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Warschburger P, Kamrath C, Lanzinger S, Sengler C, Wiegand S, Göldel JM, Weihrauch-Blüher S, Holl RW, Minden K. A prospective analysis of the long-term impact of the COVID-19 pandemic on well-being and health care among children with a chronic condition and their families: a study protocol of the KICK-COVID study. BMC Pediatr 2023; 23:130. [PMID: 36949465 PMCID: PMC10031163 DOI: 10.1186/s12887-023-03912-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/17/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND There is consistent evidence that the COVID-19 pandemic is associated with an increased psychosocial burden on children and adolescents and their parents. Relatively little is known about its particular impact on high-risk groups with chronic physical health conditions (CCs). Therefore, the primary aim of the study is to analyze the multiple impacts on health care and psychosocial well-being on these children and adolescents and their parents. METHODS We will implement a two-stage approach. In the first step, parents and their underage children from three German patient registries for diabetes, obesity, and rheumatic diseases, are invited to fill out short questionnaires including questions about corona-specific stressors, the health care situation, and psychosocial well-being. In the next step, a more comprehensive, in-depth online survey is carried out in a smaller subsample. DISCUSSION The study will provide insights into the multiple longer-term stressors during the COVID-19 pandemic in families with a child with a CC. The simultaneous consideration of medical and psycho-social endpoints will help to gain a deeper understanding of the complex interactions affecting family functioning, psychological well-being, and health care delivery. TRIAL REGISTRATION German Clinical Trials Register (DRKS), no. DRKS00027974. Registered on 27th of January 2022.
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Affiliation(s)
- Petra Warschburger
- Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany.
| | - Clemens Kamrath
- Center of Child and Adolescent Medicine, University of Giessen, Gießen, Germany
| | - Stefanie Lanzinger
- Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Claudia Sengler
- Deutsches Rheuma-Forschungszentrum (DRFZ), Program Area Epidemiology, Berlin, Germany
| | - Susanna Wiegand
- Center for Social-Pediatric Care, Department of Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt- Universität zu Berlin, Berlin, Germany
| | - Julia M Göldel
- Department of Psychology, Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany
| | - Susann Weihrauch-Blüher
- Department of Pediatrics I, Pediatric Endocrinology, University Hospital Halle/S, Halle/S, Germany
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Kirsten Minden
- Deutsches Rheuma-Forschungszentrum (DRFZ), Program Area Epidemiology, Berlin, Germany
- Department of Pediatric Respiratory Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt- Universität zu Berlin, Immunology and Critical Care Medicine at Charité University Hospital Berlin, Berlin, Germany
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Yisahak SF, Khalsa AS, Keim SA. Caregiver Concern About Child Overweight/Obesity in Grandparent Versus Parent-Headed Households in the United States. Acad Pediatr 2023; 23:117-122. [PMID: 35921996 DOI: 10.1016/j.acap.2022.07.019] [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: 04/08/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine the association of caregivers' concern about children's overweight and obesity status with family structure (grandparent versus parent-headed households). METHODS Caregivers reported their relation to the child aged 10 to 17 years and the child's weight and height (National Survey of Children's Health 2016-20). Overweight/obesity was calculated using Centers for Disease Control and Prevention growth charts. We estimated associations (prevalence odds ratio) of residing in a grandparent-headed household with lack of weight concern (responding "Yes, it's too low" or "No, not concerned" to "Are you concerned about this child's weight?") among propensity score-matched children with overweight and obesity. Covariates included child's sex, race, ethnicity, age, family poverty ratio, primary household language, highest level of education among reported adults, caregiver mental and emotional health, usual source of care and survey year. RESULTS The prevalence of child overweight/obesity was higher in grandparent-headed households. Among children with overweight/obesity, 64.65 (SE = 3.27)% of grandparents and 66.55 (SE = 0.81)% of parents did not express concern about the child's weight status. Among children with obesity, it was 52.42 (SE = 4.63)% and 49.04 (SE = 1.28)%, respectively. Family structure was not associated with caregiver lack of weight concern in propensity score-matched samples. CONCLUSIONS Appropriate caregiver concern about child's weight status was low in both grandparent and parent-headed households in the United States.
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Affiliation(s)
- Samrawit F Yisahak
- Center for Biobehavioral Health (SF Yisahak, SA Keim), Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics (SF Yisahak, AS Khalsa, SA Keim), College of Medicine, The Ohio State University, Columbus, Ohio.
| | - Amrik S Khalsa
- Division of Primary Care Pediatrics (AS Khalsa), Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics (SF Yisahak, AS Khalsa, SA Keim), College of Medicine, The Ohio State University, Columbus, Ohio; Center for Child Health Equity and Outcomes Research (AS Khalsa), Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | - Sarah A Keim
- Center for Biobehavioral Health (SF Yisahak, SA Keim), Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics (SF Yisahak, AS Khalsa, SA Keim), College of Medicine, The Ohio State University, Columbus, Ohio; Division of Epidemiology (SA Keim), College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, Ohio
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The Association between Body Weight Misclassification in Adolescence and Body Fat and Waist Circumference in Adulthood: A Longitudinal Study. Nutrients 2022; 14:nu14224765. [PMID: 36432452 PMCID: PMC9693537 DOI: 10.3390/nu14224765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/27/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
This study examined the longitudinal association between adolescent body weight misclassifications and body fat and waist circumference during adulthood. A sample was derived from a large Australian birth cohort study. The data analyses were restricted to 1002 participants for whom data on both measured and perceived weight at a 14-year follow-up and the actual measure of adult body fat and waist circumference at a 30-year follow-up were available. To determine misclassifications, we compared the perceived weight with the measured weight. The results were presented as means and mean differences (with a 95% confidence interval) of the body fat percentages and waist circumference levels across the weight misclassification groups, adjusting for potential covariates. For both male and female adolescents, weight underestimation was significantly associated with an increase in body fat percentages and waist circumference in adulthood as compared to those who correctly estimated their weight. In the mean difference analyses, adolescent males and females who underestimated their weight were found to have significantly higher body fat, and waist circumference means than those who correctly estimated their weight in the unadjusted and adjusted comparisons. The adolescent males who overestimated their weight had higher body fat, and waist circumference means when they reached adulthood. Increased awareness of weight misclassification and actual weight among adolescents might contribute to better control of weight gain in adulthood.
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Xiang C, Zhang Y, Yong C, Xi Y, Huo J, Zou H, Liang J, Jiang Z, Lin Q. Association between Parents' Perceptions of Preschool Children's Weight, Feeding Practices and Children's Dietary Patterns: A Cross-Sectional Study in China. Nutrients 2021; 13:3767. [PMID: 34836023 PMCID: PMC8624819 DOI: 10.3390/nu13113767] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/20/2021] [Accepted: 10/23/2021] [Indexed: 12/20/2022] Open
Abstract
Parental perception of children's weight may influence parents' feeding practices, and in turn, child dietary intake and weight status; however, there is limited evidence generated for preschoolers. The aim of this cross-sectional study was to investigate associations between Chinese parents' perceptions of child weight, feeding practices and preschoolers' dietary patterns. Participants (1616 parent-child pairs) were recruited from six kindergartens in Hunan, China. Parents' misperception, concern, and dissatisfaction on child weight were collected through a self-administered caregiver questionnaire. Parental feeding practices and children's dietary intake were, respectively, assessed using the Child Feeding Questionnaire and a Food Frequency Questionnaire. Linear regression models were applied to analyze associations between parental weight perceptions, feeding practices, and preschooler's dietary patterns. Associations between parents' weight perceptions and dietary patterns were significant only among underweight children. Regardless of child weight status, parental weight underestimation and preference for a heavier child were positively associated with pressure-to-eat. Parental weight concern was positively associated with restriction in normal weight child, but this was not found in other weight groups. In conclusion, Parents' misperception, concern, and dissatisfaction about child weight are associated with parents' feeding practices and may influence preschoolers' dietary quality, but the relationships vary by children's actual weight status.
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Affiliation(s)
- Caihong Xiang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (C.X.); (C.Y.); (Y.X.); (J.H.); (H.Z.); (J.L.)
| | - Youjie Zhang
- Department of Child and Adolescent Health and Social Medicine, School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou 215123, China;
| | - Cuiting Yong
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (C.X.); (C.Y.); (Y.X.); (J.H.); (H.Z.); (J.L.)
| | - Yue Xi
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (C.X.); (C.Y.); (Y.X.); (J.H.); (H.Z.); (J.L.)
| | - Jiaqi Huo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (C.X.); (C.Y.); (Y.X.); (J.H.); (H.Z.); (J.L.)
| | - Hanshuang Zou
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (C.X.); (C.Y.); (Y.X.); (J.H.); (H.Z.); (J.L.)
| | - Jiajing Liang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (C.X.); (C.Y.); (Y.X.); (J.H.); (H.Z.); (J.L.)
| | - Zhiqian Jiang
- Faculty of Agriculture, Life and Environment Science, Nutrition and Food Science Program, University of Alberta, 116st 85 Avenue, Edmonton, AB T6G 2R3, Canada;
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (C.X.); (C.Y.); (Y.X.); (J.H.); (H.Z.); (J.L.)
