Perceived Child Weight Research Articles

Caregivers' Perception of Child Weight and Its Implications on Children's BMI: Examining the Role of Weight Concern and Pressed Eating Behaviors as Mediators.

This study aims to investigate the relationship between caregivers' perception of child weight, their concern about children's weight, pressed eating behaviors, and children's BMI. A Child Feeding Questionnaire was administered to 442 primary caregivers of school-aged children (6-12y old) in Hangzhou, China. Significant differences were observed in age, family average monthly income, and family care type among children with different weight statuses (P<0.05). Caregivers' perception of child weight was positively correlated with children's BMI. Caregivers' perception of child weight and children's BMI were negatively correlated with pressed eating behaviors. Caregivers' perception of the child's weight, BMI, and pressed eating behaviors were positively correlated with caregivers' weight concerns. Caregivers' perception of child weight not only had a direct positive predictive effect on children's BMI but also influenced children's BMI through three paths: via the independent mediation of children's weight concern, the independent mediation of pressed eating behaviors, and the chain mediation of children's weight concern and pressed eating behaviors. Caregivers need to rectify perception biases regarding child weight, adopt reasonable feeding strategies, nurture children's self-regulation abilities regarding diet, and prevent the occurrence of childhood overweight and obesity.

Parental beliefs, attitudes, and practices on nutrition and children feeding: implications to preventive measures on children's obesity in Saudi Arabia.

Parents have a profound influence on their children's dietary habits. Parents' perspectives, attitudes, and behaviors regarding feeding their children a nutritious diet can have a significant impact on their children's health. The objective of this study was to examine the attitudes, beliefs, and feeding practices of parents in relation to nutrition for their children and to determine how these factors influence strategies for preventing obesity. A total of 446 Saudi mothers with children aged 2-12 years were recruited for this study. The Child Feeding Questionnaire (CFQ) was administered to mothers via an instant messaging application. Mothers' age showed a significant difference in perceived responsibility (p < 0.004), perceived parental weight (p = 0.000), perceived child's weight (p = 0.000), and concern about the child's weight (p = 0.000). Mothers with postgraduate degrees exhibited a significant difference in perceived child weight (p < 0.003); occupational status showed a significant difference in perceived parental weight (p < 0.004), perceived child weight (p < 0.001), and residence, particularly in Riyadh, which showed a significant difference in perceived parental weight (p < 0.026). There were also significant differences in body mass index (BMI) (p = 0.000) and perceived parental weight in relation to the mother's age. Mothers' age was significantly related to food restrictions (p = 0.000), pressure to eat (p = 0.000), and monitoring (p < 0.009). Mothers with only one child displayed significance in relation to pressure to eat (p < 0.019), while government-employee mothers showed a significant relationship with food restrictions (p < 0.005). There was a noteworthy association between the age of the mothers and perceived responsibility (p < 0.001), occupation (p < 0.22), residence (p = 0.000), and the mother's BMI (p = 0.000) with perceived parental weight. Finally, occupation (p < 0.006) was found to significantly influence food restriction, while the mother's age was significantly related to the pressure to eat (p < 0.002). Parental attitudes, practices, and beliefs regarding child feeding were strongly associated with maternal age, occupation, and BMI. Targeted interventions should be developed to assist mothers exhibiting these characteristics in establishing healthier and more effective feeding routines for their children. For example, interventions could be designed to educate parents on the latest findings regarding child-feeding habits and help them develop a greater sense of responsibility for their children's nutrition.

