Attitudes to weight and weight management in the early teenage years: a qualitative study of parental perceptions and views

Background

As most young teenagers grow up in families, parents might be well situated to facilitate and support their weight management and thereby prevent or manage obesity prior to adulthood.

Aim

This paper explores parents'' perceptions of, and views about, their teenage children''s weight and the factors that influence parents'' weight management strategies.

Design, setting and participants

We conducted two qualitative studies in Scotland, UK, involving in‐depth interviews with the parents of overweight/obese and ‘normal’ weight 13–15 year olds (n = 69).

Findings

Parents'' concerns about their own weight provided useful context for understanding their attitudes or actions with regards to their teenage child. Some parents described their teenager''s weight as being of concern to them, although puberty often introduced confusion about a child''s weight status. Genetic explanations were very often put forward as a way of making sense of teenage weight or body size. Frustration about advising teenagers about weight management was expressed, and some parents worried about giving their growing child a ‘problem’ if they directly raised concerns about weight with them.

Discussion

Parents'' views about their own weight as well as social and moral norms about labelling a teenager as overweight or as needing help with their weight could usefully inform patient‐centred service development. Parent/teenage partnerships and supporting parents to create a healthy home in which teenagers can make healthier choices are suggestions for intervention development.

Conclusion

The study highlights the importance of taking parents'' perceptions into account when developing family‐based interventions to address teenage overweight and obesity.     

Exploring the barriers and enablers to attendance at rural cardiac rehabilitation programs

Objective: The objectives of this study were to: (i) identify local barriers and enablers to the uptake of hospital-based cardiac rehabilitation (CR) programs, and (ii) identify preferred alternatives for the delivery of CR. Design: A questionnaire administered by local CR coordinators and focus groups facilitated by the research team. Setting: Six regional hospitals in south-west Victoria offering hospital-based CR programs. Participants: Patients and their carers referred to and eligible for local CR programs; health professionals working within local CR programs. Main outcomes measures: CR attendees and decliners demographics, patient and health professional perceived factors which contribute to enabling hospital-based CR attendance, patient and health professional perceived barriers to CR attendance, and receptiveness and preferences for alternative modes of CR delivery. Results: This study identified distance to travel to hospital-based CR programs the only statistically significant factor in determining uptake of CR. Easy access to transport (63%) and to a lesser extent family support (49%) and work flexibility (43%) were the primary enablers to attendance. Of the 97 study participants, 38% were receptive to alternative CR methods such as programs in outlying communities, evening facility-based programs, home and GP based programs, telephone support and a patient manual/workbook. Conclusions: The results of this study provide valuable information for designing strategies to increase utilisation and improve patient acceptability of existing hospital-based CR programs. It provides a basis for pilot testing alternative modes of CR program delivery for cardiac patients in rural areas unable to access hospital-based CR.     

Push and pull: Exposure of young Taiwanese women to sexually explicit materials

This study was designed to understand young Taiwanese women’s perception of sexually explicit materials (SEMs). Researchers conducted six focus group discussions with 38 young women between the ages of 18 and 22 in Taiwan in 2009–2010 and used content analysis to analyze the data based on the push-pull theory. The results showed that the exposure of young women to SEMs was a sexual exploration process from no sexual activity to future sexual activity. This process was affected by the interactions of three powers: push power, pull power, and personal factors. The push power included factors, such as parents and social values, which failed to satisfy their sexual curiosity and provide them with autonomy. The pull power included SEMs and peer influence, which increased sexual arousal stimuli and curiosity to try sexual activity. The most important personal factors were young women’s growth, including sexual curiosity, cognition of SEMs, and gender equity in freedom to make sexual decisions. Understanding this push-pull process regarding SEM can help health-care providers with their own discourses in addressing sex and influence young women’s participation in desired, protected, and enjoyable sex when sufficiently ready.     

Identification of Barriers to Adherence to a Weight Loss Diet in Women Using the Nominal Group Technique

Background: At any given time, a majority of women are engaged in some type of weight loss diet; however, these efforts are difficult to sustain for long-term weight control. Because women are more likely to develop obesity and suffer a greater severity of obesity-related health and economic consequences, we sought to identify the key factors that make adhering to a weight loss diet difficult for overweight/obese women. Methods: Ten nominal group technique (NGT) sessions aimed at identifying perceived barriers to adherence to a weight loss diet were conducted as part of a weight loss study for overweight/obese women (n = 33) during the controlled feeding weight loss phase. Results: Individual-level barriers to emerge from the sessions included knowing when to stop eating, being able to control cravings and emotional eating, and sustaining healthier dietary habits. Environmental-level barriers included family/social events that bring people together, especially those centered around food and drink, eating out, cost, and busy schedules. Conclusions: These findings offer a deeper understanding of barriers women find most salient to adhering to a weight loss diet, providing direction for the clinical application of weight loss programs.     

