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Healthcare professionals' perceptions of childhood obesity in Iquitos, Peru: a qualitative study. BMC Health Serv Res 2022; 22:175. [PMID: 35144599 PMCID: PMC8832769 DOI: 10.1186/s12913-022-07519-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 12/08/2021] [Indexed: 01/18/2023] Open
Abstract
Background Childhood obesity is an urgent worldwide concern associated with increased morbidity in adulthood. Healthcare professionals (HCPs) are well placed to influence childhood obesity trends and implement interventions. English-language studies regarding HCPs’ perceptions of childhood obesity are limited to high-income countries. Peru is an upper-middle-income country with regional disparities in childhood obesity prevalence. This qualitative study aims to explore HCPs’ perceptions of childhood obesity in Iquitos, Peru, where prevalence is relatively low. Methods Twenty-one HCPs with child healthcare experience were purposively recruited from two primary healthcare centres. Semi-structured, individual interviews were conducted with a translator and audio recorded. Transcribed data were analysed using thematic analysis. Results Eight themes were identified and divided into four categories: (1) HCPs’ perceptions and attitudes towards childhood obesity (level of concern regarding childhood obesity, perceived consequences of childhood obesity); (2) Factors which HCPs perceive to be important in the development of childhood obesity (parental factors, contextual factors); (3) HCPs’ perceptions of their role in childhood obesity prevention and management (educating parents about childhood obesity, regular monitoring of child growth); and (4) Barriers and facilitators in childhood obesity prevention and management (in healthcare, in schools). Conclusions HCPs had a low level of concern regarding childhood obesity in Iquitos and prioritised undernutrition. Parental factors were perceived to be the most influential in the development of childhood obesity. HCPs perceived themselves to have minimal influence due to prevailing positive views of excess weight and difficulties engaging parents. Educating parents about childhood obesity was felt to be essential to prevention and management although regular monitoring of child growth and home healthcare visits were viewed as useful additional measures. This study can help to inform the development of targeted public health strategies which are sensitive to local contexts and could prevent the upward childhood obesity trends evident elsewhere in Peru. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07519-z.
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Confiac N, Turk MT, Zoucha R, McFarland M. Mexican American Parental Knowledge and Perceptions of Childhood Obesity: An Integrative Review. HISPANIC HEALTH CARE INTERNATIONAL 2019; 18:105-116. [PMID: 31537084 DOI: 10.1177/1540415319873400] [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: 11/17/2022]
Abstract
INTRODUCTION For the past two decades, childhood obesity has remained a national public health concern, particularly among Hispanic populations. Multiple cross-sectoral obesity prevention strategies have been implemented yet remain unsuccessful in generating sustainable lifestyle changes. METHOD The purpose of this integrative review, using the Whittemore and Knafl method, was to examine the literature from 2009 to 2018 regarding Mexican American parental knowledge and perceptions of childhood obesity. The CINAHL, PubMed, PsycINFO, and ERIC databases were used to search the literature, and 13 peer-reviewed articles met the inclusion criteria. RESULTS Three main themes emerged from the literature synthesis: (1) parental misperception of child body weight and size, (2) influence of cultural health and growth beliefs on parental perception of child weight, and (3) parental perspectives of causes and consequences of childhood obesity and how to address it. However, cultural variations in parental perceptions were found; therefore, attempts to generalize Mexican Americans' cultural practices should be avoided. CONCLUSION Studies using qualitative approaches are needed to gain deeper insights about Mexican American culture regarding children's health as it relates to body weight, the roles of different family members in the Mexican American childrearing tradition, and the impact of their associated health beliefs.
