Advertisement

Latino Parents' Perceptions of Weight Terminology Used in Pediatric Weight Counseling

Published:December 20, 2014DOI:https://doi.org/10.1016/j.acap.2014.11.003

      Abstract

      Objective

      To identify which English and Spanish terms Latino parents consider motivating, as well as culturally and linguistically appropriate, for provider use during weight counseling of overweight and obese Latino youth.

      Methods

      Latino parent perceptions of common Spanish and English terms for overweight were discussed with 54 parents in 6 focus groups (3 English, 3 Spanish). Atlas.ti software was used for qualitative analysis. An initial codebook was used to code passages for English and Spanish terminology separately. Subsequent changes to the coded passages and creation of new codes were made by team consensus.

      Results

      “Demasiado peso para su salud” (too much weight for his/her health) was the only phrase for excess weight that was consistently identified as motivating and inoffensive by Spanish-speaking parents. “Sobrepeso” (overweight), a commonly used term among health care providers, was motivating to some parents but offensive to others. English-speaking parents had mixed reactions to “unhealthy weight,” “weight problem,” and “overweight,” finding them motivating, confusing, or insulting. Parents found “fat” “gordo” and “obese” “obeso” consistently offensive. Most participants found growth charts and the term “BMI” confusing. Parents consistently reported that providers could enhance motivation and avoid offending families by linking a child's weight to health risks, particularly diabetes.

      Conclusions

      “Demasiado peso para su salud” (too much weight for his/her health) was motivating to many Spanish-speaking Latino parents. Among English-speaking Latino parents, no single English term emerged as motivating, well-understood, and inoffensive. Linking a child's excess weight with increased health risks was motivating and valuable to many parents regardless of language spoken.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Institute of Medicine
        Preventing Childhood Obesity: Health in the Balance.
        National Academies Press, Washington, DC2005
        • Flower K.B.
        • Perrin E.M.
        • Viadro C.I.
        • Ammerman A.S.
        Using body mass index to identify overweight children: barriers and facilitators in primary care.
        Ambul Pediatr. 2007; 7: 38-44
        • Puhl R.M.
        • Peterson J.L.
        • Luedicke J.
        Parental perceptions of weight terminology that providers use with youth.
        Pediatrics. 2011; 128: e786-e793
        • Davis M.M.
        • Gance-Cleveland B.
        • Hassink S.
        • et al.
        Recommendations for prevention of childhood obesity.
        Pediatrics. 2007; 120: S229-S253
        • Bender M.S.
        • Clark M.J.
        Cultural adaptation for ethnic diversity: a review of obesity interventions for preschool children.
        Calif J Health Promot. 2011; 9: 40
        • Fitzgibbon M.L.
        • Beech B.M.
        The role of culture in the context of school-based BMI screening.
        Pediatrics. 2009; 124: S50-S62
        • Lindsay A.C.
        • Sussner K.M.
        • Greaney M.L.
        • Peterson K.E.
        Latina mothers’ beliefs and practices related to weight status, feeding, and the development of child overweight.
        Public Health Nurs. 2011; 28: 107-118
      1. Office of Minority Health; US Department of Health and Human Services. The National CLAS standards. Available at: http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=15. Accessed November 20, 2013.

      2. HealthyPeople.gov; Office of Disease Prevention and Health Promotion. Healthy People 2020: Nutrition and Weight Status. Washington, DC: US Dept of Health and Human Services; 2012, 2013. Available at: http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=29. Accessed September 6, 2013.

        • Tailor A.
        • Ogden J.
        Avoiding the term “obesity”: an experimental study of the impact of doctors’ language on patients’ beliefs.
        Patient Educ Couns. 2009; 76: 260-264
        • Wadden T.A.
        • Didie E.
        What’s in a name? Patients’ preferred terms for describing obesity.
        Obes Res. 2003; 11: 1140-1146
        • Bolling C.
        • Crosby L.
        • Boles R.
        • Stark L.
        How pediatricians can improve diet and activity for overweight preschoolers: a qualitative study of parental attitudes.
        Acad Pediatr. 2009; 9: 172-178
        • Dutton G.R.
        • Tan F.
        • Perri M.G.
        • et al.
        What words should we use when discussing excess weight?.
        J Am Board Fam Med. 2010; 23: 606-613
        • Eneli I.U.
        • Kalogiros I.D.
        • McDonald K.A.
        • Todem D.
        Parental preferences on addressing weight-related issues in children.
        Clin Pediatr. 2007; 46: 612-618
        • Harr D.
        Denver Health Community Health Services BMI Report—Peds.
        Denver Health, Ambulatory Care Services, Denver, Colo2014
        • Ogden C.L.
        • Carroll M.D.
        • Kit B.K.
        • Flegal K.M.
        Prevalence of childhood and adult obesity in the United States, 2011–2012.
        JAMA. 2014; 311: 806-814
      3. Office of Minority Health; US Department of Health and Human Services. Obesity and Hispanic Americans. Available at: http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=537&ID=6459. Accessed November 20, 2013.

