Parenting behaviors of African American and Caucasian families: parent and child perceptions, associations with child weight, and ability to identify abnormal weight status

This study examined the agreement between parent and child perceptions of parenting behaviors, the relationship of the behaviors with the child's weight status, and the ability of the parent to correctly identify weight status in 176 parent-child dyads (89 Caucasian and 87 African American). Correlational and regression analyses were used. Findings included moderate to weak correlations in child and parent assessments of parenting behaviors. Caucasian dyads had higher correlations than African American dyads. Most parents correctly identified their own and their child's weight status. Parents of overweight children used increased controlling behaviors, but the number of controlling behaviors decreased when the parent expressed concern with their child's weight.     

What can parents do to reduce youth obesity? An initial study with a diverse sample

The body mass index (BMI) of diverse, low-income fifth grade students (n = 36) was regressed on physical activity (Child Adolescent Activity Log), percentage dietary fat (Food Habits Questionnaire), and the Food/Activity Parenting Practices Questionnaire. The model explained 50% of the variance in student BMI, adjusted R(2) = .50, F (4, 19) = 6.84, p = .001. Students accurately perceived their weight status. Students' perception of parenting strategies, along with dietary fat, was significantly associated with their BMI. Parent's (n = 14) BMI, not the child's, was associated with the strategies they used. Three parents tested an online authoritative parenting program. Further research is needed.     

Racial and socioeconomic differences in risk factors for cardiovascular disease among Southern rural women

BACKGROUND: African American women living in the Southeast experience a higher mortality due to cardiovascular (CV) disease than their White counterparts. It is unclear if this vulnerability to CV disease is due to race, socioeconomic status, or health behaviors. OBJECTIVES: To examine the disparities in cardiovascular health between Southern rural, African American and White women to determine if a CV Risk-Index differed by race, education, or income levels and if differences persisted when controlling for body mass index (BMI). METHODS: Subjects were 1,110 women (27% African American, 73% White) residing in rural North Carolina. Data were collected by mailed questionnaire and analyzed using analysis of variance (ANOVA) and analysis of covariance (ANCOVA). RESULTS: African American women had significantly lower education and lower income than Whites, higher BMI, and a much greater prevalence of hypertension, angina, and diabetes. In a three-way ANOVA including race, income, and education, education and race were significant predictors of the CV Risk Index, but when adjusted for BMI race was no longer significant (p =.3039); the only significant predictors were BMI and educational level. DISCUSSION: Women with the least education had the highest CV Risk-Index, regardless of race. These findings suggest the need to focus risk reduction interventions on all Southern rural women with limited education, not only African American women. This supports the current literature that suggests race should be viewed as a risk marker rather than a risk factor.     

Gender and racial differences in the looking and talking behaviors of mothers and their 3-year-old prematurely born children

This study examined the relationship of child gender and maternal race to the looking and talking interactions of fifty-four 3-year-old prematurely born children and their mothers. More gender differences occurred for looking than for talking, whereas racial differences were stronger for talking than for looking. Transitional probabilities between looking situations suggested that gender differences occurred because girls were more likely to respond when their mothers were looking at them than were boys. Transitional probabilities between talking situations suggested that racial differences occurred because non-White mothers (African Americans and Native Americans in this study) were less likely to respond when their children were talking to them than were White mothers. The only significant interaction of gender by race was with White mothers who were more likely to respond when their girls were talking. When analyses were repeated, controlling for the effects of intelligence quotient, gestational age, neurobiologic risk score, and socioeconomic status (SES), gender differences for looking situations became smaller, whereas racial differences for talking situations became larger. Gender and ethnicity differences for looking and talking interactions cannot be explained by simple differences in health status or SES. These differences may possibly be related to the differential brain functions and hormonal effects of boys and girls, as well as to differential socialization that influences gender identity and gender roles. They also may be related to the higher incidence of language delays in non-White children and to differences in sociocultural norms and parenting between White and non-White mothers.     

