Parental Perception of Preschool Child Body Weight1

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Obesity in preschoolers has risen dramatically in the last decade. Although studies have demonstrated that parents of preschoolers have incorrect perceptions of their child's body weight, little is known about the factors that may be associated with these perceptions. The purpose of this study was to examine the relationships between parental perceptions of preschool child body weight and parental psychosocial factors. Quantitative analyses included descriptive statistics, correlations, and regression analyses. More than one third of the children in the sample were at risk for being overweight or were already overweight. However, less than 6% of parents felt that their child had an elevated body weight. Results from univariate logistic regression analyses demonstrated that the parent's health literacy level was a significant predictor of the accuracy of their perceptions regarding their child's body weight (p < .05). Parental concern regarding child weight and perceived level of efficacy did not significantly predict the accuracy of their perceptions. Results from this study indicate that assessing parental perceptions of preschool child body weight can help providers accurately understand how parents view their children and lead to tailored educational interventions. In addition, the results support previous research suggesting that parental health literacy is a key to providing high-quality family-centered care.

Section snippets

Review of Literature

Many intrapersonal, interpersonal, and environmental factors have influenced the dramatic increase in early-childhood weight problems over the past few decades (Davison and Birch, 2001, Doolen et al., 2009, Reifsnider et al., 2006b, Zeller and Daniels, 2004). Research related to childhood nutrition issues often focus on interventions to improve children's diet and exercise patterns (Davison and Birch, 2001, Towns and D'Auria, 2009). Although this research is beneficial, there is still a need

Purpose and Research Questions

The purpose of this study was to examine the relationships among parental perception of child body weight, sense of parental efficacy, health literacy, and selected demographic factors in parents of preschool children. Research questions for this study were the following: (a) What is the parent's perception of the preschool child's body weight? And (b) what factors are associated with the accuracy of a parent's perception of his or her child's body weight?

Theoretical Framework

The Revised Health Belief Model (Roden, 2004a, Roden, 2004b) served as the theoretical framework for this study because it takes into account the integral part that parents play in the development of a child's health behaviors and values. The Revised Health Belief Model (Roden, 2004a) allows nurses to incorporate “positive” health messages into the care of families and children in an attempt to increase the overall effectiveness of health promotion activities. The model, which incorporates the

Methods

This study used a descriptive, correlational, cross-sectional design. Self-report instruments were used to measure perceived parental efficacy, parent's level of health literacy, current level of parental concern for child weight, and current parental perception of child weight. This study was approved by the Institutional Review Board for Protection of Human Subjects at Vanderbilt University. Potential participants were approached by the researcher in the clinic setting, given time to discuss

Research Question 1

Table 2 provides a summary of the parental participants' perceptions of their children's body weight on the day of the clinic visit in comparison with the child's actual BMI category as determined by a standardized CDC growth chart for gender and age. There was no statistically significant difference between the private office group and the health department group on the parents' perception of their child's weight (Mann–Whitney U = 1,774.50, p = .850), nor on the distribution of child body

Discussion

The findings from this study support and validate previous findings about parents' perceptions of preschool child body weight. In this study, nearly 80% of parents perceived their child's weight as appropriate, and 15% felt that their child might be underweight (Table 2). Slightly less than 6% of parents felt that their child was overweight at the time of data collection, whereas based on CDC standards, 17.5% of the children in this study were actually overweight (Table 2). This is consistent

Conclusion

Parents in this sample were relatively unconcerned about weight issues in their children, despite 38.3% (n = 46) of the children being at risk for or already overweight (Table 2). These findings are of concern for health care providers because of a possible link that may exist between a parent's perception of a health problem and the likelihood of taking positive action on behalf of the child. Currently, more than 22 million preschoolers are overweight worldwide (World Health Organization, 2007

Acknowledgments

This research study was supported by a small research grant from the Kappa Theta Chapter of Sigma Theta Tau International. The author wishes to thank her dissertation committee members for their help in completing this study. Committee members included Dr. Tom Cook, Ph.D. (chair), Dr. Mary Jo Gilmer, Ph.D., Dr. Lynda Lamontagne, Ph.D., Dr. Mary Dietrich, Ph.D. and Dr. David Schlundt, Ph.D.

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    1

    An overview of the findings presented in this article was presented as part of a paper presentation at the Southern Nursing Research Society in Baltimore (February 2009) and at the Sigma Theta Tau International 40th Biennial Convention in Indianapolis (November 2009), and as a poster at the Obesity Treatment and Prevention Conference in Las Vegas (May 2009).

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