Preferred Child Body Size and Parental Underestimation of Child Weight in Mexican-American Families

Objective To determine whether parents who prefer a heavier child would underestimate their child’s weight more than those who prefer a leaner child. Methods Participants were Mexican-American families (312 mothers, 173 fathers, and 312 children ages 8–10) who were interviewed and had height and weight measurements. Parents reported their preferred child body size and their perceptions of their child’s weight. Parents’ underestimation of their child’s weight was calculated as the standardized difference between parent’s perception of their child’s weight and the child’s body mass index (BMI) z-score. Demographic factors and parental BMI were also assessed. Results Although 50 % of children were overweight or obese, only 11 % of mothers and 10 % of fathers perceived their children as being somewhat or very overweight. Multiple regressions controlling for covariates (parental BMI and child age) showed that parents who preferred a heavier child body size underestimated their children’s weight more, compared to those who preferred a leaner child (β for mothers = .13, p < .03; β for fathers = .17, p < .03). Conclusions for Practice Parents who preferred a heavier child body size underestimated their child’s weight to a greater degree than parents who preferred a leaner child. Attempts by pediatricians to correct parents’ misperceptions about child weight may damage rapport and ultimately fail if the misperception is actually a reflection of parents’ preferences, which may not be readily amenable to change. Future research should address optimal methods of communication about child overweight which take into account parent preferences.     

Parental Perception of Child Bodyweight and Health Among Mexican-American Children with Acanthosis Nigricans

Acanthosis nigricans (AN) is a cutaneous marker associated with elevated risk of type 2 diabetes. This study assesses mother–father differences in perception of child’s bodyweight and health by Mexican-American parents with AN-positive children. The study used medical records in conjunction with survey data collected between 2011 and 2012 for 309 Mexican-American children with AN in South Texas. Multivariate logit models were estimated to assess mother–father differences in perception of child bodyweight and health controlling for selected child- and parent-level covariates. About 91 % of the children in the sample were obese and 6.5 % were overweight. One fifth of mothers and 38.5 % of fathers in the sample expressed no concern of their children’s bodyweight. After adjusting for selected explanatory variables at both the child and parent level, the odds for fathers, relative to mothers, to be concerned about child’s bodyweight were 82 % lower (OR = 0.18, p < 0.05). Similar findings also hold for parental awareness of child’s AN (OR = 0.19, p < 0.05). Among Mexican-American families with AN-positive children, the lack of concern over child’s bodyweight, unawareness of AN, and misconception of child’s health on the part of many parents, especially of fathers, constitutes a challenge to diabetes prevention. Health education programs targeting Mexican-American families with AN-positive children might be more cost effective to consider mother–father differences in perception of child health and bodyweight.     

Changes in diet behavior when adults become parents

BackgroundCross-sectional studies suggest that parents eat more saturated fat than nonparents. Few studies exist on other dietary factors or using longitudinal data.ObjectiveTo compare change in daily dietary intake of selected foods and nutrients across 7 years between adults who have children enter the home and those who do not.DesignAnalysis of data from the Coronary Artery Risk Development in Young Adults cohort study. Dietary intake was assessed by the diet history questionnaire used in that study. The main dependent variables were change from baseline (1985-1986) to Year 7 (1992-1993) for intake of percent saturated fat, energy, daily servings of fruits and vegetables and sugar-sweetened beverages, and frequency of fast-food intake. The primary independent variable was whether or not participants had children in their home by Year 7.ParticipantsTwo thousand five hundred sixty-three black and white adults who did not have children at baseline from four urban centers.Statistical analyses performedLinear regression adjusting for baseline demographics, energy intake, physical activity, and smoking status.ResultsParents were more likely to be women, full-time workers, married, and older. Diet did not differ at baseline. Seven-year change in diet for parents and nonparents did not differ for fruit and vegetable, sugar-sweetened beverages, or fast food. Percent saturated fat decreased among both groups but parents showed a smaller decrease in percent saturated fat (1.59 vs 2.10; P<0.001). Compared with nonparents, parents increased energy intake by 79 kcal/day (P=0.058), but this difference did not reach statistical significance.ConclusionsParenthood does not have unfavorable effects on parents' diets, but neither does it lead to significant improvements. In fact, parents lag behind their childless counterparts in decreasing intake of saturated fat and overall diets remain poor. Nutrition education programs and food and nutrition practitioners should develop strategies to support and motivate healthy eating habits in parents.     

