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Potts BA, Wood GC, Bailey-Davis L. Agreement between parent-report and EMR height, weight, and BMI among rural children. Front Nutr 2024; 11:1279931. [PMID: 38496791 PMCID: PMC10940382 DOI: 10.3389/fnut.2024.1279931] [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: 08/18/2023] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Remote anthropometric surveillance has emerged as a strategy to accommodate lapses in growth monitoring for pediatricians during coronavirus disease 2019 (COVID-19). The purpose of this investigation was to validate parent-reported anthropometry and inform acceptable remote measurement practices among rural, preschool-aged children. Methods Parent-reported height, weight, body mass index (BMI), BMI z-score, and BMI percentile for their child were collected through surveys with the assessment of their source of home measure. Objective measures were collected by clinic staff at the child's well-child visit (WCV). Agreement was assessed using correlations, alongside an exploration of the time gap (TG) between parent-report and WCV to moderate agreement. Using parent- and objectively reported BMI z-scores, weight classification agreement was evaluated. Correction equations were applied to parent-reported anthropometrics. Results A total of 55 subjects were included in this study. Significant differences were observed between parent- and objectively reported weight in the overall group (-0.24 kg; p = 0.05), as well as height (-1.8 cm; p = 0.01) and BMI (0.4 kg/m2; p = 0.02) in the ≤7d TG + Direct group. Parental reporting of child anthropometry ≤7d from their WCV with direct measurements yielded the strongest correlations [r = 0.99 (weight), r = 0.95 (height), r = 0.82 (BMI), r = 0.71 (BMIz), and r = 0.68 (BMI percentile)] and greatest classification agreement among all metrics [91.67% (weight), 54.17% (height), 83.33% (BMI), 91.67% (BMIz), and 33.33% (BMI percentile)]. Corrections did not remarkably improve correlations. Discussion Remote pediatric anthropometry is a valid supplement for clinical assessment, conditional on direct measurement within 7 days. In rural populations where socioenvironmental barriers exist to care and surveillance, we highlight the utility of telemedicine for providers and researchers.
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Affiliation(s)
| | | | - Lisa Bailey-Davis
- Center for Obesity and Metabolic Research, Geisinger Health System, Danville, PA, United States
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Hermeling L, Steinacker JM, Kobel S. Beyond correlates: the social gradient in childhood overweight. Arch Public Health 2024; 82:3. [PMID: 38195594 PMCID: PMC10775653 DOI: 10.1186/s13690-023-01232-x] [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: 09/04/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Health (in)equity has a high priority on research and policy agendas. Even though it is known that inequalities in overweight prevalence accumulate with age and are already existent among children below the age of six, research on this topic is scarce. In this young age group, parents play an important role in preventing overweight and associated adverse consequences. This study examines the magnitude of parental misclassification of child weight status and its correlates, focussing on the factors that determine social status and equity. METHODS Preschool children's weight and height was measured objectively. Parents gave information on their socioeconomic background. Family education was dichotomised into tertiary and non-tertiary educational level, according to CASMIN. Binary logistic regression, adjusted for parental BMI, was applied to detect odds of childhood overweight. RESULTS Data on family educational level and anthropometrics were available from 643 children (4.5 ± 0.82 years, 52.7% male) and their parents of which 46.5% (n = 299) had a tertiary educational background. The groups (tertiary vs. non-tertiary educational level) differ significantly in overweight prevalence (3.7% vs. 11.9%, p ≤ 0.001). Odds of overweight were two times higher in children with non-tertiary educational background (OR: 2.123, CI: 1.010-4.461, p < 0.05), adjusted for parental BMI. CONCLUSION Children from families with low educational background have an elevated risk of overweight, already at a very young age. Education in general (not explicitly health education) seems to play a tremendous role in the prevention of overweight and obesity and should therefore be implied in policies enhancing health equity. TRIAL REGISTRATION DRKS-ID: DRKS00010089.
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Affiliation(s)
- Lina Hermeling
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany
| | - Jürgen M Steinacker
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany
| | - Susanne Kobel
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany.
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3
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Jones AR, Mann KD, Cutler LR, Pearce MS, Tovée MJ, Ells LJ, Araujo-Soares V, Arnott B, Harris JM, Adamson AJ. A Randomised Control Trial Investigating the Efficacy of the MapMe Intervention on Parental Ability to Correctly Categorise Overweight in Their Child and the Impact on Child BMI Z-Score Change at 1 Year. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1577. [PMID: 37761538 PMCID: PMC10528244 DOI: 10.3390/children10091577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
Research suggests parental ability to recognise when their child has overweight is limited. It is hypothesised that recognition of child overweight/obesity is fundamental to its prevention, acting as a potential barrier to parental action to improve their child's health-related behaviours and/or help seeking. The purpose of this study was to investigate the efficacy of an intervention (MapMe) to improve parental ability to correctly categorise their child as having overweight one-month post-intervention, and reduce child body mass index (BMI) z-score 12 months post-intervention. MapMe consists of body image scales of known child BMI and information on the consequences of childhood overweight, associated health-related behaviours and sources of support. We conducted a three-arm (paper-based MapMe, web-based MapMe and control) randomised control trial in fifteen English local authority areas with parents/guardians of 4-5- and 10-11-year-old children. Parental categorisation of child weight status was assessed using the question 'How would you describe your child's weight at the moment?' Response options were: underweight, healthy weight, overweight, and very overweight. Child weight status and BMI z-scores were calculated using objectively measured height and weight data and UK90 clinical thresholds. There was no difference in the percentage of parents correctly categorising their child as having overweight/very overweight (n = 264: 41% control, 48% web-based, and 43% paper-based, p = 0.646). BMI z-scores were significantly reduced for the intervention group at 12 months post-intervention compared to controls (n = 338, mean difference in BMI z-score change -0.11 (95% CI -0.202 to -0.020, p = 0.017). MapMe was associated with a decrease in BMI z-score 12 months post-intervention, although there was no direct evidence of improved parental ability to correctly categorise child overweight status. Further work is needed to replicate these findings in a larger sample of children, investigate mechanisms of action, and determine the use of MapMe as a public health initiative.
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Affiliation(s)
- Angela R. Jones
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
- Human Nutrition and Exercise Research Centre, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | - Kay D. Mann
- Health Capital Division, Queensland Health, 33 Charlotte Street, Brisbane, QLD 4000, Australia;
| | - Laura R. Cutler
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
- Human Nutrition and Exercise Research Centre, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | - Mark S. Pearce
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
| | - Martin J. Tovée
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
| | - Louisa J. Ells
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds LS1 3HE, UK;
| | - Vera Araujo-Soares
- Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, Germany;
| | - Bronia Arnott
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
| | - Julie M. Harris
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9TS, UK;
| | - Ashley J. Adamson
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
- Human Nutrition and Exercise Research Centre, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
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4
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Åsberg M, Derwig M, Castor C. Parents' recalled experiences of the child centred health dialogue in children with overweight: a qualitative study. BMC Health Serv Res 2023; 23:289. [PMID: 36973799 PMCID: PMC10045090 DOI: 10.1186/s12913-023-09308-8] [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: 09/27/2022] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Because overweight and obesity are still increasing and prevention of childhood obesity is more likely to be effective when initiated in preschool children, the Child Health Service in the south of Sweden developed a structured child-centred health dialogue model targeting all 4-year-old children and their families. The aim of this study was to describe parents' recalled experiences of this health dialogue in children with overweight. METHODS A qualitative inductive approach with purposeful sampling was used. Thirteen individual interviews with parents (including 11 mothers and 3 fathers) were conducted and analysed with qualitative content analysis. RESULTS The analysis resulted in two categories: 'A valuable visit with a subtle individual impact' that described parents' recalled experiences of the health dialogue and 'There is a complex interaction between weight and lifestyle' that reflected the parents' perceptions of the relationship between their children's weight and lifestyle. CONCLUSIONS Parents recalled the child-centred health dialogue as important and described discussing a healthy lifestyle as one of the obligations of the Child Health Service. Parents wanted confirmation that their family lifestyle was healthy; however, they did not want to discuss the relationship between their family lifestyle and their children's weight. Parents expressed that when their child followed the child's growth curve, then this indicated healthy growth. This study supports using the child-centred health dialogue as a model to provide structure for discussing a healthy lifestyle and growth but highlights the difficulties of discussing body mass index and overweight, especially in the presence of children.
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Affiliation(s)
- Malin Åsberg
- Vårdcentralen Staffanstorp, Södergatan 2, Staffanstorp, 245 31, Sweden
| | - Mariette Derwig
- Faculty of Medicine, Department of Health Sciences, Lund University, BOX 157, Lund, 222 40, Sweden
| | - Charlotte Castor
- Faculty of Medicine, Department of Health Sciences, Lund University, BOX 157, Lund, 222 40, Sweden.
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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.
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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
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Mytton OT, Nicholls D, Saxena S, Viner RM. Approach to a child or young person with concerns about excess weight. BMJ 2023; 380:e074255. [PMID: 36796840 DOI: 10.1136/bmj-2022-074255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Oliver T Mytton
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Dasha Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, UK
| | - Sonia Saxena
- School of Public Health, Imperial College London, UK
| | - Russell M Viner
- UCL Great Ormond Street Institute of Child Health, London, UK
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Lindsay AC, Caires T, Le Q, Nogueira DL, Tavares Machado MM, Greaney ML. Where Do Brazilian Immigrant Parents Obtain Information to Support the Healthful Energy Balance-related Behaviors of Their Preschool-age Children?: A Cross-sectional Study. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.2001775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Qun Le
- Rutgers University, the State University of New Jersey
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Bianchi-Hayes JM, Cataldo R, Schoenfeld ER, Hou W, Pati S. Caregivers' perceptions of the relationship among weight, health status, and asthma in their children. J Child Health Care 2021; 25:647-658. [PMID: 33382353 DOI: 10.1177/1367493520985719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Asthma and obesity are the two most common childhood illnesses and are physiologically interrelated. Few studies have assessed parental perceptions and beliefs about this relationship to better target education and therapy. This study aimed to determine caregiver beliefs and perceptions regarding weight, health status, and asthma diagnoses. Data from a survey of caregivers to children aged 4-11 years are merged with corresponding anthropometric and medical data from the electronic medical record. Caregivers of children with asthma completed a supplemental questionnaire. Univariable and multivariable logistic regressions were used to evaluate associations between perception of health problem, asthma, and weight status. Increased weight status was ≥ 85th body mass index percentile per Centers for Disease Control classifications. Compared to caregivers of healthy children and those of children with healthy weight and asthma, caregivers of dual diagnosis children were more likely to identify weight as a health problem (OR = 3.89, 95% confidence interval [1.48, 10.21]). Nevertheless, only 31% of caregivers of children with dual diagnosis believed weight contributed to the severity of their child's asthma. Less than one third of caregivers of dual diagnosis children believed that these diagnoses are interrelated. Addressing this gap in understanding is a critical next step to developing family-centered interventions.