The relationship between parent emotion, parent behavior, and health status of young African American and Latino children

The purpose of this study was to examine the relationship between parent emotion and behavior and the functional health status of young African American and Latino children. Parents were interviewed, in English or Spanish, about their child's functional health status, parents' depression, and their parenting behaviors. Standard measures used included the Functional Status IIR, the Center for Epidemiologic Studies Depression Scale, and the Parent Behavior Checklist. One hundred ninety-six children's parents attending a nurse-managed, primary care clinic in an underserved area of San Francisco participated. Multivariate analysis showed that higher functional status was related to more nurturing (p < .05). Lower functional status was related to more discipline (p < .01) and increased parental depression (p < .01). Nurses, across all settings, play an integral role in assessing and promoting healthy child development and family functioning. Implementing a rapid screening test for depression and further assessment of parenting behaviors could identify those needing more assistance in developing positive parenting skills.     

Adherence to calcium/vitamin D and estrogen protocols among diverse older participants enrolled in a clinical trial

PURPOSE: This study was intended to identify characteristics of those who adhere poorly to calcium/vitamin D and estrogen replacement protocols, and aimed to assess the effects of ethnicity, socio-economic status, and health status on medication adherence. METHODS: The adherence rates of 107 older white, African American and Hispanic participants of a clinical trial involving calcium/vitamin D and either estrogen replacement or placebo therapy were analyzed. Structural equation modeling was used to test the hypothesis that minority participants would have lower adherence rates than white participants, but only if they had lower household incomes and educational achievement, more osteoporosis risk factors, negative health assessments, and fewer somatic complaints than white participants. RESULTS: The average age of participants was 76 years. Minority participants and those with lower SES had lower adherence rates than white participants and those with higher SES. Plausible models that met goodness-of-fit criteria showed that the estrogen/placebo adherence rates were affected directly by being African American or Hispanic and the SF-36 mental health score, and indirectly by somatic complaints. History of fracture and household income directly predicted calcium/vitamin D adherence rates. CONCLUSION: Efforts to improve adherence to medical regimens should consider differences in adherence behaviors based on ethnicity, SES, and mental health.     

The impact of asthma risk factors on home management of childhood asthma

There have been few studies of childhood asthma among families who live in nonmetropolitan settings. This work is part of the baseline assessment conducted before implementing a health education program to study the impact of asthma risk factors (gender, ethnicity, socioeconomic status, asthma severity) on home asthma management. Data analysis yielded no significant differences in home asthma management performed by parents or children with asthma based on the child's gender, ethnicity, asthma severity, or family socioeconomic status. Factors that define the child's experienced asthma pattern, such as activity limitations, number of allergens, and school absenteeism, were associated with the parent's work of asthma management. Trends in the data for the different ethnic and gender subgroups that have implications for clinical practice were identified. Future directions for research to address questions that emerged in this analysis are discussed.     

Factors related to overweight and risk for overweight status among low-income Hispanic children

The purpose of this research was to investigate the agent, host, and environmental factors that are related to overweight status in a sample of low-income Hispanic toddlers who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children in a large southwestern city in the United States. Among children at risk for overweight status, the mothers' body mass index (BMI) and the number of servings of fat in the children's daily diet were positively associated with their weight/height percentiles whereas servings of protein in the daily diet and the children's reporting of hunger were negatively associated with their weight/height percentiles. Among overweight children, age was positively associated with their weight/height percentiles. No other variable in the ecological model was associated with normal weight or overweight children and their weight/height percentiles. Different approaches to dietary counseling and health promotion may be indicated based on a child's weight/height percentile or BMI.     

Exploring Relationships Among Maternal BMI,Family Factors,and Concern for Child's Weight

PROBLEM: In an effort to better understand child obesity, this study examined the association between family living location, family function, mother's body mass index (BMI), and mothers' attitudes and behaviors concerning child feeding. Recent research on obesity has shown there is limited information on family influence and parental perceptions and attitudes. METHODS: A cross-sectional analysis was performed on data from 47 mothers of school-aged children. FINDINGS: Urban African-American mothers had higher BMIs and were significantly more concerned about their child's weight status than rural white mothers. Additionally, maternal BMI was associated with the total number of individuals in the household. CONCLUSION: Results suggest the importance in understanding the family and community and its influence on childhood obesity. Armed with knowledge about family factors and parents' beliefs and perceptions, nurses can develop interventions that can assist families and communities to focus on healthy children feeding and weight management.     

