Energy balance-related parenting and child-care practices: The importance of meso-system consistency.

Jessica S Gubbels,Ilona Van De Kolk,Stef P J Kremers,Nanne K De Vries,Carel Thijs,Kelly Stessen,Jacobus P Van Wouwe

doi:10.1371/journal.pone.0203689

Abstract

BackgroundOur knowledge of the role of parental and child-care staff behavior in the development and prevention of obesity is rapidly increasing. Potential interaction between both settings in so-called meso-systems, as hypothesized by the ecological systems perspective, is however often ignored. Specifically, inconsistency between home and child-care is hypothesized to have negative effects on child outcomes.MethodsParticipants were recruited through 23 child-care centers in the Netherlands. Data regarding 161 child-parent-child-care staff triads were available. Parenting and child care practices were assessed using validated questionnaires for parents (Child Feeding Practices Questionnaire, Preschooler Physical Activity Parenting Practices instrument) and child-care staff (Child-care Food and Activity Practices Questionnaire), using similar items in both settings. Absolute difference scores between parents and child-care staff were calculated for each triad as a measure of meso-system consistency. Child outcomes were physical activity (as assessed by accelerometry), dietary intake (from the parental questionnaire), and measured BMI z-scores. Paired t-tests were used to examine consistency between practices in both settings. Linear regression analyses were used to explore the association of parenting practices, child-care practices and difference scores on the one hand, and child outcomes on the other.ResultsSignificant differences between settings were found for almost all practices, and in most cases child-care staff scores more favorable on the practices than parents. Inconsistencies were mostly associated with unhealthy dietary intake and lower physical activity levels, but not with BMI.ConclusionThe current study showed that inconsistencies in parenting and child-care practices exist, and that these inconsistencies seem to be associated with unhealthy behavior in children. The results underline the importance of studying meso-system influences on behavior in general, and children’s energy balance-related behavior specifically.

Highlights

Various studies seem to indicate an increased overweight risk in children attending child-care (e.g. [1,2,3,4]), this association seems to be dependent on a number of factors, including age at initiation and type of care [5]
The current study explored the association between inconsistency of practices in the home and child-care setting on the one hand, and children’s diet, physical activity and body mass index (BMI) on the other
This study showed the existence of inconsistencies in energy balance-related practices between child-care and home, with the large majority of examined practices showing significant differences between both settings

Summary

Introduction

Various studies seem to indicate an increased overweight risk in children attending child-care (e.g. [1,2,3,4]), this association seems to be dependent on a number of factors, including age at initiation and type of care [5]. Encouragement and modeling of healthy behaviors by child-care staff seems very promising [9, 11,12,13]. Positive supporting approaches by parents, stimulating intake of healthy foods and being physically active and being a positive role model, consistently show positive effects [7, 8]. Our knowledge of the role of parental and child-care staff behavior in the development and prevention of obesity is rapidly increasing. Potential interaction between both settings in socalled meso-systems, as hypothesized by the ecological systems perspective, is often ignored. Inconsistency between home and child-care is hypothesized to have negative effects on child outcomes

Methods

Discussion

Conclusion