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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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Foster BA, Weinstein K, Shannon J. Growing Healthy Together: protocol for a randomized clinical trial using parent mentors for early childhood obesity intervention in a Latino community. Trials 2019; 20:235. [PMID: 31023345 PMCID: PMC6485154 DOI: 10.1186/s13063-019-3342-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 04/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Latino children in the US experience high rates of obesity, increasing their risk of subsequent diabetes. There are few clinical trials among low-income, Latino families to test interventions that account for and address their unique situation. METHODS/DESIGN This trial, conducted in a Head Start (early childhood education) setting, randomly assigns children 2-5 years of age who have obesity by CDC (Centers for Disease Control and Prevention) guidelines (at least 95th percentile body mass index) and their parents to one of three conditions: (1) control, (2) parent mentor with an experimental curriculum, or (3) parent mentor with a standard curriculum (active control). We designed the experimental arm (2) using data from positive deviants: low-income, Latino families who had been successful in moving their child toward a healthy weight. Parent mentors are recruited and trained from the Head Start centers. Parent mentors then facilitate the teaching and coaching of parent-child dyads with weekly interactions over the course of a 6-month period. The primary outcome is change in adjusted body mass index z-score at the end of intervention and at 6 months post-intervention. Secondary outcomes include generalized self-efficacy, dietary intake, the home food environment, and reported physical activity. DISCUSSION This clinical trial contributes to the field by evaluating parent mentoring interventions that are potentially scalable for a population at high risk for continued obesity and subsequent morbidity and mortality. TRIAL REGISTRATION This trial was registered on October 31, 2017 (ClinicalTrials.gov identifier: NCT03330743 ).
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Affiliation(s)
- Byron A. Foster
- School of Medicine, Oregon Health and Science University, 3303 SW Bond Avenue CH16D, Portland, OR 97239 USA
| | - Kelsey Weinstein
- School of Medicine, Oregon Health and Science University, 3303 SW Bond Avenue CH16D, Portland, OR 97239 USA
| | - Jackilen Shannon
- School of Public Health, Oregon Health and Science University and Portland State University, 3181 SW Sam Jackson Park Road GH230, Portland, OR 97239 USA
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Somali, Latino and Hmong parents' perceptions and approaches about raising healthy-weight children: a community-based participatory research study. Public Health Nutr 2018; 21:1079-1093. [PMID: 28803597 PMCID: PMC9931373 DOI: 10.1017/s1368980017001719] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Immigrants in the USA are confronted with health disparities, including childhood obesity and obesity-related chronic diseases. We aimed to identify perceptions of childhood body weight, approaches to raising healthy children and desires for supportive programmes of Somali, Latino and Hmong (SLM) parents in the Twin Cities, Minnesota, USA. DESIGN Using community-based participatory research, ten focus groups (FG) were conducted with sixty-seven parents (n 28 Somali, three FG; n 19 Latino, four FG; n 20 Hmong, three FG) of 3-12-year-old children in their native language. Demographic information was collected. RESULTS SLM parents perceived that health is not necessarily weight-based; childhood obesity is caused by overeating, eating unhealthy foods and sedentary activities; traditional foods are generally healthy while American foods are generally unhealthy; and healthy children are inherently physically active. Parents identified their goals as feeding children so they would be healthy and happy, helping them be active and safe, and teaching them to cook traditional foods to be self-sufficient and maintain their cultural identity. Parents were challenged by children's unhealthy food and sedentary preferences, their own uncertainties about healthy foods and behaviours, and structural factors. Parents thought interventions could help them with these challenges, including information about healthy foods, age-appropriate portion sizes, safe places to be active and strategies tailored to their cultural norms. CONCLUSIONS SLM parents are trying to raise healthy-weight children based on their understanding of children's health, weight, diet and physical activity, while dealing with social, economic and environmental challenges and trying to maintain cultural identity and traditions.