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Affiliation(s)
- Josette M Bianchi-Hayes
- Department of Pediatrics, Stony Brook Children's Hospital, 480305Stony Brook University, NY, USA
| | - Rosa Cataldo
- Department of Pediatrics, Stony Brook Children's Hospital, 480305Stony Brook University, NY, USA
| | - Elinor R Schoenfeld
- Department of Family, Population, and Preventive Medicine, 480305Stony Brook University, NY, USA
| | - Wei Hou
- Department of Family, Population, and Preventive Medicine, 480305Stony Brook University, NY, USA
| | - Susmita Pati
- Department of Pediatrics, Stony Brook Children's Hospital, 480305Stony Brook University, NY, USA
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9
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Alshahrani A, Shuweihdi F, Swift J, Avery A. Underestimation of overweight weight status in children and adolescents aged 0-19 years: A systematic review and meta-analysis. Obes Sci Pract 2021; 7:760-796. [PMID: 34877014 PMCID: PMC8633945 DOI: 10.1002/osp4.531] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Perceptions of children's weight status may be important in obesity prevention and treatment. AIMS This review identifies the prevalence of the underestimation of overweight status in children by parents/main carers, children, and healthcare professionals (HCP). The review critically synthesized both quantitative and qualitative evidence to explore the factors associated with this underestimation. The diverse methods used to assess this phenomenon are reported. METHODS Pooled effect sizes were calculated using random-effects model. Published studies, up to 2020, were accessed using the following search engines: CINAHL, EMBASE, PUBMED, and Psych-Info and including the "Cited by" and "Related Articles" functions. Hand-searching was used to retrieve further articles. Publication language and location had no bearing on the nature of the included studies. RESULTS A total of 91 articles were included. In the quantitative studies, 55% (95% CI 49%-61%) of caregivers underestimated their child's level of overweight and obesity using a verbal scale and 47% (95% CI 36%-55%) using visual scales. Of the children studied, 34% (95% CI 25%-43%) underestimated their own level of overweight and obesity using both scales. In (n = 3) articles, HCPs reflected this misperception, but limited studies prevented meta-analysis. Underestimation was associated with the child's age, gender, BMI and parental weight status, ethnicity and education. In the qualitative studies, parents/main carers of children with overweight and obesity described their child's weight in terms other than overweight, for example, "big boned," "thick," and "solid." CONCLUSION The results confirm the prevalence of underestimation of child overweight status across international studies. Understanding the factors which lead to this inaccuracy may help to improve communication within the therapeutic triad and facilitate the recognition and management of children's overweight status.
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Affiliation(s)
- Abrar Alshahrani
- Division of Nutritional SciencesUniversity of NottinghamNottinghamUK
| | - Farag Shuweihdi
- Leeds Institute of Health SciencesFaculty of MedicineLeeds UniversityLeedsUK
| | - Judy Swift
- Division of Nutritional SciencesUniversity of NottinghamNottinghamUK
| | - Amanda Avery
- Division of Food, Nutrition and DieteticsUniversity of NottinghamNottinghamUK
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Ramos Salas X, Buoncristiano M, Williams J, Kebbe M, Spinelli A, Nardone P, Rito A, Duleva V, Musić Milanović S, Kunesova M, Braunerová RT, Hejgaard T, Rasmussen M, Shengelia L, Abdrakhmanova S, Abildina A, Usuopva Z, Hyska J, Burazeri G, Petrauskiene A, Pudule I, Sant'Angelo VF, Kujundzic E, Fijałkowska A, Cucu A, Brinduse LA, Peterkova V, Bogova E, Gualtieri A, Solano MG, Gutiérrez-González E, Rakhmatullaeva S, Tanrygulyyeva M, Yardim N, Weghuber D, Mäki P, Russell Jonsson K, Starc G, Juliusson PB, Heinen MM, Kelleher C, Ostojic S, Popovic S, Kovacs VA, Akhmedova D, Farpour-Lambert NJ, Rutter H, Li B, Boymatova K, Rakovac I, Wickramasinghe K, Breda J. Parental Perceptions of Children's Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017. Obes Facts 2021; 14:658-674. [PMID: 34818257 PMCID: PMC8739931 DOI: 10.1159/000517586] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 05/28/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child's weight status. The purpose of this study was to measure parental perceptions of their child's weight status and to identify predictors of potential parental misperceptions. METHODS We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children's weight status as "underweight," "normal weight," "a little overweight," or "extremely overweight." We categorized children's (6-9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child's weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. RESULTS Overall, 64.1% of parents categorized their child's weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child's weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child's weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28-1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26-1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98-1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99-1.24). Overall, parents' BMI was not strongly associated with the underestimation of children's weight status, but there was a stronger association in some countries. DISCUSSION/CONCLUSION Our study supplements the current literature on factors that influence parental perceptions of their child's weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents' knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
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Affiliation(s)
- Ximena Ramos Salas
- WHO European Office for Prevention and Control of NCDs, Country Health Programmes, WHO Regional Office for Europe, Copenhagen, Denmark
- European Association for the Study of Obesity, Teddington, United Kingdom
| | | | - Julianne Williams
- European Association for the Study of Obesity, Teddington, United Kingdom
| | - Maryam Kebbe
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | | | - Ana Rito
- National Institute of Health Dr. Ricardo Jorge I.P., Lisbon, Portugal
| | - Vesselka Duleva
- National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
| | - Sanja Musić Milanović
- University of Zagreb, School of Medicine/Croatian Institute of Public Health, Zagreb, Croatia
| | - Marie Kunesova
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | | | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lela Shengelia
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Shynar Abdrakhmanova
- National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Akbota Abildina
- National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | | | | | | | - Aušra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Centre for Disease Prevention and Control, Riga, Latvia
| | | | | | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Alexandra Cucu
- Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Romania, Bucharest, Romania
| | - Lacramioara Aurelia Brinduse
- Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Romania, Bucharest, Romania
| | - Valentina Peterkova
- Institute of Pediatric Endocrinology, Endocrine Research Centre, Moscow, Russian Federation
| | - Elena Bogova
- Institute of Pediatric Endocrinology, Endocrine Research Centre, Moscow, Russian Federation
| | | | - Marta García Solano
- Observatory of Nutrition and Study of Obesity, Spanish Agency for Food Safety & Nutrition, Ministry of Health, Madrid, Spain
| | - Enrique Gutiérrez-González
- Observatory of Nutrition and Study of Obesity, Spanish Agency for Food Safety & Nutrition, Ministry of Health, Madrid, Spain
| | - Sanavbar Rakhmatullaeva
- Department for Organization of Health Services to Children, Mothers, Adolescents and Family Planning, Ministry of Health and Social Protection of the Population, Dushanbe, Tajikistan
| | - Maya Tanrygulyyeva
- Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health, Ashgabat, Turkmenistan
| | - Nazan Yardim
- Ministry of Health, Public Health General Directorate, Ankara, Turkey
| | - Daniel Weghuber
- WHO European Office for Prevention and Control of NCDs, Country Health Programmes, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Päivi Mäki
- European Association for the Study of Obesity, Teddington, United Kingdom
| | | | | | | | - Mirjam M. Heinen
- National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
| | - Cecily Kelleher
- National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
| | - Sergej Ostojic
- University of Zagreb, School of Medicine/Croatian Institute of Public Health, Zagreb, Croatia
| | - Stevo Popovic
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | - Dilorom Akhmedova
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Harry Rutter
- National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Bai Li
- Centre for Health Promotion, Bishkek, Kyrgyzstan
| | | | - Ivo Rakovac
- European Association for the Study of Obesity, Teddington, United Kingdom
| | - Kremlin Wickramasinghe
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Joao Breda
- European Association for the Study of Obesity, Teddington, United Kingdom
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Lotrean LM, Popa I, Florea M, Lazea C, Stanescu AMA, Lencu C. Actual Weight, Perceived Weight and Desired Weight of Romanian School Children by Parents and Children. ACTA ACUST UNITED AC 2021; 57:medicina57040333. [PMID: 33915949 PMCID: PMC8066543 DOI: 10.3390/medicina57040333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The perception of the body weight by children and parents influences the consequent actions undertaken for children’s body weight management. This study investigated the correspondence between objective evaluations of Romanian school children (actual weight) and perceptions about weight (perceived weight), preoccupation with body weight management (desired weight) and parents’ perceptions on children’s weight. Materials and Methods: A cross sectional study was performed among 344 children aged 11 to 14 and 147 parents from Cluj-Napoca, Romania. We made anthropometric measurements of children, and short questionnaires were completed by the children and the parents. Results: The results show that 3.8% of children were underweight, 68.3% had a normal weight and 27.9% were overweight. Of this sample, 61.5% of underweight children, 20% of normal weight children and 43.7% of overweight children had misperceptions about their weight. The percentage of parents who did not estimate their children’s weight correctly was 50%, 11.9% and 41.5%, respectively, for each of the three weight groups. The results of the logistic regression analyses showed that several factors were associated with the misclassification of their own body weight by the children, such as body mass index, gender, weight management practices, misclassification by the parents as well as parent–child discussions on these issues. Conclusions: Education for both Romanian parents and children is needed with regard to correctly identifying and managing children’ body weight.