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Kharofa RY, Khalsa AS, Zeller MH, Modi AC, Ollberding NJ, Copeland KA. Giving "prescriptions" for paediatric weight management follow-up in primary care. Clin Obes 2021; 11:e12448. [PMID: 33733574 DOI: 10.1111/cob.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 12/01/2022]
Abstract
The American Academy of Paediatrics recommends that primary care paediatricians "prescribe" follow-up for weight management between well child checks. We sought to describe rates and predictors of prescribed and actual clinic attendance for weight management in primary care in a predominantly low-income population. A chart review was performed at a large, hospital-based, primary care clinic, where a treatment algorithm for obesity exists. Eligible children were 6 to 12 years of age with a body mass index (BMI) ≥85th percentile and seen for a well child check in 2014. Primary outcomes were the physician prescribing follow-up in primary care and the patient returning for weight management. Multivariable logistic regression was used to identify predictors of prescribing follow-up and predictors of return. Participants included 1339 patients: mean age 9 years (SD: 1.8 years); 53% female; 79% Black; 89% Medicaid-insured; 56% with an obese BMI (vs overweight). Twenty-seven percent of patients were prescribed follow-up in primary care, of which 13% returned (only 4% of the original sample). The odds of the physician prescribing follow-up were greater if the child had obesity (vs overweight), was older, female or non-Medicaid insured. Older and non-Black patients had greater odds of returning. Patients prescribed follow-up within 2 months or less (vs 3-6 months) were also more likely to return (aOR 2.66; CI: 1.34, 5.26). Rates of prescription for weight management in primary care are low and few patients return, even when follow-up is prescribed. Prescribing follow-up at shorter intervals from the index visit (≤ 2 months) may improve patient return.
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Affiliation(s)
- Roohi Y Kharofa
- Centre for Better Health and Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Meg H Zeller
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Centre for Child Behavior and Nutrition Research and Training, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
| | - Avani C Modi
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Centre for Adherence and Self-Management, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
| | - Nicholas J Ollberding
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
| | - Kristen A Copeland
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
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Parents' perceptions and dissatisfaction with child silhouette: associated factors among 7-year-old children of the Generation XXI birth cohort. Eat Weight Disord 2021; 26:1595-1607. [PMID: 32772335 DOI: 10.1007/s40519-020-00953-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/30/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE We compared parent's perceived child's silhouette, and investigated predictors of their dissatisfaction. METHODS Participants were 4930 mother-child dyads enrolled at a Portuguese birth cohort. Parents' perceptions of child's current and desired silhouette was assessed and dissatisfaction with child's silhouette was defined as the discrepancy between these ratings (current-desired body). Multinomial logistic regressions, adjusted for potential confounders, were performed. RESULTS Mothers were more dissatisfied with child's silhouette, compared to fathers, in all weight categories. Mothers and fathers of girls were more dissatisfied, preferring thinner silhouettes (OR = 2.77, 95% CI 2.19; 3.51 and OR = 2.08, 95% CI 1.18; 3.66, respectively), compared to parents of boys. Lower birth weight increased maternal desire for a heavier child silhouette. Younger (< 20 years) and less educated (≤ 9 years of schooling) mothers were more dissatisfied with their child's silhouette, preferring heavier children (OR = 1.65, 95% CI 1.10; 2.48 and OR = 1.73, 95% CI 1.42; 2.09, respectively). Parents' own dissatisfaction was also associated with child's silhouette dissatisfaction. CONCLUSION Sociodemographic characteristics and parents' dissatisfaction with their own silhouette influenced their dissatisfaction with child's silhouette and should be considered when developing obesity interventions. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Ziser K, Decker S, Stuber F, Herschbach A, Giel KE, Zipfel S, Ehehalt S, Junne F. Barriers to Behavior Change in Parents With Overweight or Obese Children: A Qualitative Interview Study. Front Psychol 2021; 12:631678. [PMID: 33841261 PMCID: PMC8034266 DOI: 10.3389/fpsyg.2021.631678] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/24/2021] [Indexed: 12/20/2022] Open
Abstract
Overweight and obesity among children and adolescents are global problems of our time. Due to their authority and role modeling, parents play an essential part in the efficacy of prevention and intervention programs. This study assessed the barriers that parents of overweight/obese children face in preventive and interventional health care utilization. Sixteen parents were qualitatively interviewed. A content analysis was performed, and barriers to change were allocated to their stage of change according to the transtheoretical model. Among the main barriers is the underestimation of health risks caused by overweight/obesity in association with diminished problem awareness. Parents seem not necessarily in need of theoretical knowledge for prevention and interventions. They do however need support in evaluating the weight status of their child and the knowledge of whom to turn to for help as well as specific and hands-on possibilities for change. The results extend past studies by adding specific barriers to change that parents commonly experience. Possibilities to address these barriers, e.g., through trainings at the pediatric practice or adoption of conversation techniques, are discussed. Future studies might identify subgroups experiencing specific barriers and thus be able to address these in an individualized way.
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Affiliation(s)
- Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Decker
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Anne Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stefan Ehehalt
- Public Health Department of Stuttgart, Stuttgart, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Imoisili OE, Lundeen EA, Freedman DS, Womack LS, Wallace J, Hambidge SJ, Federico S, Everhart R, Harr D, Vance J, Kompaniyets L, Dooyema C, Park S, Blanck HM, Goodman AB. Body Mass Index and Blood Pressure Improvements With a Pediatric Weight Management Intervention at Federally Qualified Health Centers. Acad Pediatr 2021; 21:312-320. [PMID: 33279738 PMCID: PMC8091487 DOI: 10.1016/j.acap.2020.11.026] [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: 07/21/2020] [Revised: 11/24/2020] [Accepted: 11/29/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The Mind, Exercise, Nutrition, Do It! 7-13 (MEND 7-13) program was adapted in 2016 by 5 Denver Health federally qualified health centers (DH FQHC) into MEND+, integrating clinician medical visits into the curriculum and tracking health measures within an electronic health record (EHR). We examined trajectories of body mass index (BMI, kg/m2) percentile, and systolic and diastolic blood pressures (SBP and DBP) among MEND+ attendees in an expanded age range of 4 to 17 years, and comparable nonattendees. METHODS Data from April 2015 to May 2018 were extracted from DH FQHC EHR for children eligible for MEND+ referral (BMI ≥85th percentile). The sample included 347 MEND+ attendees and 21,061 nonattendees. Mixed-effects models examined average rate of change for BMI percent of the 95th percentile (%BMIp95), SBP and DBP (mm Hg), after completion of the study period. RESULTS Most children were ages 7 to 13 years, half were male, and most were Hispanic. An average of 4.2 MEND+ clinical sessions were attended. Before MEND+, %BMIp95 increased by 0.247 units/month among MEND+ attendees. After attending, %BMIp95 decreased by 0.087 units/month (P < .001). Eligible nonattendees had an increase of 0.084/month in %BMIp95. Before MEND+ attendance, SBP and DBP increased by 0.041 and 0.022/month, respectively. After MEND+ attendance, SBP and DBP decreased by 0.254/month (P < .001) and 0.114/month (P < .01), respectively. SBP and DBP increased by 0.033 and 0.032/month in eligible nonattendees, respectively. CONCLUSIONS %BMIp95, SBP, and DBP significantly decreased among MEND+ attendees when implemented in community-based clinical practice settings at DH FQHC.
