Abstract
Objective
To examine parental perspectives/rankings of the most important weight-management
clinical practices and to determine whether preferences/rankings differ when parents
disagree that their child is overweight.
Methods
We performed mixed-methods analysis of a 32-question survey of parents of 2- to 18-year-old
overweight children assessing parental agreement that their child is overweight, the
single most important thing providers can do to improve weight status, ranking American
Academy of Pediatrics–recommended clinical practices, and preferred follow-up interval.
Four independent reviewers analyzed open-response data to identify qualitative themes/subthemes.
Multivariable analyses examined parental rankings, preferred follow-up interval, and
differences by agreement with their child's overweight assessment.
Results
Thirty-six percent of 219 children were overweight, 42% obese, and 22% severely obese;
16% of parents disagreed with their child's overweight assessment. Qualitative analysis
of the most important practice to help overweight children yielded 10 themes; unique
to parents disagreeing with their children's overweight assessments was “change weight-status
assessments.” After adjustment, the 3 highest-ranked clinical practices included,
“check for weight-related problems,” “review growth chart,” and “recommend general
dietary changes” (all P < .01); parents disagreeing with their children's overweight assessments ranked “review
growth chart” as less important and ranked “reducing screen time” and “general activity
changes” as more important. The mean preferred weight-management follow-up interval
(10–12 weeks) did not differ by agreement with children's overweight assessments.
Conclusions
Parents prefer weight-management strategies that prioritize evaluating weight-related
problems, growth-chart review, and regular follow-up. Parents who disagree that their
child is overweight want changes in how overweight is assessed. Using parent-preferred
weight-management strategies may prove useful in improving child weight status.
Keywords
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References
- Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.Pediatrics. 2007; 120: S164-S192
- Parent participation in weight-related health interventions for children and adolescents: a systematic review and meta-analysis.Prev Med. 2012; 55: 3-13
- Parental perspectives regarding primary-care weight-management strategies for school-age children..Matern Child Nutr. 2014 Apr 10; ([Epub ahead of print])https://doi.org/10.1111/mcn.12131
- Parental underestimates of child weight: a meta-analysis.Pediatrics. 2014; 133: e689-e703
- Change in misperception of child's body weight among parents of American preschool children..Child Obes. 2015 Apr 30; ([Epub ahead of print])
- Underestimation of children's weight status: views of parents in an urban community.Clin Pediatr. 2010; 49: 470-476
Children's Medical Center 2011 report. Beyond a, b, c. Available at: http://www.scribd.com/doc/72738921/Children-s-Medical-Center-report. Accessed June 24, 2015.
- Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement.Pediatrics. 2010; 125: 361-367
- Health status, emotional/behavioral problems, health care use, and expenditures in overweight/obese US children/adolescents.Acad Pediatr. 2013; 13: 251-258
- Using BMI to determine cardiovascular risk in childhood: how do the BMI cutoffs fare?.Pediatrics. 2009; 124: e905-e912
- The Discovery of Grounded Theory: Strategies for Qualitative Research.Aldine Publishing, New York, NY1967
- Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults.N Engl J Med. 1998; 338: 1650-1656
- Pediatricians' communication about weight with overweight Latino children and their parents.Pediatrics. 2014; 134: 892-899
- Do parents understand growth charts? A national, internet-based survey.Pediatrics. 2009; 124: 1100-1109
- Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study.J Pediatr. 2007; 150: 12-17.e2
- Predictors of body mass index and associations with cardiovascular risk factors in Australian children: a prospective cohort study.Int J Obes (Lond). 2005; 29: 15-23
- The utility of body mass index as a measure of body fatness in children and adolescents: differences by race and gender.Pediatrics. 1997; 99: 804-807
- Racial differences in the tracking of childhood BMI to adulthood.Obes Res. 2005; 13: 928-935
- CDC health disparities and inequalities report—United States, 2013.MMWR Surveill Summ. 2013; 62 (Available at:) (Accessed August 27, 2015): 1-186
- Staged treatment of pediatric obesity according to age and BMI percentile.Pediatrics. 2007; 120 (Available at:) (Accessed August 27, 2015): S254-S288
- The obesity epidemic in the United States—gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis.Epidemiol Rev. 2007; 29: 6-28
- The participation of minorities in published pediatric research.J Natl Med Assoc. 2005; 97: 777-783
Article info
Publication history
Published online: September 17, 2015
Accepted:
September 8,
2015
Received:
April 29,
2015
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.