Comparisons of parent cardiovascular knowledge, attitudes, and behaviors based on screening and perceived child risks

Questionnaire reports and universal screening procedures from 244 children (kindergarten, 5th grade, and 9th grade) were used to explore differences in parent health knowledge and attitudes of cardiovascular risks among children and parental involvement in promoting healthy lifestyles relative to whether their children were identified as being overweight or at risk of being overweight. The knowledge, attitudes, and behaviors of the parents of children who were identified as being at risk or overweight were further examined based on their perceptions of their children's level of risk. Parents' reports demonstrated significantly greater parent encouragement and knowledge of issues related to eating healthier foods and ways to cut calories among parents of children who were identified as being at risk or already overweight. A significant portion of parents underestimated their children's weight risks. Differences in parents' appraisals of their children's overweight risks were associated with differences in their knowledge, attitudes, and behaviors. These findings illustrate the need to address inaccuracies in parents' assessments of their children's overweight risks to improve parent investment and involvement in children's health modification programs.     

Children at play: an innovative method for studying and teaching nutritional behaviors

Children under 6 years of age are one of the key groups for interventions establishing lifelong nutritional behaviors that will promote health and prevent obesity. Adults in young children's social environments play important roles in encouraging healthy nutritional behaviors. Parents, childcare providers, and teachers must teach children healthy eating behaviors in age-appropriate and applicable ways. Researchers need to determine as completely as possible how children learn nutritional behaviors. Current research methods and teaching approaches continue to challenge researchers and parents alike in achieving these important goals. This article details the need for developing new approaches to nutritional behavior development in children and describes the theoretical background and practical applications of one such novel approach: play-based settings. It explores the possibilities play-based settings offer for studying and developing healthy nutritional behaviors in young children. Following further refinement of this method, future research and practice in children's nutritional behavior development should benefit from this new approach.     

A primer on early childhood obesity and parental influence

Childhood obesity is a common health problem facing U.S. children with an increasing prevalence particularly in certain populations. Recognizing obesity in children is a clinical determination with specific measures that can indicate potential future associated health problems, but parental perception of overweight and/or obesity is influenced by other conditions. This primer offers a brief synopsis of parental influence in the etiology of early childhood obesity beginning with parameters of obesity and how it is operationalized through measurement. The importance of parental perceptions of their children relative to obesity and eating are discussed, and how parents influence the development of childhood eating behaviors or physical activity are considered.     

Comparisons of Parent Cardiovascular Knowledge,Attitudes, and Behaviors Based on Screening and Perceived Child Risks

Questionnaire reports and universal screening procedures from 244 children (kindergarten, 5th grade, and 9th grade) were used to explore differences in parent health knowledge and attitudes of cardiovascular risks among children and parental involvement in promoting healthy lifestyles relative to whether their children were identified as being overweight or at risk of being overweight. The knowledge, attitudes, and behaviors of the parents of children who were identified as being at risk or overweight were further examined based on their perceptions of their children's level of risk. Parents' reports demonstrated significantly greater parent encouragement and knowledge of issues related to eating healthier foods and ways to cut calories among parents of children who were identified as being at risk or already overweight. A significant portion of parents underestimated their children's weight risks. Differences in parents' appraisals of their children's overweight risks were associated with differences in their knowledge, attitudes, and behaviors. These findings illustrate the need to address inaccuracies in parents' assessments of their children's overweight risks to improve parent investment and involvement in children's health modification programs.     

Health Promotion Guidance for a Rural Community

PurposeTo determine if an educational pamphlet would be useful to parents of overweight/obese/at risk children living in a rural county in the southeastern United States.Data SourcesA sample of 44 rural parents whose children, ages 6–18, attended a private rural health center and have a body mass index (BMI) recorded in the patient chart.ConclusionAn educational pamphlet on diet and exercise is both helpful and acceptable.Implications for practiceAn educational pamphlet that outlines healthy eating guidelines and exercise suggestions used as a first line intervention should accompany BMI screening results to aid in parental education.     