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Affiliation(s)
| | | | - David S. Freedman
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga
| | - Lindsay S. Womack
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Ga; United States Public Health Service,Rockville, Md
| | | | | | | | | | - Delia Harr
- Denver Health Ambulatory Care Services, Denver, Co
| | | | - Lyudmyla Kompaniyets
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga
| | - Carrie Dooyema
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga
| | - Sohyun Park
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga
| | - Heidi M. Blanck
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity,National, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga; United States Public Health Service, Rockville, Md
| | - Alyson B. Goodman
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga; United States Public Health Service, Rockville, Md
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Natale R, Weerakoon S, Woody MT, Kolomeyer E, Pena K, Schladant M, Bulotsky-Shearer RJ, Messiah SE. Parent concerns regarding paediatric obesity in community-based programmes serving children with developmental disabilities. Child Care Health Dev 2020; 46:733-740. [PMID: 32803796 DOI: 10.1111/cch.12803] [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: 05/06/2020] [Revised: 07/18/2020] [Accepted: 08/07/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Previous studies show a higher prevalence of obesity among preschool-age children with developmental disabilities (DDs) versus children who are typically developing (TD). Little is known about parent concerns about obesity in young children with DD. The purpose of this study was to examine concerns regarding paediatric obesity among parents who had a preschool-age child with DD compared with parents with a child who is TD. METHODS A cross-sectional analysis occurred at baseline entry into one of three community-based programmes. Parents of a child with DD (n = 815) or TD (n = 563) were asked obesity-related questions about their child and in general. Multinomial and logistic regression unadjusted and adjusted models were run to generate the odds of obesity concerns based on disability status. RESULTS The average child age was 38 months. Parent concerns about paediatric obesity differed by disability status. Unadjusted odds of parents 'doing anything to control their child's weight' was 38% lower among parents of a child with DD versus TD (OR: 0.62, 95% CI: 0.48, 0.82). The adjusted odds of perceiving that their child was underweight was 83% higher among parents of a child with DD compared with parents of a child who is TD (aOR: 1.83, 95% CI: 1.27, 2.64). Parents of a child with DD were 179% more likely to believe that childhood obesity is a public health problem (aOR: 2.79, 95% CI: 1.88, 3.96). The models were adjusted for age, sex and race/ethnicity. CONCLUSIONS Findings indicate that parents of preschool-age children with DD are more likely to acknowledge that obesity is a public health concern. Because some parents of children with DD are concerned about their child's weight, families of preschool-age children with DD may be receptive to the delivery of healthy weight strategies in community-based programs.
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Affiliation(s)
- Ruby Natale
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sitara Weerakoon
- School of Public Health, University of Texas Health Science Center, Houston, Texas, USA
| | - Malaika T Woody
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ellen Kolomeyer
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Kristyna Pena
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | | | - Sarah E Messiah
- School of Public Health, University of Texas Health Science Center, Houston, Texas, USA
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Ochieng BMN. Healthy weight maintenance strategy in early childhood: The views of black African migrant parents and health visitors. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1551-1559. [PMID: 32173948 DOI: 10.1111/hsc.12979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
In Europe and the US, childhood obesity is found to be higher in migrant children from black African communities and other visible minority ethnic groups. However, very little is known about the factors that contribute to the significant rates of obesity in these groups. The material for this study is drawn from a community-based qualitative study that examined the sociocultural, familial and environmental factors that either facilitate or hinder healthy weight in black African children during early childhood. The participants for the study were black African parents (n = 30) and health visitors (n = 32), residing and working in the East Midlands, UK. The participants were purposively selected according to an inclusion/exclusion criterion and invited to participate in seven focus groups (FG-7) conducted for parents (FG-4) and health visitors (FG-3) at a time and place convenient to the participants, between March and June 2018. The focus groups examined a number of issues, including the participants' views on the barriers and facilitators to achieving and maintaining a healthy weight. Thematic analysis was used to identify themes within the data. Although participants were knowledgeable about the need for a healthy weight in early childhood, the parents discussed how immigration status and experiences of discrimination had an impact on their children's diet and well-being, also discussing how structural factors influenced the decisions they made regarding healthy weight in early childhood. While the health visitors in general felt they did not have the skills to advise black African parents about the cultural influences on diet during early childhood, findings highlighted a need for a system-based approach in meeting the nutritional needs of black African children. This study concludes by suggesting the need for broad social-environment and economic changes that address factors such as migration status, deprivation and discrimination, coupled with culturally specific healthy diet messages.
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Affiliation(s)
- Bertha M N Ochieng
- Integrated Health and Social Care, Faculty of Health & Life Sciences, De Montfort University, Leicester, UK
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Accuracy of anthropometric measurements and weight status perceptions reported by parents of 4-year-old children. Public Health Nutr 2019; 23:589-598. [PMID: 31685044 DOI: 10.1017/s1368980019003008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the validity of self-reported height and weight by parents of 4-year-old children and subjective weight perception. DESIGN Descriptive cross-sectional study. SETTING Paediatric population living in the Autonomous Community of Madrid. PARTICIPANTS Children born in 2008-2009 examined at 47-59 months of age. Data were collected by paediatricians of the Madrid Primary Care Physicians Sentinel Network. Parents reported weight and height data. Prevalence of weight status categories was calculated using WHO and International Obesity Task Force (IOTF) reference criteria. Sensitivity, specificity and positive predictive value (PPV) were estimated. The appraisal of their child's weight perception and parental misperception were assessed. RESULTS For 2914 children, reported height was underestimated by -1·38 cm, weight by -0·25 kg and BMI was overestimated by +0·41 kg/m2 on average. The prevalence of obesity estimated with reported data was 2·7 times higher than that calculated with measured data (16·2 v. 6·0 %) according to WHO classification, and 3·6 times higher with IOTF classification. Sensitivity to identify obesity was 70·5 %, specificity was 87·3 % and PPV was 26·2 % (WHO classification). Half of the parents of pre-schoolers with obesity failed to identify their child's weight status. Parental misperception among children classified as having overweight or obesity reached 93·0 and 58·8 %, respectively. CONCLUSIONS Parents underestimated children's height and weight, leading to an overestimation of the prevalence of obesity. Small inaccuracies in reported measures have an important effect for the estimation of population prevalences. Parents' report of child weight status is unreliable. Parental awareness and acknowledgement of child weight status should be improved.
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Kovacs BE, Gillison FB, Barnett JC. Is children's weight a public health or a private family issue? A qualitative analysis of online discussion about National Child Measurement Programme feedback in England. BMC Public Health 2018; 18:1295. [PMID: 30477468 PMCID: PMC6257949 DOI: 10.1186/s12889-018-6214-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/12/2018] [Indexed: 02/08/2023] Open
Abstract
Background The National Child Measurement Programme (NCMP) is a child weight monitoring system in England, taking place in the first and final years of primary school. Many local authorities consider it important to inform parents if their child is overweight, and do so by letter alongside the offer of support and advice. Such letters have been met with mixed reactions from parents, but research seeking to better understand parents’ responses is often limited by reliance on survey data and low participation rates. This study aimed to collect a broad variety of perspectives on the programme by analyzing views expressed in parent-to-parent discussions posted online. Methods UK-based online parenting fora were used to identify discussion threads based around the NCMP between 2010 and 2017. Thirty-one discussion threads from two parent fora were identified. Thematic analysis was used to identify themes in these data. Results The primary themes identified related to (1) the legitimacy of feedback and judgement from health professionals, (2) the relative importance of collecting population level data above individual preferences, and (3) risks versus benefits of having conversations with children about weight. Most threads adopted an ‘argument, counter-argument’ format, providing two sides to each issue raised. Information and opinions consistent with public health messages were frequently provided, such as how data are used, that feedback is intended to be helpful, and the importance of collecting national data. There was little evidence of individual parents shifting their views in response to others’ arguments. Conclusions This study provides novel insight into peer-to-peer debates about the NCMP, including the arguments parents find convincing and acceptable for and against a national programme to weigh children and provide feedback to parents about their weight. Online fora were used as an opportunity to express criticism or distress, but also to seek advice from peers regarding concerns about whether or not to opt-out. Thus, both general issues related to the legitimacy of population screening and outcomes for individual children were of concern to parents.
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Affiliation(s)
- B E Kovacs
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - F B Gillison
- Department for Health, University of Bath, Bath, BA2 7AY, UK.
| | - J C Barnett
- Department of Psychology, University of Bath, Bath, UK
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Pedroso J, Toral N, Bauermann Gubert M. Maternal dissatisfaction with their children's body size in private schools in the Federal District, Brazil. PLoS One 2018; 13:e0204848. [PMID: 30300380 PMCID: PMC6177138 DOI: 10.1371/journal.pone.0204848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 09/14/2018] [Indexed: 11/19/2022] Open
Abstract
We investigated the prevalence of maternal dissatisfaction with their child's body size and its associated factors among mothers of first- to third-grade elementary school students in private schools in the Federal District, Brazil. This is a cross-sectional study with 548 mother-schoolchildren pairs. We measured children's weight and height, and collected their mother's sociodemographic data and Body Mass Index using an online questionnaire. We also verified maternal body dissatisfaction and maternal dissatisfaction with their child's body size using Shape Scales. Most mothers (50.5%) were dissatisfied with their child's body size. Mothers of boys (Adjusted OR = 2.85) were more likely to want a larger silhouette for their child, while mothers of girls (Adjusted OR = 3.18), overweight (Adjusted OR = 24.83) and obese (Adjusted OR = 189.86) children were more likely to want a thinner silhouette for their child. A positive correlation was observed between maternal dissatisfaction with their own body and maternal dissatisfaction with their children's body size (rs = 0.178). There was a high prevalence of maternal dissatisfaction with their child's body size, particularly among mothers of overweight and obese children. Additional studies should be conducted to better understand the influence of this dissatisfaction on maternal practices and attitudes related to their child's body, food consumption, and lifestyle.
