100:233-240. [PMID: 38538511 DOI: 10.1016/j.anpede.2024.03.009] [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: 09/21/2023] [Accepted: 01/31/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6-9 years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics. METHODOLOGY The analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6-9 years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization and the International Obesity Task Force) and of central obesity, in addition to associated demographic and socioeconomic variables. RESULTS Between 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8 years (by -5.4%, -5.7% and -5.3%, respectively) and boys whose parents had a higher educational attainment (by -5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable. CONCLUSIONS The prevalence of overweight and the prevalence of obesity in schoolchildren aged 6-9 years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6-8 years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable.
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Affiliation(s)
- Enrique Gutiérrez-González
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Sanidad, Madrid, Spain
| | - Blanca Andreu-Ivorra
- Servicio de Epidemiología, Consejería de Salud de la Región de Murcia, Murcia, Spain
| | - Almudena Rollán-Gordo
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Sanidad, Madrid, Spain
| | - Laura Tejedor-Romero
- Servicio de Medicina Preventiva, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Marta García-Solano
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Sanidad, Madrid, Spain.
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Koivumäki T, Jallinoja P. The good, the bad, and the blameless in parenting: a thematic analysis of discussions of childhood obesity on an internet forum. BMC Public Health 2023; 23:452. [PMID: 36890492 PMCID: PMC9993749 DOI: 10.1186/s12889-023-15314-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/23/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Childhood obesity is affecting an increasing percentage of families globally. For families, obesity is often a tense issue, not least because of the negative stigma and cultural perceptions associated with it. Discussions around childhood obesity do not take place only at home or in healthcare, but increasingly on social media, such as Internet discussion forums. Our aim was to analyse how childhood obesity is discussed on a Finnish online discussion forum by parents of children with obesity and other commenters. METHOD We gathered and analysed 16 discussion threads on childhood obesity taken from a Finnish Internet discussion forum, vauva.fi, between 2015 and 2021 (a total of 331 posts). For the analysis, we chose threads where the parents of a child with obesity took part. The parents' and other commenters' discussions were analysed and interpreted with inductive thematic analysis. RESULTS In the online discussions, childhood obesity was discussed mostly in the context of parenting, parental responsibility and lifestyle choices within the family. We identified three themes that were used to define parenting. In the theme of proving good parenting, parents and commenters listed healthy elements in their family's lifestyle to show their responsibility and parenting skills. In the theme of blaming bad parents, other commenters pointed out mistakes in the parents' behaviour or offered them advice. Moreover, many acknowledged that some factors causing childhood obesity were outside the parents' influence, forming the theme of lifting the blame from parents. In addition, many parents brought up that they were genuinely ignorant of the reasons for their child's overweight. CONCLUSIONS These results are in line with previous studies suggesting that in Western cultures obesity - including childhood obesity - is typically seen as the individual's fault and is associated with negative stigma. Consequently, counselling parents in healthcare should be expanded from supporting a healthy lifestyle to strengthening parents' identity as being good enough parents who are already making many health enhancing efforts. Situating the family in a wider context of the obesogenic environment could ease the parents' feelings that they have failed at parenting.