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Affiliation(s)
- Lucia Maria Lotrean
- Department of Community Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Ioana Popa
- Dietician, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Mira Florea
- Family Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: or
| | - Cecilia Lazea
- Department Pediatrics I, Emergency Pediatric Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | | | - Codruta Lencu
- Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
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Bektas G, Boelsma F, Baur VE, Seidell JC, Dijkstra SC. Parental Perspectives and Experiences in Relation to Lifestyle-Related Practices in the First Two Years of a Child's Life: A Qualitative Study in a Disadvantaged Neighborhood in The Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165838. [PMID: 32806644 PMCID: PMC7460357 DOI: 10.3390/ijerph17165838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023]
Abstract
The first two years of a child's life are a critical period in preventing several lifestyle-related health problems. A qualitative study was conducted to explore parental experiences and perspectives in relation to lifestyle-related child-rearing practices in order to minimize risk factors at an early stage. Data were collected through interviews (n = 25) and focus groups (n = 4) with parents of children aged 0-2 years, in a disadvantaged neighborhood in Amsterdam, the Netherlands. Results showed that parents were often uncertain about a number of lifestyle-related practices. Ambiguity also appeared regarding the parents' intentions to engage in certain practices and what they were able to achieve in everyday life. In addition, parents experienced strong sociocultural influences from their family, which interfered with their ability to make their own decisions on lifestyle-related practices. Parents also expressed a need for peer-support and confirmation of their practices. Future studies should focus on supporting parents in their parental practices during the first two years of their child's life. Any such study should take into account the specific sociocultural context accompanying lifestyle-related parental practices.
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Affiliation(s)
- Gülcan Bektas
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands; (F.B.); (J.C.S.)
- Correspondence: (G.B.); (S.C.D.); Tel.: +31-20-598-28-02 (G.B.); +31-20-598-61-28 (S.C.D.)
| | - Femke Boelsma
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands; (F.B.); (J.C.S.)
| | - Vivianne E. Baur
- Department of Care Ethics, University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD Utrecht, The Netherlands;
| | - Jacob C. Seidell
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands; (F.B.); (J.C.S.)
| | - S. Coosje Dijkstra
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands; (F.B.); (J.C.S.)
- Correspondence: (G.B.); (S.C.D.); Tel.: +31-20-598-28-02 (G.B.); +31-20-598-61-28 (S.C.D.)
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13
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Brown CL, Howard JB, Perrin EM. A randomized controlled trial examining an exam room poster to prompt communication about weight. Pediatr Obes 2020; 15:e12625. [PMID: 32072772 PMCID: PMC8394047 DOI: 10.1111/ijpo.12625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/19/2019] [Accepted: 01/20/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Recognition of childhood weight status is important to the adoption of healthy lifestyle behaviours. OBJECTIVES We assessed whether an exam room educational poster addressing weight and healthy lifestyle behaviours was acceptable to parents, prompted parent-provider communication or improved parental weight perception accuracy. METHODS In this multi-site randomized controlled trial, exam rooms were randomized to display the posters (English and Spanish) or not. Children ages 3 to 8 years (N = 965) attending well visits were weighed and roomed per usual clinic protocol. After the visit, parents completed a questionnaire assessing demographics, child weight status perceptions and whether they discussed weight status with provider or were shown growth charts. We used separate logistic regression analyses to examine associations between intervention status and: asking provider about child weight, being shown growth charts, and accuracy of weight perception, adjusting for covariates and clustering by exam room. RESULTS Of the parents who saw the poster, 97% liked seeing it and reported greater understanding of weight status visualization (96%) and healthy lifestyle behaviours (94%). Parents who saw the poster were more likely to report being shown a growth chart (OR 1.87, 95% 1.06, 3.30) but were not more likely to ask about their child's weight status nor accurately report their child's weight status. CONCLUSIONS An educational exam room poster about healthy weight was well-received by parents and prompted providers to show the child's growth chart but did not prompt parent-initiated conversations about weight status nor improve parental weight perception accuracy.
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Affiliation(s)
- Callie L. Brown
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina,Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Janna B. Howard
- Department of Pediatrics, Duke University, Durham, North Carolina,Duke Center for Childhood Obesity Research, Duke University, Durham, North Carolina
| | - Eliana M. Perrin
- Department of Pediatrics, Duke University, Durham, North Carolina,Duke Center for Childhood Obesity Research, Duke University, Durham, North Carolina
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Blanchet R, Kengneson CC, Bodnaruc AM, Gunter A, Giroux I. Factors Influencing Parents' and Children's Misperception of Children's Weight Status: a Systematic Review of Current Research. Curr Obes Rep 2019; 8:373-412. [PMID: 31701349 DOI: 10.1007/s13679-019-00361-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Misperception of children's weight status is prevalent among parents and children themselves and may impact parents' and children's health behaviors. This study was conducted in order to provide a descriptive systematic review of research on factors influencing parents' and children's misperceptions of children's weight status published in the past 5 years. RECENT FINDINGS Factors studied most often in relation to parents' and children's misperception included children's weight status, gender, and age, as well as parents' weight status, parental education levels and socioeconomic status, and ethnicity. Most determinants that were found to have a significant influence on misperception in parents also did in children. The literature on misperception of children's weight status is extensive. Most determinants assessed in included studies were known determinants of childhood obesity. Further research should be directed toward better understanding the impact of weight status perception (whether it is accurate or not) on health behaviors and weight gain over time.
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Affiliation(s)
- Rosanne Blanchet
- Department of Agricultural, Food & Nutritional Sciences, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Canada
| | - Cris-Carelle Kengneson
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Alexandra M Bodnaruc
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Ashley Gunter
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
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15
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Jones AR, Tovée MJ, Cutler LR, Parkinson KN, Ells LJ, Araujo-Soares V, Pearce MS, Mann KD, Scott D, Harris JM, Adamson AJ. Development of the MapMe intervention body image scales of known weight status for 4-5 and 10-11 year old children. J Public Health (Oxf) 2019; 40:582-590. [PMID: 29190364 PMCID: PMC6266708 DOI: 10.1093/pubmed/fdx129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 09/18/2017] [Indexed: 11/12/2022] Open
Abstract
Background Parents tend to visually assess children to determine their weight status and typically underestimate child body size. A visual tool may aid parents to more accurately assess child weight status and so support strategies to reduce childhood overweight. Body image scales (BIS) are visual images of people ranging from underweight to overweight but none exist for children based on UK criteria. Our aim was to develop sex- and age-specific BIS for children, based on British growth reference (UK90) criteria. Methods BIS were developed using 3D surface body scans of children, their associated weight status using UK90 criteria from height and weight measurements, and qualitative work with parents and health professionals. Results Height, weight and 3D body scans were collected (211: 4–5 years; 177: 10–11 years). Overall, 12 qualitative sessions were held with 37 participants. Four BIS (4–5-year-old girls and boys, 10–11-year-old girls and boys) were developed. Conclusions This study has created the first sex- and age-specific BIS, based on UK90 criteria. The BIS have potential for use in child overweight prevention and management strategies, and in future research. This study also provides a protocol for the development of further BIS appropriate to other age groups and ethnicities.
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Affiliation(s)
- A R Jones
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - M J Tovée
- School of Psychology, University of Lincoln, Lincoln, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - L R Cutler
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - K N Parkinson
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - L J Ells
- School of Health and Social Care, Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | - V Araujo-Soares
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - M S Pearce
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - K D Mann
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - D Scott
- Department of Public Health and Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - J M Harris
- School of Psychology and Neuroscience. University of St Andrews, Fife, UK
| | - A J Adamson
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
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16
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Talking About Childhood Obesity: A Survey of What Parents Want. Acad Pediatr 2019; 19:756-763. [PMID: 30867135 DOI: 10.1016/j.acap.2019.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/17/2019] [Accepted: 03/02/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Determine parent preferences when discussing their child's weight with regard to weight-based terms, terms that are the most motivating, preferred setting, and whether or not awareness of their child's weight status impact these preferences. METHODS Parents of children ages 3 to 17 years (N = 349) presenting for health supervision visits completed a survey to assess the degree of offensiveness and motivation for change of commonly used weight-based terminology, as well as the preferred setting for discussion of weight. Parents were asked to assess their child's weight status using recommended terminology ("obese," "overweight," "healthy weight," "underweight"), and their responses were compared to the children's objective body mass index (BMI) percentile. RESULTS The children had a median age of 10.3 years; 47.3% were female, 15.8% had overweight (85th-94th percentile BMI), and 11.5% had obesity (≥95th percentile BMI). Of children with overweight/obesity, 84.2% of parents underestimated their child's weight status. The least offensive terms were "at-risk weight," "BMI is high," "BMI is above 95%," and "unhealthy weight." The more offensive terms (P < .001) were "overweight" and "obese." The parent's perception of their child's weight did not affect offensiveness ratings. "Obese" was the strongest motivator for change (P < .001), and "unhealthy weight" was next. Well visits were preferred for discussing weight (P < .001). Most parents preferred to have the child remain in the room (P < .001), especially if the child was older (P < .001). CONCLUSIONS Providers should use preferred terms when discussing excess weight regardless of a parent's perception of their child's status and should also consider the motivational value of the term. "Unhealthy weight" was both preferred and motivating, but "obese" was the most motivating.