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Affiliation(s)
- Jéssica Pedroso
- Postgraduate Program in Human Nutrition, University of Brasília, Brasília, Federal District, Brazil
| | - Natacha Toral
- Postgraduate Program in Human Nutrition, University of Brasília, Brasília, Federal District, Brazil
| | - Muriel Bauermann Gubert
- Postgraduate Program in Human Nutrition, University of Brasília, Brasília, Federal District, Brazil
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Queally M, Doherty E, Matvienko-Sikar K, Toomey E, Cullinan J, Harrington JM, Kearney PM. Do mothers accurately identify their child's overweight/obesity status during early childhood? Evidence from a nationally representative cohort study. Int J Behav Nutr Phys Act 2018; 15:56. [PMID: 29921288 PMCID: PMC6006594 DOI: 10.1186/s12966-018-0688-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 06/04/2018] [Indexed: 12/22/2022] Open
Abstract
Background Maternal recognition of overweight/obesity during early childhood is a key determinant in achieving healthy weight status in children. The aim of this study is to 1) investigate maternal perceptions of their child weight, focusing on whether or not mothers accurately identify if their child is overweight or obese at three years old and five years old; 2) identify the factors influencing maternal misperceptions regarding their child’s weight at three years old and five years old, 3) ascertain if a failure to recognize overweight/obesity at three years old is associated with the likelihood of doing so at five years old. Methods Using two waves of the longitudinal Growing Up in Ireland study data regarding child, maternal, and household characteristics as well as healthcare access and utilization variables were obtained for mothers when their children are three and five years old respectively. Multivariate logistic analysis was used to examine the factors associated with mothers inaccurately perceiving their child to be of normal weight status when the child is in fact either clinically overweight or obese. Results In wave 2, 22% of mothers failed to accurately identify their child to be overweight or obese. This inaccuracy decreased to 18% in wave 3. A failure of mothers to identify their child’s overweight/obesity was more likely to occur if the child was a girl (OR: 1.25) (OR: 1.37), had a higher birth weight (OR:1.00), if the mother was obese (OR: 1.50), (OR: 1.72) or working (OR:1.25) (OR:1.16) in wave 2 and wave 3, respectively. Other factors affecting the odds of misperceiving child’s weight include gestation age, income and urban living. Conclusion These findings suggest that mothers of overweight or obese three and five year olds show poor awareness of their child’s weight status. Both child and mother characteristics play a role in influencing this awareness. Mothers unable to accurately identify their child’s overweight or obesity status at three years old are likely to do again when the child is five years old. This study highlights the need for increased support to help improve mothers’ understanding of healthy body size in preschool aged children.
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Affiliation(s)
- Michelle Queally
- Discipline of Economics, JE Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland.
| | - Edel Doherty
- Discipline of Economics, JE Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland
| | | | - Elaine Toomey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - John Cullinan
- Discipline of Economics, JE Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland
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Costa S, Pinto A, Santos AC, Oliveira A. The association of problematic eating behaviours with food quality and body mass index at 7 years of age. Eur J Clin Nutr 2018; 73:549-557. [PMID: 29748660 DOI: 10.1038/s41430-018-0169-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/27/2018] [Accepted: 03/29/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES There is scarce evidence of how certain eating behaviours compromise the compliance with dietary guidelines and weight status in school-aged children. This study aims to evaluate the association of children's problematic eating behaviours with food quality and body mass index at 7 years of age. SUBJECTS/METHODS Participants were children aged 7 years old from a population-based cohort study from Porto, Portugal-Generation XXI. Children's quantity and speed of ingestion, food refusal at the table and food rewards requesting were evaluated by caregiver's perception. Food consumption was evaluated by a food frequency questionnaire and compared with age-appropriate guidelines. Children's weight status was assessed by objective measurements and parent's perceptions. Associations were estimated by logistic regressions (odds ratio (OR), 95% confidence intervals (95% CI)) adjusted for maternal age, education, smoking during pregnancy, birth type, child's sex, weight-for-gestational age and sports (n = 3801). RESULTS Children eating small amounts of food, refusing to eat at the table with the rest of the family during meals and asking for food rewards showed a higher consumption of energy-dense foods (OR = 1.51; 95% CI:1.23-1.86; OR = 1.58; 95% CI:1.16-2.16; OR = 1.56; 95% CI:1.14-2.12) and presented higher odds of consuming fruit and vegetables below recommendations (OR = 1.41; 95% CI:1.22-1.64; OR = 1.20; 95% CI:1.00-1.45; OR = 1.28; 95% CI:1.05-1.55). Children displaying these eating behaviours were less likely to be overweight/obese, hence their parents were less likely to show concern with their weight. Including food quality as covariate in the final models with obesity status did not change the associations. CONCLUSIONS Problematic eating behaviours were associated with poorer food quality (more energy-dense foods and low fruit and vegetables), but food quality does not seem to explain the association with obesity status. Parents were less likely to be concerned about their child's weight if the child ate slowly or poorly, and accordingly the odds of them being overweight or obese were lower.
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Affiliation(s)
- Sara Costa
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Andreia Pinto
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal. .,Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal.
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Effectiveness of a parental school-based intervention to improve young children’s eating patterns: a pilot study. Public Health Nutr 2018; 21:2485-2496. [DOI: 10.1017/s1368980018000952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AbstractObjectiveTo evaluate the effectiveness of a pilot study of a parental school-based intervention to promote healthy eating behaviours in young children.DesignA quasi-experimental longitudinal design with three conditions (complete intervention (CIG), minimal intervention (MIG), control (CG)), with repeated measures at baseline, immediately after the intervention, 6 months and 1 year after intervention.SettingFourteen public and state-funded kindergartens near Lisbon, Portugal.SubjectsParents (n349) of 3- to 6-year-old children assigned to the three conditions completed the baseline protocol. The ‘Red Apple’ intervention included four parental group sessions about young children’s growth, nutritional guidelines and positive parental feeding strategies, which was combined with adult–child activities at home and in the classroom, and newsletters (CIG). MIG included only a single nutritional counselling session, whereas the CG had no intervention. At the end, thirty-eight, twenty-six and fifty-four parents in the CIG, MIG and CG, respectively, had completed all evaluation components. Data regarding parental perception of children’s weight, self-efficacy, nutritional knowledge, feeding strategies, eating behaviours and BMI were collected at the four assessment moments.ResultsThe CIG showed improvements in children’s healthy food intake, compared with the MIG and CG. Parental self-efficacy regarding the regulation of children’s eating behaviours decreased in the CG but not in both intervention groups.ConclusionsConsidering the low dosage of the intervention, the results obtained were positive. Future studies should offer additional solutions to overcome barriers to parents’ participation.
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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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Tavares BM, Klein CH, Bloch KV. Validity of informed birth weight. Study of Cardiovascular Risk in Adolescents (ERICA) - Rio de Janeiro. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2017. [DOI: 10.1590/1806-93042017000400006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to verify the agreement between birth weight information referred by the guardians of the adolescents who participated in the Study of Cardiovascular Risks in Adolescents (Portuguese acronym ERICA) and the birth weight data of the adolescents identified in the National Information System on Live Births (Portuguese acronym Sinasc). Methods: probabilistic record linkage of 1,668 records was conducted between the ERICA databases and the Sinasc databases from 1996 to 2002, both from the state of Rio de Janeiro. The agreement between the informed birth weight and the one registered in Sinasc was estimated by the Intraclass Correlation Coefficient (ICC), BlandAltman plot, Cohen's Kappa index, and Gwet's agreement coefficient. Results: the ICC was = 0.89; CI95% =0.880.90 and the higher the mother's educational level was, the higher it became. There was also an elevated agreement between the birth weight classification in the low (< 2,500 g), adequate (2,500 to 3,999 g) and elevated (≥ 4,000 g) birth weight categories, Gwet's Agreement Coefficient = 0.91; CI95%= 0.890.92. Conclusions: the results showed satisfying agreement between the birth weight referred by the parent/guardian of the adolescents, and the ones registered in SINASC, this agreement being directly proportional to the mother's educational level.