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Jang M, Grey M, Sadler L, Jeon S, Nam S, Song HJ, Whittemore R. Factors associated with school-aged children's body mass index in Korean American families. J Adv Nurs 2017; 73:1896-1909. [DOI: 10.1111/jan.13277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Lois Sadler
- School of Nursing; Yale University; Orange CT USA
| | | | - Soohyun Nam
- School of Nursing; Yale University; Orange CT USA
| | - Hee-Jung Song
- Nutrition and Food Science; University of Maryland; College Park MD USA
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Hochdorn A, Faleiros VP, Camargo BV, Bousfield AB, Wachelke JF, Quintão IP, Azzolina D, Gregori D. Obese children are thin in parents' eyes: A psychologically, socially, or culturally driven bias? J Health Psychol 2016; 23:114-126. [PMID: 27821680 DOI: 10.1177/1359105316676328] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although obesity presents a serious health problem in children, parents often underestimate their children's overweight and obesity status. Therefore, scientific literature was systematically screened through PubMed and PsycINFO to demonstrate the psychological, social, and cultural processes that underlie this evaluation bias. A total of 37 papers that focused on research conducted in different geopolitical contexts were taken into account. Furthermore, a lexicometric analysis of the papers' conclusions was performed. The findings showed that education plays a key role in promoting parents' awareness and their realistic recognition of their children's weight. Accordingly, adequate educational support for parents should be implemented in all healthcare policies addressing childhood obesity.
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Montoya C, Boursaw B, Tigges B, Lobo ML. Mirror, Mirror on the Wall: Children's Preferences and Self-Perceptions of Weight in a Rural Hispanic Community. J Pediatr Health Care 2016; 30:528-534. [PMID: 26810855 DOI: 10.1016/j.pedhc.2015.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 11/23/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Although studies have documented parents' misperceptions regarding their children's weight, studies examining preadolescent children's self-perceptions of weight-in particular, Hispanic children's self-perceptions of weight-are limited. METHOD A convenience sample of 424 children from a rural community, aged 8 to 11 years and in grades 3 through 5, participated in this cross-sectional, descriptive, nonexperimental study. Using the Children's Body Image Scale, the children were asked to select a figure representing their actual body perception and a figure representing their ideal body perception. The children were weighed and measured, body mass index (BMI) was calculated, and each child was assigned to one of the Centers for Disease Control and Prevention weight categories: underweight, normal or healthy weight, overweight, or obese. RESULTS Only BMI category was found to be significantly associated with accurate perception, χ2(3) = 201.4, p < .001, with only 9% of overweight or obese children selecting figures representing their actual BMI category. Actual BMI category, χ2(3) = 8.8, p = .032, and grade level, χ2(2) = 6.7, p = .036, had a significant association with selection of an underweight ideal. Overall, 32% of children selected an underweight figure as ideal. DISCUSSION Prepubertal children who are either overweight or obese do not accurately perceive their weight status. Rather than focusing solely on weight reduction programs, emphasis should be placed on promoting healthy lifestyles and choices.
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Duarte LS, Fujimori E, Minagawa Toriyama AT, Palombo CNT, Borges ALV, Kurihayashi AY. Brazilian Maternal Weight Perception and Satisfaction With Toddler Body Size: A Study in Primary Health Care. J Pediatr Nurs 2016; 31:490-7. [PMID: 27132799 DOI: 10.1016/j.pedn.2016.03.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 03/15/2016] [Accepted: 03/31/2016] [Indexed: 11/15/2022]
Abstract
UNLABELLED Maternal perception and satisfaction with child's weight status are important to detect early and to successfully treat the extremes in weight, especially during early childhood, when the child is more dependent on maternal care. OBJECTIVES To assess the inaccuracy of maternal perception of toddler body size and its associated factors and to analyze maternal dissatisfaction with toddler body size. METHODS Cross-sectional study with 135 mother-toddler dyads attending Primary Health Care Facilities, São Paulo, Brazil. Children's actual weight status was classified using body mass index-for-age. Inaccuracy and dissatisfaction were assessed using an image scale. We used logistic regression to identify the factors associated with inaccuracy of maternal perception of toddler body size. RESULTS Inaccuracy in maternal perception was observed in 34.8% of participants. Mothers of excessive weight children were more likely to have inaccurate perceptions (OR=4.6; 95% CI 2.0-10.7), and mothers of children who attended well-child care were less likely to have inaccurate perceptions (OR=0.3, 95% CI 0.1-0.9). More than half of mothers (52.6%) were dissatisfied with their toddler's size and desired a larger child (75.0% of mothers of underweight children, 25.0% of mothers whose children were at risk for overweight and 23.0% of mothers of overweight children). CONCLUSION The majority of mothers were inaccurate in their perception and was dissatisfied with their toddler's body size. Maternal inaccuracy and dissatisfaction differed by the weight status of the toddler. Attendance at well-child visits was an effective way to decrease maternal inaccuracy, which reinforces the importance of the influence of health professionals.