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17
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Firman N, Dezateux C. Does parental concern about their child's future risk of overweight vary by their ethnic background? Cross-sectional analysis of a national cohort study. BMJ Open 2019; 9:e027226. [PMID: 31471432 PMCID: PMC6720322 DOI: 10.1136/bmjopen-2018-027226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Children from South Asian ethnic backgrounds are at increased risk of obesity and its associated future health risks; however, evidence is lacking as to whether parental concern about their child's future overweight risk varies by ethnic background. We hypothesised that parents of 5-year-old children from South Asian backgrounds would be more likely to express such concerns. DESIGN Cross-sectional. SETTING UK. PARTICIPANTS 15 039 singleton 5-year-old Millennium Cohort Study participants (48.9% girls; 86.7% White). PRIMARY OUTCOME MEASURE Parent-reported concern (some/none) about future overweight risk. METHODS We estimated the adjusted ORs (aORs) of some parental concern (ranging from a little to very concerned) by child's ethnic background (reference group: White), adjusted for parent and child weight status, and child sex. RESULTS Parents of girls from Pakistani (aOR 0.4; 95% CI 0.2 to 0.5), Bangladeshi (0.3; 0.2 to 0.5), Black African (0.5; 0.3 to 0.7) and Mixed (0.7; 0.5 to 0.99) ethnic backgrounds and of boys from Pakistani ethnic backgrounds (0.6; 0.4 to 0.9) were less likely to report concern about their child's future overweight risk than parents of White girls and boys, respectively. Overweight (2.5; 2.2 to 2.8) and obesity (6.7; 5.7 to 7.9) in children, and overweight (1.4; 1.2 to 1.5) and obesity (1.9; 1.7 to 2.2) in parents, were associated with increased likelihood of concern. CONCLUSIONS Parents of children from South Asian ethnic backgrounds express less concern about their child's future overweight risk. Qualitative studies are needed to understand the concerns of parents from different ethnic backgrounds to inform weight-management interventions in ethnically diverse populations.
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Affiliation(s)
- Nicola Firman
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Carol Dezateux
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Davidson K, Vidgen H, Denney‐Wilson E. Parental opinions about the responsibility for assessing children’s weight status – a survey of Rockhampton parents. Aust N Z J Public Health 2019; 43:436-442. [DOI: 10.1111/1753-6405.12928] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/01/2019] [Accepted: 06/01/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Kamila Davidson
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology
| | - Helen Vidgen
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology
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Sallis A, Porter L, Tan K, Howard R, Brown L, Jones A, Ells L, Adamson A, Taylor R, Vlaev I, Chadborn T. Improving child weight management uptake through enhanced National Child Measurement Programme parental feedback letters: A randomised controlled trial. Prev Med 2019; 121:128-135. [PMID: 30771362 DOI: 10.1016/j.ypmed.2019.01.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/15/2019] [Accepted: 01/29/2019] [Indexed: 01/20/2023]
Abstract
This single-blind, pragmatic, cluster randomised controlled trial aims to investigate uptake of children's weight management services in response to enhanced National Child Measurement Programme (NCMP) letters providing weight status feedback to parents in three English counties in 2015. Parents of 2642 overweight or very overweight (obese) children aged 10-11 years received an intervention or control letter informing them of their child's weight status. Intervention letters included (i) a visual tool to help weight status recognition, (ii) a social norms statement, and for very overweight children, (iii) a prepopulated booking form for weight management services. The primary outcome was weight management service enrolment. Additional outcome measures included attendance at and contact made with weight management services, and a number of self-report variables. A small effect was observed, with intervention parents being significantly more likely to enrol their children in weight management services (4.33% of Intervention group) than control parents (2.19% of Control group) in both unadjusted (OR = 2.08, p = .008) and adjusted analyses (AOR = 2.48, p = .001). A similar picture emerged for contact with services (4.80% Intervention vs. 2.41% Control; OR = 2.10, p = .003; AOR = 2.46, p < .001) and attendance at services, although group differences in the latter measure were not significant after corrections for multiple comparisons (1.89% Intervention vs. 1.02% Control; AOR = 2.11, p = .047). No effects were found on self-report variables. Theoretically informed weight status feedback letters appear to be an effective strategy to improve enrolment in paediatric weight management services.
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Affiliation(s)
- A Sallis
- PHE Behavioural Insights Team (PHE BI), Research, Translation & Innovation Division, 6th Floor, Wellington House, 133-155 Waterloo Road, London SE1 8UG, United Kingdom of Great Britain and Northern Ireland.
| | - L Porter
- PHE Behavioural Insights Team (PHE BI), Research, Translation & Innovation Division, 6th Floor, Wellington House, 133-155 Waterloo Road, London SE1 8UG, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Exeter, Washington Singer Laboratories, Perry Road, Exeter EX4 4QG, United Kingdom of Great Britain and Northern Ireland
| | - K Tan
- PHE Behavioural Insights Team (PHE BI), Research, Translation & Innovation Division, 6th Floor, Wellington House, 133-155 Waterloo Road, London SE1 8UG, United Kingdom of Great Britain and Northern Ireland; HM Courts and Tribunals Services, 6.02, 102 Petty France, London SW1H 9AJ, United Kingdom of Great Britain and Northern Ireland
| | - R Howard
- Leicestershire County Council, County Hall, Glenfield, Leicestershire LE3 8TB, United Kingdom of Great Britain and Northern Ireland
| | - L Brown
- PHE Behavioural Insights Team (PHE BI), Research, Translation & Innovation Division, 6th Floor, Wellington House, 133-155 Waterloo Road, London SE1 8UG, United Kingdom of Great Britain and Northern Ireland
| | - A Jones
- Human Nutrition Research Centre and Institute of Health & Society, Newcastle University, M1.51 William Leech Building, Framlington Place, Newcastle-Upon-Tyne NE2 4HH, United Kingdom of Great Britain and Northern Ireland
| | - L Ells
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BA, United Kingdom of Great Britain and Northern Ireland
| | - A Adamson
- Human Nutrition Research Centre and Institute of Health & Society, Newcastle University, M1.51 William Leech Building, Framlington Place, Newcastle-Upon-Tyne NE2 4HH, United Kingdom of Great Britain and Northern Ireland
| | - R Taylor
- Health Intelligence Division, Public Health England, Wellington House, 133-155 Waterloo Road, London SE1 8UG, United Kingdom of Great Britain and Northern Ireland
| | - I Vlaev
- Warwick Business School, University of Warwick, Scarman Road, Coventry CV4 7AL, United Kingdom of Great Britain and Northern Ireland
| | - T Chadborn
- PHE Behavioural Insights Team (PHE BI), Research, Translation & Innovation Division, 6th Floor, Wellington House, 133-155 Waterloo Road, London SE1 8UG, United Kingdom of Great Britain and Northern Ireland
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Hildebrand DA, Betts NM, Gates GE. Parents' Perceptions of Childhood Obesity and Support of the School Wellness Policy. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:498-504. [PMID: 30737096 DOI: 10.1016/j.jneb.2018.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 12/10/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Investigate differences in familiarity of parents of school-aged children with school wellness polices (SWP) and perceptions of the problem of childhood obesity related to support for the SWP and school's role in providing a healthy environment. METHODS Descriptive, cross-sectional study using telephone surveys conducted in spring, 2016. T test statistics compared differences between parents with high vs low SWP familiarity and agreement vs disagreement of childhood obesity as problematic. RESULTS Nearly half of parents (49.5%) had low familiarity with SWP. Overall, fewer parents agreed that obesity was a local school problem compared with a statewide problem (P < .001). Differences in agreement about childhood obesity explained some differences in SWP support. CONCLUSIONS AND IMPLICATIONS Greater awareness is needed among parents of schoolchildren regarding the SWP as well as the prevalence of childhood obesity. This could be achieved through increased development, implementation, and evaluation of communication efforts between schools and families regarding health-promoting environments.
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Affiliation(s)
- Deana A Hildebrand
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK.
| | - Nancy M Betts
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
| | - Gail E Gates
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
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Factors that Influence Parental Misperception of Their Child's Actual Weight Status in South Carolina. Matern Child Health J 2019; 22:1077-1084. [PMID: 29473136 DOI: 10.1007/s10995-018-2491-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives Studies suggest that parents tend to misperceive their child's actual weight status and typically underestimate their child's weight. Since few studies examine the factors that influence parental misperception, this study aims to assess the influence of parent and child factors with parental misperception of their child's actual weight status who were either at their recommended weight or overweight/obese in South Carolina in 2013 and 2014. Methods Secondary data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) and the Children's Health Assessment Survey (CHAS) in 2013 and 2014 in SC. Parental misperception of child's actual weight status was measured by comparing parental perception to their child's actual weightstatus measured via BMI. Logistic regression was conducted to assess the association between parental and child factors with parental misperception of child's weight status. Results In the adjusted multivariate analysis, only child's age was significantly and positively associated with parental misperception of their child's actual weight status. Conclusions for Practice This cross sectional analysis showed an association between child's age and parental misperception of child's actual weight status. It is essential to educate parents about their children's weight status, especially among young children.
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Kim LP, Mallo N. Maternal Perceptions of Self-Weight and Child Weight May Influence Milk Choice of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). J Obes 2019; 2019:3654728. [PMID: 30719345 PMCID: PMC6335787 DOI: 10.1155/2019/3654728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 12/11/2018] [Indexed: 11/17/2022] Open
Abstract
Objective To examine the association between maternal perceptions of self-weight and child weight status and milk consumption behavior of Hispanic WIC participants. Methods Mixed methods design with phone survey (n=529) and one-on-one interviews (n=35). Demographic characteristics, Chi-square, and thematic analyses were conducted. Results More than half of overweight mothers misperceived their own weight status as well as those of their children. Mothers who perceived their child to be overweight were more likely to make a healthier food choice for their family, namely, choosing reduced-fat milk instead of whole milk. Qualitative interviews revealed a cultural preference for larger size children, and mothers defined healthy weight for their child as a function of (1) the child's ability to be as active as other children their age, regardless of child's BMI, and (2) the pediatrician's opinion of the child's weight status. Conclusions Maternal perception of self-weight and child weight status seems to guide milk choices. Mothers may have some level of recognition of overweight in themselves and their child, thus adopting healthier milk choices. Culturally related perceptions should be considered when designing obesity prevention strategies, and the role of a pediatrician cannot be understated when developing obesity prevention programs for Hispanic families.
