Factors Associated With Parental Readiness to Make Changes for Overweight Children

Abstract

ABSTRACT. Objective. The prevalence of childhood obesity is increasing in the United States. However, it has been difficult to help children successfully lose weight and maintain weight loss. Parental involvement in this effort is important. Currently, little is known about parents' readiness to make behavior changes to help their children lose weight. The objective of this study was to describe demographic factors and parental perceptions associated with parents' readiness to make weight-reducing lifestyle changes for their overweight and at-risk-foroverweight children.Methods. A total of 151 parents of children who were aged 2 to 12 years and had BMIs >85th percentile for age and gender completed a 43-item self-administered questionnaire. Parental stage of change, defined as precontemplation stage, contemplation stage, and preparation/ action stage, was determined using an algorithm involving current parental practices and future intentions. Parents in the preparation/action stage were considered to be ready to make behavior changes to help their child lose weight. Maximum-likelihood multinomial logistic regression was used to identify demographics and perceptions associated with parental stage of change.Results. Sixty-two percent of the children had a BMI >95th percentile. Their mean age was 7.5 years, and 53% were male. Of the 151 parents, 58 (38%) were in the preparation/action stage of change, 26 (17%) were in the contemplation stage, and 67 (44%) were in the precontemplation stage. Factors associated with being in the preparation/action stage of change were having overweight or older (>8 years) children, believing that their own weight or child's weight was above average, and perceiving that their child's weight was a health problem. After controlling for multiple factors, having an older child (odds ratio ABBREVIATIONS. OR, odds ratio; CI, confidence interval.[

Do you see what I see? Weight status misperception and exposure to obesity among children and adolescents

“…8 Parents' recognition that their children's weight was in excess and presented a health risk was found to be key to parental readiness to encourage lifestyle changes in their children. 15 However, although more than 25% of Canadian children aged 2-17 are overweight or obese, only 9% of parents believe their child to be overweight or obese. 41 Results of this study suggest that children and youth exposed to overweight/obesity in their immediate environments in which people they see on a daily basis, such as parents and schoolmates, are overweight or obese may develop false perceptions of what constitutes an appropriate weight status.…”

“…It is also important that parents have an accurate perception of their child's body weight, as parental awareness is key to behavioral change in children and adolescents. 8,15,41 Previous research has shown that one's weight status perception develops early in life, reportedly as early as age 9. 42,43 Our finding that variation in misperception was attributable to schoolmate and parent BMI in children as young as age 9 further highlights the need for obesity prevention early in the life course.…”

“…Accurately perceiving oneself as overweight or obese is considered an important cue for action and change and has been linked to greater motivation to engage in healthy lifestyle behaviors. 14,15 Growing evidence suggests that actual weight and perception of weight status often do not coincide, and that deviations between actual and perceived weight status are more common among overweight and obese individuals. [16][17][18][19] Among overweight adults, 43% of men and 18% of women perceived themselves to be of 'healthy weight or underweight'.…”

Utility of the waist-to-height ratio as an instrument to measure parental perception of body weight in children and its use in a population-based survey of children

“…However, active participation in these strategies depends partly on the ability of parents to recognize when their child is overweight. Several studies (2)(3)(4)(5)(6)(7)(8)(9)(10) have examined how parents perceive their child's weight status. Their perception of weight status is then usually compared with actual weight status categorized using BMI.…”

“…Their perception of weight status is then usually compared with actual weight status categorized using BMI. These studies have reported that the prevalence of overweight, calculated from parental perception, is significantly lower than the prevalence of overweight categorized using BMI (2)(3)(4)(5)(6)(7)(8)(9)(10) . The reasons for underestimating weight status are varied and include: parents' belief that their child will 'grow into their weight' and is therefore not an immediate problem (4,9) ; the belief that a bigger child may be healthier than one who is thin (4) ; and the concern that highlighting overweight may encourage the development of eating disorders (3,4) .…”