Comparing Maternal and Paternal Complementary Feeding Practices: Findings From an Online Survey

ObjectiveTo explore differences between mothers’ and fathers’ complementary feeding practices.MethodsAn online survey of UK parents with a healthy child in complementary feeding age. Timing of introducing solid foods and adherence to feeding guidelines were assessed. Dietary quality was measured using the Complementary Feeding Utility Index.ResultsIn a sample of 60 mothers and fathers (nondyads), there were no differences between fathers and mothers in the timing of introduction of solid foods, compliance with complementary feeding guidelines, or dietary quality. Most fathers who participated had a male child, whereas mothers had an equal number of male and female children (P < 0.001). The proportion of mothers who followed baby-led weaning was higher compared with fathers (P = 0.02).Conclusions and ImplicationsStudy findings reveal no gender differences in parental complementary feeding practices apart from the use of baby-led weaning. Future studies with bigger male samples are warranted to explore the paternal role during complementary feeding.     

Temperament,parental personality and parenting stress in relation to socio-emotional development at 51 months

ABSTRACT

This study examined the relevance of infant temperament, parent personality and parenting stress for children’s socio-emotional development, looking in addition for any differences between mothers and fathers. Participants, from a community sample, were 410 mothers and fathers reporting their personality (NEO Personality Inventory), child temperament in the first (Infant Characteristics Questionnaire) and second (Toddler Behavior Assessment Questionnaire) years, parenting stress to 36 months (Parenting Stress Index Short Form) and child behaviour at 51 months (Strengths and Difficulties Questionnaire). Difficult toddler temperament was associated with more externalizing and internalizing problems. Higher paternal extraversion was associated with more prosocial behaviour whereas lower maternal extraversion was associated with more internalizing problems. For both parents, describing a dysfunctional parent–child relationship was related to more externalizing problems and to less prosocial behaviour, for fathers also to more internalizing problems, which associated for mothers with more parental distress.     

Trajectories of growth in body mass index across childhood: Associations with maternal and paternal employment

Research links mothers’ employment to higher body mass index (BMI), a measure of weight-for-height, among their children. However, how maternal employment patterns relate to their children’s BMI trajectories, and the role that fathers’ employment plays in when and at what rate children grow, remain unclear. With data on children from 2 to 15 years of age living in two-parent families from the U.S. NICHD’s Study of Early Child Care and Youth Development (N = 1107), individual growth models are used to describe American children’s BMI trajectories as predicted by maternal and paternal employment characteristics. Results indicate that, by age 15, children’s BMIs are, on average, nearly one-half of a standard deviation above recommended levels, and the majority of growth occurs during the preschool period. The duration of maternal employment, and combined measures of maternal and paternal employment duration, are both associated with higher child BMI across childhood. Associations are small but cumulative. Notably, the association between the duration of time children lived in dual-earner families and child BMI is larger than that between maternal employment duration alone and children’s BMI, which is strongest during the preschool period. Combined measures of maternal and paternal employment intensity, defined as the number of periods both parents worked 35 or more hours per week, are associated with higher child BMI during the preschool period only. Findings highlight the importance of taking into account both parents’ employment characteristics in investigating children’s physical development.     

Low-Income Minority and Homeless Mothers�� Perceptions of Their 9�C13 Year-Old Children��s Weight Status, Diet, and Health

