Family intervention focused on effective parenting is associated with decreased child obesity prevalence 3-5 years later

Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Evidence-based medicine 02/2013; 18(1):e5. DOI: 10.1136/eb-2012-100710
Source: PubMed
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    ABSTRACT: Background: Nonalcoholic fatty liver disease (NAFLD) affects 30% of obese children globally. The main treatment for NAFLD is to promote gradual weight loss through lifestyle modification. Very little is known regarding parental perspectives about the barriers and facilitators that influence the ability to promote healthy lifestyle behaviours in children with NAFLD. Objectives: To explore and describe parental perspectives regarding barriers to and facilitators of implementing lifestyle modification in children with NAFLD. Methods: A mixed-methods approach, including qualitative methodology (focus groups) and validated questionnaires (Lifestyle Behaviour Checklist), was used to assess parental perceptions regarding barriers to and facilitators of lifestyle change in parents of children with healthy body weights (control parents) and in parents of children with NAFLD (NAFLD parents). Results: NAFLD parents identified more problem behaviours related to food portion size and time spent in nonsedentary physical activity, and lower parental self-efficacy than parents of controls (P<0.05). Major barriers to lifestyle change cited by NAFLD parents were lack of time, self-motivation and role modelling of healthy lifestyle behaviours. In contrast, control parents used a variety of strategies to elicit healthy lifestyle behaviours in their children including positive role modelling, and inclusion of the child in food preparation and meal purchasing decisions, and perceived few barriers to promoting healthy lifestyles. Internet sources were the main form of nutrition information used by parents. Conclusions: Lifestyle modification strategies focused on promoting increased parental self-efficacy and parental motivation to promote healthy lifestyle behaviour are important components in the treatment of obese children with NAFLD.
    Full-text · Article · May 2014 · Paediatrics & child health
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    ABSTRACT: Background Information on the relationship between sleep duration and obesity among children in urban Guangzhou, China is limited. This study aims to examine the relationship between sleep duration and obesity in children aged 6–18 years. Methods The sample consisted of 11,830 children aged 6–18 years. The children were randomly selected from 13 schools in three urban districts of Guangzhou. The study was conducted from September to November 2013. The height and weight of the children were measured. Adiposity status was estimated using body mass index and according to the cut point in China criteria. In the structured questionnaire, children reported daily sleep hours (less than 7 h, 7–9 h and more than 9 h), weekly food intake amount (including vegetables, fruit, sugar beverages and meat), physical activity and sedentary time. A caretaker would answer the questionnaire on behalf of a child aged below nine. Results A total of 8,760 children (49.0 % boys) completed the study. The prevalence of obesity was 8.4 % (9.8 % in boys and 5.7 % in girls). Adjusted for age, diet and physical activity/sedentary behaviour, the odds ratio (OR) for obesity comparing sleeping <7 h (short sleep duration, SSD) with ≥9 h (long sleep duration, LSD) was 0.70 (95 % CI: 0.69–0.72) among boys and 1.73 (95 % CI: 1.71–1.74) among girls. Stratified by age, OR for boys aged 6–12 years comparing SSD with LSD was 0.60 (95 % CI: 0.55–0.66); by contrast, OR was 1.33 (95 % CI: 1.30–1.37) for boys aged 13–18 years. Conclusion Short sleep duration is associated with increased chances of obesity among girls and 13- to 18-year-old boys, but the chances of obesity are decreased among 6- to 12-year-old boys. Age and gender should be regarded as specific characteristics for the effects of short sleep on obesity.
    Full-text · Article · Oct 2015 · BMC Public Health
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    ABSTRACT: Objective: To characterize patient preferences about parenting preparation during pregnancy and the role of healthcare providers. Methods: A nationally representative, cross-sectional survey was administered to parents of children 0-3 years old. Respondents (N = 459 non-institutionalized US adults from the GfK Knowledge Panel(®)) completed an online survey about parenting preparation (response rate = 61.2 %). Primary outcomes were perceived importance of parenting, regret about opportunities to prepare for parenting, acceptability of parenting support from healthcare workers, and preferred healthcare setting for perinatal parenting support. Statistical analyses included descriptive statistics, Chi square analyses and logistic regression. Results: A majority of respondents (87.6 %, 95 % CI 83.3-90.8) believed that parenting had an equal or greater effect on early childhood behavior than the child's personality. Overall, 68.7 % (63.5-73.5 %) wished there were more opportunities during pregnancy to prepare for parenting, and a large majority (89.2, 84.9-92.4 %) believed that it would be helpful to receive parenting information from healthcare providers during pregnancy, with no differences across demographic groups. The preferred clinical encounters for receiving parenting education were at "a visit with my ObGyn/midwife" during pregnancy (58.2, 52.5-63.7 %) and at "a visit with my child's doctor/nurse practitioner" during 0-2 months postpartum (60.7, 55.0-66.2 %). Conclusion: A majority of US parents of young children express interest in receiving parenting support at perinatal healthcare visits. Preferences for parenting support at prenatal visits during pregnancy and at pediatric visits in the immediate postpartum period should guide clinicians, community-based outreach organizations, and governmental stakeholders seeking to design and evaluate parenting preparation interventions.
    No preview · Article · Nov 2015 · Maternal and Child Health Journal