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23
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Validity of Maternal-Reported Weight and Height of 2-5 Year Old Children. Indian J Pediatr 2018; 85:567-568. [PMID: 24788912 DOI: 10.1007/s12098-014-1400-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 03/05/2014] [Indexed: 10/25/2022]
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'A little bit offended and slightly patronised': parents' experiences of National Child Measurement Programme feedback. Public Health Nutr 2018; 21:2884-2892. [PMID: 29914583 DOI: 10.1017/s1368980018001556] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop a descriptive account of parents' experiences of written feedback from the National Child Measurement Programme (NCMP), based on primary data collected from semi-structured focus groups. DESIGN Four focus groups were held with a purposive sample of parents who had recently received written weight feedback from the NCMP in one local authority in England. Thematic data analysis was undertaken to develop a narrative of emergent themes regarding parents' experiences and the social influences shaping this.Setting/SubjectsThe population of interest was parents of 4- and 5-year-olds who had recently received written feedback from the NCMP. Eighteen parents participated and represented the full spectrum of categories provided in NCMP feedback (under-, healthy, over- and very overweight). RESULTS Participants often rejected overweight feedback as lacking in credibility and considered NCMP communication to be targeting parents other than themselves. Family and peers collaborated in the dismissal of overweight feedback, further legitimising participants' decision to disregard their child's overweight categorisation. CONCLUSIONS Our study provides an insight into parents' experiences of NCMP feedback, including how they relate to and understand that experience within a social context. By doing so, it makes a unique contribution to the existing body of evidence. Recommendations for practice based on the findings include further efforts to raise parents' and communities' awareness of childhood obesity, risks associated with childhood excess weight and obesity prevalence as a mainstream issue.
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Yang WY, Burrows T, MacDonald-Wicks L, Williams LT, Collins CE, Chee WSS. Parent-child feeding practices in a developing country: Findings from the Family Diet Study. Appetite 2018; 125:90-97. [DOI: 10.1016/j.appet.2018.01.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/15/2017] [Accepted: 01/30/2018] [Indexed: 11/16/2022]
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Santana GS, Giugliani ERJ, Vieira TDO, Vieira GO. Factors associated with breastfeeding maintenance for 12 months or more: a systematic review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Santana GS, Giugliani ERJ, Vieira TDO, Vieira GO. Factors associated with breastfeeding maintenance for 12 months or more: a systematic review. J Pediatr (Rio J) 2018; 94:104-122. [PMID: 28886401 DOI: 10.1016/j.jped.2017.06.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 04/10/2017] [Accepted: 04/21/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Synthesize the information about the factors associated with maintenance of breastfeeding for 12 months or more. DATA SOURCE A systematic review was conducted in the Pubmed/Medline, Scielo, and Lilacs databases, including articles published in Portuguese or English since 2004 on the factors associated with breastfeeding maintenance for at least 12 months; review articles and those with qualitative design were excluded. The factors were organized into four levels, according to the chronological proximity to the outcome: distal, distal intermediate, proximal intermediate, and proximal; nationality and place/area of residence were considered contextual factors. SUMMARY OF DATA 1174 articles were identified, of which 19 were included in this review, comprising seven cohort studies and 12 cross-sectional studies. A total of 39 of the 75 assessed factors were associated with the outcome at least once. The factors with the highest percentages of associations with maintenance of breastfeeding for 12 months or more, considering the number of times they were tested were: children whose parents are the caregivers (100%), none type of maternal exposure to smoke (54%), children and/or parents are immigrants/foreigners (50%), live in urban areas (42.9%), older maternal age (40%), married women (37.5%), higher level of maternal education (31.3%), greater parity (30.8%), and lower income (30%). CONCLUSIONS The maintenance of breastfeeding for 12 months or more is associated with multiple factors, emphasizing the contextual factors and those related to some maternal sociodemographic characteristics. Associations differ in effect and magnitude between the different populations studied.
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Affiliation(s)
- Géssica S Santana
- Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil.
| | - Elsa Regina J Giugliani
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil
| | | | - Graciete O Vieira
- Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil
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Adeniyi OF, Ekure E, Olatona FA, Ajayi EO, Nworgu N. Nutritional Assessment and Maternal Perception of Toddler Body Size using Toddler Silhouette Scale in Nigeria a Developing Country. Int J MCH AIDS 2018; 7:9-16. [PMID: 30305985 PMCID: PMC6168796 DOI: 10.21106/ijma.217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The toddler silhouettes scales have been validated in the caucascian population in developing countries but in the African population, the use of these scales is yet to be evaluated. The aim of this study was to determine the perception of mothers on the body size of toddlers using a validated scale in an African population. METHODS This was a cross sectional study of 241 mothers and their toddlers. Study participants were recruited from the immunization and pediatric clinics. The mothers' perceptions of the body sizes of toddlers and their own child was determined with the use of a validated 7-scale toddler silhouette. Each mother also assessed their own child with the scale. Each child's anthropometry was documented. RESULTS Majority of the mothers were able to correctly classify the underweight (95.0%) and overweight toddler silhouettes (95.7%). However, 30% of the respondents misclassified Silhouette 6 (overweight silhouette) as normal and 48.2% of the respondents misclassified a normal silhouette as underweight. The overall maternal accuracy in assessing their toddler size was 41.1%. There was a significant relationship between maternal accuracy and the maternal educational status, tribe, and toddler size. CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS Toddler silhouette scales is a quick way of assessing the body size of children and could be of significant use in the developing countries. There is a need for caregivers to accurately assess the body size of their children as this will significantly influence the food mothers will give their children and thus children's eventual growth and development.
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Affiliation(s)
- Oluwafunmilayo Funke Adeniyi
- Department of Paediatrics, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Idi-Araba, Lagos, NIGERIA
| | - Ekanem Ekure
- Department of Paediatrics, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Idi-Araba, Lagos, NIGERIA
| | - Foluke A Olatona
- Department of Community Health, College of Medicine, University of Lagos, NIGERIA
| | - Elizabeth O Ajayi
- Department of Paediatrics, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Idi-Araba, Lagos, NIGERIA
| | - Nwaoma Nworgu
- Department of Paediatrics, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Idi-Araba, Lagos, NIGERIA
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Abstract
PURPOSE Obesity prevention efforts may be ineffective if parents lack awareness of their children's overweight status. This study examined the factors that predicted parents' underestimation of child weight status. DESIGN AND METHODS Using a cross sectional design, researchers recruited children and parents in a local children's museum. Parents completed a demographic questionnaire, the Newest Vital Sign, and the Child Body Image Scale. Children's height and weight were measured to calculate child BMI. Random effects modeling examined the association between predictor variables (parent race/ethnicity, income, education, and health literacy, and child BMI percentile, gender, and age) and the dependent variable, parent underestimation of child weight status. RESULTS Participants included 160 parents (213 children aged 7-12years) representing a racially and ethnically diverse sample who were affluent, educated, and with 36.6% of parents assessed with limited health literacy. Although 45.1% of children were overweight/obese, only 7.5% of parents chose this weight status; 80% of parents underestimated the weight of their normal weight children, 96% underestimated their overweight children, and 72% underestimated their obese children. Parents were more likely to underestimate weight of older children and those under 81st percentile of BMI. No other predictors were significant. CONCLUSIONS Parent underestimation of child weight status appears to be a widespread phenomenon in this sample, regardless of race, ethnicity, income, education, and health literacy. PRACTICE IMPLICATIONS The consistent underestimation of child weight suggests that parents' misperception of weight status represents a critical pathway for intervention. Methods to improve parents' perception of child weight need be developed and tested.
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Affiliation(s)
- Carol J Howe
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, United States.
| | - Gina Alexander
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, United States.
| | - Jada Stevenson
- Department of Nutritional Sciences, College of Science and Engineering, Texas Christian University, Fort Worth, TX, United States.
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Vangeepuram N, Ramos MA, Fei K, Fox AM, Horowitz CR, Kleinman LC, Galvez MP. Are Parental Perceptions of Child Activity Levels and Overall Health More Important than Perceptions of Weight? Matern Child Health J 2017; 20:1456-63. [PMID: 27010551 DOI: 10.1007/s10995-016-1944-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives To examine relationships between parental perceptions of child weight and overall health, reported lifestyle behaviors and measured body mass index (BMI). Methods Using community-partnered methods, we surveyed families residing in a two census tract area identified for targeted interventions to decrease diabetes related disparities. The survey included demographics, child dietary and physical activity behaviors, and parental perception of child's health and weight. We measured child BMI using a standardized protocol. Results We surveyed parents of 116 children with a mean age of 7 years (range 3-15) with 51 % boys, 74 % Hispanic, and 26 % Black. Over half of the children (55 %) were overweight or obese. Half (50 %) of the parents underestimated their children's weight. Reported daily hours of walking and/or running trended higher (3.6 vs. 2.6 h, p = 0.08) for children perceived to be of normal weight. Parents who correctly estimated their child's weight status reported more hours of daily walking/running than parents who underestimated child weight status, 4.5 versus 2.4 h, p = 0.0002. Parents of healthy weight children were more likely to report that children were in excellent or very good health compared to parents of overweight/obese children, 75 versus 56 % respectively (p = 0.04). We found significant racial/ethnic differences in reported diet and physical activity behaviors and perception of overall health. Conclusions for Practice Parental perceptions of child health and physical activity level may be related to perceptions of their child's weight status. Study findings informed community-based initiatives for reducing diabetes risk among children.