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Lefere S, Verghote K, De Bruyne R, Provoost V, Satalkar PP. 'A radical operation' - a thematic analysis of newspaper framing of bariatric surgery in adolescents. BMC Public Health 2023; 23:447. [PMID: 36882787 PMCID: PMC9993750 DOI: 10.1186/s12889-023-15366-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Obesity in adolescents is a growing public health issue. Bariatric surgery is an effective, yet controversial treatment option for adolescents. The moral acceptability of this procedure by health-care professionals as well as the general public can be influenced by its portrayal in the news media. Our objective was to analyze how newspaper articles portrayed adolescent bariatric surgery, with attention to the language used and moral arguments made. METHODS Using an inductive thematic analysis approach, we analyzed 26 UK and 12 US newspaper articles (2014-2022) on adolescent bariatric surgery for implicit or explicit moral evaluations and use of normative language. Coding was performed after immersive reading, assisted by NVivo. Themes were identified and refined iteratively through consecutive auditing cycles to enrich the depth and rigor of our analysis. RESULTS The major themes identified related to (1) defining the burden of adolescent obesity, (2) sparking moral outrage, (3) sensation-seeking, and (4) raising ethical issues. The articles employed moral language, specifically non-neutral and negative discourse regarding surgery. Blame was attributed to adolescents or their parents. Sensationalist wording often reinforced the normative content, drawing the attention of the reader and contributing to stigmatization of adolescents with severe obesity as lacking will power and being lazy. Further moral issues that stood out were the challenges in obtaining an informed consent, and the unequal access to surgery for socially disadvantaged groups. CONCLUSIONS Our findings provide insights into how adolescent bariatric surgery is represented in the print news media. Despite frequent citing of experts and studies on the efficacy, safety and unmet need for bariatric surgery, obesity and surgery in adolescents are often stigmatized and sensationalized, with (prospective) patients depicted as looking for an easy way out in the form of a solution brought by others (health systems, society, tax payers). This may increase the stigma surrounding adolescent obesity, and therefore limit the acceptability of specific treatments such as bariatric surgery.
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Affiliation(s)
- Sander Lefere
- Hepatology Research Unit, Department Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.
- Liver Research Center Ghent, Ghent University, Ghent, Belgium.
| | - Kato Verghote
- Department Moral Sciences and Empirical (Bio) Ethics Research, Bioethics Institute Ghent, Ghent University, Ghent, Belgium
| | - Ruth De Bruyne
- Pediatric Gastroenterology, Hepatology and Nutrition, Department Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Veerle Provoost
- Department Moral Sciences and Empirical (Bio) Ethics Research, Bioethics Institute Ghent, Ghent University, Ghent, Belgium
| | - Priya P Satalkar
- Department Moral Sciences and Empirical (Bio) Ethics Research, Bioethics Institute Ghent, Ghent University, Ghent, Belgium
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Gillison FB, Grey EB, Cumming SP, Sherar LB. Does adjusting for biological maturity when calculating child weight status improve the accuracy of predicting future health risk? BMC Public Health 2021; 21:1979. [PMID: 34727900 PMCID: PMC8561871 DOI: 10.1186/s12889-021-12037-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 10/06/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The aim of this study was to assess whether adjusting the weight categorisation of children for their biological maturity status could improve the accuracy of predicting weight status and cardiometabolic risk at age 17. METHODS Data from 1525 participants (787 female) from the ALSPAC study were analysed. Participants' weight status at age 11 was estimated using first standard chronological age and sex adjusted BMI cut-offs, and again using maturity adjusted BMI cut-offs. Each BMI category at age 11 was regressed against cardiometabolic risk score and BMI category at age 17, controlling for sex, ethnicity and socio-economic status. RESULTS At age 11 years, 22% of boys and 46% of girls who were categorised as overweight or having obesity based on chronological age were re-categorised into a lower BMI category after adjusting for biological maturity. Biologically adjusted BMI categories better predicted BMI category at age 17 compared with non-adjusted BMI categories (∆BIC = - 21.69); the odds of having obesity at age 17 were 18.28 times greater with each increase in BMI category at age 11. Adjusted and non-adjusted BMI status at 11 years showed equivalent accuracy in predicting cardiometabolic risk at age 17; the odds ratio of high cardiometabolic risk was 1.85, with heightened risk in boys, particularly early maturers. CONCLUSION The traditional method of categorising adolescents into a BMI category may over-predict overweight and obesity, particularly in girls. Adjusting for biological maturity when estimating weight status through calculating adolescents' BMI classification was equivalent to standard approaches in predicting other cardiovascular risk at age 17.