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Affiliation(s)
- Luciane Simões Duarte
- Public Health Nursing Department of University of São Paulo School of Nursing, Brazil.
| | - Elizabeth Fujimori
- Public Health Nursing Department of University of São Paulo School of Nursing, Brazil
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Hernandez DC, Reesor L, Machuca I, Chishty M, Alonso Y. Low-Income Immigrant Hispanic Mothers' Concerns and Perceptions of Their Young Child's Weight. Public Health Nurs 2016; 33:412-20. [PMID: 26854020 DOI: 10.1111/phn.12252] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To describe how low-income Hispanic immigrant mothers' concerns and perceptions of her child's health, along with her concerns for herself becoming overweight, relate to her (a) concerns that her child will become overweight and (b) underestimation of her child's weight status. DESIGN AND SAMPLE Cross-sectional survey and direct body composition assessments were collected among 96 low-income Hispanic mothers and their young children from Houston-area community centers. MEASURES Data were collected on maternal concerns and perceptions of child's weight and health, concerns about her own weight, demographic characteristics, and measured child's height and weight. RESULTS Fifty-four percent of mothers with an overweight/obese child perceived their child was "about the right weight." Mothers concerned with becoming overweight themselves had 3 times higher odds of being concerned that her child would become overweight (OR = 3.01, p < .01). Mothers who perceived their child as less healthy had approximately 2 times higher odds of underestimating their child's weight (OR = 1.86, p < .01). CONCLUSIONS Short screeners that focus on maternal concerns about herself and her child becoming overweight, along with perceptions of her child's health and weight status, may assist nurses in effectively tailoring their health message at point of care.
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Affiliation(s)
- Daphne C Hernandez
- Department of Health and Human Performance, University of Houston, Houston, Texas.
| | - Layton Reesor
- Department of Health and Human Performance, University of Houston, Houston, Texas
| | - Iris Machuca
- Department of Health and Human Performance, University of Houston, Houston, Texas
| | - Misha Chishty
- Department of Health and Human Performance, University of Houston, Houston, Texas
| | - Yanely Alonso
- Department of Health and Human Performance, University of Houston, Houston, Texas
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Foster BA, Farragher J, Parker P, Hale DE. A positive deviance approach to early childhood obesity: cross-sectional characterization of positive outliers. Child Obes 2015; 11:281-8. [PMID: 25885174 PMCID: PMC4484711 DOI: 10.1089/chi.2014.0098] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Positive deviance methodology has been applied in the developing world to address childhood malnutrition and has potential for application to childhood obesity in the United States. We hypothesized that among children at high-risk for obesity, evaluating normal weight children will enable identification of positive outlier behaviors and practices. METHODS In a community at high-risk for obesity, a cross-sectional mixed-methods analysis was done of normal weight, overweight, and obese children, classified by BMI percentile. Parents were interviewed using a semistructured format in regard to their children's general health, feeding and activity practices, and perceptions of weight. RESULTS Interviews were conducted in 40 homes in the lower Rio Grande Valley in Texas with a largely Hispanic (87.5%) population. Demographics, including income, education, and food assistance use, did not vary between groups. Nearly all (93.8%) parents of normal weight children perceived their child to be lower than the median weight. Group differences were observed for reported juice and yogurt consumption. Differences in both emotional feeding behaviors and parents' internalization of reasons for healthy habits were identified as different between groups. CONCLUSIONS We found subtle variations in reported feeding and activity practices by weight status among healthy children in a population at high risk for obesity. The behaviors and attitudes described were consistent with previous literature; however, the local strategies associated with a healthy weight are novel, potentially providing a basis for a specific intervention in this population.