Insufficient weight management in pregnant women with gestational diabetes mellitus

ObjectivesThis study investigated whether weight was managed appropriately in pregnant women with gestational diabetes mellitus (GDM) and examined the association between insufficient gestational weight gain (GWG) and adverse pregnancy outcomes.Methods The study included 235 pregnant women with GDM from the Korean Pregnancy Outcome Study. GWG from the second to the third trimester (kg/wk ) and total GWG (kg) were classified as insufficient, appropriate, or excessive according to the 2009 Institute of Medicine guidelines. Adverse pregnancy outcomes included maternal (hypertensive disorders of pregnancy, preterm birth, cesarean delivery, and delivery complications) and infant (low birth weight, high birth weight, neonatal intensive care unit admission, and congenital anomalies) outcomes.Results The proportion of pregnant women with GDM who had insufficient GWG from the second to the third trimester was 52.3%, and that of participants with total insufficient GWG was 48.1%. There were no significant associations between insufficient GWG from the second to the third trimester and adverse pregnancy outcomes. Participants with total insufficient GWG had a significantly lower risk of preterm birth (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.05–0.60) and high birth weight (OR, 0.23; 95% CI, 0.07–0.80).Conclusion Our findings suggest the importance of appropriate weight management and the need for GWG guidelines for pregnant women with GDM.     

年轻妇女宫颈癌34例临床分析

目的:分析年轻妇女宫颈癌的临床病理特征和治疗特点。方法:对2004年1月～2009年3月收治的34例年轻宫颈癌患者的临床资料进行回顾性分析,以同期收治的35岁以上宫颈癌患者253例作为对照组,分析两组患者的临床表现、病理特征和淋巴结转移情况及治疗特点。结果:35岁以下宫颈癌的比例高达11.8%,研究组临床表现以接触性出血为主(P0.05),组织学分级中低分化比例较对照组高但无统计学差异(P0.05),临床分期、病理学类型及淋巴结转移与对照组差异无统计学意义(P0.05)。结论:宫颈癌有年轻化趋势,接触性阴道流血为年轻妇女宫颈癌的危险信号。临床分期、病理学类型及淋巴结转移均与年龄无关,年轻宫颈癌治疗时应注意保留患者的卵巢功能。     

Rapid weight gain in early infancy is associated with adult body fat percentage in young women

Objectives  

Although rapid childhood weight gain has been suggested to be a risk factor for lifetime obesity and other chronic diseases, few studies have been conducted in Asian populations. The aim of this study was, therefore, to ascertain whether rapid childhood weight gain is associated with indices of obesity in adulthood and, if so, which period in early development provides the greatest predictive value of future obesity in young Japanese women.     

Examining the contraceptive decisions of young,HIV-infected women: A qualitative study

This study qualitatively examined factors that influenced contraceptive choices in a sample of young, HIV-infected women. Individual qualitative interviews were conducted among 30 vertically and horizontally HIV-infected women (n = 26 African American) from the ages of 14 to 24 years (Mean age = 20.9 years). We recruited sample groups with the following characteristics: (a) current contraceptive/condom use with ≥1 child (n = 11); (b) current contraceptive/condom use with no children (n = 12); and (c) no current contraceptive/condom use with no children (n = 7). A semi-structured interview guide was used to ask participants about factors influencing past and current contraceptive choices. Individual interviews were digitally recorded and transcribed verbatim; analyses to identify core themes were informed by the Grounded Theoretical approach. Young, HIV-infected women did not identify their HIV serostatus or disease-related concerns as influential in their contraceptive decisions. However, they reported that recommendations from health-care providers and input from family and friends influenced their contraceptive choices. They also considered a particular method’s advantages (e.g., menstrual cycle improvements) and disadvantages (e.g., increased pill burden) when selecting a method. Findings suggested that HIV-infected young women’s contraceptive decisions were influenced by factors other than those related to their infection.     

Termination of pregnancy: associations with partner violence and other factors in a national cohort of young Australian women

OBJECTIVE: To examine the associations between termination and other reproductive events, socio-demographic characteristics and experience of violence among a community-based national sample of young Australian women. METHODS: Using multiple logistic regression, we analysed data from the Younger cohort of the Australian Longitudinal Study on Women's Health comprising 14,776 young women aged 18-23 in survey 1 (1996), of whom 9,683 aged 22-27 also responded to survey 2 (2000). We stratified respondents into those aged below 20 and those who were older at survey 1. We compared the characteristics associated with terminations among teenage women in 1996 (survey 1) with those of women aged over 20 in 1996 who had not then reported a termination and who responded to survey 2 in 2000. Finally, we compared the characteristics of women reporting terminations, births, preterm births and miscarriages. RESULTS: Women reporting teenage terminations were more likely to be in a de facto relationship (OR = 1.94, 95% CI 1.17-3.21), less well educated (OR = 2.32, 95% CI 1.44-3.74), have no private health insurance, and be a victim of partner violence (OR = 3.11, 95% CI 1.76-5.49). Women reporting later terminations were also more likely to be abused by a partner (OR = 3.52, 95% CI 2.14-5.81).The relationship with violence held for the other reproductive events. CONCLUSION AND IMPLICATIONS: Partner violence is a strong predictor of termination and other reproductive outcomes among young Australian women. Education has a protective effect. Prevention and reduction of partner violence may reduce the rate of unwanted pregnancy.