The purpose of this study was to examine low-income mothers?? perceptions of their children??s height and weight in relation to actual measures, and perceptions of dietary quality and health status. Demographic, anthropometric, and dietary quality/health status data were collected during a multi-phase nutrition research project with low-income Minnesotans, and a sub-set of non-pregnant mother?Cchild dyads (mothers ages ?? 18 years, children ages 9?C13 years) were analyzed (n = 257). Participants were Caucasian, African American, American Indian, Hispanic, Asian, or Other/mixed race, and most were homeless. Relationships between maternal perceptions of their child??s height and weight and the actual measures, and maternal perceptions of dietary quality and health status for the dyad, were examined using independent and paired samples t-tests, ANOVA, and paired samples correlations. Comparisons were also made by maternal and child body mass index (BMI) status and living situation. Mothers significantly underestimated their child??s height and weight (?4.8 ± 13.9 cm, P = 0.000; ?5.3 ± 8.5 kg, P = 0.000); greatest misperceptions of weight were among mothers of overweight/obese children (P = 0.000). Mothers not reporting estimates of their child??s height and weight (n = 53) had higher BMIs (P = 0.029), and their children were younger (P = 0.000) and lighter (P = 0.021) compared to mothers who provided estimates. Inability to objectify children??s weight status may contribute to the obesity epidemic affecting low-income minority populations. Underestimation of weight status may be influenced by cultural perceptions of body image and socioeconomic status.     

Do disability,parenthood, and gender matter for health disparities?: A US population-based study

BackgroundExisting research has documented adverse health outcomes among parents with disabilities relative to parents without disabilities, but little is known about whether parenthood adds unique stress and health consequences for people with disabilities. Less is known about whether the effects of parenthood differ between mothers and fathers with disabilities.ObjectivesThis paper examined health-related quality of life, obesity, and health behaviors between US parents and nonparents with and without disabilities. We also explored differences in health outcomes separately for men and women by one's parental and disability status.MethodsAn analytic sample of parents and nonparents aged 18–64, with and without disabilities, were derived from the 2016 Behavioral Risk Factor Surveillance System (9,117 parents and 33,961 nonparents with disabilities). Multivariate logistic regression analyses were applied, controlling for individuals’ socio-demographic characteristics and their history of chronic conditions.ResultsParents with disabilities, compared to parents without disabilities and nonparents with and without disabilities, were at higher risk of reporting frequent physical distress, obesity, smoking, and insufficient sleep. Among those with disabilities, fathers were more likely than nonfathers to report poor or fair health, frequent physical and mental distress, and obesity; these differences were not evident between mothers and nonmothers with disabilities.ConclusionsThe findings suggest the urgent need for policies and programs to address the health-related needs of parents with disabilities, as well as the need for targeted programs to support fathers with disabilities.     

Primary care of overweight children: the importance of parent weight and attitudes about overweight: a MetroNet study.

PURPOSE: The purpose of this study was to identify the association of parents' weight and attitude about their child's weight with the child's body mass index (BMI) status. DESIGN: Cross-sectional, clinic-based study in a practice-based research network. METHODS: One hundred seventy-one parents or adults accompanying children aged 5 to 17 years to a primary care visit in 4 family medicine centers completed a questionnaire. Parent/adult overweight status and attitudes were compared with child overweight status. RESULTS: Forty-eight percent of children were overweight or obese (BMI >or= the 85th percentile) as were 56% of mothers and 77% of fathers (BMI >or= 25 kg/m(2)). Child and parent overweight were significantly associated, as were mother overweight and beliefs about child overweight status. Children aged 5 to 13 years were more likely to be overweight than those aged >or=14 years. CONCLUSIONS: Parents of overweight children are often overweight and many do not recognize that their children are overweight. Suggestions are made for primary care physicians to engage parents of overweight children in family weight control efforts.     

Perceptions and acceptability of HPV vaccination among parents of young adolescents: A multicenter national survey in China

Prophylactic HPV vaccines target young adolescents to prevent related cervical lesions and even genital warts prior to onset of sexual activity. Parental consent is often essential for success of vaccination program for this age group. We conducted a national multicenter study to explore the acceptability of HPV vaccination among parents of young adolescents and associated factors in relevant parent decision making in China. A total of 2899 parents of young adolescents (11–17 years) participated in the survey between November 28, 2011 and May 9, 2012, but four were excluded from analysis because of inconsistencies in their given information in the questionnaire. Mothers accounted for 62.8% of the parent participants. The mean age of the parents was 40.40 (standard deviation, 4.68) years. Only 36.2% of the parents accepted the vaccine for their children. Knowledge about HPV and HPV vaccine was a positive correlate with HPV vaccination acceptability (P_trend = 0.003). Grade of child (P_trend = 0.015), prior vaccination experience outside the National Expanded Program on Immunization (OR: 1.43; 95%CI: 1.19–1.72), fear of cervical cancer and/or genital warts (OR: 2.47; 95%CI: 2.00–3.05), and prior consultation regarding HPV vaccine information (OR: 2.35; 95%CI: 1.57–3.52) were also positively associated with higher HPV vaccine acceptability. The acceptability was lower in mothers (OR: 0.45; 95%CI: 0.37–0.54) and who had better education (P_trend = 0.009). 57.3% of the parents agreed that the most appropriate venue for HPV vaccination was the local center for disease prevention and control. In conclusion, our study indicates a low acceptability of HPV vaccination among parents of young adolescents in China. We understand there are many challenges in implementing HPV vaccination program. Our findings will serve as valuable references for future HPV vaccination policies and campaigns after HPV vaccines are approved in China.     