Parental issues in feeding young children with bronchopulmonary dysplasia

This study examined the feeding issues that parents of 11 children with bronchopulmonary dysplasia (BPD) identified and explored the informational bases or criteria for decisions to initiate, continue, and/or terminate the feeding. An oral feeding by the parents was videotaped and replayed to assist in interviewing the parents regarding the decisions they had made during the feeding. Six types of feeding issues were identified. The smoothness or amenability of the child's feeding behavior was most frequently expressed as important, and about half of the parents mentioned the child's dietary intake as an issue. Most parents consistently tried to maintain the child's eating and to achieve a predetermined amount of nutritional intake. Over half the parents were concerned about adequacy of the child's nutrition, and many were concerned about their child's acceptance of or resistance to food. Parents did not express concern about their child's development but were concerned about their child's somatic growth. Parents' concern about feeding behaviors requires joint problem-solving by nurses and parents. Whether use of decision criteria that refer to the child's behavior rather than a predetermined amount of food is possible for parents and likely to contribute to reduced vomiting and resistive behavior and increased dietary intake needs further study.     

Parents' reports of children's medical care access: are there Mexican-American versus non-Hispanic white disparities?

OBJECTIVES: We investigated whether there were Mexican-American versus non-Hispanic white disparities in parents' reports of problems with 4 dimensions of children's medical care access after controlling for a range of demographic, social, economic, and health status factors. METHODS: Data were collected through a telephone survey of 5941 parents residing in Texas. The survey questionnaire included measures of the parent's demographic and socioeconomic status and the child's health-related quality of life. The behavioral model was used to guide the inclusion of factors in multivariate logistic regression analyses of parents' reports of their children's ability to obtain an appointment for routine/regular care, obtain care for illness/injury, obtain help/advice over the phone when calling the doctor's office, and having to wait more than 15 minutes in the doctor's office. RESULTS: Mexican-American parents had worse reports of all 4 dimensions of their children's access even after controlling for predisposing, enabling, and need factors. Among Mexican-Americans, there were no differences between those who primarily spoke English versus Spanish. Other factors that were significantly associated with at least 2 reports of access were household income, the child's insurance status, and the child's health-related quality of life. CONCLUSIONS: Mexican-American children face problems accessing medical care in a timely manner that are not fully explained by parents' demographic, social, and economic status or children's health-related quality of life. Health policy makers, managers, and clinicians should further consider how they could reduce the inequity of access to medical services among Mexican-American children.     

Cardiovascular risk factors and socioeconomic status in African American and Caucasian women

Self-reported cardiovascular risk factors of obesity, physical inactivity, and smoking in African American and Caucasian women in North Carolina were compared, controlling for socioeconomic status (SES). Participants were 1,945 women aged 23 to 53 years; 20.1% African American and 79.9% Caucasian. Of the African American women, 38.8% were obese, 51.7% were inactive, and 31.2% smoked; of the Caucasians, 19.9% were obese, 31.2% were inactive, and 33.8% smoked. SES differed significantly by race (p < 0.001). Low and middle SES African American women were much more likely than high SES African Americans to be obese, inactive, and smokers. Among Caucasian women, those with low SES had the greatest prevalence for all three risk factors. After controlling for income and education, African American women were more than twice as likely as Caucasian women to be obese and to be inactive, but were only half as likely to smoke. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21: 285–295, 1998     

