Parental Perception Of Child Weight Research Articles

Empowering parents to optimize feeding practices with preschool children (EPO-Feeding): A study protocol for a feasibility randomized controlled trial.

Parental feeding practices (PFPs) play a key role in fostering preschoolers' dietary habits and in mitigating the risk of childhood obesity. Nevertheless, parents often employ inappropriate feeding practices, leading to children's potential nutrition-related issues. Thus, research is needed to inform interventions that focus on optimizing feeding practices. This protocol describes the evaluation of a novel intervention-Empowering Parents to Optimize Feeding Practices (EPO-Feeding Program). The program will be evaluated with a two-arm feasibility randomized controlled trial (RCT) in Yangzhou, China. The program includes four weekly group-based training sessions led by healthcare professionals for parents of preschool children. The intervention incorporates sessions, group discussions, motivational interviewing, and supplementary materials (e.g., key messages and educational videos) aimed at enhancing parents' knowledge, skills, and behaviours related to feeding practices. The primary outcomes include i) implementation feasibility, primarily assessed through retention rates; and ii) program acceptability through a survey and qualitative process evaluation. Secondary outcomes encompass the potential impacts on i) PFPs, ii) parental perception of child weight (PPCW), iii) parenting sense of competence, iv) children's eating behaviours, and v) child weight status. Quantitative analyses include descriptive estimates for evaluating the feasibility and linear mixed regression analysis for testing the potential effects. Qualitative valuation will use thematic framework analysis. If this study shows this program to be feasible to implement and acceptable to parents, it will be used to inform a fully powered trial to determine its effectiveness. The research will also help inform policy and practices in the context of child nutrition promotion, particularly regarding implementing group-based training sessions by healthcare providers in similar settings. Clinicaltrials.gov, Protocol #NCT06181773, 20/11/2023.

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.

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

Parental feeding practices and child weight status in Bahraini families

Background: Home environment shapes the eating behavior of children thus their weight status. Parental feeding practices (restriction, pressure to eat, and monitoring) are behaviors taken by parents to manage a child’s dietary intake. Objectives: Raising awareness on the role of parental feeding practices in childhood obesity to allow for early parental intervention. Materials and Methods: In this cross-sectional study, a sample size of 332 children (6–11 years old) was chosen conveniently form eight health centers in Bahrain in August–September 2018. A translated Arabic version of the Child Feeding Questionnaire (CFQ) was filled by parents. Anthropometric measurements of children were conducted. Descriptive statistics were used to describe mean item scores of the CFQ. Correlation tests determined relationships between parental feeding practices and body mass index (BMI)-for-age Z-scores. Chi-square statistics and independent sample t-tests compared parental perception of child weight and feeding practices. Results: The prevalence of obesity among Bahraini children aged 6–11 years was estimated to be 16.87% and overweight was 14.46%. Obesity was more prevalent among males, while overweight in females. The predominant feeding practice was monitoring followed by restriction. Child BMI was negatively correlated with pressure to eat and positively correlated with restriction in males. No significant correlation was found with monitoring. About 56.0% of parents were found to misperceive their child weight status, 50.9% underestimated the weight status. Conclusion: Childhood obesity has reached alarming levels, which may persist due to the parental misperception of child weight status. Avoiding restrictive feeding could limit this problem.

Mexican American Parental Knowledge and Perceptions of Childhood Obesity: An Integrative Review.

For the past two decades, childhood obesity has remained a national public health concern, particularly among Hispanic populations. Multiple cross-sectoral obesity prevention strategies have been implemented yet remain unsuccessful in generating sustainable lifestyle changes. The purpose of this integrative review, using the Whittemore and Knafl method, was to examine the literature from 2009 to 2018 regarding Mexican American parental knowledge and perceptions of childhood obesity. The CINAHL, PubMed, PsycINFO, and ERIC databases were used to search the literature, and 13 peer-reviewed articles met the inclusion criteria. Three main themes emerged from the literature synthesis: (1) parental misperception of child body weight and size, (2) influence of cultural health and growth beliefs on parental perception of child weight, and (3) parental perspectives of causes and consequences of childhood obesity and how to address it. However, cultural variations in parental perceptions were found; therefore, attempts to generalize Mexican Americans' cultural practices should be avoided. Studies using qualitative approaches are needed to gain deeper insights about Mexican American culture regarding children's health as it relates to body weight, the roles of different family members in the Mexican American childrearing tradition, and the impact of their associated health beliefs.