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Wells M, Goldstein LN, Bentley A. The Use of Body Habitus Reference Images Improves the Ability of Novices to Accurately Estimate Children's Weight Using the PAWPER XL Tape System. J Emerg Med 2017; 54:165-175. [PMID: 29169918 DOI: 10.1016/j.jemermed.2017.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 09/05/2017] [Accepted: 10/07/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The original methodology of the PAWPER (Pediatric Advanced Weight Prediction in the Emergency Room) tape relies on a gestalt visual assessment of a child's body habitus to adjust a length-based weight estimation. This assessment is dependent on the user's subjective opinion, which may result in aberrations in accuracy between users and populations. With the development of the second-generation PAWPER XL tape, a more objective method of habitus evaluation was desired. OBJECTIVE The aim of this study was to evaluate a new, more objective figural reference image system and a new checklist system for quantifying body habitus. METHODS Volunteers were asked to assess the body habitus score of 90 children from a sequence of photographic images using the standard gestalt visual assessment system, a new checklist system, and a system using figural reference images. PAWPER XL tape weight estimations were generated from these scores, which were compared between the three test groups. Participants were also surveyed on their preferences for the different methodologies. RESULTS There were 11,505 habitus score assessments from 138 doctor, nurse, and paramedic participants. The figural reference image system significantly outperformed the checklist system and the gestalt visual assessment system in terms of weight estimation accuracy, achieving 70.9%, 61.1%, and 60.9% of estimations within 10% of measured weight, respectively. The participants expressed a strong subjective preference for the image system because of speed of use, ease of use, perceived accuracy, objectivity, and low cognitive load. CONCLUSIONS The figural reference image system was objectively much more accurate than, and subjectively preferable to, the original gestalt visual estimation methodology.
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Affiliation(s)
- Mike Wells
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
| | - Lara Nicole Goldstein
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
| | - Alison Bentley
- Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
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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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Miura K, Ballard E, Clemens SL, Harper CM, Begum N, O'Rourke PK, Green AC. Sex-specific associations with youth obesity in Queensland, Australia. Public Health 2017; 145:146-148. [PMID: 28359383 DOI: 10.1016/j.puhe.2016.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/14/2016] [Accepted: 12/18/2016] [Indexed: 10/20/2022]
Affiliation(s)
- K Miura
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group, 300 Herston Road, Herston, Queensland, Australia
| | - E Ballard
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group, 300 Herston Road, Herston, Queensland, Australia
| | - Susan L Clemens
- Preventative Health Branch, Queensland Government Department of Health, Brisbane, Queensland, Australia
| | - C M Harper
- Preventative Health Branch, Queensland Government Department of Health, Brisbane, Queensland, Australia
| | - N Begum
- Preventative Health Branch, Queensland Government Department of Health, Brisbane, Queensland, Australia
| | - P K O'Rourke
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group, 300 Herston Road, Herston, Queensland, Australia
| | - A C Green
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group, 300 Herston Road, Herston, Queensland, Australia; CRUK Manchester Institute, University of Manchester, Wilmslow Road, Manchester, UK.
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Ávila-Ortiz MN, Castro-Sánchez AE, Zambrano-Moreno A. Mexican mothers' perceptions of their child's body weight. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:569-577. [PMID: 27038122 DOI: 10.1111/hsc.12344] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 06/05/2023]
Abstract
Currently, Mexico holds one of the top rankings in childhood obesity worldwide. This present qualitative study aims to explore and describe mothers' perceptions concerning the body weight of their children and, based on these findings, be able to arrive at a typology. Research included 91 semi-structured interviews administered to mothers of children who were underweight (UW), normal weight (NW), overweight (OW) or obese (OB). The data were collected between June 2011 and December 2013. The information was analysed with MAXQDA qualitative software. It was found that overestimated perception in UW children is observed in mothers who fear gaining weight. Mothers of NW children tend to gauge the weight of their children close to that which is normal. OW children are appropriately perceived by their mothers; however, these mothers are not concerned by this situation because for them, it is something temporary that will disappear as the child grows. The majority of boys who were OB were underestimated in their weight; those who were appropriately perceived showed class II or III obesity. Mothers typically perceived OW and OB girls with greater precision. The mothers who perceived obesity in their sons or daughters felt responsible, which motivated them to change their children's habits and behaviours. Therefore, health professionals should communicate and help these mothers recognise OW and OB status in their children. Furthermore, the importance of prevention should be stressed when a child is OW, and they should be informed of the high health risks that accompany obesity.
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Affiliation(s)
| | - Ana Elisa Castro-Sánchez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León (UANL), Nuevo León, México
| | - Adriana Zambrano-Moreno
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León (UANL), Nuevo León, México
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Gomes AI, Barros L, Pereira AI. Predictors of parental concerns about child weight in parents of healthy-weight and overweight 2–6 year olds. Appetite 2017; 108:491-497. [DOI: 10.1016/j.appet.2016.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 10/14/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
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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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Byrne R, Magarey A, Daniels L. Maternal perception of weight status in first-born Australian toddlers aged 12-16 months--the NOURISH and SAIDI cohorts. Child Care Health Dev 2016; 42:375-81. [PMID: 27001154 DOI: 10.1111/cch.12335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/09/2016] [Accepted: 02/15/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND The preference amongst parents for heavier infants is in contrast to obesity prevention efforts worldwide. Parents are poor at identifying overweight in older children, but few studies have investigated maternal perception of weight status amongst toddlers and none in the Australian setting. METHODS Mothers (n = 290) completed a self-administered questionnaire at child age 12-16 months, defining their child's weight status as underweight, normal weight, somewhat overweight or very overweight. Weight-for-length z-score was derived from measured weight and length, and children categorized as underweight, normal weight, at risk overweight or obese (WHO standards). Objective classification was compared with maternal perception of weight status. Mean weight-for-length z-score was compared across categories of maternal perception using one-way ANOVA. Multinomial logistic regression was used to determine child or maternal characteristics associated with inaccurate weight perception. RESULTS Most children (83%) were perceived as normal weight. Twenty nine were described as underweight, although none were. Sixty-six children were at risk of overweight, but 57 of these perceived as normal weight. Of the 14 children who were overweight, only 4 were identified as somewhat overweight by their mother. Compared with mothers who could accurately classify their normal weight child, mothers who were older had higher odds of perceiving their normal weight child as underweight, while mothers with higher body mass index had slightly higher odds of describing their overweight/at risk child as normal weight. CONCLUSION The leaner but healthy weight toddler was perceived as underweight, while only the heaviest children were recognized as overweight. Mothers unable to accurately identify children at risk are unlikely to act to prevent further excess weight gain. Practitioners can lead a shift in attitudes towards weight in infants and young children, promoting routine growth monitoring and adequate but not rapid weight gain.
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Affiliation(s)
- R Byrne
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Centre for Children's Health Research, South Brisbane, Queensland, Australia
| | - A Magarey
- Nutrition and Dietetics, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - L Daniels
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
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Pesch MH, Rizk M, Appugliese DP, Rosenblum KL, Miller A, Lumeng JC. Maternal concerns about children overeating among low-income children. Eat Behav 2016; 21:220-7. [PMID: 27010491 PMCID: PMC4851563 DOI: 10.1016/j.eatbeh.2016.03.017] [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: 08/18/2015] [Revised: 02/05/2016] [Accepted: 03/01/2016] [Indexed: 10/22/2022]
Abstract
Addressing overeating is essential to obesity treatment and prevention. The objectives of this study were to investigate maternal concern for child overeating, to identify associated participant characteristics and to determine if concern for child overeating is associated with maternal feeding practices. Low-income mothers (N=289) of children (mean age 70.8months) participated in a semi-structured interview. Themes of maternal concern for child overeating were identified and a coding scheme was reliably applied. Maternal feeding practices were measured by questionnaire and videotaped eating interactions. Logistic regressions were used to test the associations of participant characteristics with the presence of each theme, and bivariate analyses were used to test the associations of the presence of each theme with feeding practices. Three themes were identified: 1) mothers worry that their child does overeat, 2) mothers acknowledge that their child may overeat but indicate that it is not problematic because they manage their child's eating behavior, and 3) mothers acknowledge that their child may overeat but indicate that it is not problematic because of characteristics inherent to the child. Child obesity predicted the themes; mothers of obese and overweight children are more likely to be concerned about overeating. Themes were associated with lower levels of observed pressure to eat. Only Theme 2 was associated with greater restrictive feeding practices. Interventions that provide parents' practical, healthy ways to prevent child overeating may be helpful.
