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Parent Perspectives on Implementing Health Behavior Recommendations for Their Infants. REPORTS 2020. [DOI: 10.3390/reports3040035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Little is known about the influence of parental values, preferences, and child achievement and health expectations on parent choices for their child’s rearing practices. We aimed to explore parents’ perceptions of immediate and future impact of health behavior decisions for their child and to understand factors associated with child-specific health behavior decisions. This pilot study included interviews with 25 parents of 9–24-month-old children attending well child care visits at a primary care practice. Questions assessed parental perceptions and attitudes in making health behavior changes now for their child’s future health. Themes suggest parents perceive many factors are involved, and intricately connected, in health behavior decision-making. Although almost all parents believed there is a connection between the foods they feed their child and achieving their goals, only half are willing to make a change. In addition, parents failed to consider the impact of the health practices they currently have with their children to influence the future acquisition of life skills and of healthy versus obesogenic behaviors. Our results add to the understanding of the process of health behavior change through anticipatory guidance. Study findings will be used to guide next steps towards refining our understanding of health and lifestyle change decisions made by parents.
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Lowenstein LM, Perrin EM, Berry D, Vu MB, Pullen Davis L, Cai J, Tzeng JP, Ammerman AS. Childhood obesity prevention: fathers' reflections with healthcare providers. Child Obes 2013; 9:137-43. [PMID: 23472966 PMCID: PMC3621357 DOI: 10.1089/chi.2012.0111] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND To prevent childhood obesity, parents and their children's healthcare providers need to engage in effective dialogue. We know much about mothers' experiences, but very little about fathers' experiences. METHODS We explored African-American, Caucasian, and Latino fathers' perceptions and experiences communicating with their children's provider during clinic visits regarding weight, diet, and physical activity. Focus groups (n=3), grouped by race/ethnicity, including a total of 24 fathers, were conducted. The men were asked open-ended questions; responses were recorded and transcribed, and analyzed using ATLAS.ti. RESULTS Findings revealed that these fathers were involved in their children's healthcare and found providers to be helpful partners in keeping their children healthy, yet they generally felt "left out" during clinic appointments. The quality of the relationship with their children's provider influenced how receptive fathers were to discussing their children's weight, diet, and physical activity behaviors. Fathers made suggestions to help improve communication between providers and fathers, such as personalizing the discussion. CONCLUSIONS These fathers expressed strong feelings about the provider-parent relationship when discussing weight, diet, and physical activity.
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Affiliation(s)
- Lisa M. Lowenstein
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Present address: Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Eliana M. Perrin
- Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC.,Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
| | - Diane Berry
- School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Maihan B. Vu
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
| | - Lisa Pullen Davis
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC.,Present address: Duke Translational Medicine Institute, Duke University, Durham, NC
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Janice P. Tzeng
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Present address: RTI International, Raleigh, NC
| | - Alice S. Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
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Ariza AJ, Laslo KM, Thomson JS, Seshadri R, Binns HJ. Promoting growth interpretation and lifestyle counseling in primary care. J Pediatr 2009; 154:596-601.e1. [PMID: 19028389 DOI: 10.1016/j.jpeds.2008.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Revised: 08/27/2008] [Accepted: 10/02/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To pilot a practice-directed intervention to promote growth interpretation and lifestyle counseling during child health supervision visits. STUDY DESIGN The intervention at 4 diverse primary care practices included education, facilitation by a practice-change leadership team, tools, and guidance from the study team. Preintervention and postintervention evaluations used were clinician interviews, in-office surveys of parents, 1-month post-visit telephone survey, visit observations, and medical record reviews. Outcomes evaluated growth interpretation documentation, clinician recognition of overweight, topic discussed at health supervision visit, and parental visit content recall and health behavior changes. RESULTS The intervention was well accepted, and tools provided were deemed helpful. Documentation of growth interpretation was higher after intervention (pre versus post: 32% vs 87%; P< .001). Parent reports of topics discussed were similar between evaluation periods (pre versus post: growth 96% vs 99%; diet 90% vs 93%; physical activity 81% vs 85%). Observed topics at health supervision visits were similarly high and were unchanged between periods. Parental recall of topics at 1 month was also high and similar between periods. Parental report of adoption of a healthier behavior for themselves or their child at 1 month did not significantly change. CONCLUSIONS The Systematic Nutritional Assessment in Pediatric Practice intervention provides a promising model to increase interpretation and documentation of growth.
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Affiliation(s)
- Adolfo J Ariza
- Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Chicago, IL, USA.
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Taveras EM, Gortmaker SL, Mitchell KF, Gillman MW. Parental perceptions of overweight counseling in primary care: the roles of race/ethnicity and parent overweight. Obesity (Silver Spring) 2008; 16:1794-801. [PMID: 18497738 DOI: 10.1038/oby.2008.264] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine parental perceptions of primary care efforts aimed at childhood obesity prevention. METHODS AND PROCEDURES We interviewed 446 parents of children, aged 2-12 years, with an age- and sex-specific BMI > or =85th percentile; interviews occurred within 2 weeks of their child's primary care visit. We assessed parental ratings of the nutrition and physical activity advice received. Using children's clinical heights and weights and parents' self-reported heights and weights, we classified children into three categories: BMI 85th-94th percentile without an overweight parent, BMI 85th-94th percentile with an overweight parent (adult BMI > or =25 kg/m(2)), and BMI > or =95th percentile. RESULTS In multivariate analyses, compared to parents of children with BMI > or =95th percentile, overweight parents with children whose BMI was 85th-94th percentile were more likely to report receiving too little advice on nutrition and physical activity (odds ratio (OR) 3.05; 95% confidence interval (CI) 1.49, 6.25) and to rate as poor or fair the quality of advice they received (OR 2.23; 95% CI 1.18, 4.24). Independently, African-American (OR 2.55; 95% CI 1.18, 5.51) and Hispanic/Latino (OR 2.78; 95% CI 1.27, 6.10) parents were more likely than white parents to rate as poor or fair the quality of advice they received. DISCUSSION Parental overweight is associated with low subjective ratings of overweight counseling in pediatric primary care. Our findings of poorer perceived quality among racial/ethnic minority parents need further investigation.
