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How Pediatricians Can Improve Diet and Activity for Overweight Preschoolers: A Qualitative Study of Parental Attitudes

  • Christopher Bolling
    Correspondence
    Address correspondence to Christopher Bolling, MD, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, ML 7035, 3333 Burnet Avenue, Cincinnati, Ohio 45229.
    Affiliations
    Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio (Drs Bolling, Crosby, and Stark); and the University of Colorado Health Sciences Center, Department of Pediatrics, Denver, Colo (Dr Boles)
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  • Lori Crosby
    Affiliations
    Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio (Drs Bolling, Crosby, and Stark); and the University of Colorado Health Sciences Center, Department of Pediatrics, Denver, Colo (Dr Boles)
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  • Richard Boles
    Affiliations
    Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio (Drs Bolling, Crosby, and Stark); and the University of Colorado Health Sciences Center, Department of Pediatrics, Denver, Colo (Dr Boles)
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  • Lori Stark
    Affiliations
    Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio (Drs Bolling, Crosby, and Stark); and the University of Colorado Health Sciences Center, Department of Pediatrics, Denver, Colo (Dr Boles)
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Published:March 20, 2009DOI:https://doi.org/10.1016/j.acap.2009.01.010

      Objective

      This study sought feedback from parents of overweight preschoolers on terms for overweight and treatment strategies pediatricians could use to help parents improve diet and activity for their children.

      Methods

      Twenty-three parents of 21 children aged 2 to 6 years and between the 85th and 94th percentile body mass index participated in focus groups conducted by a pediatrician to assess 1) terms and health risks that motivate parents, 2) barriers that prevent adoption of recommended behaviors, and 3) recommendations for pediatricians on strategies to help parents improve child diet and activity.

      Results

      With regard to weight status, parents preferred the terms overweight and obese as long as pediatricians provided rationale for the classification. Parents recommended that pediatricians avoid colloquial terms to describe weight status. With regard to American Academy of Pediatrics recommendations for weight management in overweight preschoolers, parents were reluctant to restrict 100% fruit juice, needed specific strategies to increase vegetable consumption, and said limiting screen time would be difficult, especially when busy or during inclement weather. Despite identification of barriers, parents reported confidence in adopting all recommended behaviors except vegetable intake if given the rationale for the recommendation and strategies for implementation.

      Conclusion

      Parents recommended that pediatricians speak clearly about weight status, explain rationale for concern, relate that concern to family history, and provide specific advice and treatment recommendations.

      Key Words

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