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Affiliation(s)
- Megan H. Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
| | - Monika Rizk
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan
| | | | - Katherine L. Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Medical School, University of Michigan. Ann Arbor, Michigan
| | - Alison Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan,Department of Psychology, University of Michigan. Ann Arbor, Michigan,Department of Health Behavior and Health Education, School of Public Health, University of Michigan. Ann Arbor, Michigan
| | - Julie C. Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan,Department of Nutritional Sciences, School of Public Health, University of Michigan. Ann Arbor, Michigan
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Zarychta K, Mullan B, Luszczynska A. Am I Overweight? A Longitudinal Study on Parental and Peers Weight-Related Perceptions on Dietary Behaviors and Weight Status Among Adolescents. Front Psychol 2016; 7:83. [PMID: 26869979 PMCID: PMC4740369 DOI: 10.3389/fpsyg.2016.00083] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 01/15/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE An investigation of the interplay between various types of adolescents' perceptions of weight status in predicting adolescents' nutrition behavior and their body mass was conducted. In particular, it was hypothesized that the relationship between parental and peers' perceptions of their own weight status (reported by adolescents) and objectively measured weight status of adolescents would be mediated by three types of adolescents' weight status perceptions (adolescents' own weight perceptions, parental perceptions of adolescents' weight status perceived by participants, and peers' perceptions of adolescents' weight status perceived by participants) and by adolescents' nutrition behaviors. DESIGN Data were collected twice, with a 13-month follow-up. Participants (N = 1096) were aged 14-20, with BMI ranging from 16.20 to 41.21. Multiple mediation analysis with two sequential mediators was applied. MAIN OUTCOME MEASURES At the baseline adolescents completed the questionnaire assessing their nutrition behaviors and weight status perceptions. Weight and height were measured objectively at baseline and follow-up. RESULTS Two types of weight perceptions (adolescents' own weight status perceptions, peers' perceptions of adolescents' weight status reported by participants), and adolescents' nutrition behaviors mediated the relationship between the others' own weight perceptions and adolescents' weight status. No indirect effects of others' own weight perceptions on adolescents' weight status through parental perceptions were found. CONCLUSION Adolescents' nutrition behaviors and body weight status depend on what they think about their own weight status and what they think of their peers' perceptions, but do not depend on what adolescents think of their parents' perceptions.
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Affiliation(s)
| | | | - Aleksandra Luszczynska
- SWPS University of Social Sciences and HumanitiesWroclaw, Poland; University of Colorado at Colorado Springs, Colorado SpringsCO, USA
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Nascimento MMR, Melo TR, Pinto RMC, Morales NMO, Mendonça TMS, Paro HBMDS, Silva CHM. Parents’ perception of health‐related quality of life in children and adolescents with excess weight. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2016. [DOI: 10.1016/j.jpedp.2015.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Nascimento MMR, Melo TR, Pinto RMC, Morales NMO, Mendonça TMS, Paro HBMDS, Silva CHM. Parents' perception of health-related quality of life in children and adolescents with excess weight. J Pediatr (Rio J) 2016; 92:65-72. [PMID: 26397741 DOI: 10.1016/j.jped.2015.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/09/2015] [Accepted: 04/15/2015] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception. METHODS This was a cross-sectional study involving 297 caregivers of children and adolescents with normal weight (n=170) and with overweight/obesity (n=127), from public and private schools in the study municipality. HRQOL scores obtained through the Child Health Questionnaire - Parent Form 50 (CHQ-PF50) were compared according to the nutritional status and gender of the children/adolescents. Multiple regression analysis was used to determine the predictive value of studied variables for the variation in HRQOL scores. RESULTS Parents of children/adolescents with overweight/obesity attributed lower HRQOL scores to their children in the following domains: physical functioning (p<0.01; d=0.49), self-esteem (p<0.01; d=0.38), parental impact-emotional (p<0.05; d=0.29), family cohesion (p<0.05; d=0.26), physical summary score (p<0.05; d=0.29), and psychosocial summary score (p<0.05; d=0.25). In the multiple regression models, the variables with the highest contribution to the variation in HRQOL scores were: in the physical functioning domain, parental impact-time (β=0.23; p<0.05); self-esteem, nutritional status (β=-0.18; p≤0.01); emotional impact on parents, impact on parents' time (β=0.31; p<0.05); and in family cohesion, global behavior (β=0.30; p<0.05). CONCLUSIONS A negative impact on HRQOL of children/adolescents with overweight/obesity was observed in the physical and psychosocial aspects. The nutritional status was the variable with the greatest contribution for the assessment the self-esteem of children and adolescents in this study.
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Affiliation(s)
| | - Tatiana Rocha Melo
- Post-Graduate Program in Health Sciences, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil
| | - Rogério Melo Costa Pinto
- Post-Graduate Program in Health Sciences, Faculdade de Matemática, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil
| | - Nívea Macedo Oliveira Morales
- Post-Graduate Program in Health Sciences, Department of Pediatrics, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil
| | - Tânia Maria Silva Mendonça
- Post-Graduate Program in Health Sciences, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil
| | - Helena Borges Martins da Silva Paro
- Post-Graduate Program in Health Sciences, Department of Gynecology and Obstetrics, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil.
| | - Carlos Henrique Martins Silva
- Post-Graduate Program in Health Sciences, Department of Pediatrics, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil
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Vallejo M, Cortes-Rodríguez BA, Colin-Ramirez E. Maternal Underestimation of Child's Weight Status and Health Behaviors as Risk Factors for Overweight in Children. J Pediatr Nurs 2015; 30:e29-33. [PMID: 25764943 DOI: 10.1016/j.pedn.2015.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/19/2015] [Accepted: 02/21/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate children's risk of being overweight associated with maternal underestimation of weight status and health behaviors. RESULTS One hundred forty mother-child dyads were included. Children whose weight status was underestimated by their mothers were at greater risks of being overweight compared to those whose weigh status was correctly perceived (adjusted OR 2.31, 95% CI 1.11-4.81). Less television viewing time was associated with a 63% reduced risk of being overweight (adjusted OR .37, 95% CI .17-.83). CONCLUSIONS Maternal underestimation of weight status was common among overweight and normal-weight children, and it was associated with an increased children's risk of being overweight.
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Affiliation(s)
- Maite Vallejo
- National Institute of Cardiology, Mexico City, Mexico
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FREITAS TPDDA, SILVA LLSD, TELES GS, PEIXOTO MDRG, MENEZES IHCF. Fatores associados à subestimação materna do peso da criança: um estudo de base populacional. REV NUTR 2015. [DOI: 10.1590/1415-52732015000400006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo Investigar os fatores associados à subestimação materna do peso de crianças menores de cinco anos de Goiânia, Goiás. Métodos Estudo transversal, de base populacional, domiciliar, com 673 crianças menores de cinco anos de idade. A percepção materna do peso da criança foi obtida pela pergunta: "Atualmente, o que a senhora (mãe) acha do peso do seu filho?", e o estado nutricional da criança foi avaliado pelo índice de massa corporal por idade. Regressão múltipla de Poisson foi realizada a um nível de significância de 5%. Para a análise de concordância, foi utilizado o teste Kappa. Resultados Das crianças estudadas, 1,6% estavam magras, 87,7% eutróficas e 10,7% com excesso de peso. A maioria das mães (66,0%) identificou corretamente o peso de seus filhos; 5,2% superestimaram, e 28,8% subestimaram. Mães de crianças com excesso de peso, idade superior a 24 meses, apresentaram maior prevalência de subestimação, enquanto as mães com excesso de peso e maior escolaridade apresentaram menor subestimação do peso das crianças. A concordância entre a opinião materna sobre o peso da criança e o real estado nutricional da criança foi de 0,12 (p<0,001). CONCLUSÃO Existe uma distorção na percepção materna do peso de crianças menores de cinco anos. A subestimação materna do peso da criança apresentou associação direta com idade e estado nutricional da criança e associação inversa com escolaridade e estado nutricional materno. Sugere-se atenção no atendimento a essas mães com o objetivo de evitar o ganho de peso excessivo nessa idade e prejuízos na saúde da criança.