Parental perceptions of body weight and appetite in infants and toddlers with cystic fibrosis

Nutritional status has clinical relevance and is a target of guidance to parents of children with cystic fibrosis (CF). Growth is routinely monitored in CF clinics but there is no standardized way of assessing appetitive behaviors or parents' perceptions of their children's appetite. Greater understanding of these factors could improve clinical guidance regarding parent feeding behaviors. We therefore aimed to assess parent perceptions of child weight, and parent reports of child appetite using the Baby Eating Behavior Questionnaire (BEBQ), in a sample of infants and toddlers with CF, compared with a community sample. We additionally assessed relationships of parent perceptions of child weight with parent feeding behaviors in the sample with CF. Anthropometric and questionnaire data were collected for 32 infants and toddlers with CF, as well as 193 infants and toddlers drawn from RESONANCE, a community cohort study. Parents perceived children with CF to be lower in weight than their actual weight, to a greater extent than was evident in the community sample. Parents who perceived their children with CF to be underweight vs. right weight reported greater slowness in eating on the BEBQ. Parents perceived children with CF to have greater slowness in eating and lower enjoyment of food, compared to parents of children in the community sample, independent of sample differences in child weight, age, and sex. Our results demonstrate the potential utility of the BEBQ in a clinical sample and suggest it may be helpful for clinicians to assess parents' perceptions of their child's weight and appetite to promote a fuller understanding of the child's nutritional status, facilitate appropriate feeding behaviors and alleviate unnecessary concerns.

Adaptation and Validation of the MapMe Body Image Scales in Spanish Parents of Schoolchildren.

Childhood overweight and obesity is a worldwide problem and to treat it parents' detection has to be improved. The MapMe Body Image Scales (BIS) are a visual tool developed to improve parental perception of child weight in the United Kingdon (UK) based on British growth reference criteria. The aim of this study was to make a transcultural adaptation and validation of the MapMe BIS in Spain based on International Obesity Task Force (IOTF) cut offs A descriptive cross-sectional study was done. First, a translation and cultural adaptation was carried out. A total of 155 10-11-year-old children and their parents participated in this study. Children were measured to calculate their weight status, Body Mass Index (BMI), Body Fat Percentage (BFP) and Waist Circumference (WC), and their parents completed a purpose designed questionnaire about their perception and satisfaction of child's body weight status using the adapted BIS. Test-retest reliability, criterion validity and concurrent validity of the adapted BIS were analyzed. This study shows that the adapted MapMe BIS has good psychometric properties and is a suitable visual scale to assess parental perception of weight status in 10 and 11-year-old children in Spain.

Individual, family and social-related factors of eating behavior among Chinese children with overweight or obesity from the perspective of family system.

The purpose of the present study is to examine the factors contributing to the development of eating behavior in overweight and obese children from the perspective of the family system. A cross-sectional survey was conducted by using convenience sampling method to select 388 participants in two primary schools in Jiangsu, China. Individual, family and social-related factors were collected. Individual factors included age, gender, ethnicity, single child, social anxiety, depression, physical activity, sleep duration, screen time. Family factors included family environment, family structure, family function, family income, parenting style, parental feeding behavior, home food environment and marital satisfaction. Social-related factors included place of residence, number of surrounding restaurants and social support. Univariate analysis, correlation analysis and multivariate analysis were used to identify factors of eating behavior among Chinese children with overweight and obese. In this study, 388 participants took part with a 94.865% response rate. In the univariate analysis, the significant differences regarding Dutch Eating Behavior Questionnaire (DEBQ) scores were found between children aged 6-9 years and those aged >9 years. Correlation analysis indicated that parent's nutrition literacy (r = 0.118, P < 0.05), pressure to eat (r = 0.212, P < 0.01), perception of child weight (r = -0.112, P < 0.05) and family function (r = -0.563, P < 0.01) were associated with children's eating behavior. With regard to psychosocial factors, children's social anxiety (r = 0.299, P < 0.01) and depressive symptoms (r = 0.081, P < 0.05) were in positive correlation with eating behavior. The independent variables included in the initial model were age, father's employment status, social anxiety, maternal punishment and harshness, parents' nutrition literacy, pressure to eat, family function and perception of child weight. These variables in the final model accounted for 20.7% of the variance. We found that age, father's employment status, social anxiety, maternal punishment and harshness, parents' nutrition literacy, pressure to eat, family function and perception of child weight have great effect on children's eating behavior who are overweight or obese. As early childhood is a critical timeline for child development, children's social anxiety, parenting style, parent's nutrition literacy, parent's feeding behavior and family function should be intervened to promote eating behavior. Intervention programs aimed at promoting healthy eating behaviors among children, thereby mitigating the risk of pediatric obesity, should primarily target parents.