Weight status and diets of children aged 1-12 years attending a tertiary public paediatric outpatient clinic.

To assess the weight status and diets of a sample of paediatric outpatients, explore the relationship between the two and compare child weight status with parental perception of child weight and parents' self-reported weight. Parents/carers of 1-12-year-olds attending paediatric outpatients at Flinders Medical Centre, South Australia, between October 2015 and May 2016 completed a demographic and validated age-based dietary questionnaire (toddlers (1-3 years), pre-schoolers (>3 to <5 years) or children (5-12 years)). Dietary risk scores (low/moderate/high/very high) were calculated for toddlers and pre-schoolers and diet quality and food behaviours scores for children. Body mass index (BMI) z-score and weight status were determined from measured height and weight. Of 114 toddlers, 115 pre-schoolers and 250 children, 65% were of a healthy weight, 10% underweight and 25% overweight or obese. Most (~80%) toddlers and pre-schoolers had diets classified as 'moderate' risk, and the diets (35-90%) and behaviours (90%) of most 5-12-year-olds fell short of the guidelines. There was no significant relationship between overall diet risk or quality and BMI z-score. Healthier food behaviours scores were inversely correlated with BMI z-scores (ß -0.061, 95% confidence interval (CI) -0.089, -0.033, P < 0.005). Parents' perception of child weight status was inaccurate. Parent's self-reported weight status was significantly associated with the BMI z-scores of toddlers (ß 0.301, 95% CI 0.189-1.174, P = 0.007) and pre-schoolers (ß 0.220, 95% CI 0.032-0.859, P = 0.035). Poor diets and high rates of overweight/obesity highlight the need for screening within the paediatric outpatient setting. Parents' own weight status, and their inaccurate perception of their child's, should be considered future intervention targets for improving child and parent health.

Factors influencing obesity among preschoolers: multilevel approach.

Childhood obesity is a complex and multifaceted problem involving interactions among child, family and community environment. The purpose of this study was to examine the contributing factors to early childhood obesity within a multilevel context, including child and family, childcare setting and community. A cross-sectional, quantitative research design was employed. A total of 129 preschoolers and their parents in northwest Florida participated in this study. Child height and weight were measured, and body mass index (BMI) was calculated. Parents and directors of preschools completed survey questionnaires to assess child/family, childcare setting and community factors, respectively. Hierarchical multiple regression was used to evaluate the association of each level of factors with child BMI z-score. Twenty-one per cent of children were overweight or obese (≥85th BMI percentile). In hierarchical multiple regression, household income, parent beliefs, attitudes and practices for child feeding, family obesogenic environment, child routines (screen time on weekends, sleep hours, bedtime) and physical activity environment were significantly related to child BMI z-score. The findings of this study provide a broader understanding of factors that influence child BMI z-score. Shaping a non-obesogenic environment by establishing healthy routines for children in the home, childcare setting and community is essential in childhood obesity prevention. Paediatric nurses should routinely assess accurate parental perception of child weight, feeding style and child routines in well-child care visits. Healthcare professionals and health policymakers should enact policies that build a healthy environment for preschoolers in their childcare setting and community.

Parental perception of child weight and its association with weight-related parenting behaviours and child behaviours: a Chinese national study.