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Affiliation(s)
- Byron Alexander Foster
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Jill Farragher
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Paige Parker
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Daniel E. Hale
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
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Westefeld JS, Casper D, Lewis AM, Manlick C, Rasmussen W, Richards A, Sieck BC. Physician-Assisted Death and Its Relationship to the Human Services Professions. JOURNAL OF LOSS & TRAUMA 2013. [DOI: 10.1080/15325024.2012.719345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Aljunaibi A, Abdulle A, Nagelkerke N. Parental weight perceptions: a cause for concern in the prevention and management of childhood obesity in the United Arab Emirates. PLoS One 2013; 8:e59923. [PMID: 23555833 PMCID: PMC3608558 DOI: 10.1371/journal.pone.0059923] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 02/19/2013] [Indexed: 11/18/2022] Open
Abstract
Parental participation is a key factor in the prevention and management of childhood obesity, thus parental recognition of weight problems is essential. We estimated parental perceptions and their determinants in the Emirati population. We invited 1541 students (grade 1-12; 50% boys) and their parents, but only 1440 (6-19 years) and their parents consented. Of these, 945 Emirati nationals provided data for analysis. Anthropometric and demographic variables were measured by standard methods. CDC BMI percentile charts for age and sex were used to classify children's weight. Parental perception of their children's weight status (underweight, normal, and overweight/obese) was recorded. Logistic regression analyses were used to identify independent predictors of parental perceptions of children's weight status. Of all parents, 33.8% misclassified their children's' weight status; underestimating (27.4%) or overestimating (6.3%). Misclassification was highest among parents of overweight/obese children (63.5%) and underweight (55.1%) children. More importantly, parental perceptions of their children being overweight or obese, among truly overweight/obese children, i.e. correct identification of an overweight/obese child as such, were associated with the true child's BMI percentile (CDC) with an OR of 1.313 (95% CI: 1.209-1.425; p<0.001) per percentile point, but not age, parental education, household income, and child's sex. We conclude that the majority of parents of overweight/obese children either overestimated or, more commonly, underestimated children's weight status. Predictors of accurate parental perception, in this population, include the true children's BMI, but not age, household income, and sex. Thus, parents having an incorrect perception of their child's weight status may ignore otherwise appropriate health messages.
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Affiliation(s)
- Abdulla Aljunaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Abdishakur Abdulle
- Department of Internal Medicine, College of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Nico Nagelkerke
- Department of Community Medicine; College of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
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Van Hook J, Baker E, Altman CE, Frisco ML. Canaries in a coalmine: Immigration and overweight among Mexican-origin children in the US and Mexico. Soc Sci Med 2012; 74:125-34. [PMID: 22153862 PMCID: PMC3259272 DOI: 10.1016/j.socscimed.2011.10.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 09/26/2011] [Accepted: 10/03/2011] [Indexed: 11/25/2022]
Abstract
The prevalence of overweight is higher for Hispanic children of immigrants than children of natives. This does not fit the pattern of the epidemiological paradox, the widely supported finding that immigrants tend to be healthier than their U.S.-born peers, and it suggests that exposure to the U.S. increases immigrant children's risk of overweight. This study's primary contribution is to better assess how exposure to the U.S. environment affects childhood overweight among a homogamous ethnic group, Mexican-Americans. We do so by using an innovative binational study design to compare the weight of Mexican-American children of immigrants, Mexican-American children of natives, and Mexican children in Mexico with different propensities of having immigrant parents. Cross-sectional data are derived from a pooled sample of 9982 6-19 year old children living in either Mexico or the United States in the early 2000s. Mexican-resident children with a very high propensity to have immigrant parents have significantly lower percentile BMIs and lower odds of overweight than Mexican children with lower propensities of emigration and U.S.-resident Mexican-American children. This suggests that selection into immigration streams does not account for the high prevalence of overweight among children of Mexican immigrants. Rather, U.S. exposure significantly raises children of Mexican immigrants' risk of being overweight. Moreover, second generation children have the highest percentile BMIs and greatest odds of overweight of all comparison groups, including children of natives. This suggests that they experience risks above and beyond the effects of exposure to American society.