Weight, exercise, and health: children's perceptions

Childhood overweight is increasing, yet limited information is available on children's perspectives of overweight. The purpose of this investigation was to identify children's perspective of their weight, exercise, and health status. Participants were 17 children, 8 to 12 years of age, with body mass indexes > or = 95% for age and gender. A qualitative investigation using a phenomenological approach was conducted with a thematic analysis. Themes that emerged included intellectual disconnect, body image incongruence, social importance, and exercise perspectives. Children correctly identified healthy and unhealthy behaviors: dietary intake and physical activity. Children's knowledge about healthy dietary intake and physical activities disconnected from actual health practices. Children demonstrated confusion about physical activity requirements: frequency, intensity, and duration. Nurses need to develop strategies to bridge disconnect between what children know and actual dietary intake and physical activities. Nurses are fundamental to increasing children's knowledge of physical activity requirements for health promotion and disease prevention.     

Low-Income Mothers' Perceptions of Health in Their Children With Growth Delay

ISSUES AND PURPOSE. Parental characteristics are the strongest predictor of poor health for children. This study examined how low-income mothers of children with growth delay define health for their children, and the behaviors they use to monitor their children's health.
DESIGN AND METHODS. Naturalistic design using Kleinman's Explanatory Model approach and interviews with 22 mothers.
RESULTS. Mothers consider nutritious food as a primary contributor to their children's health and consider healthy children to be chubby. Other indicators of health include children's energy levels, provision of nutritious food, and physical and mental activity balanced with rest.
PRACTICE IMPLICATIONS. A mother's explanatory model of health for her child can guide health promotion targeted to the mother's beliefs.     

Use of a tool to determine perceived barriers to children's healthy eating and physical activity and relationships to health behaviors

This pilot investigation assesses whether barriers to children's healthy eating and physical activity reported by parents on a newly developed brief pediatric obesity screening and counseling tool are related to healthy eating and physical activity behaviors. The sample included parents of 115 Medicaid-enrolled children in a general pediatric clinic. Of 10 barriers, 7 were statistically associated with parent-reported behaviors with odds ratios (ORs) ranging from 0.6 to 9.4. Relationships remained significant when child characteristics were controlled in the analysis. Although additional testing is needed, the tool provides clinicians with an approach to identify barriers and behaviors for targeted counseling.     

Satisfaction with care: a study of parents of children with congenital heart disease and parents of children with other diseases

AIM: We compared parents of children with congenital heart disease (PCCHD, n=1092) with parents of children with other diseases (PCOD, n=112) regarding satisfaction with their children's care (SCC). We also examined the association between parental/patient characteristics and SCC. METHOD: The parents completed a questionnaire about such areas as satisfaction with care, children's health status, and financial situation. The design was cross-sectional and data were gathered over 20 consecutive days. RESULTS: The univariate and multivariate analyses showed that PCCHD were more satisfied with their children's medical care and waiting period for treatment of their ill children than PCOD, although the difference was only modest. Furthermore, mothers were less satisfied with staff attitudes than fathers, with the lowest satisfaction among mothers of children with CHD. However, the multivariate analysis indicated that less satisfaction with care was more associated with decreasing child age, unemployment, financial burden of disease, social isolation and psychological distress than with children's diseases, their severity and parental gender. CONCLUSION: We corroborated some previous findings and may have provided new insights regarding determinants of SCC among parents. Interventions to improve SCC may need to address issues of parental psychological distress, socialization, and financial burden of illness. Possible ways of achieving this are discussed. Finally, research in a longitudinal format is needed to further scrutinize determinants of parental SCC.     