Mother-child pairs’ eating and feeding behaviours in two different nutritional status from two distinct provinces

Nutrition plays a crucial role for the bio-psycho-social growth and development of children. Mother-child pairs’ eating-feeding problems can be hypothesized to relate to the child’s nutritional status and living area. Our focus was to assess maternal attitudes and children’s eating habits in thin and normal-weight children across two cities characterized by distinct socioeconomic and demographic profiles: Ankara and Şanlıurfa. This double case-control study included the mothers whose children are aged between 2 and 7 years old in both cities. Figure Rating Scale, Child Feeding Questionnaire and Behavioral Pediatrics Feeding Assessment Scale were filled by mothers of children. The mothers of thin children were concerned more about the weight of their children, felt more responsible for feeding their children, and use of pressured them to eat more frequently compared to normal-weight children’s mothers in both cities. In Ankara, the duration of breastfeeding is longer, using formula is rarer and starting complementary food on time is more common, mother had higher scores on perceived responsibility, perceived child weight, and concern about child weight subscales; lower score on the restriction subscale compared to Şanlıurfa. Mothers of both thin and normal weight children in Şanlıurfa rated their children as weaker compared to those in Ankara. In conclusion, child eating behaviors and parental feeding practices were associated with the weight of children depending on demographic and sociocultural differences. Implementing customized, location-specific preventive educational initiatives on child feeding will not only foster behavioral changes but also yield valuable insights for shaping future interventions.

Children's eating behavior and weight-related outcomes: A latent profile analysis of parenting style and coparenting

Parenting style is associated with children's eating behavior, yet less is known about how parenting style and coparenting are both related to children's eating behavior (food approach behavior and palatable food intake) and weight-related outcomes (concern about child weight and perceived child weight). The aims of the current research were 1) to determine family profiles based on parenting style and coparenting, 2) to examine whether the family profiles were associated with parent (sex, BMI, age) and child (sex, age) characteristics, and 3) to examine whether the family profiles differed in children's outcomes. Parents (n = 185; Mage = 36.38 years, SD = 7.69) of 3- to 8-year-old children completed an online survey. Latent profile analysis revealed three family profiles: 1) Responsive and Cooperative, 2) Minimally Structured, and 3) Demanding and Competitive. The family profiles were not related to any parent or child characteristics. The Responsive and Cooperative family profile was associated with the lowest food approach behavior, palatable food intake, and weight-related outcomes, followed by the Minimally Structured family profile, and finally the Demanding and Competitive family profile with the highest scores. These findings suggest family dynamics play an important role in children's propensity to engage in food approach behavior and palatable food intake.

FACTORS ASSOCIATED WITH BODY WEIGHT STATUS AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER AGED 2-11 IN KUCHING DIVISION, SARAWAK