Parents commonly fail to correctly recognize the weight status of their child. Whether parental perception of child weight is associated with weight-related parenting behaviours and child behaviours is unclear. The present study aimed to investigate the distribution of parental perception of child weight and its associations with weight-related parenting behaviours and child behaviours in China. Cross-sectional study. Seven provinces in China. A total of 47 417 children aged 6-17 years and their parents were included from a national survey in 2013. Parental perception of child weight, weight-related parenting behaviours and child behaviours were self-reported. Child's weight and height were objectively measured. A total of 30·5 % of parents underestimated and 8·7 % overestimated the child's weight. Parental underestimation was more common among younger children, boys and children with a lower BMI Z-score. Parents who perceived that their child had a healthy weight (accurately or inaccurately) were more likely to prepare breakfast for the child, exercise with him/her, set apart his/her exercise time, restrict his/her screen time, and were less likely to store soft drinks for the child. Children perceived to have a healthy weight, regardless of their actual weight status, behaved healthier on dietary intake, physical activity and homework time. Parental underestimation of their child's weight was prominent in China, especially among younger children, boys and children with a lower BMI Z-score. Parental recognition of their child being overweight did not appear to translate into healthy changes in weight-related parenting behaviours or child behaviours.

Parental perception of child weight and inflammation: Perceived overweight is associated with higher child c-reactive protein

Self-perceived overweight and weight discrimination are associated with inflammation in adulthood. We test whether there is an intergenerational association of parent perception of child overweight on higher levels of child c-reactive protein (CRP), a marker of inflammation implicated in stress. Data were from the National Health and Nutrition Examination Survey 2005–2014 (N=4988). Parents reported their perception of their child’s weight; CRP was assayed from children’s blood samples. Children whose parents perceived them as overweight had higher CRP levels than children who were perceived about the right weight; perceived underweight was also associated with higher CRP (F(2,4977)=9.23, p<.001). These associations were independent of the child’s objective weight status and waist circumference and held when the sample was limited to children with objective overweight and obesity. These results suggest an intergenerational transfer of the psychological perception of body weight from parents to the inflammatory health of their child.

Parental Perception of Weight Status and Weight Gain Across Childhood.

Parents of children who are overweight often fail to accurately identify their child's weight status. Although these misperceptions are presumed to be a major public health concern, little research has examined whether parental perceptions of child weight status are protective against weight gain during childhood. Our objective was to examine whether parental perceptions of child weight status are associated with weight gain across childhood. Data from the Longitudinal Study of Australian Children were used to assess parental perceptions of child weight status and to examine changes in researcher measured child BMI z scores across childhood, from 4 to 13 years old. Participants included 3557 Australian children and their parents. Children whose parents perceived their weight as being "overweight," as opposed to "about the right weight," gained more weight (increase in BMI z score) from baseline to follow-up in all analyses. This finding did not depend on the actual weight of the child; the association between perceiving one's child as being overweight and future weight gain was similar among children whose parents accurately and inaccurately believed their child was overweight. Contrary to popular belief, parental identification of child overweight is not protective against further weight gain. Rather, it is associated with more weight gain across childhood. Further research is needed to understand how parental perceptions of child weight may counterintuitively contribute to obesity.

Are Parental Perceptions of Child Activity Levels and Overall Health More Important than Perceptions of Weight?

Objectives To examine relationships between parental perceptions of child weight and overall health, reported lifestyle behaviors and measured body mass index (BMI). Methods Using community-partnered methods, we surveyed families residing in a two census tract area identified for targeted interventions to decrease diabetes related disparities. The survey included demographics, child dietary and physical activity behaviors, and parental perception of child's health and weight. We measured child BMI using a standardized protocol. Results We surveyed parents of 116 children with a mean age of 7years (range 3-15) with 51% boys, 74% Hispanic, and 26% Black. Over half of the children (55%) were overweight or obese. Half (50%) of the parents underestimated their children's weight. Reported daily hours of walking and/or running trended higher (3.6 vs. 2.6h, p=0.08) for children perceived to be of normal weight. Parents who correctly estimated their child's weight status reported more hours of daily walking/running than parents who underestimated child weight status, 4.5 versus 2.4h, p=0.0002. Parents of healthy weight children were more likely to report that children were in excellent or very good health compared to parents of overweight/obese children, 75 versus 56% respectively (p=0.04). We found significant racial/ethnic differences in reported diet and physical activity behaviors and perception of overall health. Conclusions for Practice Parental perceptions of child health and physical activity level may be related to perceptions of their child's weight status. Study findings informed community-based initiatives for reducing diabetes risk among children.