Mealtime interactions relate to dietary adherence and glycemic control in young children with type 1 diabetes

OBJECTIVE: This study examined the relationships between parent-child mealtime interactions and dietary adherence and glycemic control in young children with type 1 diabetes. It was hypothesized that young children who exhibited disruptive mealtime behaviors would have more dietary deviations (poorer dietary adherence) and poor glycemic control. It was also hypothesized that parents of young children who used ineffective/coercive parenting strategies at mealtimes would have children with more dietary deviations and poor glycemic control. RESEARCH DESIGN AND METHODS: A total of 35 families of children (aged 2.2-7.9 years) with type 1 diabetes were recruited from a pediatric hospital. Families had at least three meals videotaped in their home, which were coded for parent, child, and eating behaviors, using the Dyadic Interaction Nomenclature for Eating. Children's dietary adherence was assessed according to deviations from the prescribed number of carbohydrate units per meal. Children's average glycemic excursion was assessed prospectively for 2 weeks, using a standardized home blood glucose meter. RESULTS: Findings demonstrated significant positive relationships between children's mealtime behavior, dietary deviations, and glycemic control. An examination of parent behaviors revealed significant positive correlations between parents' use of ineffective/coercive parenting strategies and children's dietary deviations and glycemic control. CONCLUSIONS: This was the first study to examine the relationship between parent-child mealtime interactions and health outcomes in young children with type 1 diabetes. The mealtime problems examined can be improved through specific behavioral interventions. Future research is needed to examine how parent-child interactions at mealtimes relate to children's health outcomes to inform clinical care.     

Eating habits and physical activity of adolescents in Katowice - the teenagers' declarations vs. their parents' beliefs

Aims and objectives. To analyse eating and physical activity preferences among adolescent school children and to compare the teenagers' lifestyle declarations with their parents' beliefs. Background. Unfavorable behavior in eating habits and physical activity may result in serious dysfunctions and diseases, such as eating disorders and incorrect body mass. Design. A retrospective cross-sectional study conducted in 2010-2011. Methods. The data was collated from 711 pupils and 266 parents. The survey included questions on: breakfast consumption, types of food eaten for breakfast, time of supper, the daily number of meals, the quantity of fruit and vegetables, food products purchased in the school shop, as well as the type and level of physical activity. Results. In the population of children aged 14-15?years, 10% do not eat 1st breakfast and 15% do not eat 2nd breakfast, 50% eat dairy products for 1st breakfast, 70% have sandwiches for 2nd breakfast, 45% most frequently buy snacks in the school shop, 65% prefer physical activity in the form of team games, and 90% willingly participate in PE classes. The parents' beliefs differ from their children's declarations with regard to: breakfast consumption, the number of meals a day, the quantity of fruit, and participation in PE classes. Conclusions. The lifestyle of the studied adolescents is within the norms recommended for their age group, although there is a tendency to skip breakfast. A positive aspect is the adolescents' engagement in physical activity. Parents underestimate their children's level of physical activity and overestimate their daily number of meals. Relevance to clinical practice. The study confirms the validity of conducting health education, addressed to both children and their parents, with regard to correct eating habits and physical activity, as well as prevention of eating disorders.     

Parent-nurse interactions: care of hospitalized children

BACKGROUND: An essential component of quality nursing care is nurses' ability to work with parents in the hospital care of their children. However, changes in the health care environment have presented nurses with many new challenges, including meeting family-centred care expectations. AIM OF THE PAPER: To report a research study examining the experiences of parents who interacted with nurses in a hospital setting regarding the care of their children. METHODS: A qualitative approach was employed for this study. In-depth audiotaped interviews were conducted with eight parents representing seven families. Data collection was completed over a 7-month period in 2001. FINDINGS: Parents characterized their experiences with nurses caring for their children as interactions, and identified the elements of establishing rapport and sharing children's care as key to a positive perception of the interactions. These elements were influenced by parental expectations of nurses. Changes in nurses' approach were reported by parents as the children's conditions changed. CONCLUSION: Nurses were able to work with families in the hospital care of their children in ways that parents perceived as positive. However, in parents' views, their interactions with nurses did not constitute collaborative relationships. A deeper understanding of these interactions may provoke new thinking about how to promote an agency's philosophy, and how nurses enact this philosophy in practice.     