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Affiliation(s)
- Nita Vangeepuram
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY, 10029, USA.
| | - Michelle A Ramos
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY, 10029, USA
| | - Kezhen Fei
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY, 10029, USA
| | - Ashley M Fox
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY, 10029, USA
| | - Carol R Horowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY, 10029, USA
| | - Lawrence C Kleinman
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY, 10029, USA
| | - Maida P Galvez
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY, 10029, USA
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Bentley F, Swift JA, Cook R, Redsell SA. "I would rather be told than not know" - A qualitative study exploring parental views on identifying the future risk of childhood overweight and obesity during infancy. BMC Public Health 2017; 17:684. [PMID: 28851331 PMCID: PMC5576317 DOI: 10.1186/s12889-017-4684-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 08/16/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Risk assessment tools provide an opportunity to prevent childhood overweight and obesity through early identification and intervention to influence infant feeding practices. Engaging parents of infants is paramount for success however; the literature suggests there is uncertainty surrounding the use of such tools with concerns about stigmatisation, labelling and expressions of parental guilt. This study explores parents' views on identifying future risk of childhood overweight and obesity during infancy and communicating risk to parents. METHODS Semi-structured qualitative interviews were conducted with 23 parents and inductive, interpretive and thematic analysis performed. RESULTS Three main themes emerged from the data: 1) Identification of infant overweight and obesity risk. Parents were hesitant about health professionals identifying infant overweight as believed they would recognise this for themselves, in addition parents feared judgement from health professionals. Identification of future obesity risk during infancy was viewed positively however the use of a non-judgemental communication style was viewed as imperative. 2) Consequences of infant overweight. Parents expressed immediate anxieties about the impact of excess weight on infant ability to start walking. Parents were aware of the progressive nature of childhood obesity however, did not view overweight as a significant problem until the infant could walk as viewed this as a point when any excess weight would be lost due to increased energy expenditure. 3) Parental attributions of causality, responsibility, and control. Parents articulated a high level of personal responsibility for preventing and controlling overweight during infancy, which translated into self-blame. Parents attributed infant overweight to overfeeding however articulated a reluctance to modify infant feeding practices prior to weaning. CONCLUSION This is the first study to explore the use of obesity risk tools in clinical practice, the findings suggest that identification, and communication of future overweight and obesity risk is acceptable to parents of infants. Despite this positive response, findings suggest that parents' acceptance to identification of risk and implementation of behaviour change is time specific. The apparent level of parental responsibility, fear of judgement and self-blame also highlights the importance of health professionals approach to personalised risk communication so feelings of self-blame are negated and stigmatisation avoided.
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Affiliation(s)
- Faye Bentley
- Anglia Ruskin University, Cambridge, United Kingdom
| | - Judy Anne Swift
- Behavioural Nutrition, University of Nottingham, Nottingham, United Kingdom
| | - Rachel Cook
- Department of Psychology, Anglia Ruskin University, Cambridge, United Kingdom
| | - Sarah A Redsell
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, United Kingdom
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Epidemiology of adult overweight recording and management by UK GPs: a systematic review. Br J Gen Pract 2017; 67:e676-e683. [PMID: 28847775 PMCID: PMC5604831 DOI: 10.3399/bjgp17x692309] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 05/21/2017] [Indexed: 11/22/2022] Open
Abstract
Background Primary care guidelines for managing adult overweight/obesity recommend routine measurement of body mass index (BMI) and the offer of weight management interventions. Many studies state that this is rarely done, but the extent to which overweight/obesity is recognised, considered, and documented in routine care has not been determined. Aim To identify the epidemiology of adult overweight documentation and management by UK GPs. Design and setting A systematic review of studies since 2006 from eight electronic databases and grey literature. Method Included studies measured the proportion of adult patients with documented BMI or weight loss intervention offers in routine primary care in the UK. A narrative synthesis reports the prevalence and pattern of the outcomes. Results In total, 2845 articles were identified, and seven were included; four with UK-wide data and three with regional-level data. The proportion of patients with a documented BMI was 58–79% (28–37% within a year). For overweight/obese patients alone, 43–52% had a recent BMI record, and 15–42% had a documented intervention offer. BMI documentation was positively associated with older age, female sex, higher BMI, coexistent chronic disease, and higher deprivation. Conclusion BMI is under-recorded and weight loss interventions are under-referred for primary care adult patients in the UK despite the obesity register in the Quality and Outcomes Framework (QOF). The review identified likely underserved groups such as younger males and otherwise healthy overweight/obese individuals to whom attention should now be directed. The proposed amendment to the obesity register QOF could prompt improvements but has not been adopted for 2017.
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Ramiro-González MD, Sanz-Barbero B, Royo-Bordonada MÁ. Exceso de peso infantil en España 2006-2012. Determinantes y error de percepción parental. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Parental optimism about childhood obesity-related disease risks. Int J Obes (Lond) 2017; 41:1467-1472. [PMID: 28465611 PMCID: PMC5626577 DOI: 10.1038/ijo.2017.103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 03/30/2017] [Accepted: 04/19/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Most parents believe childhood obesity is a problem for society, but not for their own children. We sought to understand whether parents' risk assessment was skewed by optimism, the tendency to overestimate one's chances of experiencing positive events. METHODS We administered a national web-based survey to 502 parents of 5-12-year-old children. Parents reported the chances that (a) their child and (b) 'a typical child in their community' would be overweight or obese, and develop hypertension, heart disease, type 2 diabetes and depression in adulthood. Respondents self-reported demographic and health information, and we obtained demographic and health information about the typical child using zip code-level census and lifestyle data. We used regression models with fixed effects to evaluate whether optimism bias was present in parent predictions of children's future health outcomes. RESULTS Parents had 40 times lower adjusted odds (OR=0.025, P<0.001, 99% CI: 0.006, 0.100) of predicting that their child (versus a typical child) would be overweight or obese in adulthood. Of the 20% of parents who predicted their child would be overweight in adulthood, 93% predicted the typical child would also be overweight in adulthood. Controlling for health and demographic characteristics, parents estimated that their children's chances of developing obesity-related comorbidities would be 12-14 percentage points lower those that of a typical child. CONCLUSIONS Parent risk assessment is skewed by optimism, among other characteristics. More accurate risk perception could motivate parents to engage in behavior change.
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Parkinson KN, Reilly JJ, Basterfield L, Reilly JK, Janssen X, Jones AR, Cutler LR, Le Couteur A, Adamson AJ. Mothers' perceptions of child weight status and the subsequent weight gain of their children: a population-based longitudinal study. Int J Obes (Lond) 2017; 41:801-806. [PMID: 28119532 PMCID: PMC5418556 DOI: 10.1038/ijo.2017.20] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 12/14/2017] [Accepted: 01/11/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is a plethora of cross-sectional work on maternal perceptions of child weight status showing that mothers typically do not classify their overweight child as being overweight according to commonly used clinical criteria. Awareness of overweight in their child is regarded as an important prerequisite for mothers to initiate appropriate action. The gap in the literature is determining whether, if mothers do classify their overweight child's weight status correctly, this is associated with a positive outcome for the child's body mass index (BMI) at a later stage. OBJECTIVE To explore longitudinal perceptions of child weight status from mothers of a contemporary population-based birth cohort (Gateshead Millennium Study) and relationships of these perceptions with future child weight gain. METHODS Data collected in the same cohort at 7, 12 and 15 years of age: mothers' responses to two items concerning their child's body size; child's and mother's BMI; pubertal maturation; demographic information. RESULTS Mothers' perceptions of whether their child was overweight did not change markedly over time. Child BMI was the only significant predictor of mothers' classification of overweight status, and it was only at the extreme end of the overweight range and in the obese range that mothers reliably described their child as overweight. Even when mothers did appropriately classify their child as overweight at an earlier stage, this was not related to relatively lower child BMI a few years later. CONCLUSIONS Mothers tend to classify their child as overweight in only more extreme cases. It is an important finding that no beneficial impact was shown on later child BMI in overweight children whose mothers classified their child's weight status as overweight at an earlier stage.
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Affiliation(s)
- K N Parkinson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - J J Reilly
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - L Basterfield
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - J K Reilly
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - X Janssen
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - A R Jones
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - L R Cutler
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - A Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A J Adamson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
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Reyes I, Higgins M. Parental perception of child's body mass index and health within primary care. J Am Assoc Nurse Pract 2017; 29:375-383. [PMID: 28440560 DOI: 10.1002/2327-6924.12463] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 03/03/2017] [Accepted: 03/10/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Overweight and obesity are sensitive issues to address with pediatric patients during any visit. Patients and families may not recognize that their child is overweight or obese and may not be ready to make change. The goals for this study were to collect overall statistics on the clinic in regards to weight status of children presenting for well child visits and to capture parental perception of the child's weight status in relation to child's age. METHODS A consecutive sample of parents and caregivers with a child aged 2-18 completed the survey and consented for the study on the day of the survey during a well child visit. CONCLUSIONS Parents, regardless of culture and age tended to underestimate the weight of their child. These findings further support the literature in that the younger the child, the more likely it is that the parent underestimates their weight status. IMPLICATIONS FOR PRACTICE Interventions should include early education with parents on what a healthy weight is and how it can predict future health. Addressing and recognizing early concerns and assessing parental perception can be important if educational messages are delivered throughout the span of the early years.
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Affiliation(s)
- Imelda Reyes
- Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia
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Carrillo-Larco RM, Bernabe-Ortiz A, Miranda JJ, Xue H, Wang Y. Children's weight changes according to maternal perception of the child's weight and health: A prospective cohort of Peruvian children. PLoS One 2017; 12:e0175685. [PMID: 28422975 PMCID: PMC5396911 DOI: 10.1371/journal.pone.0175685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/29/2017] [Indexed: 11/19/2022] Open
Abstract
The aim of the study was to estimate the association between maternal perception of their child’s health status and (mis)classification of their child’s actual weight with future weight change. We present cross-sectional and longitudinal analyses from the Peruvian younger cohort of the Young Lives Study. For cross-sectional analysis, the exposure was maternal perception of child health status (better, same or worse); the outcome was underestimation or overestimation of the child’s actual weight. Mothers were asked about their perception of their child’s weight (same, lighter or heavier than other children). Actual weight status was defined with IOTF BMI cut-off points. For longitudinal analysis, the exposure was (mis)classification of the child’s actual weight; the outcome was the standardized mean difference between follow-up and baseline BMI. A Generalized Linear Model with Poisson family and log-link was used to report the prevalence ratio (PR) and 95% confidence intervals (95% CI) for cross-sectional analyses. A Linear Regression Model was used to report the longitudinal analysis as coefficient estimates (β) and 95% CI. Normal weight children who were perceived as more healthy than other children were more likely to have their weight overestimated (PR = 2.06); conversely, those who were perceived as less healthy than other children were more likely to have their weight underestimated (PR = 2.17). Mean follow-up time was 2.6 (SD: 0.3) years. Overall, underweight children whose weight was overestimated were more likely to gain BMI (β = 0.44); whilst overweight children whose weight was considered to be the same of their peers (β = -0.55), and those considered to be lighter than other children (β = -0.87), lost BMI. Maternal perception of the child’s health status seems to influence both overestimation and underestimation of the child’s actual weight status. Such weight (mis)perception may influence future BMI.