Parental presence during pediatric anesthetic inductions

Children's responses to parental presence during anesthetic induction have been researched thoroughly; however, not much is known about the response of parents to being present at their child's induction. The purpose of this research was to examine parent's preparation for, attitudes and emotions about, and experiences with being present for their child's anesthetic induction. Participants included parents who accompanied their children ranging from 1 to 10 years of age during induction by general anesthesia. Multiple-choice surveys were distributed preoperatively to a convenience sample of 55 parents who were present for their child's anesthetic induction. Of 55 surveys, 38 (69%) were returned postoperatively. Data were analyzed using frequency distributions, cross-tabulations with chi 2 tests, and correlation coefficients. In general, parents felt accurately prepared and satisfied with their preparation. They thought their presence was beneficial to their child, themselves, and anesthesia personnel. Overall satisfaction with preparation was related to the completeness of the information they received (r = 0.35; P < .04). Complete and accurate information about the induction event before surgery and emotional support during induction are important psychosocial aspects of anesthesia care for parents who plan to be present during their child's induction.     

Parenting and childhood behavior problems: mothers' and fathers' voices

Through thematic analysis of interviews, we explored parents' perceptions of their child's behaviors and their own parenting. A purposive sample of four mothers and four fathers who reported behavior problems for their 7(1/2) year-old-child was selected from a larger study. Parents appraised their child positively despite episodic behavior problems, and described parenting in the context of financial difficulties, marital conflict, chronic illness, lack of support for parenting, and abuse in the parent's family of origin. Data suggest a need for timely mental health services to assist parents with managing their child's behaviors within the context of the family's situation.     

Mother's and Father's Responses to Signals of Children With Cerebral Palsy During Feeding

This paper describes mothers' and fathers' interactions in responding to children with cerebral palsy during a meal. Participants were 47 children aged 17–54 months, and their parents. Children were assessed via Bayley, Peabody Picture Vocabulary Test, Vineland, or observations, or all of these, and parents by Dyadic Adjustment Scale, Parenting Stress Index, and Reaction to Diagnosis Interview. Parent and child characteristics were related to interactions during lunch. Parents generally responded individually to signals; children gave nonspecific signals or signaled mothers more than fathers. Mothers responded significantly more often than did fathers, even controlling for frequency of signals. Undifferentiated signals were less often responded to by either parent. Parent–child interactions were not related to child's degree of motor impairment. Few significant relations existed between child gender, age, or cognitive function, and child or parent behaviors. Mothers' marital happiness related to father involvement in responding to child signals. Results are discussed in terms of parenting as a cooperative function.     

Cardiovascular risk in Hispanic and non-Hispanic preschoolers

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in the United States for both men and women among all racial and ethnic groups. Identifying risk factors early in life can facilitate use of preventive strategies to reduce risk and improve health status across the life span. OBJECTIVE: The aim of this study was to identify modifiable (tobacco smoke exposure, physical inactivity, dietary fat intake, overweight, and high blood pressure [BP]) and nonmodifiable (family history, gender, and age) cardiovascular risk factors in low-income preschool children. METHODS: Low-income preschool children (N = 205) 3-5 years old were recruited to participate. Parents completed a multigenerational cardiovascular health history form and a 24-hour dietary recall for themselves and their child. The children's height, weight, and BP were obtained. RESULTS: Of the 205 children, 61% reported ethnicity as Latino or Hispanic, 31.7% non-Hispanic White, 1% non-Hispanic Black, 3.9% Asian, and 2.4% mixed race. The number of males (50.7%) and females (49.3%) was similar. Only 22 (10.7%) children had no identified cardiovascular risk factors. At least one modifiable risk factor was present in 179 (87.3%) children. Fifty-two (25.5%) children had a body mass index (BMI) > or = 85th percentile for gender and age; 44 (22.3%) had a systolic or diastolic BP over the 90th percentile for gender, age, and height; 128 (66.3%) had a dietary fat intake of > 30%; 77 (37.6%) watched TV or played video games more than 2 hr/day; and 48 (23.4%) were exposed to passive tobacco smoke. DISCUSSION: The identification of cardiovascular risk factors in almost 90% of presumably healthy preschoolers provides evidence to support testing of interventions that can improve health behaviors and reduce risks.