Abstract
Clinical settings need rapid yet useful methods to screen for diet and activity behaviors for brief interventions and to guide obesity prevention efforts. In an urban pediatric emergency department, these behaviors were screened in children and parents with the 33-item Pediatric-Adapted Liking Survey (PALS) to assess the reliability and validity of a Healthy Behavior Index (HBI) generated from the PALS responses. The PALS was completed by 925 children (average age = 11 ± 4 years, 55% publicly insured, 37% overweight/obese by Body Mass Index Percentile, BMI-P) and 925 parents. Child–parent dyads differed most in liking of vegetables, sweets, sweet drinks, and screen time. Across the sample, child and parent HBIs were variable, normally distributed with adequate internal reliability and construct validity, revealing two dimensions (less healthy—sweet drinks, sweets, sedentary behaviors; healthy—vegetables, fruits, proteins). The HBI showed criterion validity, detecting healthier indexes in parents vs. children, females vs. males, privately- vs. publicly-health insured, and residence in higher- vs. lower-income communities. Parent’s HBI explained some variability in child BMI percentile. Greater liking of sweets/carbohydrates partially mediated the association between low family income and higher BMI percentile. These findings support the utility of PALS as a dietary behavior and activity screener for children and their parents in a clinical setting.
Highlights
The worldwide childhood overweight/obesity prevalence ranges from 22 to 24% [1]
37.4% of children were classified as overweight or obese by Body Mass Index Percentile (BMI-P) (Table 3), which was comparable to the U.S average of 36.6% of children aged 5 to
The present study found that white children reported higher diet quality and health behaviors than Hispanics/Latinos, consistent with an analysis of 2003–2004 U.S NHANES [50], yet no significant difference was found between Blacks/African Americans and Hispanics/Latinos [50]
Summary
The worldwide childhood overweight/obesity prevalence ranges from 22 to 24% [1]. Obesity inU.S children is estimated at 17%, including 5.8% extreme obesity (BMI ≥ 120% of the 95th percentile) [2].Obesity prevention requires a multi-sector approach [3], including screening, brief interventions and referrals between clinical and community sectors [4]. The worldwide childhood overweight/obesity prevalence ranges from 22 to 24% [1]. U.S children is estimated at 17%, including 5.8% extreme obesity (BMI ≥ 120% of the 95th percentile) [2]. Obesity prevention requires a multi-sector approach [3], including screening, brief interventions and referrals between clinical and community sectors [4]. Is utilized for non-urgent care [5], it should be part of this multi-sector approach [6,7,8,9] to reach low-income children who often have unhealthy dietary behaviors and lack access to primary care [6]. Brief obesity interventions have been successfully accomplished in the PED [7]. Clinicians need rapid, yet useful tools to screen behaviors for patient-centered interventions to promote healthy behaviors [10]
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