The high prevalence of overweight and obese among children with autism spectrum disorder (ASD) gains attention due to its substantial adverse health impacts. This study aimed to determine the associations between sociodemographic characteristics, parental feeding practices, child eating behaviour, and dietary intake with the body weight status of ASD children in Kuching Division, Sarawak. A cross-sectional study was conducted among 124 ASD children (83.9% boys and 16.1% girls) aged 2-11 years, together with their caregivers. The weight and height of ASD children were taken, and body mass index-for-age z-score (BAZ) was computed using AnthroPlus software. Child feeding practices, eating behaviour, and dietary intake were assessed through interviews, with the aid of a questionnaire. Multiple binary logistic regression was used in data analysis. The prevalence of underweight, risk-of-overweight, overweight, and obese ASD children was 3.2% (3.8% boys; 0% girls), 4.8% (2.9% boys; 15.0% girls), 16.9% (17.3% boys; 15.0% girls), and 20.2% (23.1% boys; 5.0 % girls), respectively. The multiple binary logistic regression revealed that the caregivers with high perceived child weight (AOR 31.313, 95% CI=6.127-47.218), high concern towards child weight (AOR 1.774, 95% CI=1.112-2.829), and high sodium intakes (AOR 3.747, 95% CI= 1.515-9.269) were significantly associated with increased risk of overweight or obesity, explaining 37.2% of the variation in body weight status. It is important to prioritise the perspective of caregivers’ feeding practices especially the caregivers with high perceived child weight and concerned child’s weight as well as sodium level of the ASD children while planning for obesity intervention programmes.

Parental Perceptions and Concerns Related to the Consequences of Pediatric Obesity: Feeling or Real Problem?

Lifestyle modifications (i.e., nutrition and physical activity) remain the main tools in the context of childhood obesity’s treatment and prevention of short and long-term consequences. At the same time, parental perception of child weight represents an even more important tool. It is known that more than half of parents of overweight/obese children underestimate their child’s weight status or are not worried about the risks associated with childhood overweight/obesity. Consequently, parental perception of childhood obesity can often be erroneous, and, even when accurate, subsequent parental behaviors can inadvertently contribute to the onset or persistence of childhood and adult obesity. Starting from the evidence that targeting a parent to induce a behavioral change is more effective than targeting the child only without parental participation, parental perceptions of childhood obesity can therefore represent a very important tool to take into consideration to achieve improvements in the context of childhood obesity. Therefore, knowledge of parental perception of children's weight status is needed to help pediatricians to organize and adapt activities and programs that promote healthy weight management among children. Specifically, early assessments of parents' perceptions of a child's weight, followed by regular follow-up visits, appropriate feedback, continuing education efforts, and efforts to follow the child’s weight status over time, can be potentially very helpful

Relationships of Maternal Employment and Work Impact with Weight-Related Behaviors and Home Environments of Mothers and Their School-Age Children.

The prevalence of obesity continues to rise. Preventing obesity, especially childhood obesity, is critically important. Parents, especially mothers, play a vital role in preventing childhood obesity. Numerous factors, such as maternal employment, may influence maternal weight-related practices and home environment characteristics that affect the risk of childhood obesity. Given the prevalence of both childhood obesity and maternal employment, this study was conducted to examine how weight-related maternal, child, and household behaviors as well as home environment characteristics differ by maternal employment hours and extends existing research by examining work impact on behaviors and home characteristics. U.S. mothers (n = 527) with at least one school-age child (6 to 11 years), who were between the ages of 25 and 54 years and the main food gatekeeper in the household completed an online survey. ANOVA comparisons of non-working, part-time employed, and full-time employed mothers revealed few differences in any of the variables studied. Cluster analysis of the 336 employed mothers based on six work impact scale scores found three unique clusters characterized as Enthusiastic Earners, Indifferent Earners, and Strained Earners. Few differences in sociodemographic and job characteristics occurred among clusters and the differences noted had small effect sizes. Clusters did not differ by maternal BMI or perceived child weight status. However, the clusters differed in numerous weight-related behaviors and home environment characteristics. Future research should aim to determine the direction of the associations of work impact with weight-related behaviors and home environments as well as identify potential strategies for overcoming the negative effects of employment on weight-related behaviors and environments and weight status as well as clarify other factors that may affect maternal work impact, such as time management, reasons for employment, and stress.

