How Pediatricians Can Improve Diet and Activity for Overweight Preschoolers: A Qualitative Study of Parental Attitudes

Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, ML 7035, 3333 Burnet Avenue, Cincinnati, Ohio 45229, USA.
Academic pediatrics (Impact Factor: 2.01). 05/2009; 9(3):172-8. DOI: 10.1016/j.acap.2009.01.010
Source: PubMed


This study sought feedback from parents of overweight preschoolers on terms for overweight and treatment strategies pediatricians could use to help parents improve diet and activity for their children.
Twenty-three parents of 21 children aged 2 to 6 years and between the 85th and 94th percentile body mass index participated in focus groups conducted by a pediatrician to assess 1) terms and health risks that motivate parents, 2) barriers that prevent adoption of recommended behaviors, and 3) recommendations for pediatricians on strategies to help parents improve child diet and activity.
With regard to weight status, parents preferred the terms overweight and obese as long as pediatricians provided rationale for the classification. Parents recommended that pediatricians avoid colloquial terms to describe weight status. With regard to American Academy of Pediatrics recommendations for weight management in overweight preschoolers, parents were reluctant to restrict 100% fruit juice, needed specific strategies to increase vegetable consumption, and said limiting screen time would be difficult, especially when busy or during inclement weather. Despite identification of barriers, parents reported confidence in adopting all recommended behaviors except vegetable intake if given the rationale for the recommendation and strategies for implementation.
Parents recommended that pediatricians speak clearly about weight status, explain rationale for concern, relate that concern to family history, and provide specific advice and treatment recommendations.

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    • "Elle semble le « ciment » du collage parent—enfant [6] [40] [41] [43] [44] [48] [53] [70]. Adopter une attitude thérapeutique impose donc une nécessaire remise en question des parents : de l'utilisation qu'ils font de la nourriture, mais aussi et surtout de leur propre rapport à la nourriture [12] [38] [46] [47] [49] [57]. Ce qui apparaît de manière très forte dans le discours des thérapeutes, c'est le sentiment d'inefficacité des prises en charges, et d'inutilité du discours qu'ils proposent aux familles : les barrières à la perte de poids sont trop nombreuses , notamment à la maison. "
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    ABSTRACT: The Silences of the Archives, the Reknown of the Story. The Martin Guerre affair has been told many times since Jean de Coras and Guillaume Lesueur published their stories in 1561. It is in many ways a perfect intrigue with uncanny resemblance, persuasive deception and a surprizing end when the two Martin stood face to face, memory to memory, before captivated judges and a guilty feeling Bertrande de Rols. The historian wanted to go beyond the known story in order to discover the world of the heroes. This research led to disappointments and surprizes as documents were discovered concerning the environment of Artigat’s inhabitants and bearing directly on the main characters thanks to notarial contracts. Along the way, study of the works of Coras and Lesueur took a new direction. Coming back to the affair a quarter century later did not result in finding new documents (some are perhaps still buried in Spanish archives), but by going back over her tracks, the historian could only be struck by the silences of the archives that refuse to reveal their secrets and, at the same time, by the possible openings they suggest, by the intuition that almost invisible threads link here and there characters and events.
    03/2015; DOI:10.1016/j.neurenf.2015.01.009
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    • "Two articles discussed strategies that PCPs could use to deliver diagnosis and treatment options. In focus groups, parents expressed preferences for health care providers to communicate using clinical terms to explain the rationale for their concern and to provide specific treatment recommendations [46, 47]. "
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    Journal of obesity 04/2013; 2013(11):172035. DOI:10.1155/2013/172035
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    • "Parents may indeed have more concerns about feeding their child [34], whereas they may not have too many concerns about their child watching too much television [35] or not being physically active. Earlier studies even found that parents often do not know that watching too much television is related to the development of obesity [35,36]. "
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    ABSTRACT: Background Evaluating whether parental challenges and self-efficacy toward managing children’s lifestyle behaviors are successfully addressed by interventions requires valid instruments. The Lifestyle Behavior Checklist (LBC) has recently been developed in the Australian context. It consists of two subscales: the Problem scale, which measures parental perceptions of children’s behavioral problems related to overweight and obesity, and the Confidence scale, measuring parental self-efficacy in dealing with these problems. The aim of the current study was to systematically translate the questionnaire into Dutch and to evaluate its internal consistency, construct validity and test-retest reliability. Methods The LBC was systematically translated by four experts at Maastricht University. In total, 392 parents of 3-to13-year-old children were invited to fill out two successive online questionnaires with a two-week interval. Of these, 273 parents responded to the first questionnaire (test, response rate = 69.6%), and of the 202 who could be invited for the second questionnaire (retest), 100 responded (response rate = 49.5%). We assessed the questionnaire’s internal consistency (Cronbach’s α), construct validity (Spearman’s Rho correlation tests, using the criterion measures: restrictiveness, nurturance, and psychological control), and test-retest reliability (Spearman’s Rho correlation tests). Results Both scales had high internal consistency (Cronbach’s α ≥ 0.90). Spearman correlation coefficients indicated acceptable test-retest reliability for both the Problem scale (rs = 0.74) and the Confidence scale (rs = 0.70). The LBC Problem scale was significantly correlated to all criterion scales (nurturance, restrictiveness, psychological control) in the hypothesized direction, and the LBC Confidence scale was significantly correlated with nurturance and psychological control in the hypothesized direction, but not with restrictiveness. Conclusions The Dutch translation of the LBC was found to be a reliable and reasonably valid questionnaire to measure parental perceptions of children’s weight-related problem behavior and the extent to which parents feel confident to manage these problems.
    International Journal of Behavioral Nutrition and Physical Activity 01/2013; 10(1):7. DOI:10.1186/1479-5868-10-7 · 4.11 Impact Factor
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