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Affiliation(s)
- Fiona B Gillison
- Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
| | - Elisabeth B Grey
- Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Sean P Cumming
- Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Herrmann BW, Campbell K, Meier M, Haemer M, Crowder R, Tholen K, Hoefner-Notz R, Nguyen T, Friedman NR. Parental Perception of Weight Status for Adenotonsillectomy Patients. Laryngoscope 2021; 131:2121-2125. [PMID: 33569790 PMCID: PMC8355242 DOI: 10.1002/lary.29445] [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: 01/05/2021] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Weight status can affect outcomes in pediatric adenotonsillectomy performed for obstructive sleep disordered breathing. Parents frequently underestimate their child's weight and are unaware weight status may affect adenotonsillectomy success. Accurate understanding of a child's weight status is important for shared decision making with the family and perioperative care. The purpose of this study is to analyze the accuracy of the parent's perception of their child's weight status. METHODS A retrospective analysis was performed of prospective data collected from families of children undergoing adenotonsillectomy from June 2018 through June 2019. RESULTS A total of 522 children met the inclusion criteria. Two hundred and thirty-two children were either overweight (n = 46, 9%) or obese (n = 186, 36%). Among parents of this cohort whose children were overweight or obese, 74 (32%) erroneously reported that their child was normal weight. For the 290 nonoverweight children, 99% of parents accurately reported weight status. After adjusting for ethnicity, race, BMI%, and sex, for every 1-year increase in age of the child, the odds of the parent correctly identifying their child as overweight increased by a factor of 1.18 (95% CI: 1.09, 1.27). CONCLUSION One-third of families with children who were overweight or obese undergoing adenotonsillectomy for obstructive sleep disordered breathing underestimated their child's weight. This study highlights the need to facilitate family understanding of weight status' potential impact on both obstructive sleep disordered breathing severity and adenotonsillectomy success, especially for younger children. LEVEL OF EVIDENCE 4 Laryngoscope, 131:2121-2125, 2021.
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Affiliation(s)
- Brian W Herrmann
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
- Department of Pediatric Otolaryngology, Children’s Hospital Colorado, Aurora, CO
| | | | - Maxene Meier
- The Center for Research in Outcomes for Children’s Surgery, University of Colorado School of Medicine, Aurora, CO
| | - Matthew Haemer
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO
| | - Renee Crowder
- University of Colorado School of Medicine, Aurora, CO
| | - Kaitlyn Tholen
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
- Department of Pediatric Otolaryngology, Children’s Hospital Colorado, Aurora, CO
| | - Regina Hoefner-Notz
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO
| | - Thanh Nguyen
- University of Colorado School of Medicine, Aurora, CO
- Division of Pediatric Anesthesia, Children’s Hospital Colorado, Aurora, CO
| | - Norman R Friedman
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
- Department of Pediatric Otolaryngology, Children’s Hospital Colorado, Aurora, CO
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Fraser K, Markides BR, Barrett N, Laws R. Fussy eating in toddlers: A content analysis of parents' online support seeking. MATERNAL & CHILD NUTRITION 2021; 17:e13171. [PMID: 33739624 PMCID: PMC8189205 DOI: 10.1111/mcn.13171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 01/02/2023]
Abstract
The development of healthy eating habits in childhood is essential to reducing later risk of obesity. However, many parents manage fussy eating in toddlerhood with ineffective feeding practices that limit children's dietary variety and reinforce obesogenic eating behaviours. Understanding parents' feeding concerns and support needs may assist in the development of feeding interventions designed to support parents' uptake of responsive feeding practices. A total of 130 original posts by parents of toddlers (12-36 months) were extracted from the online website Reddit's 'r/Toddlers' community discussion forum over a 12-month period. Qualitative content analysis was used to categorise the fussy eating topics that parents were most concerned about and the types of support they were seeking from online peers. The most frequently raised fussy eating concerns were refusal to eat foods offered, inadequate intake (quantity and quality), problematic mealtime behaviours and changes in eating patterns. Parents were primarily seeking practical support (69.2%) to manage emergent fussy eating behaviours. This consisted of requests for practical feeding advice and strategies or meal ideas. Nearly half of parents sought emotional support (47.7%) to normalise their child's eating behaviour and seek reassurance from people with lived experience. Informational support about feeding was sought to a lesser extent (16.2%). Fussy eating poses a barrier to children's dietary variety and establishing healthy eating habits. These results suggest parents require greater knowledge and skills on 'how to feed' children and support to manage feeding expectations. Health professionals and child feeding interventions should focus on providing parents with practical feeding strategies to manage fussy eating. Supporting parents to adopt and maintain responsive feeding practices is vital to developing healthy eating habits during toddlerhood that will continue throughout adulthood.