Comparing relationships of food parenting practices and concern for child weight between siblings

AbstractThe objective of this cross‐sectional study was to compare the difference in food parenting practices based upon parent concern and/or perception of child weight among siblings. U.S. parents (n = 63) with two or more children between the ages of 2.5 and 10 years old completed the Comprehensive Food Parenting Questionnaire, select items from the Child Feeding Questionnaire, and seven open‐ended questions for each child. There were significant differences in how parents fed siblings. For example, the relationship between concern for child weight and restriction for weight control was stronger for the older child, which was supported by parents' qualitative data.

Perceived Role of Asian Indian Fathers in Florida During Mealtimes: Factors to Consider for Their Involvement in Childhood Obesity Prevention.

Research has shown that fathers play an important role in children's mealtimes and dietary habits; yet, little is known about the factors that affect how fathers perceive this role, especially among Asian Indians. This study aimed to examine how Asian Indian fathers perceive their role during child mealtimes and the factors that are associated with fathers' mealtime perceptions. Eighty Asian Indian fathers of 6- to 11-year-old children completed an online survey including measures of demographics, acculturation, gender roles, nutrition knowledge, parental self-efficacy, perceived child weight, and the role of father at mealtime (ROFM). Data were analyzed using descriptive statistics and linear regression. Participants perceived a moderately high level of responsibility during child mealtimes. Regression analysis showed that fathers who had higher income, perceived child weight as being higher, and had higher self-efficacy in feeding children healthy food had higher ROFM. Higher father nutrition knowledge was correlated with lower perceived ROFM, indicating a lack of confidence in utilizing their nutrition knowledge during child mealtimes. The results indicate potential targets to improve Asian Indian fathers' involvement during child mealtimes. These results could be utilized to enhance their engagement in child mealtime healthy eating practices and for childhood obesity prevention.

Ultraprocessed Food Consumption, Diet Patterns, and Perception of Diet Quality and Body Weight in the US

ObjectivesUltraprocessed foods (UPF) have recently been examined as a risk factor for diet-related disease in adults. Studies have demonstrated changes in trends in consumption patterns of UPF over the past several decades, but few studies have evaluated the association between UPF and perception of diet along with measured dietary intake. The objective of this study was to examine the association between UPF consumption, dietary intake patterns, and self-perceived diet quality in a nationally representative sample of US children and adults. MethodsData from the 2017–2018 NHANES was used for this study. Dietary intake information was collected using 24-hour recall; recalled foods were classified using the NOVA classification system and NOVA Category 4 (ultraprocessed) were identified. All data were analyzed using SAS 9.4 survey procedures to account for the unequal sampling probability and complex survey design of the. ResultsConsumption of ultraprocessed foods is associated with poor diet in US children and adults. In adults, higher consumption of ultraprocessed foods was is associated with higher dietary energy density (p = 0.0001), lower vegetable consumption (p = 0.002), greater intake of added sugars (p < 0.0001), and lower intake of plant-based protein foods (p < 0.0001). In children, consumption of ultraprocessed foods was associated with higher dietary energy density (p < 0.0001), lower consumption of vegetables (p < 0.0001) even when including fewer servings of white potatoes (p = 0.04). Interestingly, perception of diet quality was also strongly associated with ultraprocessed food consumption. Individuals who self-reported a ‘poor’ diet consumed 84% of daily calories from ultraprocessed foods, compared to individuals who self-reported an ‘excellent’ diet reporting 52% of daily calories from ultraprocessed foods, p < 0.0001. Adults who perceived themselves to be overweight also reported higher consumption of processed foods than adults who perceived themselves to be about the right weight (60% vs. 56%, p = 0.004). There was no association with processed food consumption and parent perception of child weight. ConclusionsUltraprocessed food consumption is associated with lower diet quality in US children and adults. Additionally, UPF consumption is associated with perception of diet quality and body weight. Funding SourcesNone.

Maternal perception of child weight and concern about child overweight mediates the relationship between child weight and feeding practices.