The apple of their eye: Attitudinal and behavioral correlates of parents’ perceptions of child obesity

This study addressed gaps in the existing literature about correlates of parental perception of child weight using a community sample. This study evaluated how weight-status and its perception related to parents' personal and parenting attitudes/behaviors. Participants were parents (N = 1,007; 65.3% mothers, 34.4% fathers) of children 5 to 15 years old. Parents completed online measures of personal eating attitudes/behaviors, attitudes/behaviors about their children's eating and weight, and parental practices related to weight-related attitudes. Parents frequently underestimated children's overweight/obesity, even more frequently than their own overweight/obesity (P < 0.001). Parents' personal eating attitudes/behaviors were related to their own weight-status (P < 0.001) and perceived child weight-status (P < 0.001) but not actual child weight-status. Parents' child-focused eating attitudes/behaviors were related to actual (P < 0.001) and perceived child weight-status (P < 0.001), but not parent weight-status. In general, parents' personal attitudes/behaviors did not extend into their perceptions of their children's weight or their response to it. Results suggest a dual need to improve parent accuracy perceiving children's overweight/obesity and to guide parent responses to perceived overweight/obesity. Given the high prevalence of childhood obesity, and the serious consequences during childhood and into adulthood, further research is needed to enhance understanding of parents' specific needs to engage in prevention and treatment programs.

Parental Influences on Child Weight: Perception, Willingness to Change, and Barriers

Background: Although parents are primary to development of obese genic behaviors, many parents do not perceive their child’s obesity as problematic and are not ready to make changes to address their child’s weight. The purpose of the study is to examine relationships between parental perception of child weight, parental readiness to change behaviors, and barriers to behavior change. Methods: A sample of low-socioeconomic and minority parents of 6-12 year old children who are overweight or obese completed questionnaires on perception of their child’s weight, stage of readiness to change behaviors for their child’s weight (SOC), and barriers to changing child weight control behaviors. Parents were blinded to the purpose of the study. Child weight status was categorized ‘overweight’ (BMI ≤85th-95th percentile) or ‘obese’ (BMI ≥95th percentile). Results: Of the 48 parent-child dyads, 77.1% of parents underestimated their child’s weight status and 54.2% perceived their child as normal weight. Older (p=0.045) and married parents (p=0.025) were more likely to perceive their child as overweight. Accurate parental perception was significantly associated with advanced stage of change (SOC; r=0.358, p=0.012). Conclusions: Parents of overweight or obese children underestimated their child’s weight status. Parental perception of child weight was associated with the parent’s SOC for their child’s weight.

Hispanic Parental Perceptions of Child Weight in Preschool-Aged Children: An Integrated Review

Obesity continues to disproportionately affect ethnic minorities. Parents play an integral role in early childhood, and parental perceptions regarding their child's weight are key to obesity prevention. Cultural differences contribute to parental perceptions, and increased understandings of these characteristics provide a basis to address obesity in high-risk populations at an earlier age. The aim of this integrative review was to analyze extant literature to identify Hispanic parental perceptions of their preschool-aged child's weight status. An integrative review of studies measuring Hispanic parental perception was conducted. Computerized searches were completed using MEDLINE, PubMed, CINHAL, Eric, and PsychINFO. Articles were included if they were English, included children 2-5 years of age, included a Hispanic population, and evaluated parental perception of their child's weight status. A total of 14 articles (n=8 qualitative; n=6 quantitative) met criteria and were included in the review. Cooper's integrative review methodology was used, and articles were evaluated for quality using Polit and Beck's evidence hierarchy leveling system. The results revealed six themes of Hispanic parental perceptions relative to their preschool-aged child's weight: parental perception of body weight; relationship between child weight and health; causes and consequences of overweight; familial roles and influences on child weight; prevention of overweight; and cultural influences within the United States. This review highlights the importance of developing sociocultural approaches to addressing childhood obesity within the Hispanic population. Additional research is needed to incorporate what is known about Hispanic parental perceptions to positively influence behavior change during early childhood.