A Randomized Clinical Trial of the Building on Family Strengths Program: An Education Program for Parents of Children with Chronic Health Conditions

To test the 6-month efficacy of an inclusive non-diagnosis-specific, 7-session parent education curriculum on five pre-specified outcomes. A randomized clinical trial with 100 parents having children 2–11 years with a variety of chronic conditions was conducted. The 7-session curriculum, Building on Family Strengths (BFS), was created by an interdisciplinary pediatric team as a derivative of a successful adult chronic disease self-Management program distributed by Stanford University Patient and Education Research Center. Despite no differences at baseline, intervention participants had higher scores on self-efficacy to manage the child’s condition (p = 0.049), coping with childhood chronic illness (p < 0.001), parent–child shared management of the condition (p = 0.097), family quality of life (p = 0.010), and, lower scores on a measure of depressive symptoms (p = 0.046) at the 6-month end-point. Average effect-sizes were modest across outcomes (7–11 % improvement) with intervention participants having baseline scores in the least favorable quartile improving the most (12–41 %). This research provides evidence that the BFS curriculum can yield significant improvements across five important outcomes for parents of children with various chronic conditions. Parent education programs should be offered especially to parents of children with chronic health conditions, regardless of the type of condition, who lack adequate support. These programs can help parents cope with and manage their children’s chronic conditions more effectively.     

Parent skills training to enhance weight loss in overweight children: Evaluation of NOURISH

ObjectiveAlthough there is general agreement that parents should be involved in pediatric obesity treatment, few studies have investigated the effectiveness of interventions that target parents exclusively. Moreover, the effectiveness of this approach has not been adequately assessed with racially diverse families, particularly African Americans(AA), a group at high risk for elevated Body Mass Index (BMI).MethodsNOURISH (Nourishing Our Understanding of Role modeling to Improve Support and Health) is a culturally-sensitive parenting intervention targeting overweight (AA) children (ages 6–11; M_BMI = 98.0%ile). Families (N = 84; 61% AA, 37% White) were randomly assigned to NOURISH or a control group.ResultsNOURISH families significantly improved on child BMI from pre- to post-testing after adjustment for random effects, baseline BMI, and child race. NOURISH parents were very satisfied with the intervention and would recommend it to other parents; 91% strongly or moderately agreed that NOURISH helped them eat in a healthier manner.ConclusionsThese pilot data suggest that NOURISH is acceptable and, with refinement, offers promise for reducing pediatric BMI. Outcomes, lessons learned, and parent feedback will inform a larger randomized controlled trial.     

The relationship of childhood adiposity to parent body mass index and eating behavior

OBJECTIVE: To better understand risk factors for the development of obesity in early childhood, we examined the association between children's adiposity and their parents' eating behavior and body mass index (BMI). RESEARCH METHODS AND PROCEDURES: Parents of 85 white children 36 months of age (49 boys and 36 girls) completed the Three-Factor Eating Questionnaire measuring three dimensions of parent eating behavior: disinhibited eating, cognitive restraint of eating, and susceptibility to hunger. Parent BMI (kg/m2) was calculated using self-reported height and weight. The children's percentage body fat was assessed by dual energy X-ray absorptiometry analysis. RESULTS: Twenty-six percent of parents were obese (BMI > or = 30 kg/m2). Both maternal and paternal BMI were associated with higher scores for disinhibition (r = 0.69 and r = 0.68, p < 0.001), and maternal BMI was also associated with higher scores for hunger (r = 0.51, p < 0.001). There were no significant relationships between children's percentage body fat and parent eating scores, and the correlation between children's percentage body fat and parent BMI was significant only between mothers and daughters (r = 0.35, p = 0.04). Obese parents were no more likely to have a child who was fatter (upper quintile of percentage body fat for gender). DISCUSSION: Among 36 month-old white children, parent eating behavior was related to parent BMI, but not to children's adiposity. There was only a weak relationship between parent BMI and child adiposity. Despite the aggregation of adiposity within families due to shared genes and environments, children may not express differences in susceptibility to obesity by 3 years of age.     