To examine the mediating effects of maternal perception of child weight (weight perception) and concern about overweight (weight concern) on the paths between child weight and maternal feeding practices. Pudong District, Shanghai, China. A convenience sample of 1164 mothers who were primary caregivers of preschool children. Sixty per cent of the mothers perceived their overweight/obese children as normal weight or even underweight. The disagreement between actual child weight and maternal weight perception was statistically significant (Kappa = 0·212, P < 0·001). Structural equation modelling indicated that weight perception fully mediated the relationship between child BMI Z-scores and pressure to eat. Weight concern fully mediated the relationships between child BMI Z-scores and the other three feeding practices. The serial mediating effects of weight perception and concern were statistically significant for the paths between child BMI Z-score and monitoring (β = 0·035, P < 0·001), restriction (β = 0·022, P < 0·001), and food as a reward (β = -0·017, P < 0·05). Child weight may influence maternal feeding practices through weight perception and concern. Thus, interventions are needed to increase the accuracy of weight perception, which may influence several maternal feeding practices and thereby contribute to child health.

Child feeding practices in children with Down syndrome in relationship to ethnicity and BMI

Children with Down syndrome (DS) exhibit higher overweight and obesity rates than their typically developing peers, although it is unknown whether parent feeding practices for children with DS are associated with child weight status or parental and demographic factors, especially in the Hispanic and Latino populations. A prospective study of 68 children with DS from 2 to 7 years of age, who received care at a single, large, pediatric academic hospital was conducted to evaluate parent child feeding practices. Parents completed the Child Feeding Questionnaire+ (CFQ+) assessing seven primary factors of feeding practices and comparisons to children without DS were conducted. Data for body mass index (BMI) and BMI-for-sex/age z score (BMIz scores) were collected in clinic at the time of CFQ+ completion for both parent and child. Parents of children with DS endorsed higher perceived responsibility but lower concern about child weight and restriction compared to previously reported feeding practices in typically developing children. Hispanic/Latino parents of children with DS reported higher perceived responsibility and monitoring than non-Hispanic/Latino parents of children with DS. Higher BMIz scores in children with DS correlated with greater perceived child weight (p = 0.001) and concern about child weight (p = 0.008). Differences in BMIz scores were observed when comparing sex/ethnicity groups as determined by one-way ANOVA (F(3,64) = 4.170, p = 0.009); with Hispanic/Latino boys with DS more likely to have obesity. Our results suggest a need for specific DS Guidelines to educate providers and parents of children with DS on recommended feeding practices prior to parental concern about their child's weight, especially in the Hispanic/Latino population.

Association between Parents' Perceptions of Preschool Children's Weight, Feeding Practices and Children's Dietary Patterns: A Cross-Sectional Study in China.

Parental perception of children’s weight may influence parents’ feeding practices, and in turn, child dietary intake and weight status; however, there is limited evidence generated for preschoolers. The aim of this cross-sectional study was to investigate associations between Chinese parents’ perceptions of child weight, feeding practices and preschoolers’ dietary patterns. Participants (1616 parent-child pairs) were recruited from six kindergartens in Hunan, China. Parents’ misperception, concern, and dissatisfaction on child weight were collected through a self-administered caregiver questionnaire. Parental feeding practices and children’s dietary intake were, respectively, assessed using the Child Feeding Questionnaire and a Food Frequency Questionnaire. Linear regression models were applied to analyze associations between parental weight perceptions, feeding practices, and preschooler’s dietary patterns. Associations between parents’ weight perceptions and dietary patterns were significant only among underweight children. Regardless of child weight status, parental weight underestimation and preference for a heavier child were positively associated with pressure-to-eat. Parental weight concern was positively associated with restriction in normal weight child, but this was not found in other weight groups. In conclusion, Parents’ misperception, concern, and dissatisfaction about child weight are associated with parents’ feeding practices and may influence preschoolers’ dietary quality, but the relationships vary by children’s actual weight status.

