Perceived Child Weight Research Articles

Telling Parents Their Child's Weight Status: Psychological Impact of a Weight-Screening Program

This was a descriptive study examining the psychological impact of a school-based, weight-screening intervention that included feedback to parents. Children from years 3 and 6 (6-7 and 10-11 years old) in London schools were measured in school, and parents were sent information on the child's weight status. Children and parents completed questionnaires 6 weeks before and 4 weeks after the feedback; 358 children and 287 parents completed both questionnaires. The main outcome measures (parental feeding practices, parental perception of child weight, child body esteem, child eating behavior, and weight-related teasing) were assessed before and after feedback. Qualitative data on health-behavior change and parents' and children's views of the measurement and feedback process were collected at follow-up. Fifty-one percent of the parents (n = 398) volunteered for child measurements and weight feedback. Feedback was not associated with changes in child feeding among parents of healthy-weight children, but dietary restriction increased in parents of overweight girls. Among healthy-weight children, restrained eating decreased and body esteem increased, but there were no significant changes among the overweight group and no changes in reports of teasing. Perceptions of child overweight did not increase significantly, but 50% of the parents of overweight children reported positive changes in health behaviors. The majority (65%) of parents wanted weight feedback on a regular basis, and most children enjoyed the measuring process. Weight feedback was acceptable to the majority of parents participating in an "opt-in" measurement and feedback program; adverse effects were minimal for children and parents, even when feedback indicated overweight. However, a minority of participants found it distressing, which highlights the importance of managing the process sensitively, particularly for families with overweight children.

Confirmatory factor analysis of the child-feeding questionnaire among parents of adolescents

We investigated the validity of the child-feeding questionnaire (CFQ) among parents of adolescents. The original CFQ was developed to assess perceptions of obesity-proneness and child-feeding practices among parents of 2- to 11-year-old children. We modified the CFQ to make it applicable to parents of adolescents and added one item on monitoring sugared beverages. Confirmatory factor analysis was conducted using the latent variable approach. Factor scores were related to adolescent body mass index percentiles (BMI%) using structural equation modeling. The modified CFQ was completed by 260 parent/guardians (mean age 39.8 years; 92% female; 55% Black, 35% White, 10% Other). The original published measurement model was fit to our sample and yielded an acceptable fit (CFI=0.95, TLI=0.93, RMSEA=0.05). Adding the extra variables decreased the fit; however, minor modifications improved the fit without changing the factor structure (CFI=0.95, TLI=0.94, RMSEA=0.05). Cronbach's alphas for the subscales ranged from 0.60 to 0.88. The factors, parental perceptions of child weight, concern for child weight, monitoring and restriction were positively associated, and pressure to eat was inversely associated with adolescent BMI%. In conclusion, the psychometric properties of the modified CFQ tested among parents of a multi-ethnic adolescent sample were similar to those of the original CFQ.

Cross-cultural equivalence of feeding beliefs and practices: The psychometric properties of the child feeding questionnaire among Blacks and Hispanics

Background Psychometrically sound measures are considered a necessary condition for valid research. This study used structural equation modeling to examine the cross-cultural equivalence of a widely used measure of parental beliefs and practices regarding child feeding, the Child Feeding Questionnaire [Birch L.L., Fisher J.O., Grimm-Thomas K., Markey C.N., Sawyer R., Johnson S.L. Confirmatory factor analysis of the child feeding questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite 2001;36:201–10]. Methods Low-income parents of 101 Black and 130 Hispanic pre-school children (126 girls, 105 boys) completed a reduced version of the CFQ. Results Confirmatory factor analyses using LISREL 8.51 supported the hypothesized factor structure but revealed cross-cultural conceptual problems on the perceived child weight factor and problematic items on the restriction factor that were addressed in a modified model. Invariance analyses demonstrated invariance of factor structure, loadings, and covariances in the modified model across ethnic groups. MANCOVA, that controlled for parent BMI and marital status, revealed ethnic differences on the child feeding responsibility, child weight concern, and perceived weight of child factors that were moderated by parent education and child BMI. Conclusions Results supported the use of a modified version of the CFQ among Blacks and Hispanics and revealed no ethnic differences on factor scores, except on interactions with parent education and overweight status of child.

Parental feeding attitudes and styles and child body mass index: prospective analysis of a gene-environment interaction.

Parental feeding styles were linked to child weight in cross-sectional studies, which were unable to test the direction of effect. Prospective studies can best establish causal relationships among such variables. We tested the 2-year stability of parental feeding attitudes and styles and investigated whether these variables predict child body mass index (BMI) z scores 2 years later. We evaluated whether these associations were dependent on children's predisposition to obesity. Participants were 57 families enrolled in an Infant Growth Study of children born at high risk or low risk for obesity, on the basis of maternal prepregnancy overweight or leanness. Children were evaluated for weight and height at 3, 5, and 7 years of age. Measures of parental feeding attitudes and styles were ascertained with the Child Feeding Questionnaire at 5 and 7 years of age. Correlation and multiple regression analyses tested whether parental feeding styles at age 5 predicted increased child BMI z scores 2 years later. Parental feeding attitudes and styles were stable for child ages of 5 to 7 years. With respect to feeding attitudes, perceived responsibility at age 5 predicted reduced child BMI z scores at age 7 among low-risk families, whereas child weight concern and perceived child weight predicted increased child BMI z scores among high-risk families. With respect to feeding styles, monitoring predicted reduced child BMI z scores at age 7 among low-risk children. In contrast, restriction predicted higher BMI z scores and pressure to eat predicted reduced BMI z scores among high-risk children. These associations remained significant after controlling for child weight status at age 3. The relationship between parental feeding styles and child BMI z scores depends on child obesity predisposition, suggesting a gene-environment interaction. Among children predisposed to obesity, elevated child weight appears to elicit restrictive feeding practices, which in turn may produce additional weight gain. Parenting guidelines for overweight prevention may benefit from consideration of child characteristics such as vulnerability to obesity and current weight status.

Attitudes, practices, and concerns about child feeding and child weight status among socioeconomically diverse white, Hispanic, and African-American mothers

Parents play an important role in the development of their children’s eating behaviors. We conducted 12 focus groups (three white, three African-American, and three Hispanic-American low-income groups; three white middle-income groups) of mothers (N=101) of 2- to less than 5-year-old children to explore maternal attitudes, concerns, and practices related to child feeding and perceptions about child weight. We identified the following major themes from responses to our standardized focus group guide: 12 groups wanted to provide good nutrition, and most wanted children to avoid eating too many sweets and processed foods; 12 groups prepared foods their children liked, accommodated specific requests, and used bribes and rewards to accomplish their feeding goals (sweets were commonly used as bribes, rewards, or pacifiers); and 11 of 12 groups believed their children were prevaricating when they said they were full and mothers encouraged them to eat more. The common use of strategies that may not promote healthful weight suggests work is needed to develop culturally and socioeconomically effective overweight prevention programs. Further study is needed to verify racial/ethnic or income differences in attitudes, practices, and concerns about child feeding and perceptions of child weight.