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Affiliation(s)
- Kylie Fraser
- School of Health and Social DevelopmentDeakin UniversityVictoriaAustralia
| | - Brittany Reese Markides
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityVictoriaAustralia
| | - Norma Barrett
- School of Health and Social DevelopmentDeakin UniversityVictoriaAustralia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityVictoriaAustralia
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Humphrey G, Dobson R, Parag V, Hiemstra M, Howie S, Marsh S, Morton S, Mordaunt D, Wadham A, Bullen C. See How They Grow: Testing the feasibility of a mobile app to support parents' understanding of child growth charts. PLoS One 2021; 16:e0246045. [PMID: 33606687 PMCID: PMC7894826 DOI: 10.1371/journal.pone.0246045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/11/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mobile devices provide new opportunities for the prevention of overweight and obesity in children. We aimed to co-create and test an app that offered comprehensible feedback to parents on their child's growth and delivered a suite of age-specific information about nutrition and activity. METHODS A two-phased approach was used to co-create the digital growth tool-See How They Grow-and test its feasibility. Phase one used focus groups (parents and professionals such as paediatricians and midwives) and a national on-line survey to gather requirements and build the app. Phase two involved testing the app over 12-weeks, with parents or carers of children aged ≤ 2-years. All research activities were undertaken exclusively through the app, and participants were recruited using social media and hard copy materials given to patents at a child health visit. FINDINGS Four focus groups and 101 responses to the national survey informed the features and functions to include in the final app. Two hundred and twenty-five participants downloaded the app, resulting in 208 eligible participants. Non-Māori/Non-Pacific (78%) and Māori (14%) had the highest downloads. Fifty-four per cent of participants were parents of children under 6-months. These participants were more likely to regularly use the app than those with children older than 6-months (64% vs 36%, P = 0.011). Over half of the participants entered three measures (n = 101, 48%). Of those that completed the follow-up survey (n = 101, 48%), 72 reported that the app helped them better understand how to interpret growth charts. CONCLUSION The app was acceptable and with minor modifications, has the potential to be an effective tool to support parents understanding of growth trajectories for their children. A larger trial is needed to evaluate if the app can have a measurable impact on increasing knowledge and behaviour, and therefore on preventing childhood overweight and obesity.
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Affiliation(s)
- Gayl Humphrey
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Rosie Dobson
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Varsha Parag
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | | | - Stephen Howie
- Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Samantha Marsh
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Susan Morton
- Growing Up in New Zealand, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Dylan Mordaunt
- University of Adelaide, South Australia, Australia
- Flinders University, South Australia, Australia
| | - Angela Wadham
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
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"They Just Need to Come Down a Little Bit to your Level": A Qualitative Study of Parents' Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103605. [PMID: 32455567 PMCID: PMC7277501 DOI: 10.3390/ijerph17103605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 12/28/2022]
Abstract
The first 1000 days is a critical window of opportunity to promote healthy growth and associated behaviours. Health professionals can play an important role, in part due to the large number of routine contacts they have with parents. There is an absence of research on the views of parents towards obesity prevention and the range of associated behaviours during this time period. This study aimed to elicit parents’ views on early life interventions to promote healthy growth/prevent childhood obesity, particularly those delivered by health professionals. Semi-structured interviews were conducted with 29 parents (24 mothers, 5 fathers) who were resident in Ireland and had at least one child aged under 30 months. Data were analysed using reflexive thematic analysis. Two central themes were generated: (1) navigating the uncertainty, stress, worries, and challenges of parenting whilst under scrutiny and (2) accessing support in the broader system. Parents would welcome support during this critical time period; particularly around feeding. Such support, however, needs to be practical, realistic, evidence-based, timely, accessible, multi-level, non-judgemental, and from trusted sources, including both health professionals and peers. Interventions to promote healthy growth and related behaviours need to be developed and implemented in a way that supports parents and their views and circumstances.