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Affiliation(s)
- Jennifer Van Hook
- The Pennsylvania State University, University Park, PA 16802, United States.
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Duran-Gonzalez J, Ortiz I, Gonzales E, Ruiz N, Ortiz M, Gonzalez A, Sanchez EK, Curet E, Fisher-Hoch S, Rentfro A, Qu H, Nair S. Association study of candidate gene polymorphisms and obesity in a young Mexican-American population from South Texas. Arch Med Res 2011; 42:523-31. [PMID: 22056417 DOI: 10.1016/j.arcmed.2011.10.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 07/21/2011] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIMS Obesity is increasingly a health problem and a risk factor for diabetes in young Mexican-American populations. Genetic association studies in older, mostly non-Hispanic populations have reported that polymorphisms in the candidate genes HSD11B1, CRP, ADIPOQ, PPARG, ANKK1, ABCC8 and SERPINF1 are associated with obesity or diabetes. We analyzed the polymorphisms rs846910, rs1205, rs1501299, rs1801282, rs1800497, rs757110 and rs1136287 in these candidate genes, for association with obesity and metabolic traits in a young Mexican-American population from south Texas. METHODS Genotyping of the seven common SNPs were performed by allelic discrimination assays in 448 unrelated Mexican Americans (median age = 16 years) from south Texas. χ(2) tests and regression analyses using additive models were used for genetic association analyses adjusting for covariates; p values were corrected for multiple testing by permutation analyses. RESULTS rs1800497 (ANKK1) shows association with waist circumference (p = 0.009) and retains the association (p = 0.03) after permutation testing. Analysis of metabolic quantitative traits shows that rs846910 (HSD11B1) was associated with HOMA-IR (p = 0.04) and triglycerides (p = 0.03), and rs1205 (CRP) with HOMA-IR (p = 0.03) and fasting glucose levels (p = 0.007). However, the quantitative traits associations are not maintained after permutation analysis. None of the other SNPs in this study showed associations with obesity or metabolic traits in this young Mexican-American population. CONCLUSIONS We report a potential association between rs1800497 (linked to changes in brain dopamine receptor levels) and central obesity in a young Mexican-American population.