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Affiliation(s)
- Rodrigo M Carrillo-Larco
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hong Xue
- Systems-Oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York, United States of America
| | - Youfa Wang
- Systems-Oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York, United States of America
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Ramiro-González MD, Sanz-Barbero B, Royo-Bordonada MÁ. Childhood Excess Weight in Spain From 2006 to 2012. Determinants and Parental Misperception. ACTA ACUST UNITED AC 2017; 70:656-663. [PMID: 28330819 DOI: 10.1016/j.rec.2017.02.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/14/2016] [Indexed: 01/23/2023]
Abstract
INTRODUCTION AND OBJECTIVES Due to the high prevalence of childhood obesity in Spain, we analyzed changes in its prevalence from 2006 to 2007 and from 2011 to 2012, as well as diet, sleep, and sedentary habits in 5- to 14-year-olds and parental misperceptions about their children's excess weight. METHODS The sample was from the Spanish National Health Surveys for 2006 to 2007 (n=5590) and for 2011 to 2012 (n=3601). Data were collected by trained personnel through telephone interviews with parents/guardians. Weight and height were self-reported and the International Obesity Task Force cutpoints were used to define overweight and obesity. RESULTS The prevalence of childhood excess weight was 30.1% from 2006 to 2007 and 29.7% from 2011 to 2012, while that of childhood obesity was 9.6% and 9%, respectively. Parental misperception of childhood excess weight increased from 60.8% to 71.4% (P<.001). Daily consumption of vegetables increased by 7.8%, while that of soft drinks and snacks decreased. This decrease was greatest in children from families with a low socioeconomic status, who also decreased their consumption of sweets and fast food. Adherence to sleep recommendations decreased by 5%, but adherence to recommended sedentary time did not change. CONCLUSIONS High childhood overweight and obesity rates remained stable in Spain from 2006 to 2007 and from 2011 to 2012, but there was an increase in parental misperception of childhood excess weight. Despite reduced consumption of soft drinks and snacks, there was low adherence to dietary recommendations, hours of sleep, and sedentary habits.
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Affiliation(s)
- María D Ramiro-González
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Belén Sanz-Barbero
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
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Wang GH, Tan TX, Cheah CSL. Preschool-Age Chinese Children's Weight Status: WHO Classification, Parent Ratings, Child/Family Characteristics. J Pediatr Nurs 2017; 33:63-69. [PMID: 27889302 DOI: 10.1016/j.pedn.2016.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 11/01/2016] [Accepted: 11/20/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE We aimed to compare preschool-age Chinese children's weight status based on the WHO guidelines with parental ratings on their children's body type, and child/family demographic characteristics. METHOD The sample included 171 preschool-age children (M=60.5months, SD=6.7; boys: 46.8%) randomly selected from 23 classrooms. Based on BMIs from their height and weight from physical examinations, the children were divided into three groups using the 2006 WHO guidelines: underweight (n=46), normal weight (n=65), and overweight (n=60). Data on the parental ratings of children's current body type, ideal body type and child/family demographic characteristics were collected with surveys. RESULTS Parents' accurately classified 91.1% of the underweight children, 52.3% of the normal weight children, and 61.7% of the overweight children. In terms of ideal body shape for their children, parents typically wanted their children to have normal weight or to remain underweight. Most of the child and family demographic characteristics were not different across children who were underweight, had normal weight, and were overweight. CONCLUSION Because parents tended to underestimate their children's weight status, it is important to increase Chinese parents' knowledge on what constitutes healthy weight, as well as the potential harm of overweight status for children's development. Training healthcare providers in kindergartens and pediatric clinics to work with parents to recognize unhealthy weight status in children is valuable.
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Affiliation(s)
| | - Tony Xing Tan
- Department of Educational and Psychological Studies, College of Education, University of South Florida, United States.
| | - Charissa S L Cheah
- Department of Psychology, University of Maryland, Baltimore County, United States
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Cullinan J, Cawley J. Parental misclassification of child overweight/obese status: The role of parental education and parental weight status. ECONOMICS AND HUMAN BIOLOGY 2017; 24:92-103. [PMID: 27915138 DOI: 10.1016/j.ehb.2016.11.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/20/2016] [Accepted: 11/07/2016] [Indexed: 06/06/2023]
Abstract
Childhood overweight and obesity is a major public health challenge for policymakers in many countries. As the most common supervisors of children's activities, parents have a potentially important role to play in obesity prevention. However, a precondition for parents to improve their children's diets, encourage them to be more physically active, or take them to see a doctor about their weight is for the parent to first recognize that their child is overweight or obese. This paper examines the extent of parental misclassification of child weight status, and its correlates, focusing on the role of parental education and the parent's own obesity status. We find evidence that, among non-obese parents, those who are better-educated report their child's weight status more accurately, but among obese parents, the better-educated are 45.18% more likely than parents with lower secondary education to give a false negative report of their child's overweight/obesity; this may reflect social desirability bias.
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Affiliation(s)
- John Cullinan
- JE Cairnes School of Business & Economics, National University of Ireland, Galway, Ireland.
| | - John Cawley
- Department of Policy Analysis and Management and Department of Economics, Cornell University, Ithaca, NY 14853, United States.
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Kelleher E, Davoren MP, Harrington JM, Shiely F, Perry IJ, McHugh SM. Barriers and facilitators to initial and continued attendance at community-based lifestyle programmes among families of overweight and obese children: a systematic review. Obes Rev 2017; 18:183-194. [PMID: 27862851 PMCID: PMC5245104 DOI: 10.1111/obr.12478] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/04/2016] [Accepted: 09/20/2016] [Indexed: 12/13/2022]
Abstract
The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community-based lifestyle programmes among families of overweight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed-method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition.
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Affiliation(s)
- E Kelleher
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - M P Davoren
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - J M Harrington
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - F Shiely
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.,HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
| | - I J Perry
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - S M McHugh
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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Vieira TDO, Martins CDC, Santana GS, Vieira GO, Silva LR. Intenção materna de amamentar: revisão sistemática. CIENCIA & SAUDE COLETIVA 2016; 21:3845-3858. [DOI: 10.1590/1413-812320152112.17962015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/27/2015] [Indexed: 11/22/2022] Open
Abstract
Resumo O presente estudo tem como objetivo identificar os fatores associados à intenção materna para amamentar (IMA) em gestantes. Foi realizada revisão sistemática de estudos de bases de dados Medical Literature Analysis and Retrieval System Online (PubMed/Medline) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). Dois revisores independentes buscaram artigos, com os “Medical Subject Headings” e os “Descritores em Ciência e Saúde”, referentes: ao aleitamento materno, à intenção e às gestantes. Foram incluídas pesquisas que apresentavam IMA como desfecho, em inglês, português e espanhol; e classificadas, quanto à qualidade metodológica, de acordo com critérios de validade interna e externa de uma pesquisa, com pontuação máxima de 30 pontos. Selecionou-se nove artigos, com qualificação metodológica entre 12 e 21 pontos, que investigaram 68 variáveis; 35 dessas se associaram à IMA. As características associadas à IMA em gestantes, relatadas em dois ou mais estudos, foram: primeira gestação, maior escolaridade e idade materna, experiência prévia com a amamentação, ausência do hábito de fumar e residir com o companheiro. O conhecimento das características associadas à IMA representa um passo fundamental no delineamento de ações que visem maior duração do aleitamento materno.
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Child obesity cut-offs as derived from parental perceptions: cross-sectional questionnaire. Br J Gen Pract 2016; 65:e234-9. [PMID: 25824183 DOI: 10.3399/bjgp15x684385] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Overweight children are at an increased risk of premature mortality and disease in adulthood. Parental perceptions and clinical definitions of child obesity differ, which may lessen the effectiveness of interventions to address obesity in the home setting. The extent to which parental and objective weight status cut-offs diverge has not been documented. AIM To compare parental perceived and objectively derived assessment of underweight, healthy weight, and overweight in English children, and to identify sociodemographic characteristics that predict parental under- or overestimation of a child's weight status. DESIGN AND SETTING Cross-sectional questionnaire completed by parents linked with objective measurement of height and weight by school nurses, in English children from five regions aged 4-5 and 10-11 years old. METHOD Parental derived cut-offs for under- and overweight were derived from a multinomial model of parental classification of their own child's weight status against school nurse measured body mass index (BMI) centile. RESULTS Measured BMI centile was matched with parent classification of weight status in 2976 children. Parents become more likely to classify their children as underweight when they are at the 0.8th centile or below, and overweight at the 99.7th centile or above. Parents were more likely to underestimate a child's weight if the child was black or South Asian, male, more deprived, or the child was older. These values differ greatly from the BMI centile cut-offs for underweight (2nd centile) and overweight (85th). CONCLUSION Clinical and parental classifications of obesity are divergent at extremes of the weight spectrum.
