He Said, She Said: Examining Parental Concordance on Home Environment Factors and Adolescent Health Behaviors and Weight Status

Abstract

Introduction Few studies have examined concordance/discordance between caregivers to identify whether caregivers see familial and parental factors in the home environment similarly or differently and whether the agreement or disagreement is related to adolescent obesity risk. Answers to these questions are important and may inform whether family-based childhood obesity interventions need to target both parents. Objective The main objective of the study is to examine whether and how parental concordance/discordance on factors in the home environment (e.g., importance of family meals, parent feeding practices, encouraging child physical activity, limit setting on child screen time) are associated with adolescent health behaviors and weight status. Design Data from two linked population-based studies were used in cross-sectional analyses. Linear regression models examined associations between parental concordance/discordance on home environment factors and adolescents’ health behaviors and weight status. Participant/Settings Racially/ethnically and socioeconomically diverse adolescents (n=1,052; 54% girls; mean age = 14.3 years) and their parents (n=2,104; 52% female; mean age = 41.0 years) from Minneapolis and St. Paul, Minnesota participated in the study. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. Results Parental concordance on home environment factors was high for some factors (e.g., 68% concordance on not pressuring adolescent to eat) and low for other factors (e.g., 2% concordance on parent engaging in physically activity with child 4+ hours/week). Parental concordance on positive home environment factors (e.g., frequency of family meals) was associated with more adolescent healthful eating patterns and hours of physical activity (p < 0.05), but not consistently. When parents were discordant, adolescents had higher consumption of fast food and more unhealthy weight control behaviors (p < 0.05), but not consistently. Conclusions Results suggest there is some degree of parental concordance on home environment factors, however the results were inconsistent and approximately one third of parents were discordant on these factors. Future research is needed to further examine the role of parental concordance/discordance on adolescent health behaviors and weight status.

Youth weight status and family functioning in paediatric primary care

“…13 Further, adolescent females with reports of higher family functioning had lower BMI z-scores and rates of overweight/obesity, less sedentary behaviour, and consumed more fruits and vegetables. 17,18 Adolescent males with higher family functioning had greater physical activity and less sedentary behaviour, but not lower BMI z-scores or weight status. 17,18 Families with impaired family functioning may have challenges with every day communication, providing rules, structure, and support.…”

“…17,18 Adolescent males with higher family functioning had greater physical activity and less sedentary behaviour, but not lower BMI z-scores or weight status. 17,18 Families with impaired family functioning may have challenges with every day communication, providing rules, structure, and support. 7,14 These challenges can further extend to making healthy specialty clinics for more intensive family-based behavioural treatment with a multidisciplinary treatment team.…”

“…In population‐level data, adolescents with healthier family functioning, assessed by the FAD, had healthier diet and physical activity behaviours and weight status . Further, adolescent females with reports of higher family functioning had lower BMI z‐scores and rates of overweight/obesity, less sedentary behaviour, and consumed more fruits and vegetables . Adolescent males with higher family functioning had greater physical activity and less sedentary behaviour, but not lower BMI z ‐scores or weight status …”

Development of text messages targeting healthy eating for children in the context of parenting partnerships

“…Parenting partnership or ‘co‐parenting’ is the term used to describe the relationship that both parents share in raising children . The quality of the parenting partnership has been shown to positively impact a child's social and emotional development, including impulse control, which suggests that it might influence a child's lifestyle behaviour and weight status.…”

“…8 Parenting partnership or 'co-parenting' is the term used to describe the relationship that both parents share in raising children. 9 The quality of the parenting partnership has been shown to positively impact a child's social and emotional development, including impulse control, [10][11][12] which suggests that it might influence a child's lifestyle behaviour and weight status. However, a systematic review of 213 studies on childhood obesity interventions found no interventions that focused on the parenting partnership in relation to dietary intake or childhood obesity.…”