O44 Comparing the Relationship Between Food Parenting Practices and Concern for Child Weight Between Siblings

<h3>Background</h3> Parental concern for child weight can impact food parenting practices utilized; however, most studies only ask parents about 1 child in the family. <h3>Objective</h3> The objective of this study was to compare the difference in food parenting practices based upon parent concern and/or perception of child weight among siblings. <h3>Study Design, Setting, Participants</h3> This quantitative, cross-sectional study recruited U.S. parents (n = 63) who had more than 1 child between the ages of 2.5 (M = 4.12, SD = 1.57) and 10 (M = 7.52, SD=1.97) years old to complete an online survey. Parents were mostly White (75%), non-Hispanic (76%) females (79%). <h3>Measurable Outcome/Analysis</h3> Each parent completed the Comprehensive Food Parenting Questionnaire, child weight concern and perception items from the Child Feeding Questionnaire for their oldest and youngest child (2.5-10 years old). Parents also reported demographic information. Linear regression was utilized to compare the relationships between parent concern and perception of child weight (independent variable) and food parenting practices (dependent variable) for the oldest and youngest child. Child age and gender were used as control variables. <h3>Results</h3> There were differences in the relationships between food parenting practices and weight concern/perception for younger and older children. For example, for the older child only, parents used more pressure to eat if they were less concerned about their child's weight (β = −0.32, SE = 0.15, <i>P</i> = 0.034). Additionally, if parents were highly concerned about their child's weight, they reported more use of restriction for weight control, but this relationship was stronger for the older child (β = 0.55, SE = 0.11, <i>P</i> < 0.001) compared to the younger child (β = 0.34, SE = 0.16, <i>P</i> = 0.039). <h3>Conclusion</h3> Parents may use different food parenting practices for children based upon their perception or concern for their child's weight, which may be counterproductive. Concerned parents may be especially important targets for food parenting interventions.

Classes of Caregivers Feeding Practices and Associated Factors Among Preschoolers

ObjectivesDuring early childhood, eating habits are formed, and excess weight gain may begin. Caregivers’ feeding practices (FP) influence childhood obesity and may get influenced by cultural and economic considerations5 6, as well as caregivers’ perception of child’s size and temperament7 8. FP are employed simultaneously, thus influencing each other9. There is limited evidence on implementing FP simultaneously and what factors are associated with them2. This study examined (1) the heterogeneity in FP among caregivers and (2) associated child, caregiver, and family factors. MethodsCaregivers of 466 preschoolers (55.4% boys, mean age of 48 months), enrolled in 50 childcare centers, completed the Comprehensive Feeding Practices Questionnaires (CFPQ), demographic information, and perceptions of their child’s weight and temperament. From Exploratory Factor Analysis of the CFPQ items, we identified 13 factors and conducted latent profile analysis (LPA), identifying three classes. We used Structural Equation Modeling to regress the emergent classes on child sex, race, age, family’s economic status, and education level, and on caregiver’s perception of child weight and temperament. ResultsClass 1 had high coercive control and low autonomy practices (69%), Class 2 had high coercive control, but moderate in balance and autonomy practices (16%), and Class 3 were moderate in all practices (15%). Caregiver’s perception of child size was associated with classes (P < .001). Among the 22.2% of caregivers who wanted their child to be heavier, 22.2% were in the restricting class, 8.6% were in the balanced class, and 68.8% were in the controlling group. ConclusionsFP are modifiable factors and may be a good target for obesity prevention interventions. In this sample, most caregivers reported using coercive control behaviors with low autonomy to promote preschooler’s independent eating. Future plans are to relate FP classes to diet quality and obesity in children. Funding SourcesThe mother study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases [Grant number R01 DK107761; PI: Black]. This study was funded by Sigma (Pi at-Large Chapter).