Parental perception of child weight in the first two years-of-life: a potential link between infant feeding and preschoolers' diet

Approximately 23% of preschoolers are overweight or obese. Establishing a healthy dietary lifestyle at an early age can improve later child diet and body weight. This study examined the determinants of past infant feeding practices that do not follow standard feeding recommendations (breastfeeding for less than 6 months duration, cow's milk prior to the first year of age and solid foods at or before 4 months of age). It also examined the role of parental perception of child weight in the first 2 years-of-life on past infant feeding practices as well as current child diet and body weight. Families of 497 preschoolers aged 22–63 months (39.0 ± 8.2) were recruited from 30 child care centers in East-Central Illinois. Main findings indicate that past infant feeding practices were common and varied by socio-demographic factors including race/ethnicity, parental education and child gender. Children perceived as overweight in the first 2 years-of-life tended to breastfeed for lesser duration. Additionally, the majority (79.8%) of preschoolers who were classified as overweight using BMI percentile were perceived as non-overweight by the parent in the first 2 years-of-life. Mean daily total fatty/sugary food intake was higher among those perceived to be non-overweight in the first 2 years-of-life. These findings have identified parental perception of child weight in the first 2 years-of-life as a modifiable risk factor for unhealthy child diet and obesity among preschoolers.

Parental Perception of Child Weight Status Before Age 2 is Associated With Preschoolers Diet

Nearly a quarter of 2-5 year-olds in the U.S. are overweight or obese. Early intervention is key to preventing childhood obesity. However, parents must accurately perceive their child's weight status in order to be receptive to preventive messages. Herein, the association of parental perception of child weight in the first 24 months with current child body mass index (BMI) and diet at 39.0±8.2 months-of-age was assessed. Families of 497 children ages 2-5 years from the Synergistic Theory and Research on Obesity and Nutrition Group (STRONG) Kids cross-sectional cohort. Parents completed the Child Feeding Questionnaire (CFQ) and Comprehensive Feeding Practices Questionnaire (CFPQ) items. Child dietary intake in past 7 days was estimated using items from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) interview protocol. Child BMI percentiles were calculated using measured height and weight. The majority (79.8%) of currently overweight (OW) children were perceived as non-overweight (NO) by parents in the first 24 months (P<0.001). Children perceived to be NO consumed more fatty/sugary foods and milk than those perceived to be OW (P<0.03); differences persisted irrespective of BMI percentile. Higher child fruits/vegetables intake was associated with child-centered parental feeding practices (e.g., modeling; involvement) and more monitoring; higher child fatty/sugary foods intake was associated with controlling parental feeding practices (e.g., pressure to eat; emotion regulation) and less monitoring (P<0.05). Parental perception of child weight in the first 24 months does not reflect subsequent child BMI, and may lead to less healthy diets by affecting parental feeding practices.

Controlling parental feeding practices and child body composition in ethnically and economically diverse preschool children

Controlling parental feeding practices may be associated with childhood overweight, because coercive or intrusive feeding practices may negatively impact children’s development of self-regulation of eating. This study examined pressuring or forcing a child (healthy or unhealthy foods) and restricting child from unhealthy or snack foods as two types of controlling feeding practices that explain unique variances in measures of child body composition (BMI, percent body fat, and parental perception of child weight). In an ethnically and economically diverse sample of 243 children aged 4–6years old and their biological parents (89% biological mothers, 8% biological fathers, and 3% step or grand-parent), descriptive statistics indicate ethnic and family income differences in measures of feeding practices and child body composition. Additionally, the two “objective” indices of body composition (BMI and percent body fat) were related to low pressure to eat, whereas the “subjective” index (perceived child weight) was related to restriction. Regression analyses accounting for ethnic and family income influences indicate that pressure to eat and restriction both explained unique variances in the two “objective” indices of body composition, whereas only restriction explained variance in perceived child weight. Findings have implications for helping parents learn about feeding practices that promote children’s self-regulation of eating that simultaneously serves as an obesity prevention strategy.