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.     

Optimism bias and parental views on unintentional injuries and safety: improving anticipatory guidance in early childhood

The purpose of this integrative literature review is to improve anticipatory guidance in early childhood by reviewing the influence of optimism bias on parents' views about safety and beliefs about their children's risk for unintentional injuries. This article reviews the theory of optimism bias and recent research utilizing optimism bias to explain parental health-related behaviors. The three articles in this literature review find a link between optimism bias and parents' failure to implement safety behaviors. Currently, there is no tool to measure a parent's level of optimism bias concerning the risk of unintentional injury to his or her child. It is important for primary care providers to try and identify optimism bias in parents and address it as a barrier to implementation of safety recommendations. More research should be dedicated to developing screening tools to identify optimism bias in parents and interventions to help them accept their children's vulnerability.     

Parental attitude and coping behaviors in families of children with epilepsy

This study investigated the relationship between parental attitudes toward their children's epilepsy and parental coping patterns. Subjects were 27 parents whose children had epilepsy. Parental attitude was measured using the Fishbein Expectancy-Value Model, while coping was measured using the Coping Health Inventory for Parents. Significant positive correlations were found between parental attitude and the coping pattern of Maintaining Family Integration, Cooperation and Optimistic Definition of the Situation (r = .42, p less than .02). Parental attitude was also positively related to the coping pattern of Maintaining Social Support, Self-esteem and Psychological Stability (r = .32, p less than .05). Results suggest parents with positive attitudes toward their children's epilepsy use more positive coping behaviors than parents with less positive attitudes.     

Perioperative care of children in a transcultural context

As part of a large, comparative study of how children are cared for in developed and developing countries' hospitals, health care professionals and parents were asked questions relating to their beliefs about parental presence during anesthesia induction and in postanesthesia care units. Children were not questioned. The researcher compared parents' (n = 957) and staff members' (n = 780) responses between developed and developing countries. Results indicate that parents and staff members in developed and developing countries responded significantly differently (P < .000001) to whether they believe parents or relatives should stay with their children until anesthesia takes effect. More staff members in developing countries responded that parents should be present (P = .007). Cultural constructions (e.g., class) are believed to influence strongly how care is delivered in developing countries studied. Cultural constructions were not as important in the developed countries.     

Beliefs Held by Parents of Autistic Children

Autism is an unusual disorder that offers varied and complex challenges. Recent shifts in educational and treatment foci have left many parents of autistic children floundering regarding how best to view and interact with their children. Furthermore, it has become clinically evident that these parents often maintain beliefs that may influence parent-child interactions and even the prognoses of the children. To date, no published research exists that examines how parental beliefs may affect autistic children. The author's purpose is to identify several common beliefs held by parents of autistic children and discuss implications for clinical practice and research.     

Broadening the understanding of injury prevention: a case study.

The death or injury of a loved one is tragic, especially if that injury could have been prevented. Programs to reduce the incidence and severity of neurological trauma are traditionally driven by injury statistics, and the literature on neurological injury prevention often fails to capture individual experiences. Understanding community members' concerns about injury and safety efforts can move injury-prevention programs to a new level by assessing injury-related beliefs and refining interventions suited to the community. Pediatric injury is an especially complex problem that is influenced by developmental, environmental, sociopolitical, economic, geographic, parental, and child-related factors. Recognition of injury as a public health concern supports updating program development. The following case study, based on an in-depth parent interview, offers a unique perspective on pediatric injury. The audiotaped interview was transcribed verbatim following qualitative guidelines. Three main themes emerged from the analysis: (a) sources of parental concern for children's safety, (b) private versus public safety influences, and (c) behaviors making children vulnerable to injury. As this case study illustrates, parents may consider children susceptible to injury as a result of factors often not considered by injury prevention programs, for example, being "injury prone." Parents also have access to resources, grandparents, for example, not typically considered when programs are marketed. The challenge is to identify how programs become an accepted public safety influence and to address real-life parental concerns.