Low-Income Immigrant Hispanic Mothers' Concerns and Perceptions of Their Young Child's Weight

Prevalence of Overweight and Obesity in Children of Immigrant Origin in Spain: A Cross-Sectional Study

Social determinants of health are a major contributing factor to health inequalities and have important effects on the health of the population. The aim of the study was to estimate the prevalence of overweight/obesity in native and immigrant children aged 2-14 years residing in Spain, and to explore its relationship with socioeconomic factors, habits, and living and health conditions. This study used data from the 2017 Spanish National Health Survey, which collects health information on the population residing in Spain. Multivariate logistic regression models were fitted to estimate the risk of overweight/obesity controlling for the variables of interest. The final sample consisted of 2351 households. Children of immigrant origin had a significantly higher overall prevalence of overweight and/or obesity than natives, both in boys (40.5% vs. 29.5%) and girls (44.8% vs. 30.3%), and a higher adjusted risk of overweight/obesity (OR = 1.67). In addition, it has been observed that children of immigrant origin were at higher risk of consuming sugary soft drinks, exercising less, and using screens more. In conclusion, the increased risk of having different habits that may contribute to developing excess weight and of having overweight/obesity in children with a migrant background should guide public health policies and interventions, emphasizing those groups at higher risk and incorporating considerations of socioeconomic inequalities.

Perceptions and Barriers to Physical Activity in Childhood and Adulthood Among Latinas

Objective

The purpose of this qualitative study was to identify perceptions and barriers to physical activity in childhood and adulthood among Latina adults.

Methods

Three focus groups, 2 dyadic interviews, and an individual interview were conducted using semi-structured interview guides with 23 Latina women aged 21-35. A thematic analysis approach employing inductive and deductive coding was utilized to code, categorize, and summarize data into themes.

Results

The themes that emerged focused on: (1) physical activity is enjoyable; (2) family influenced physical activity; (3) different lifestyle in the US influenced physical activity; (4) physical activity is important for health; and (5) responsibilities (eg, work, caregiving) as barriers to physical activity in adulthood.

Conclusions

Perceptions and barriers to physical activity experienced in both childhood and adulthood should be considered in the promotion of physical activity among Latinas.

Maternal perceptions and concerns about children's weight status and diet quality: a study among Black immigrant families

OBJECTIVE

To identify factors influencing Black immigrant mothers' perceptions and concerns about child weight and to compare children's diet quality according to these perceptions and concerns.

DESIGN

Mothers' perceptions and concerns about child weight were assessed with sex-specific figure rating scales and the Child Feeding Questionnaire, respectively. Participants' weights and heights were measured and characterised using WHO references. Children's dietary intakes were estimated using a 24-h dietary recall. Children's diet quality was evaluated using the relative proportion of their energy intake provided by ultra-processed products, which were identified with the NOVA classification. χ2 tests, multivariate logistic regressions and t tests were performed.

SETTING

Ottawa, Ontario, Canada.

PARTICIPANTS

Black immigrant mothers of Sub-Saharan African and Caribbean origin (n 186) and their 6-12-year-old children.

RESULTS

Among mothers, 32·4 % perceived their child as having overweight while 48·4 % expressed concerns about child weight. Girls and children with overweight or obesity were significantly more likely to be perceived as having overweight by their mothers than boys and normal-weight children, respectively. Mothers of children living with obesity, but not overweight, were significantly more likely to be concerned about their child's weight than mothers of normal-weight children. Children's diet quality did not differ according to mothers' perceptions and concerns.

CONCLUSIONS

Children's gender and weight status were major determinants of perceptions and concerns about child weight among Black immigrant mothers. Including knowledge about mothers' perceptions and concerns about child weight will help nutrition professionals develop interventions tailored to specific family needs within the context of their cultural backgrounds.

Maternal feeding style and child weight status among Hispanic families with low-income levels: a longitudinal study of the direction of effects

BACKGROUND

The home environment is a central and modifiable influence on the development of childhood obesity. Evidence supports the central role of parents in shaping problematic child eating behaviors and excess weight. Most studies of feeding emphasize parent-driven influences without taking into account the child's role in eating interactions. Few studies have addressed the bi-directional nature of feeding dynamics in studies of young children.