        • Skelton J.A.
        • Cook S.R.
        • Auinger P.
        • et al.
        Prevalence and trends of severe obesity among US children and adolescents.
        Acad Pediatr. 2009; 9: 322-329
      4. Centers for Disease Control and Prevention. Obesity and overweight. Available at: http://www.cdc.gov/obesity/data/childhood.html. Accessed Novermber 20, 2013.

        • Taveras E.M.
        • Gortmaker S.L.
        • Mitchell K.F.
        • Gillman M.W.
        Parental perceptions of overweight counseling in primary care: the roles of race/ethnicity and parent overweight.
        Obesity (Silver Spring). 2008; 16: 1794-1801
        • Hambidge S.J.
        • Emsermann C.B.
        • Federico S.
        • Steiner J.F.
        Disparities in pediatric preventive care in the United States, 1993–2002.
        Arch Pediatr Adolesc Med. 2007; 161: 30-36
        • Branner C.M.
        • Koyama T.
        • Jensen G.L.
        Racial and ethnic differences in pediatric obesity-prevention counseling: national prevalence of clinician practices.
        Obesity (Silver Spring). 2008; 16: 690-694
        • Lopez-Quintero C.
        • Berry E.M.
        • Neumark Y.
        Limited English proficiency is a barrier to receipt of advice about physical activity and diet among Hispanics with chronic diseases in the United States.
        J Am Diet Assoc. 2009; 109: 1769-1774
        • Breitkopf C.R.
        • Egginton J.S.
        • Naessens J.M.
        • et al.
        Who is counseled to lose weight? Survey results and anthropometric data from 3,149 lower socioeconomic women.
        J Community Health. 2012; 37: 202-207
        • Mikhailovich K.
        • Morrison P.
        Discussing childhood overweight and obesity with parents: a health communication dilemma.
        J Child Health Care. 2007; 11: 311-322
        • Hackie M.
        • Bowles C.L.
        Maternal perception of their overweight children.
        Public Health Nurs. 2007; 24: 538-546
        • Agne A.A.
        • Daubert R.
        • Munoz M.L.
        • et al.
        The cultural context of obesity: exploring perceptions of obesity and weight loss among Latina immigrants.
        J Immigr Minor Health. 2012; 14: 1063-1070
        • Ahluwalia I.B.
        • Ford E.S.
        • Link M.
        • Bolen J.C.
        Acculturation, weight, and weight-related behaviors among Mexican Americans in the United States.
        Ethn Dis. 2007; 17: 643-649
        • Ceballos N.
        • Czyzewska M.
        Body image in Hispanic/Latino vs European American adolescents: implications for treatment and prevention of obesity in underserved populations.
        J Health Care Poor Underserved. 2010; 21: 823-838
        • Gee L.
        • Peebles R.
        • Storfer-Isser A.
        • et al.
        Underestimation of weight status in Californian adolescents.
        Child Obes. 2013; 9: 132-136
        • Giardina E.G.
        • Sciacca R.R.
        • Flink L.E.
        • et al.
        Cardiovascular disease knowledge and weight perception among Hispanic and non-Hispanic white women.
        J Womens Health (Larchmt). 2013; 22: 1009-1015
        • Sosa E.T.
        Mexican American mothers’ perceptions of childhood obesity: a theory-guided systematic literature review.
        Health Educ Behav. 2012; 39: 396-404
        • Gabow P.
        • Eisert S.
        • Wright R.
        Denver Health: a model for the integration of a public hospital and community health centers.
        Ann Intern Med. 2003; 138: 143-149
      5. Colorado Health Foundation. The Colorado health report card, 2013. Available at: http://www.coloradohealth.org/report_card.aspx. Accessed December 1, 2014.

      6. Centers for Disease Control and Prevention. CDC Vital Signs. Progress on childhood obesity: many states show declines. August 2013. Available at: http://www.cdc.gov/vitalsigns/pdf/2013-08-vitalsigns.pdf. Accessed December 1, 2014.

      7. Centers for Disease Control and Prevention. Clinical growth charts, 2009. Available at: http://www.cdc.gov/growthcharts/clinical_charts.htm. Accessed December 1, 2014.

      8. Improving Aging and Public Health Research: Qualitative and Mixed Methods. American Public Health Association and the Gerontological Society of America, Washington, DC2006
        • Oettinger M.D.
        • Finkle J.P.
        • Esserman D.
        • et al.
        Color-coding improves parental understanding of body mass index charting.
        Acad Pediatr. 2009; 9: 330-338