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Mansoor Y, Hale I. Parent perceptions of routine growth monitoring: A scoping review. Paediatr Child Health 2020; 26:154-158. [PMID: 33936334 DOI: 10.1093/pch/pxaa041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 03/02/2020] [Indexed: 11/13/2022] Open
Abstract
Background Despite being a well-accepted part of paediatric care, little is known about the benefits or potential harms of routine growth monitoring (RGM) from a parent's perspective. Objective To explore parental experiences with RGM. Methods Literature searches were performed on Google Scholar, psycINFO, CINAHL, and PubMed. Included studies were published after 2000 and described parental comprehension, preferences, attitudes toward, and/or behaviour change related to RGM. Results Of 24 reviewed studies, four themes were identified: reliance on growth monitoring, understanding, influence on feeding and behaviour, and response to obesity-related classification. RGM was familiar but not strongly preferred to identify a child's weight status. Parental understanding of RGM was poor, particularly among parents with low socioeconomic status. A common belief was that heavier babies were healthier, while smaller babies should prompt concern. Parents may be anxious and change behaviour in response to RGM, such as by halting breastfeeding, supplementing, or restricting their child's diet. Parents frequently discounted RGM information when their child was identified as overweight, and expressed concerns about self-esteem and eating disorders. Conclusion This scoping review identifies that although RGM is familiar and sometimes reassuring to parents, increased consideration should be given to potential harms from parental perspectives when conducting growth monitoring.
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Affiliation(s)
- Yasmeen Mansoor
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia
| | - Ilona Hale
- Department of Family Practice, University of British Columbia, Kimberley, British Columbia
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Butler ÉM, Derraik JGB, Glover M, Morton SMB, Tautolo ES, Taylor RW, Cutfield WS. Acceptability of early childhood obesity prediction models to New Zealand families. PLoS One 2019; 14:e0225212. [PMID: 31790443 PMCID: PMC6886750 DOI: 10.1371/journal.pone.0225212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE While prediction models can estimate an infant's risk of developing obesity at a later point in early childhood, caregiver receptiveness to such information is largely unknown. We aimed to assess the acceptability of these models to New Zealand caregivers. METHODS An anonymous questionnaire was distributed online. The questionnaire consisted of multiple choice and Likert scale questions. Respondents were parents, caregivers, and grandparents of children aged ≤5 years. RESULTS 1,934 questionnaires were analysed. Responses were received from caregivers of various ethnicities and levels of education. Nearly two-thirds (62.1%) of respondents would "definitely" or "probably" want to hear if their infant was at risk of early childhood obesity, although "worried" (77.0%) and "upset" (53.0%) were the most frequently anticipated responses to such information. With lower mean scores reflecting higher levels of acceptance, grandparents (mean score = 1.67) were more receptive than parents (2.10; p = 0.0002) and other caregivers (2.13; p = 0.021); males (1.83) were more receptive than females (2.11; p = 0.005); and Asian respondents (1.68) were more receptive than those of European (2.05; p = 0.003), Māori (2.11; p = 0.002), or Pacific (2.03; p = 0.042) ethnicities. There were no differences in acceptance according to socioeconomic status, levels of education, or other ethnicities. CONCLUSIONS Almost two-thirds of respondents were receptive to communication regarding their infant's risk of childhood obesity. While our results must be interpreted with some caution due to their hypothetical nature, findings suggest that if delivered in a sensitive manner to minimise caregiver distress, early childhood obesity risk prediction could be a useful tool to inform interventions to reduce childhood obesity in New Zealand.