METHODS

The goals of this study were: 1) to examine if parental feeding styles during preschool (4-5 years) predict child weight status at 7-9 years, and 2) to examine the direction of effects between parental feeding styles and child weight status over time. Participants were part of a larger longitudinal study of Hispanic Head Start families living in the West South Central United States. Data from mother/child dyads were collected at three time points: Time 1 (ages 4-5), Time 2 (ages 5 ½-6 ½), and at Time 3 (ages 7-9). Only data from the Times 1 and 3 were used in the current analyses. A total of 128 mothers and their children had data on all variables needed for the analyses. Assessments included parent-reported feeding styles, feeding practices, acculturation, child eating behaviors, and child height and weight. Hierarchical regression was used to examine the first aim; a cross-lagged panel analysis examined the second aim.

RESULTS

An indulgent parental feeding style at ages 4-5 was associated with increased child BMI z-score at ages 7-9. Indulgent feeding significantly contributed to child BMI z-score beyond demographics, baseline child BMI z-score, parental acculturation, and child eating behaviors. Regarding the direction of effects in parental feeding interactions, the cross-lagged analyses showed that both indulgent feeding style and authoritative feeding style at Time 1 positively predicted child BMI z-scores at Time 3. Child effects were significant as well. Child BMI z-score at Time 1 positively predicted indulgent feeding and negatively predicted authoritarian feeding at Time 3.

CONCLUSIONS

Indulgent feeding should be addressed in future family-focused childhood obesity initiatives focused on young children and their parents.

Observations of Maternal Feeding Practices and Styles and Young Children's Obesity Risk: A Longitudinal Study of Hispanic Mothers with Low Incomes

Background: Maternal feeding practices and styles are well-established correlates of children's BMI z-scores in the preschool years. Most studies, however, are cross-sectional, using maternal self-reports to examine feeding. This study examined, over a 3½-year period, the relationship between observed and self-reported feeding practices/styles and children's BMI z-scores in a sample of Hispanic mothers with low incomes and their preschool children. Methods: One hundred eighty-seven mothers were observed feeding their 4- to 5-year old during a buffet meal in a laboratory setting and completed self-report measures on their feeding practices and styles. Children's BMI z-scores were assessed at this visit and 3½ years later. Results: Consistent with previous research, observed and self-reported pressure to eat and/or authoritarian feeding were negatively associated with children's BMI z-scores at the first time point; observed discouraging eating was positively associated. However, children's BMI z-scores 3½ years later, controlling for Time 1 BMI z-scores, were positively associated with observed pressure to eat. Observed maternal reasoning and self-reported monitoring of children's eating behavior at Time 1 were negatively associated with later BMI z-scores. Only self-reported feeding styles predicted later children's BMI z-scores, with indulgent and authoritative styles positively associated with children's BMI z-scores at the third time point. Conclusions: These findings demonstrate that mothers who ignore their children's fullness cues and pressure them to eat have children who are at greater risk for the development of later obesity. Implications for the development of family-focused childhood obesity prevention programs are discussed.

Examining Determinants and Co-associations Between Fruit and Vegetable and Sugar-Sweetened Beverage Monitoring Practices Among a Sample of Low-Income Hispanic Mothers

The etiology of obesity is complex, and a growing body of research suggests that changing two or more behaviors at the same time will likely have a stronger impact than changing one behavior in isolation. A lack of fruit and vegetable (FV) intake and high sugar-sweetened beverage (SSB) consumption are two behaviors related to childhood obesity in the Hispanic community. The purpose of this study was to evaluate theory-based determinants of monitoring practices of FV and SSB among Hispanic mothers with young children using the reasoned action approach. The study also examined the co-associations among the theoretical antecedents for both behaviors. Surveys were distributed in several community settings to urban Hispanic mothers (n = 238) of 2-5-year-old children. Surveys assessed FV and SSB monitoring practices, attitudes, perceived norms, perceived behavioral control (PBC), and intentions. Two models were evaluated using structural equation modeling: attitudes, perceived norms, and PBC of both behaviors were associated with intentions for both behaviors, and PBC and intentions were associated with monitoring practices of FV and SSB. Both models had adequate fit (FV (CFI = 0.973; GFI = 0.980; RMSEA = 0.121); SSB (CFI = 0.994; GFI = 0.993; RMSEA = 0.066)). PBC for both FV and SSB monitoring was significantly associated with SSB monitoring, whereas FV intentions was only significantly associated with FV monitoring. Results from this study gives evidence that among Hispanic mothers, FV and SSB monitoring behaviors are interrelated. To promote SSB monitoring, more implementation strategies (i.e., skills-based interventions) are warranted, whereas to promote FV monitoring, motivational strategies are warranted.