Exploratory Cross-Sectional Study of Factors Associated with the Healthfulness of Parental Responses to Child Food Purchasing Requests

Objective The main objective of this study was to investigate the relationship between various factors (e.g., sociodemographic, child, and parental factors) and the healthfulness of parental responses to child in-store food purchasing requests. Additionally, a secondary objective is to describe “resist strategies” used by parents to respond to child food-purchasing requests and their efficacy in avoiding conflict. Methods Parent–child dyads (children aged 2–6 years) completed an audio-/visual-recoded food shopping trip at their usual grocery store and time. Recordings of trips were coded for behavioral and environmental factors. Parental healthful response rate (i.e., percent of responses that were healthful) was the primary outcome variable. A healthful response occurred when a parent yielded to a healthful child request, or resisted a non-healthful request. Parents also completed a questionnaire. Kruskal–Wallis tests were used to assess the relationship between the main outcome variable and sociodemographic, child, and parent factors. Results Parents (n = 39) responded healthfully to 62.9 % (±26.7 %) of child food purchasing requests. Low- and middle-income parents, and black and white parents, had significantly higher healthful response rates compared to high-income parents (p = 0.03) and Hispanic/Indian-descent parents (p = 0.02), respectively. Using the “ignore” strategy proved an effective resist strategy in this study, leading to no parent–child conflicts. Conclusions Programming that seeks to improve the healthfulness of food purchasing in families with young children should address unhealthful response behaviors in Hispanic/Indian-descent parents and high-income parents; although, the needs of these groups are different. Further research is needed to confirm and expand on these findings.     

Combining scores from different patient reported outcome measures in meta-analyses: when is it justified?

Background

The estimated prevalence rate of Pervasive Developmental Disorders (PDD) in children is 6 per 1.000. Parenting children who are intellectually impaired and have PDDs is known to be linked to the impaired well-being of the parents themselves. However, there is still little available data on health-related quality of life (HRQL) in parents of children with Asperger Syndrome (AS) and High-Functioning Autism (HFA), or other PDD diagnoses in children of normal intelligence. The present study aimed to evaluate aspects of HRQL in parents of school-age children with AS/HFA and the correlates with child behaviour characteristics.

Methods

The sample consisted of 31 mothers and 30 fathers of 32 children with AS/HFA and 30 mothers and 29 fathers of 32 age and gender matched children with typical development. Parental HRQL was surveyed by the use of the 12 Item Short Form Health Survey (SF-12) which measures physical and mental well-being. The child behaviour characteristics were assessed using the structured questionnaires: The High-Functioning Autism Spectrum Screening Questionnaire (ASSQ) and The Strengths and Difficulties Questionnaire (SDQ).

Results

The mothers of children with AS/HFA had lower SF-12 scores than the controls, indicating poorer physical health. The mothers of children with AS/HFA also had lower physical SF-12 scores compared to the fathers. In the AS/HFA group, maternal health was related to behaviour problems such as hyperactivity and conduct problems in the child.

Conclusion

Mothers but not fathers of children with AS/HFA reported impaired HRQL, and there was a relationship between maternal well-being and child behaviour characteristics.     