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Abstract
AbstractObjectiveParental body image dissatisfaction (BID) is associated with children’s weight in cross-sectional studies; however, it is unknown whether BID predicts development of adiposity. The objective of the present study was to investigate the associations between maternal dissatisfaction with her or her child’s body and children’s BMI trajectories.DesignLongitudinal study. Maternal dissatisfaction (BID) with her and her child’s body was calculated based on ratings of Stunkard scales obtained at recruitment, as current minus desired body image. Children’s height and weight were measured at baseline and annually for a median of 2·5 years. Mixed-effects models with restricted cubic splines were used to construct sex- and weight-specific BMI-for-age curves according to maternal BID levels.SettingPublic primary schools in Bogotá, Colombia.SubjectsChildren (n 1523) aged 5–12 years and their mothers.ResultsAfter multivariable adjustment, heavy boys and thin girls whose mothers desired a thinner child gained an estimated 1·7 kg/m2 more BMI (P=0·04) and 2·4 kg/m2 less BMI (P=0·004), respectively, between the age 6 and 14 years, than children of mothers without BID. Normal-weight boys whose mothers desired a thinner child’s body gained an estimated 1·8 kg/m2 less BMI than normal-weight boys of mothers without BID (P=0·02). Maternal BID with herself was positively related to children’s BMI gain during follow-up.ConclusionsMaternal BID is associated with child’s BMI trajectories in a sex- and weight-specific manner.
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Abstract
OBJECTIVE To determine what factors are associated with parental motivation to change body weight in overweight children. DESIGN Cross-sectional study. SETTING Dunedin, New Zealand. SUBJECTS Two hundred and seventy-one children aged 4-8 years, recruited in primary and secondary care, were identified as overweight (BMI ≥ 85th percentile) after screening. Parents completed questionnaires on demographics; motivation to improve diet, physical activity and weight; perception and concern about weight; parenting; and social desirability, prior to being informed that their child was overweight. Additional measures of physical activity (accelerometry), dietary intake and child behaviour (questionnaire) were obtained after feedback. RESULTS Although all children were overweight, only 42% of parents perceived their child to be so, with 36% indicating any concern. Very few parents (n 25, 8%) were actively trying to change the child's weight. Greater motivation to change weight was observed for girls compared with boys (P = 0.001), despite no sex difference in BMI Z-score (P = 0.374). Motivation was not associated with most demographic variables, social desirability, dietary intake, parenting or child behaviour. Increased motivation to change the child's weight was observed for heavier children (P < 0.001), those who were less physically active (P = 0.002) and more sedentary (P < 0.001), and in parents who were more concerned about their child's weight (P < 0.001) or who used greater food restriction (P < 0.001). CONCLUSIONS Low levels of parental motivation to change overweight in young children highlight the urgent need to determine how best to improve motivation to initiate change.
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Duchin O, Mora-Plazas M, Marin C, de Leon CM, Lee JM, Baylin A, Villamor E. BMI and sociodemographic correlates of body image perception and attitudes in school-aged children. Public Health Nutr 2014; 17:2216-25. [PMID: 24172038 PMCID: PMC10282626 DOI: 10.1017/s1368980013002309] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/26/2013] [Accepted: 07/25/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of the present study was to identify correlates of body image perception and dissatisfaction among school-aged children from Colombia, a country undergoing the nutrition transition. DESIGN Cross-sectional study. Using child-adapted Stunkard scales, children were asked to indicate the silhouette that most closely represented their current and desired body shapes. Body image dissatisfaction (BID) score was estimated as current minus desired silhouette. Height and weight were measured in all children. Sociodemographic data were collected through questionnaires completed by the children's mothers. SETTING Public primary schools in Bogotá, Colombia. SUBJECTS Children aged 5-12 years (n 629) and their mothers. RESULTS Mean BID score was 0·1 (SD 1·7). The strongest predictor of BID was actual BMI-for-age Z-score (BAZ). Compared with children with BAZ ≥ -1 and < 1, those with BAZ ≥ 2 had a 1·9 units higher BID score (P for trend < 0·0001). BID tended to be higher in girls than boys at any level of BAZ. Other correlates of BID included child's height-for-age Z-score, maternal BMI and dissatisfaction with the child's body, and home ownership. CONCLUSIONS Among school-aged children from a country experiencing the nutrition transition, body image perception was associated with the child's weight and height, and with maternal BMI, dissatisfaction with the child's body and socio-economic level.
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Affiliation(s)
- Ofra Duchin
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Constanza Marin
- Fundación para Investigación en Nutrición y Salud, FINUSAD, Bogotá, Colombia
| | - Carlos Mendes de Leon
- Department of Epidemiology, University of Michigan School of Public Health, M5055 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
| | - Joyce M Lee
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Division of Pediatric Endocrinology, University of Michigan, Ann Arbor, MI, USA
| | - Ana Baylin
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan School of Public Health, M5055 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
| | - Eduardo Villamor
- Department of Epidemiology, University of Michigan School of Public Health, M5055 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
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Kelishadi R, Azizi-Soleiman F. Controlling childhood obesity: A systematic review on strategies and challenges. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:993-1008. [PMID: 25538786 PMCID: PMC4274579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 01/26/2014] [Accepted: 03/03/2014] [Indexed: 11/03/2022]
Abstract
BACKGROUND Childhood obesity is a global health problem with short- and long-term health consequences. This systematic review presents a summary of the experiences on different family-, school-, and clinic-based interventions. MATERIALS AND METHODS Electronic search was conducted in MEDLINE, PubMed, ISI Web of Science, and Scopus scientific databases. We included those studies conducted among obese individuals aged up to 18 years. Our search yielded 105 relevant papers, 70 of them were conducted as high quality clinical trials. RESULTS Our findings propose that school-based programs can have long-term effects in a large target group. This can be related to this fact that children spend a considerable part of their time in school, and adopt some parts of lifestyle there. They have remarkable consequences on health behaviors, but as there are some common limitations, their effects on anthropometric measures are not clear. Due to the crucial role of parents in development of children's behaviors, family-based interventions are reported to have successful effects in some aspects; but selection bias and high dropout rate can confound their results. Clinic-based interventions revealed favorable effects. They include dietary or other lifestyle changes like increasing physical activity or behavior therapy. It seems that a comprehensive intervention including diet and exercise are more practical. When they have different designs, results are controversial. CONCLUSION We suggest that among different types of interventional programs, a multidisciplinary approach in schools in which children's family are involved, can be the best and most sustainable approach for management of childhood obesity.
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Affiliation(s)
- Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primary Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Azizi-Soleiman
- School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Fatemeh Azizi-Soleiman, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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Lupi JL, Haddad MB, Gazmararian JA, Rask KJ. Parental perceptions of family and pediatrician roles in childhood weight management. J Pediatr 2014; 165:99-103.e2. [PMID: 24721470 DOI: 10.1016/j.jpeds.2014.02.064] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/15/2014] [Accepted: 02/19/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To characterize parental perceptions of the respective roles of families and the pediatrician in childhood weight management. STUDY DESIGN Structured in-person interviews (n = 69) were conducted with parents of children ages 3-12 years visiting a pediatric clinic. Interview topics included perceptions of weight and associated problems, child weight status and concerns, and the pediatrician's role in weight management. Interviews were coded qualitatively and analyzed thematically. RESULTS Nine major themes were developed from the findings. Parents were clear about the health consequences of excess weight but were not clear about the concept of body mass index, often relying on visual cues or symptoms to identify excess weight. Parents relied on pediatricians to identify weight problems and suggest diet and exercise plans, but few recognized them as a link to additional weight-management resources. Parents were divided on the role of the pediatrician in managing child weight and were most interested in receiving tailored nutrition information. Parents preferred family behavioral change strategies over singling out an overweight child. Although parents did not always define their child as overweight, many parents of overweight children did express concerns about their child's weight. CONCLUSIONS Parents believe that pediatricians have a central role in identifying childhood weight problems by completing screening tests such as body mass index assessments, interpreting the health implications, and communicating those implications to parents. Ensuring that parents understand the health implications of excess weight is critical given gaps in parental knowledge and confidence with healthy lifestyle changes as well as parental ambivalence toward child-directed interventions.
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Affiliation(s)
- Jenna L Lupi
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
| | - Maryam B Haddad
- Laney Graduate School, Emory University, Atlanta, GA; Department of Epidemiology, Emory University, Atlanta, GA
| | | | - Kimberly J Rask
- Department of Health Policy and Management, Emory University, Atlanta, GA.
