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Use of a Pediatrician Toolkit to Address Parental Perception of Children's Weight Status, Nutrition, and Activity Behaviors

  • Eliana M. Perrin
    Correspondence
    Address correspondence to Eliana M. Perrin, MD, MPH, Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, 231 MacNider Building, 333 South Columbia St, CB# 7225, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7225.
    Affiliations
    Department of Pediatrics (Drs Perrin, Benjamin, and Skinner), Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Nursing, Health Care Systems (Dr Jacobson Vann), University of North Carolina at Chapel Hill, Chapel Hill, NC; AccessCare, Morrisville, NC (Dr Wegner); and Department of Nutrition (Dr Ammerman) and Center for Health Promotion Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Chapel Hill, NC. Dr Benjamin is retired
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  • Julie C. Jacobson Vann
    Affiliations
    Department of Pediatrics (Drs Perrin, Benjamin, and Skinner), Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Nursing, Health Care Systems (Dr Jacobson Vann), University of North Carolina at Chapel Hill, Chapel Hill, NC; AccessCare, Morrisville, NC (Dr Wegner); and Department of Nutrition (Dr Ammerman) and Center for Health Promotion Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Chapel Hill, NC. Dr Benjamin is retired
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  • John T. Benjamin
    Affiliations
    Department of Pediatrics (Drs Perrin, Benjamin, and Skinner), Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Nursing, Health Care Systems (Dr Jacobson Vann), University of North Carolina at Chapel Hill, Chapel Hill, NC; AccessCare, Morrisville, NC (Dr Wegner); and Department of Nutrition (Dr Ammerman) and Center for Health Promotion Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Chapel Hill, NC. Dr Benjamin is retired
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  • Asheley Cockrell Skinner
    Affiliations
    Department of Pediatrics (Drs Perrin, Benjamin, and Skinner), Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Nursing, Health Care Systems (Dr Jacobson Vann), University of North Carolina at Chapel Hill, Chapel Hill, NC; AccessCare, Morrisville, NC (Dr Wegner); and Department of Nutrition (Dr Ammerman) and Center for Health Promotion Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Chapel Hill, NC. Dr Benjamin is retired
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  • Steven Wegner
    Affiliations
    Department of Pediatrics (Drs Perrin, Benjamin, and Skinner), Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Nursing, Health Care Systems (Dr Jacobson Vann), University of North Carolina at Chapel Hill, Chapel Hill, NC; AccessCare, Morrisville, NC (Dr Wegner); and Department of Nutrition (Dr Ammerman) and Center for Health Promotion Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Chapel Hill, NC. Dr Benjamin is retired
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  • Alice S. Ammerman
    Affiliations
    Department of Pediatrics (Drs Perrin, Benjamin, and Skinner), Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Nursing, Health Care Systems (Dr Jacobson Vann), University of North Carolina at Chapel Hill, Chapel Hill, NC; AccessCare, Morrisville, NC (Dr Wegner); and Department of Nutrition (Dr Ammerman) and Center for Health Promotion Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Chapel Hill, NC. Dr Benjamin is retired
    Search for articles by this author

      Background

      Communication of children's weight status and targeted counseling by pediatricians may change parental perceptions or child dietary and physical activity behaviors. The aim of this study was to determine whether accuracy of parental perception of children's weight status and reports of related behaviors changed following a brief pediatrics resident intervention.

      Methods

      Parents (N = 115) of children aged 4 to 12 years enrolled in Medicaid completed baseline questionnaires with providers about prior communication of weight status and/or body mass index (BMI), perceptions of their children's weight, and children's dietary and physical activity behaviors, and children were weighed and measured. Trained residents used a toolkit to communicate weight status to parents (via color-coded BMI charts) and counseled about mutually chosen healthy behaviors. Questionnaires were repeated at 1 and 3 months, and measurements were repeated for children with BMI ≥85%.

      Results

      At baseline, 42% of parents of overweight children believed their children were at healthy weight. Most (n = 96; 83%) parents completed 1-month questionnaires, and 56% completed 3-month follow-up questionnaires. Improvements in fruit and vegetable consumption, sweet drinks, unhealthy snacks, frequency of restaurant food, lower-fat milk, and screen time occurred among both overweight and healthy weight children. There were also increases in discussions with providers about weight/BMI and parental accuracy of overweight assessment.

      Conclusions

      Parent accuracy of weight status and short-term childhood dietary and physical activity behavior changes improved following resident pediatrician use of a toolkit to support communication of weight status and counseling. Further research needs to determine whether accurate parental perception motivates improved behavior change or healthier BMI trajectories.

      Key Words

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