Uptake of a government-funded pertussis-containing booster vaccination program for parents of new babies in Victoria,Australia

IntroductionAn epidemic of Bordetella pertussis in Victoria, Australia, led to the implementation of a Government-funded vaccination program for parents of new babies. The rationale was to protect unimmunised infants from infection by vaccinating parents with a pertussis-containing vaccine. This is known as cocooning.AimTo estimate uptake of the vaccine among parents of new babies, two-and-a-half years after the program was implemented.MethodsA state-wide cross-sectional survey of parents was conducted to ascertain vaccine uptake, and to identify where and when the vaccination took place. Surveys were administered between 15 February and 14 March 2012, inclusive.ResultsOf 6308 surveys distributed, 2510 completed surveys were returned (response rate 40%). Ninety-five surveys completed outside the study period were excluded, leaving 2415 available for analysis. Overall, 1937 (80%) mothers and 1385 (70%) fathers were vaccinated in relation to the birth of their most recent child. A majority of mothers were vaccinated in hospital (62%). Most fathers were vaccinated by a general practitioner (72%). The most common point at which mothers were vaccinated was before their child turned two weeks of age (65%). Fathers’ vaccination time-point varied more widely: during pregnancy (25%); before their child turned two weeks of age (29%); and when their child was between two and eight weeks of age (28%).ConclusionResults of this survey indicated excellent uptake of the vaccine among both mothers and fathers under the Government-funded cocooning program. The findings are suggestive of an effective communications program designed to raise awareness of the risks of pertussis, and to promote availability of the funded vaccination program. The results may contribute to policy implementation of adult immunisation programs such as cocooning.     

Evaluation of parent-reported feeding practices in a racially diverse,treatment-seeking child overweight/obesity sample

This study examined psychometric properties and baseline/post-treatment racial differences in the Child Feeding Questionnaire (CFQ) in parents of overweight/obese children in a randomized controlled obesity trial. Participants were 302 (n = 285 mothers, n = 17 fathers) diverse (n = 207 Black, n = 80 White), treatment-seeking parents of children (5–11 years) with overweight/obesity. CFQ data fit the established Anderson factor structure in the full sample and subsample of Black parents. Black parents had higher scores than White parents on only Pressure to Eat. The CFQ yields reliable and valid scores in a racially diverse treatment-seeking sample, suggesting its utility in culturally-sensitive pediatric obesity treatment.     

Healthy Eating in Summer Day Camps: The Healthy Lunchbox Challenge

ObjectiveTo describe the development and evaluation of Healthy Lunchbox Challenge, a nutrition program targeting staff, parents, and children in summer day camps (SDCs).MethodsA single-group, pre/post-assessment design was used during summer, 2011(baseline) and 2012 (intervention). Four community-based SDCs in South Carolina participated. Intervention components were applied over the 11-week SDC program (2012) and consisted of (1) parent/staff education on Building a Better Lunchbox, and (2) a child/staff incentive program. Child and staff foods and beverages were assessed via direct observation (1,977 children and 241 staff). Percentages of foods and beverages brought by children and staff during the intervention were compared with baseline measures using mixed-effects regression models.ResultsThe percentage of children bringing fruits, vegetables, and water increased from 31% to 42% (P = .01), 5% to 16% (P = .01), and 47% to 60% (P = .01) from baseline to post-assessment. Staff fruits and vegetables increased from 30% to 47% (P = .03) and 9% to 22% (P = .03). A slight decrease was observed for staff water (64% to 58%); however, this was not statistically significant. Decreases in low-nutrient-dense foods and beverages were also observed.Conclusions and ImplicationsThe Healthy Lunchbox Challenge represents a low-cost, innovative way to influence the nutritional content of child and staff foods and beverages in SDCs.     

Are parenting style and controlling feeding practices related?

This study examined the relationships between parenting styles, feeding practices and BMI in a non-clinical sample of mothers and fathers of UK preschool children. Ninety-six cohabiting parents of 48 children (19 male, 29 female, mean age 42 months) completed a series of self-report questionnaires assessing parenting style, feeding practices, eating psychopathology and a range of demographic information. There were no relationships between authoritarian parenting and controlling feeding practices. In both mothers and fathers, permissive parenting style was related to lower monitoring of children's unhealthy food intake. Permissive parenting was also associated with increased use of restriction by mothers and pressure to eat by fathers. Authoritative parenting style was also related to lower use of pressure to eat by fathers only. Parenting styles were not related to child BMI in this sample. Higher child BMI was best predicted by lower paternal application of pressure to eat and greater paternal reports of drive for thinness. Parenting style may not have a direct impact on child BMI until child food selection and consumption becomes more autonomous.