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Falconer CL, Park MH, Croker H, Skow Á, Black J, Saxena S, Kessel AS, Karlsen S, Morris S, Viner RM, Kinra S. The benefits and harms of providing parents with weight feedback as part of the national child measurement programme: a prospective cohort study. BMC Public Health 2014; 14:549. [PMID: 24888972 PMCID: PMC4057922 DOI: 10.1186/1471-2458-14-549] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 05/14/2014] [Indexed: 01/18/2023] Open
Abstract
Background Small-scale evaluations suggest that the provision of feedback to parents about their child’s weight status may improve recognition of overweight, but the effects on lifestyle behaviour are unclear and there are concerns that informing parents that their child is overweight may have harmful effects. The aims of this study were to describe the benefits and harms of providing weight feedback to parents as part of a national school-based weight-screening programme in England. Methods We conducted a pre-post survey of 1,844 parents of children aged 4–5 and 10–11 years who received weight feedback as part of the 2010–2011 National Child Measurement Programme. Questionnaires assessed general knowledge about the health risks associated with child overweight, parental recognition of overweight and the associated health risks in their child, child lifestyle behaviour, child self-esteem and weight-related teasing, parental experience of the feedback, and parental help-seeking behaviour. Differences in the pre-post proportions of parents reporting each outcome were assessed using a McNemar’s test. Results General knowledge about child overweight as a health issue was high at baseline and increased further after weight feedback. After feedback, the proportion of parents that correctly recognised their child was overweight increased from 21.9% to 37.7%, and more than a third of parents of overweight children sought further information regarding their child’s weight. However, parent-reported changes in lifestyle behaviours among children were minimal, and limited to increases in physical activity in the obese children only. There was some suggestion that weight feedback had a greater impact upon changing parental recognition of the health risks associated with child overweight in non-white ethnic groups. Conclusions In this population-based sample of parents of children participating in the National Child Measurement Programme, provision of weight feedback increased recognition of child overweight and encouraged some parents to seek help, without causing obvious unfavourable effects. The impact of weight feedback on behaviour change was limited; suggesting that further work is needed to identify ways to more effectively communicate health information to parents and to identify what information and support may encourage parents in making and maintaining lifestyle changes for their child.
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Affiliation(s)
- Catherine L Falconer
- Bristol Biomedical Research Unit in Nutrition, Diet and Lifestyle, Level 3, University Hospitals Bristol Education Centre, Bristol BS2 8AE, UK.
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"Teens Talk Healthy Weight": the impact of a motivational digital video disc on parental knowledge of obesity-related diseases in an adolescent clinic. J Acad Nutr Diet 2014; 114:1611-8. [PMID: 24882205 DOI: 10.1016/j.jand.2014.04.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 04/09/2014] [Indexed: 12/16/2022]
Abstract
The purpose of the study was to investigate the impact of a 7-minute educational and motivational weight-management digital video disc (DVD) that uses real patient/parent testimonials and provider-patient interactions, on adolescent and parent knowledge of obesity-related diseases; readiness, motivation, and self-efficacy to lose weight; connectedness to care provider; and likelihood of return to clinic for follow-up care. A randomized controlled trial was conducted among 40 overweight/obese adolescent participants (22.5% male, 77.5% female, mean age=15.43 years) and their parents (n=38) who visited a referral-only adolescent clinic for the first time from October 2009 to March 2010. Adolescents were randomly assigned by a research assistant to standard care alone or standard care plus DVD. Standard care (protocol-driven medical and nutritional assessment and counseling) was provided to all adolescents by a registered dietitian nutritionist and physician or nurse practitioner. Adolescents in the intervention group also viewed the DVD. Adolescents and parents completed assessments pre- and post-clinic visit. Repeated measures analysis of covariance was used to evaluate group differences, while controlling for race/ethnicity and age. Parents who viewed the DVD experienced greater improvements in obesity-related disease knowledge than parents who did not view the DVD. Adolescents in both groups improved on measures of motivation to lose weight and dieting self-efficacy, based on pre and post-test questionnaires. A 7-minute educational and motivational DVD helped improve parent knowledge, but was not more powerful than standard care alone in changing other weight-related outcomes in this adolescent clinic. Because it led to increased parental knowledge, incorporating the DVD into clinical practice could also allow more time for health providers to focus on specific obesity-related treatment/education. Future research might examine whether the DVD has more utility in different settings, such as primary care.
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Gerards SMPL, Gubbels JS, Dagnelie PC, Kremers SPJ, Stafleu A, de Vries NK, Thijs C. Parental perception of child's weight status and subsequent BMIz change: the KOALA birth cohort study. BMC Public Health 2014; 14:291. [PMID: 24678601 PMCID: PMC3983903 DOI: 10.1186/1471-2458-14-291] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 03/24/2014] [Indexed: 11/15/2022] Open
Abstract
Background Parents often fail to correctly perceive their children’s weight status, but no studies have examined the association between parental weight status perception and longitudinal BMIz change (BMI standardized to a reference population) at various ages. We investigated whether parents are able to accurately perceive their child’s weight status at age 5. We also investigated predictors of accurate weight status perception. Finally, we investigated the predictive value of accurate weight status perception in explaining children’s longitudinal weight development up to the age of 9, in children who were overweight at the age of 5. Methods We used longitudinal data from the KOALA Birth Cohort Study. At the child’s age of 5 years, parents filled out a questionnaire regarding child and parent characteristics and their perception of their child’s weight status. We calculated the children’s actual weight status from parental reports of weight and height at ages 2, 5, 6, 7, 8, and 9 years. Regression analyses were used to identify factors predicting which parents accurately perceived their child’s weight status. Finally, regression analyses were used to predict subsequent longitudinal BMIz change in overweight children. Results Eighty-five percent of the parents of overweight children underestimated their child’s weight status at age 5. The child’s BMIz at age 2 and 5 were significant positive predictors of accurate weight status perception (vs. underestimation) in normal weight and overweight children. Accurate weight status perception was a predictor of higher future BMI in overweight children, corrected for actual BMI at baseline. Conclusions Children of parents who accurately perceived their child’s weight status had a higher BMI over time, probably making it easier for parents to correctly perceive their child’s overweight. Parental awareness of the child’s overweight as such may not be sufficient for subsequent weight management by the parents, implying that parents who recognize their child’s overweight may not be able or willing to adequately manage the overweight.
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Affiliation(s)
- Sanne M P L Gerards
- Department of Health Promotion, and NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
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Brødsgaard A, Wagner L, Peitersen B, Poulsen I. Action competence obstacles to managing childhood overweight: in-depth interviews with mothers of 7- to 9-year-old children. J Pediatr Nurs 2013; 28:453-63. [PMID: 23531468 DOI: 10.1016/j.pedn.2013.02.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 02/25/2013] [Accepted: 02/27/2013] [Indexed: 01/19/2023]
Abstract
This qualitative phenomenological study interviewed seven mothers to overweight children and six mothers to non-overweight children aged 7 to 9 years old about their views and experiences with preventing and managing overweight in their children. The essence was that the mothers felt responsible for their children's habits, including those leading to overweight. They also felt that competent and had the opportunity to take preventive measures against child overweight but they did not always have the energy to do so. Even resourceful mothers required support from nurses and health professionals. Our results contribute to better understanding how to approach, motivate and support mothers to draw on their own competencies to benefit their children's weight and health.
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Affiliation(s)
- Anne Brødsgaard
- Department of Paediatrics, Copenhagen University Hospital Hvidovre and Research Unit of Nursing, Institute of Clinical Research, University of Southern Denmark, Odense.
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Perceptions of health risk among parents of overweight children: a cross-sectional study within a cohort. Prev Med 2013; 57:55-9. [PMID: 23591440 DOI: 10.1016/j.ypmed.2013.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 04/01/2013] [Accepted: 04/08/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify the socio-demographic and behavioural characteristics associated with perceptions of weight-related health risk among the parents of overweight children. METHODS Baseline data from a cohort of parents of children aged 4-11 years in five areas in England in 2010-2011 were analysed; the sample was restricted to parents of overweight children (body mass index ≥ 91(st) centile of UK 1990 reference; n=579). Associations between respondent characteristics and parental perception of health risk associated with their child's weight were examined using logistic regression analyses. RESULTS Most parents (79%) did not perceive their child's weight to be a health risk. Perception of a health risk was associated with recognition of the child's overweight status (OR 10.59, 95% CI 5.51 to 20.34), having an obese child (OR 4.21, 95% CI 2.28 to 7.77), and having an older child (OR 2.67, 95% CI 1.32 to 5.41). However, 41% of parents who considered their child to be overweight did not perceive a health risk. CONCLUSIONS Parents that recognise their child's overweight status, and the parents of obese and older children, are more likely to perceive a risk. However, many parents that acknowledge their child is overweight do not perceive a related health risk.
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Tanner C, Maher J, Fraser S. ‘I DON'T WANT HER TO BE OVERWEIGHT LIKE I WAS AS A GIRL’. AUSTRALIAN FEMINIST STUDIES 2013. [DOI: 10.1080/08164649.2013.789583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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