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Flores-Peña Y, Aguado-Barrera ME, Cerda-Flores RM, Cortés-Gutiérrez EI, Dávila-Rodríguez MI. [Maternal perception of her child's weight and unrelated children less than 1 year old]. Aten Primaria 2016; 48:579-585. [PMID: 26718345 PMCID: PMC6876006 DOI: 10.1016/j.aprim.2015.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 10/06/2015] [Accepted: 10/13/2015] [Indexed: 11/30/2022] Open
Abstract
AIMS To evaluate the maternal perception of their child's weight (MPCW) and perception of unrelated children's weight. DESIGN Cross-sectional. LOCATION Maternal and Child Nursing Health Department at 6 Units of Family Medicine. PARTICIPANTS 486 dyads (mother and child under 1 year). MAIN MEASUREMENTS The following question was applied: "I think my child is", and images were provided according the child's gender. Children's weight and height were measured. RESULTS A total of 20.5% of the mothers of overweight (OW) children accurately perceived this situation, while none of the mothers of obese (OB) children did (κ=0.14±0.03, Z=5.36, p=.001). By images, 63.3% of mothers of OW children and 33.3% of mothers of OB children perceived this situation (κ=0.01±0.02, Z=0.73, p=.46). Most mothers selected the image of OW child as the image of a healthy child (κ=-0.04±0.01, Z=-2.65, p=.008), the image of a child under 1 year (κ=-0.01±0.02, Z=-0.86, p=.38) and the image that they would like their child to look like (κ=0.0004±0.01, Z=0.02, p=.98). CONCLUSION The mothers do not perceive the OW-OB of their children.
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Affiliation(s)
- Yolanda Flores-Peña
- Facultad de Enfermería, Universidad Autónoma de Nuevo León, Monterrey, N.L., México
| | - Miguel E Aguado-Barrera
- División de Genética, Centro de Investigación Biomédica del Noreste, Instituto Mexicano del Seguro Social, Monterrey, N.L., México
| | | | - Elva I Cortés-Gutiérrez
- División de Genética, Centro de Investigación Biomédica del Noreste, Instituto Mexicano del Seguro Social, Monterrey, N.L., México
| | - Martha I Dávila-Rodríguez
- División de Genética, Centro de Investigación Biomédica del Noreste, Instituto Mexicano del Seguro Social, Monterrey, N.L., México.
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McDonald SW, Ginez HK, Vinturache AE, Tough SC. Maternal perceptions of underweight and overweight for 6-8 years olds from a Canadian cohort: reporting weights, concerns and conversations with healthcare providers. BMJ Open 2016; 6:e012094. [PMID: 27798005 PMCID: PMC5073603 DOI: 10.1136/bmjopen-2016-012094] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES The majority of mothers do not correctly identify their child's weight status. The reasons for the misperception are not well understood. This study's objective was to describe maternal perceptions of their child's body mass index (BMI) and maternal report of weight concerns raised by a health professional. DESIGN Prospective, community-based cohort. PARTICIPANTS Data were collected in 2010 from 450 mothers previously included in a longitudinal birth cohort. Mothers of children aged 6-8 years reported their child's anthropometric measures and were surveyed concerning their opinion about their child's weight. They were also asked if a healthcare provider raised any concerns regarding their child's body weight. Child BMI was categorised according to the WHO Growth Charts adapted for Canada. Descriptive statistics and bivariate analyses were used to evaluate mothers' ability to correctly identify their children's body habitus. RESULTS 74% of children had a healthy BMI, 10% were underweight, 9% were overweight and 7% were obese. 80%, 89% and 62% of mothers with underweight, overweight and obese children, respectively, believed that their child was at the right weight. The proportion of mothers who recalled a health professional raising concerns about their child being underweight, overweight, and obese was low (12.5%). CONCLUSIONS The majority of mothers with children at unhealthy weights misclassified and normalised their child's weight status, and they did not recall a health professional raising concerns regarding their child's weight. The highest rates of child body weight misclassification occurred in overweight children. This suggests that there are missed opportunities for healthcare professionals to improve knowledge exchange and early interventions to assist parents to recognise and support healthy weights for their children.
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Affiliation(s)
- Sheila W McDonald
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Population, Public, and Aboriginal Health, Alberta Health Services, Calgary, Alberta, Canada
| | - Heather K Ginez
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Angela E Vinturache
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne C Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Abstract
BACKGROUND AND OBJECTIVES Although the prevalence of childhood obesity has increased significantly in Saudi Arabia, parents are unable to appreciate obesity in their child. The objective of the study was to identify the percentage of parents who misclassify the status of child's weight, and determine whether there is a difference between those parents whose children are overweight and obese and those with children of normal weight. MATERIALS AND METHODS This cross-sectional study included 601 children aged 6-10 years. The children were recruited from the primary schools located in Al-Qassim, Saudi Arabia. The body mass index of the children was assessed in the school, and their parents responded to a self-administered questionnaire which contained questions on parental perception of the children's weight/obesity status. Data were entered and analyzed using SPSS. RESULTS Parents with overweight/obese children had significantly more misclassification than those with normal weight children. Ninety percent of parents of the 81 overweight children misclassified and reported that their child had normal weight, while 65% of parents of the 61 obese children, misclassified the child's weight status. CONCLUSIONS The level of misclassification of children's weight status by parents is high. Saudi parents with overweight and obese children do not recognize their child's weight status. Parents' awareness of childhood obesity and its negative health impact needs to be improved.
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Affiliation(s)
- Abdulrahman A Al-Mohaimeed
- Department of Family and Community Medicine, College of Medicine, Qassim University, Kingdom of Saudi Arabia
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Nnyanzi LA, Summerbell CD, Ells L, Shucksmith J. Parental response to a letter reporting child overweight measured as part of a routine national programme in England: results from interviews with parents. BMC Public Health 2016; 16:846. [PMID: 27544538 PMCID: PMC4992560 DOI: 10.1186/s12889-016-3481-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 08/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rising rates of childhood obesity have become a pressing issue in public health, threatening both the mental and physical well-being of children. Attempts to address this problem are multifaceted, and in England include the National Child Measurement Programme (NCMP) which assesses weight status in English primary school children in reception class (aged 4-5) and in year 6 (aged 10-11), with results being sent out to parents. However the effectiveness and impact of this routine parental feedback has yet to be fully understood. This paper reports one component of a mixed methods study undertaken in North East England, examining the impact of the feedback letters on parents' understanding and feelings about their child's weight status and whether or not this seemed likely to lead to behaviour change. METHODS One-to-one semi-structured interviews (n = 16) were conducted with a sample of parents/guardians after they had received their child's weight results letter. Eight parents/guardians were sub-sampled from the group whose child had been indicated to be overweight or obese and eight were from the group whose child had been indicated to be of ideal weight status. Interviews were conducted until data saturation was reached for both groups. RESULTS The reactions of parents/guardians whose children were identified as being overweight followed a sequence of behaviours ranging from shock, disgust with the programme, through denial and self-blame to acceptance, worry and intention to seek help. On the other hand, the reaction of parents/guardians whose children were identified as being ideal weight ranged from relief, pleasure and happiness through affirmation and self-congratulation to 'othering'. CONCLUSIONS Whilst overweight and obesity is often portrayed as a medical condition, parents/guardians see it as deeply rooted in their social lives and not in health terms. Parents believe that the causes of overeating and lack of exercise relate closely to the obesogenic environment, particularly the complex social and cultural milieu and time pressures within which this sample of people live. Associating this problem in feedback letters with dangerous diseases like cancer, and advising parents to visit GPs to resolve child weight issues was perceived as inappropriate by the parents, and caused controversy and anger. Given the likelihood that the NCMP will continue as a monitoring device, it is evident that the management of the process needs to be reviewed, with particular attention being paid to the feedback process. Local health authorities will need to manage parental expectations and ensure linkage with appropriately commissioned remedial weight management interventions.
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Affiliation(s)
- Lawrence A. Nnyanzi
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BA UK
| | - Carolyn D. Summerbell
- School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, TS17 6BH UK
| | - Louisa Ells
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BA UK
| | - Janet Shucksmith
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BA UK
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50
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Karunanayake CP, Rennie DC, Hildebrand C, Lawson JA, Hagel L, Dosman JA, Pahwa P. Actual Body Weight and the Parent's Perspective of Child's Body Weight among Rural Canadian Children. CHILDREN-BASEL 2016; 3:children3030013. [PMID: 27527235 PMCID: PMC5039473 DOI: 10.3390/children3030013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 07/22/2016] [Accepted: 07/28/2016] [Indexed: 01/04/2023]
Abstract
The prevalence of being overweight during childhood continues to increase in the USA and Canada and children living in rural areas are more at risk than their urban counterparts. The objectives of this study were to evaluate how well the parent’s perception of their child’s weight status correlated with objectively measured weight status among a group of rural children and to identify predictors of inaccurate parental perceptions of child’s weight status. Participants were children from the Saskatchewan Rural Health Study conducted in 2010. Self-administered questionnaires were distributed through rural schools to parents of children in grades one to eight. Parents reported their child’s height and weight and rated their child’s weight status (underweight, just about the right weight, or overweight). Standardized body mass index (BMI) categories were calculated for clinically measured height and weight and for parental report of height and weight for 584 children. Logistic regression analysis was performed to identify predictors of misclassification of the parent’s perception of child’s weight status adjusting for potential confounders. Clinically measured overweight was much higher (26.5%) compared to parental perceived overweight (7.9%). The misclassification of the child’s BMI was more likely to occur if the child was a boy (odds ratio (OR) = 1.58) or non-Caucasian (OR = 2.03). Overweight was high in this group of rural children and parental perception of weight status underestimated the actual weight status of overweight school-age children. Parental reporting of child weight status has implications for public health policy and prevention strategies. Future research should focus on assessing longitudinal effects of parental misperceptions of child’s weight status.
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Affiliation(s)
- Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- Correspondence: ; Tel.: +306-966-1647
| | - Donna C. Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Carole Hildebrand
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
| | - Joshua A. Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- Department of Medicine, College of Medicine, University of Saskatchewan, 5D40 Health Sciences Building, Box 19, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Louise Hagel
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
| | - James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- Department of Medicine, College of Medicine, University of Saskatchewan, 5D40 Health Sciences Building, Box 19, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 104, Clinic Place, Saskatoon, SK S7N 5E5, Canada
| | - the Saskatchewan Rural Health Study Team
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
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