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Affiliation(s)
- Jorge Duran-Gonzalez
- Department of Biological Sciences and Center of Biomedical Studies, University of Texas School of Public Health, Brownsville, TX 78520, USA
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Sharkey JR, Johnson CM, Dean WR. Nativity is associated with sugar-sweetened beverage and fast-food meal consumption among Mexican-origin women in Texas border colonias. Nutr J 2011; 10:101. [PMID: 21962014 PMCID: PMC3196692 DOI: 10.1186/1475-2891-10-101] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Accepted: 09/30/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trends of increasing obesity are especially pronounced among Mexican-origin women. There is little understanding of dietary patterns among U.S.- and Mexico-born Mexican-origin individuals residing in new-destination immigrant communities in the United States, especially behaviors related to obesity, such as consumption of sugar-sweetened beverages (SSB) and fast-food meals (FFM). METHODS The study used survey data of 599 adult Mexican-origin women from the 610 women who completed the 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA), which was completed in person by trained promotora-researchers in 44 colonias near the Texas border towns of Progreso and La Feria. Data included demographic characteristics (age, education, nativity or country of birth, household income, household composition, and employment status), access to transportation, self-reported height and weight, food and nutrition assistance program participation, and consumption of SSB and FFM. Descriptive statistics were calculated by nativity (U.S.-born vs. Mexico-born); multivariable linear regression models were estimated for correlates of consumption of SSB and FFM. RESULTS There are three major findings related to nativity. First, U.S.-born women consumed more SSB and FFM than Mexican-born counterparts in the same areas of colonias. Second, in the combined sample and controlling for other population characteristics, being born in Mexico was independently associated with FFM (fewer FFM), but not with SSB. Third, in analyses stratified by nativity, FFM and SSB were associated with each other among both nativity groups. Among Mexico-born women only, age, presence of a child, or being a lone parent was significantly associated with SSB; full-time employment, being a lone parent, and SSB consumption were each independently associated with increased frequency of FFM. CONCLUSIONS Our analyses revealed differences in prevalence and correlates of SSB and FFM based on country of birth. Nativity, as a proxy for acculturation, may indicate the extent that immigrants have adopted behaviors from their new environment. However, nativity could also indicate limited accessibility to resources such as food/nutrition assistance programs, transportation, and proper documentation. Additionally, future research should focus on expanding our understanding of the meaning of nativity among individuals who share common contextual factors, but may have different life course experiences and resources needed to transition into a new place. Additional measures should be considered such as educational and occupational background, migration history, documentation status, and dietary acculturation, which may better explain heterogeneity within Hispanic subgroups.
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Affiliation(s)
- Joseph R Sharkey
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
| | - Cassandra M Johnson
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
- UNC Center for Health Promotion and Disease Prevention and Department of Nutrition, UNC Gillings School of Global Public Health, Chapel Hill, NC (USA
| | - Wesley R Dean
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
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Johnson CM, Sharkey JR, Dean WR. It's all about the children: a participant-driven photo-elicitation study of Mexican-origin mothers' food choices. BMC Womens Health 2011; 11:41. [PMID: 21943081 PMCID: PMC3200150 DOI: 10.1186/1472-6874-11-41] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 09/26/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND There is a desperate need to address diet-related chronic diseases in Mexican-origin women, particularly for those in border region colonias (Mexican settlements) and other new destination communities in rural and non-rural areas of the U.S. Understanding the food choices of mothers, who lead food and health activities in their families, provides one way to improve health outcomes in Mexican-origin women and their children. This study used a visual method, participant-driven photo-elicitation, and grounded theory in a contextual study of food choices from the perspectives of Mexican-origin mothers. METHODS Teams of trained promotoras (female community health workers from the area) collected all data in Spanish. Ten Mexican-origin mothers living in colonias in Hidalgo County, TX completed a creative photography assignment and an in-depth interview using their photographs as visual prompts and examples. English transcripts were coded inductively by hand, and initial observations emphasized the salience of mothers' food practices in their routine care-giving. This was explored further by coding transcripts in the qualitative data analysis software Atlas.ti. RESULTS An inductive conceptual framework was created to provide context for understanding mothers' daily practices and their food practices in particular. Three themes emerged from the data: 1) a mother's primary orientation was toward her children; 2) leveraging resources to provide the best for her children; and 3) a mother's daily food practices kept her children happy, healthy, and well-fed. Results offer insight into the intricate meanings embedded in Mexican-origin mothers' routine food choices. CONCLUSIONS This paper provides a new perspective for understanding food choice through the eyes of mothers living in the colonias of South Texas -- one that emphasizes the importance of children in their routine food practices and the resilience of the mothers themselves. Additional research is needed to better understand mothers' perspectives and food practices with larger samples of women and among other socioeconomic groups.