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Affiliation(s)
- Elsie M Taveras
- Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA.
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Tyler DO, Horner SD. Family-centered collaborative negotiation: a model for facilitating behavior change in primary care. ACTA ACUST UNITED AC 2008; 20:194-203. [PMID: 18387016 DOI: 10.1111/j.1745-7599.2007.00298.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe a parent-child-based model that melds a family-centered interaction approach, Touchpoints, with brief negotiation strategies (an adaptation of motivational interviewing) to address health risks in children. An application of the model for addressing childhood overweight in the primary care setting is presented. DATA SOURCES Selected research, theoretical, and clinical articles; national recommendations and guidelines; and a clinical case. CONCLUSIONS Lifestyle health behaviors are learned and reinforced within the family; thus, changes to promote child health require family involvement. Interventions that engage parents and support parent-child relationships, while enhancing motivation and the abilities to change behavior, are recommended. IMPLICATIONS FOR PRACTICE Primary care is an appropriate setting for addressing lifestyle health behaviors. A collaborative partnership, rather than a prescriptive manner, is advocated for primary care providers when working to facilitate health-promoting behavior.
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Affiliation(s)
- Diane O Tyler
- School of Nursing, University of Texas at Austin, Austin, Texas 78701, USA.
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Meriwether RA, Lobelo F, Pate RR. Themed Review: Clinical Interventions to Promote Physical Activity in Youth. Am J Lifestyle Med 2008. [DOI: 10.1177/1559827607308557] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
National recommendations call for children and adolescents to accumulate at least 60 minutes of moderate to vigorous physical activity on most days of the week and for physicians to counsel their patients about physical activity. Physical inactivity tracks from childhood into adulthood, and among youth, it is associated with unfavorable risk factor profiles that promote the development of cardiovascular and metabolic chronic diseases. Few studies of clinical interventions to promote physical activity in children and youth have been published, and the paucity of evidence describing effective interventions and significant barriers limit delivery of counseling. However, existing studies provide evidence about elements of counseling most likely to be effective to guide clinical interventions and inform future research. Based on a literature review, this article offers guidance for incorporating physical activity promotion into clinical care, identifies gaps in current evidence, and suggests methodologic considerations for future research.
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Affiliation(s)
- Rebecca A. Meriwether
- Departments of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina,
| | - Felipe Lobelo
- Exercise Science, Arnold School of Public Health University of South Carolina School of Medicine, Columbia, South Carolina
| | - Russell R. Pate
- Exercise Science, Arnold School of Public Health University of South Carolina School of Medicine, Columbia, South Carolina
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Eckstein KC, Mikhail LM, Ariza AJ, Thomson JS, Millard SC, Binns HJ. Parents' perceptions of their child's weight and health. Pediatrics 2006; 117:681-90. [PMID: 16510647 DOI: 10.1542/peds.2005-0910] [Citation(s) in RCA: 287] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study explored parents' perceptions about their child's appearance and health and evaluated a tool to determine parents' visual perception of their child's weight. METHODS Parents of children aged 2 to 17 years were surveyed concerning their child's appearance and health and opinions about childhood overweight. They also selected the sketch (from 7 choices) that most closely matched the body image of their child using 1 of 8 gender-and age-range-specific panels of sketches. Children's height and weight were measured. Respondents were grouped by child body mass index (BMI) percentile (<5th, 5-84th, 85-94th [at risk for overweight (AROW)], and > or =95th [overweight]). Those with BMI > or =5th percentile were analyzed. Logistic regression was used to examine factors influencing parental perceptions and levels of worry about their overweight or AROW child. RESULTS Of the 223 children, 60% were <6 years old, 42% were male, 17% were black, 35% were Hispanic, 42% were white, and 7% were other; 19% were AROW, and 20% were overweight. Few parents (36%) identified their overweight or AROW child as "overweight" or "a little overweight" using words, but more (70%) selected a middle or heavier sketch. Among parents of overweight and AROW children, 18% recalled a doctor's concern and 26% were worried about their child's weight. If the overweight or AROW child was age > or =6 years, parents were more likely to identify their child as "overweight" or "a little overweight" using words, select a middle or heavier sketch, and to be worried. Parents of older children were more likely to be worried if they perceived their child as less active/slower than other children or recalled a doctor's concern. CONCLUSIONS Few parents of overweight and AROW children recognized their child as overweight or were worried. Recognition of physical activity limitations and physicians' concerns may heighten the parent's level of concern. Sketches may be a useful tool to identify overweight children when measurements are not available.
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Affiliation(s)
- Kathryn C Eckstein
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
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