Parental perception of child weight: a concept analysis

This article is a report of an analysis of the concept of parental perception of child weight. Perception is commonly studied, but lacks a strong conceptual definition. Concept analysis is important in providing a conceptual definition of parental perception of child weight. Rodgers's evolutionary view of concept analysis guided this enquiry. A search of multiple nursing and social sciences databases was undertaken, including CINAHL, Academic Search Complete, Science Direct, ProQuest, PsychINFO, Medline and SocINDEX. Data from 2000-2012 related to the concept of interest were reviewed. Fifty-eight articles meeting the inclusion criteria were included. Key attributes, antecedent occurrences and consequences of the concept's use were identified. Thematic analysis revealed common themes related to the concept attributes, antecedents and consequences. Five attributes were identified including: parental recognition of body size, physical appearance, functional abilities, psychosocial effects and health effects related to body weight. Antecedents of this concept are parental beliefs and values about body weight, fatalism, societal normalization of overweight, parental weight status and parental mental health status. The consequences of this concept are parental concern, increased knowledge about obesity-related health risks, motivation to make changes and family lifestyle changes. The ultimate goal is a healthy weight for the child. A middle-range explanatory theory of parental perception of child weight was proposed. Parents who recognize child weight issues may be motivated to initiate lifestyle changes, resulting in a healthy weight for the child.

Parental use of differential restrictive feeding practices with siblings

To investigate associations between sibling weight status, concerns about sibling weight, and parents' differential use of restrictive feeding practices. Participants included 70 mother-father pairs with two biological children between 6 and 12 years old. Each parent completed three Child Feeding Questionnaire (CFQ) subscales (perception of child weight, concern about child weight, and restriction) for each participant sibling. Researchers measured heights and weights and converted child data into Body Mass Index percentiles (BMI%). Multiple regression analysis examined predictors of restrictive feeding practices used by both parents. The nature of differential treatment was examined by calculating Pearson's correlations among sibling differences (older minus younger sibling) in maternal and paternal CFQ reports and sibling BMI%. Concern for child weight, but not actual child BMI% or parental perception of child weight, predicted restrictive feeding practices for both parents. Child gender was not related to child weight status, perception of child weight, concern for child weight, or restriction. Parents were more likely to use differential restrictive feeding practices when they had differential concern for the weight status of their children. However, this differential treatment was not related to differences in actual sibling BMI% or parental perception of child weight. Parental concern for child weight, rather than actual child weight status, predicts restriction by both mothers and fathers. Across families, parents generally tend to use similar feeding practices with each of their children. Within families, parents may have different interactions with each sibling regarding food when differentially concerned about sibling weight status.

The Role of Culture in the Context of School-Based BMI Screening

The high prevalence of overweight and obesity is a significant public health concern in the United States. Minority populations are disproportionately affected, and the impact of obesity on minority children is especially alarming. In this article we discuss school-based BMI reporting, which is intended to increase parental awareness of their children's weight status. This information could potentially lead parents of overweight and obese children to carefully examine and possibly change their children's diet and activity patterns. However, any program related to child weight status must consider culturally defined aspects of body size and shape. In other words, the cultural context in which information on child BMI is presented to and received by parents must be considered. In this article we review parental perceptions of child weight. Multiple studies have shown that parents of overweight or obese children often fail to correctly perceive their children as overweight. Possible reasons for, and implications of, this misperception of child weight status among minority parents are then explored within a cultural framework. The PEN-3 model is used to examine influences on health behaviors and could help inform the development of a culturally sensitive BMI-notification program for minority parents. Reporting materials congruent with the social and cultural values and practices of the target audience are likely to maximize program effectiveness. A culturally based BMI-notification program should be conceptualized as a small step in a comprehensive plan to reduce childhood obesity and improve the current and future health of minority children.