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Affiliation(s)
- Cassandra M Johnson
- Program for Research in Nutrition and Health Disparities, Social and Behavioral Department, School of Rural Public Health, TAMU 1266, College Station, TX, 77843, USA
- Department of Nutrition, UNC Gillings School of Global Public Health, CB# 7461, Chapel Hill, NC, 27599-7461, USA
- UNC Center for Health Promotion and Disease Prevention, CB# 7426, Chapel Hill, NC, 27599-7426, USA
| | - Joseph R Sharkey
- Program for Research in Nutrition and Health Disparities, Social and Behavioral Department, School of Rural Public Health, TAMU 1266, College Station, TX, 77843, USA
| | - Wesley R Dean
- Program for Research in Nutrition and Health Disparities, Social and Behavioral Department, School of Rural Public Health, TAMU 1266, College Station, TX, 77843, USA
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Head BJ, Barr KL, Baker SK. Mexican American Parents’ Perceptions of Childhood Risk Factors for Type 2 Diabetes. J Sch Nurs 2010; 27:51-60. [DOI: 10.1177/1059840510392050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A study was conducted to identify the norms, values, and perceptions of urban immigrant Mexican American (MA) parents of school children relative to physical activity, healthy eating, and child risk factors for type 2 diabetes. Investigators facilitated five focus groups in an urban elementary school setting and analyzed data using qualitative analysis techniques. Methods for participant recruitment, conduct of focus groups, and qualitative data analysis are detailed. Results of analysis are presented. The relationship between parent focus group discussion and the conceptual framework guiding the study are depicted. Implications for practice and research are discussed.
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Shin KO, Chung KH, Park HS. Evaluation of the health status of preschool children stratified based on the weight-length index (WLI). Nutr Res Pract 2010; 4:383-92. [PMID: 21103084 PMCID: PMC2981721 DOI: 10.4162/nrp.2010.4.5.383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 09/09/2010] [Accepted: 10/01/2010] [Indexed: 11/04/2022] Open
Abstract
This study was conducted to prepare basic materials and offer advice regarding dietary habits to prevent and cure childhood obesity by comparing and analyzing dietary habit, nutritional status, blood factors, and mineral contents of hair. All subjects were stratified by their weight-length index (WLI). According to the standard WLI values, 64.9% of children were within the normal value, 13.5% of children were underweight, and 21.6% of children were overweight and obese (WLI ≥ 110%). Overall, the score assessed dietary habit for all children was 21.32 ± 2.55 point (921 subjects), with 5.1% of children having excellent dietary habits and 3.1% having poor dietary habits. Additionally, 37.9% of underweight children, 37.6% of normal weight children, and 43.2% of overweight and obese children consumed higher amounts of protein than underweight children did (meat, fish, eggs, and soy products) (P < 0.05). Overweight and obese children consumed more fried foods than underweight or normal weight children (P < 0.05). Moreover, 38.0% of the children had hemoglobin levels of 12 g/dl, while 7.6% were anemic (11.1 g/dl). When a hematocrit level of 33% was taken as the standard, 11.0% of children were anemic. The plasma transferrin content was 263.76 ± 54.52 mg/dl in overweight and obese children. The mean values of Fe, Cu, Ca, Cr, Mn, Se, Na, K, Li, V, Co, and Mo were within the reference values, but the Zn concentrations of underweight, normal weight, and overweight and obese children were 67.97 ± 28.51 ppm, 70.09 ± 30.81 ppm, and 73.99 ± 30.36 ppm, respectively. The Zn concentration of overweight and obese children (73.99 ± 30.36 ppm) was lower than that of the standard value (180~220 ppm). Therefore, a nutritional education program and new guidance for dietary pattern should be developed to reduce the number of underweight and overweight and obese children.
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Affiliation(s)
- Kyung-Ok Shin
- Department of Food & Nutrition, Sahmyook University, Seoul 130-650, Korea
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