Factors Influencing Parents' and Children's Misperception of Children's Weight Status: a Systematic Review of Current Research

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.

Public health nurses' experiences of using interpreters when meeting with Arabic-speaking first-time mothers

OBJECTIVES

The aim of this study was to investigate public health nurses' experiences of using interpreters when meeting with Arabic-speaking first-time mothers.

DESIGN AND SAMPLE

An inductive qualitative design was used. Individual interviews were conducted with Swedish public health nurses (n = 11) with experience of working in child health care with interpreters when meeting with Arabic-speaking first-time mothers.

MEASURES

Data were analyzed using qualitative content analysis.

RESULTS

The analysis of the interviews resulted in one overarching theme: Having to accept and learn to incorporate interpreters when meeting with Arabic-speaking first-time mothers. Three subthemes were identified: (a) enabling an understanding of the situation of the mothers; (b) contributing to a trustful relationship; and (c) creating disturbing elements in the dialogue.

CONCLUSIONS

Using interpreters optimized the conversation between the public health nurse and the Arab-speaking first-time mother; however, the complexity of using interpreters was also apparent.

Maternal concerns and perceptions of elementary school-age children's weight status

PURPOSE

The purpose of this study was to identify characteristics associated with maternal concerns for her child becoming overweight, and how these concerns are related to her perceptions of her child's weight.

DESIGN

A school-based sample of 55 children and their mothers from Houston, Texas, participated in a cross-sectional survey. Mothers reported on their concerns and perceptions regarding their child's weight. Child and mother height and weight were directly assessed to calculate body mass index (BMI). Covariate-adjusted logistic regression models were conducted.

RESULTS

Over one-third of mothers misperceived their child's weight status [9% (n = 5) overestimated; 27% (n = 15) underestimated]. Mothers of sons were less accurate compared with mothers of daughters. For every one unit increase in maternal BMI, mothers had 13% higher odds of being concerned of their child becoming overweight. Concerned mothers had 82% lower odds of underestimating their child's weight.

PRACTICE IMPLICATIONS

In order for school-based childhood obesity prevention and intervention programs to be successful, parents must accurately perceive their elementary school-age child's weight status. School nurses can be vital to these efforts through proper training and resources. Nurses can use the "School Nurse Childhood Obesity Toolkit" and motivational interviewing techniques to address parental concerns and perceptions prior to teaching behavior modification strategies to children/families.

Maternal perception of child overweight status and its association with weight-related parenting practices, their children's health behaviours and weight change in China

OBJECTIVE

Childhood obesity has increased rapidly in China, but understanding is limited on how parents perceive their child's weight status and how this perception affects weight-related parenting practices. We examined maternal perception of her child's weight status and its association with demographics, subsequent weight-related parenting practices, the child's health behaviours and weight change. Design/Setting/Subjects Maternal perception of child's weight status and health behaviours from the China Health and Nutrition Surveys were assessed at baseline and in follow-up surveys for 816 children aged 6-18 years during 2004-2011. Associations were tested using mixed models.

RESULTS

Overall, maternal and child perceptions of the child's weight status were fairly consistent (κ w=0·56), 63·8 % of mothers had correct perception. While 9·6 % of mothers perceived their child as overweight, 10·9 % of children did so, and 13·6 % of children were indeed overweight. Compared with mothers who viewed their children as normal weight, mothers who thought their children were overweight were more likely to encourage their children to increase their physical activity (OR; 95 % CI: 1·8; 1·0, 3·3) and to diet (4·3; 2·3, 7·8). Children perceived as overweight by their mothers were more likely to have insufficient physical activity (2·8; 1·6, 4·7) and gain more weight during follow-up (BMI Z-score, β (se): 1·0 (0·1); P<0·01) than children perceived by their mothers as normal weight.

CONCLUSIONS

In China, mothers who perceive their child as overweight are more likely to encourage their child to exercise and modify their diet for weight management, but this encouragement does not seem to improve the child's health behaviours and weight status.