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Affiliation(s)
- Éadaoin M. Butler
- A Better Start–National Science Challenge, Auckland, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G. B. Derraik
- A Better Start–National Science Challenge, Auckland, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marewa Glover
- School of Health Sciences, College of Health, Massey University, Auckland, New Zealand
- Centre of Research Excellence Indigenous Sovereignty & Smoking, Auckland, New Zealand
| | - Susan M. B. Morton
- A Better Start–National Science Challenge, Auckland, New Zealand
- Centre for Longitudinal Research–He Ara ki Mua, The University of Auckland, Auckland, New Zealand
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - El-Shadan Tautolo
- A Better Start–National Science Challenge, Auckland, New Zealand
- Centre for Pacific Health & Development Research, Auckland University of Technology, Auckland, New Zealand
| | - Rachael W. Taylor
- A Better Start–National Science Challenge, Auckland, New Zealand
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Wayne S. Cutfield
- A Better Start–National Science Challenge, Auckland, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
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Butler ÉM, Suhag A, Hong Y, Liang L, Gong C, Xiong F, Luo F, Liu G, Chen S, Taylor RW, Cutfield WS, Fu J, Derraik JGB. Parental Perceptions of Obesity in School Children and Subsequent Action. Child Obes 2019; 15:459-467. [PMID: 31408357 DOI: 10.1089/chi.2018.0338] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: Despite perceiving their child as being above a healthy weight, many parents do not intervene. Little is known about the factors influencing parental action. We assessed parental perception of child's weight status, the prevalence of mitigating parental action, and the underlying factors. Methods: We studied 20,242 children and adolescents from 6 centers across China. Anthropometry was measured by research nurses. Parents answered questionnaires, including their perception of their child's weight status, and any subsequent weight treatment. Results: A total of 3254 children had obesity (16.1%), with 63.0% correctly perceived as overweight by their parents. These children were more likely to be older (≥8 years; p < 0.0001), have severe obesity [adjusted relative risk (aRR) 1.41; p < 0.0001], and have mothers with overweight/obesity (aRR 1.15; p < 0.0001). In particular, parents of children aged <8 years were over five times more likely to perceive their child with overweight/obesity as "thin" than parents of teenagers. Conversely, girls, older children/adolescents, and urban youth were more likely to be wrongly perceived by parents as having an overweight issue. Only one in four children (27.8%) with available information received treatment for their perceived weight problem. Children with severe obesity were more likely to be treated (aRR 1.34; p < 0.0001), as were children of mothers with overweight/obesity (aRR 1.18; p = 0.002). Conclusions: Only one in four Chinese children perceived as overweight by their parents received treatment for their weight problem. Given that overweight/obesity in childhood tracks into adulthood and many parents did not intervene despite perceiving an overweight problem in their child, interventions for childhood obesity need to extend beyond parental perception of children's weight status.
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Affiliation(s)
- Éadaoin M Butler
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand
| | - Alisha Suhag
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Ye Hong
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Liang
- First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chunxiu Gong
- Beijing Children's Hospital of Capital Medical University, Beijing, China
| | - Feng Xiong
- Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Feihong Luo
- Department of Endocrinology, Children's Hospital of Shanghai Fudan University, Shanghai, China
| | - Geli Liu
- General Hospital of Tianjin Medical University, Tianjin, China
| | - Shaoke Chen
- Maternal and Children Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Rachael W Taylor
- A Better Start-National Science Challenge, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand
| | - JunFen Fu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - José G B Derraik
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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13
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Water T, Carter B, Neville S, Dickinson A. Looking towards the horizon: changing landscapes and a shift to a more equitable future for children, young people and their families. Contemp Nurse 2017; 53:407-409. [PMID: 29144830 DOI: 10.1080/10376178.2017.1403765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- T Water
- a School of Nursing , Auckland University of Technology , Auckland , New Zealand
| | - B Carter
- b Faculty of Health and Social Care , Edge Hill University , Ormskirk , UK
| | - S Neville
- a School of Nursing , Auckland University of Technology , Auckland , New Zealand
| | - A Dickinson
- a School of Nursing , Auckland University of Technology , Auckland , New Zealand
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