Longitudinal Associations Between Child Weight Change, the Home Food Environment, and Child Feeding Practices During COVID-19

ObjectivesLifestyle changes during the coronavirus 2019 (COVID-19) pandemic may result in child weight gain thus increasing obesity risk. Weight gain during COVID-19 may be, in part, be due to changes in the home food environment and child feeding practices; yet longitudinal studies have not examined these relations. This study describes patterns of child weight change, the home food environment, and child feeding practices across two timepoints during COVID-19.MethodsParents (N = 433; 95% female) in the US with a child aged 5–18 years completed two online surveys in May (T1) and September (T2) 2020. Parents reported on child feeding practices (e.g., concern for child overweight, restriction, pressure, monitoring) using the Child Feeding Questionnaire, perceived child weight status, and the home food environment before COVID-19 (i.e., baseline; retrospective report) and at twice during COVID-19 (T1 and T2). Child weight change was categorized as having gained weight vs. not. Repeated measures and chi square analyses examined differences in changes in child feeding practices and the home food environment by child weight change.ResultsAbout 30% of parents reported child weight gain from T1 to T2 (average +9.6 ± 7.1 lbs). Interactions between parents’ concern for child overweight, monitoring, and restriction, by child weight change, were observed (ps ≤ 0.02): families with child weight gain reported baseline to T1 increases in these feeding practices, that were sustained at T2; for families without child weight gain, concern, monitoring, and restriction increased at T1, but returned to baseline at T2. Overall, pressure feeding practices increased from baseline to T1, and returned to baseline at T2. No clear patterns regarding home food environment changes and child weight change were observed.ConclusionsAlmost one-third of parents reported child weight gain during COVID-19, which was related to sustained concern for overweight and some feeding practices, yet not home food environment changes. Further research is needed to investigate different behavioral, societal, environmental, and psychosocial factors contributing to child weight gain during COVID-19, in order to identify the most salient intervention targets to mitigate the potential long-term health consequences.Funding SourcesVirginia Commonwealth University, National Cancer Institute

The process of culturally adapting the Healthy Beginnings early obesity prevention program for Arabic and Chinese mothers in Australia

BackgroundBehavioural interventions for the early prevention of childhood obesity mostly focus on English-speaking populations in high-income countries. Cultural adaptation is an emerging strategy for implementing evidence-based interventions among different populations and regions. This paper describes the initial process of culturally adapting Healthy Beginnings, an evidence-based early childhood obesity prevention program, for Arabic and Chinese speaking migrant mothers and infants in Sydney, Australia.MethodsThe cultural adaptation process followed the Stages of Cultural Adaptation theoretical model and is reported using the Framework for Reporting Adaptations and Modifications-Enhanced. We first established the adaptation rationale, then considered program underpinnings and the core components for effectiveness. To inform adaptations, we reviewed the scientific literature and engaged stakeholders. Consultations included focus groups with 24 Arabic and 22 Chinese speaking migrant mothers and interviews with 20 health professionals. With input from project partners, bi-cultural staff and community organisations, findings informed cultural adaptations to the content and delivery features of the Healthy Beginnings program.ResultsProgram structure and delivery mode were retained to preserve fidelity (i.e. staged nurse calls with key program messages addressing modifiable obesity-related behaviours: infant feeding, active play, sedentary behaviours and sleep). Qualitative analysis of focus group and interview data resulted in descriptive themes concerning cultural practices and beliefs related to infant obesity-related behaviours and perceptions of child weight among Arabic and Chinese speaking mothers. Based on the literature and local study findings, cultural adaptations were made to recruitment approaches, staffing (bi-cultural nurses and project staff) and program content (modified call scripts and culturally adapted written health promotion materials).ConclusionsThis cultural adaptation of Healthy Beginnings followed an established process model and resulted in a program with enhanced relevance and accessibility among Arabic and Chinese speaking migrant mothers. This work will inform the future cultural adaptation stages: testing, refining, and trialling the culturally adapted Healthy Beginnings program to assess acceptability, feasibility and effectiveness.