Parents' Perceptions of Their Child's Weight and Health

OBJECTIVE. This study explored parents' perceptions about their child's appearance and health and evaluated a tool to determine parents' visual perception of their child's weight. METHODS. Parents of children aged 2 to 17 years were surveyed concerning their child's appearance and health and opinions about childhood overweight. They also selected the sketch (from 7 choices) that most closely matched the body image of their child using 1 of 8 gender–and age-range–specific panels of sketches. Children's height and weight were measured. Respondents were grouped by child body mass index (BMI) percentile (<5th, 5–84th, 85–94th [at risk for overweight (AROW)], and ≥95th [overweight]). Those with BMI ≥5th percentile were analyzed. Logistic regression was used to examine factors influencing parental perceptions and levels of worry about their overweight or AROW child. RESULTS. Of the 223 children, 60% were <6 years old, 42% were male, 17% were black, 35% were Hispanic, 42% were white, and 7% were other; 19% were AROW, and 20% were overweight. Few parents (36%) identified their overweight or AROW child as “overweight” or “a little overweight” using words, but more (70%) selected a middle or heavier sketch. Among parents of overweight and AROW children, 18% recalled a doctor’s concern and 26% were worried about their child’s weight. If the overweight or AROW child was age ≥6 years, parents were more likely to identify their child as “overweight” or “a little overweight” using words, select a middle or heavier sketch, and to be worried. Parents of older children were more likely to be worried if they perceived their child as less active/slower than other children or recalled a doctor’s concern. CONCLUSIONS.Few parents of overweight and AROW children recognized their child as overweight or were worried. Recognition of physical activity limitations and physicians’ concerns may heighten the parent's level of concern. Sketches may be a useful tool to identify overweight children when measurements are not available.

[1]  S. Kety,et al.  Genetics of Neurological and Psychiatric Disorders , 1982 .

[2]  G. Ayala,et al.  Theories and intervention approaches to health-behavior change in primary care. , 1999, American journal of preventive medicine.

[3]  H. Binns,et al.  The origin and evolution of a regional pediatric practice-based research network: practical and methodological lessons from the Pediatric Practice Research Group. , 2003, Current problems in pediatric and adolescent health care.

[4]  A. Stunkard,et al.  Use of the Danish Adoption Register for the study of obesity and thinness. , 1983, Research publications - Association for Research in Nervous and Mental Disease.

[5]  W. Dietz.  Health consequences of obesity in youth: childhood predictors of adult disease. , 1998, Pediatrics.

[6]  J. Krosnick,et al.  AN EVALUATION OF A COGNITIVE THEORY OF RESPONSE-ORDER EFFECTS IN SURVEY MEASUREMENT , 1987 .

[7]  Nancy F Krebs,et al.  Prevention of pediatric overweight and obesity. , 2003, Pediatrics.

[8]  Parent Perspectives on Messages to Be Delivered After Nutritional Assessment in Pediatric Primary Care Practice , 2005, The Annals of Family Medicine.

[9]  L. Birch,et al.  Obesigenic families: parents' physical activity and dietary intake patterns predict girls' risk of overweight , 2002, International Journal of Obesity.

[10]  Shumei S. Guo,et al.  Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. , 2002, The American journal of clinical nutrition.

[11]  J. Wardle,et al.  Parental perceptions of overweight in 3–5 y olds , 2005, International Journal of Obesity.

[12]  F. Conrad,et al.  Spacing, Position, and Order Interpretive Heuristics for Visual Features of Survey Questions , 2004 .

[13]  W. Dietz,et al.  Obesity Evaluation and Treatment: Expert Committee Recommendations , 1998 .

[14]  D. Hale,et al.  Diabetes risk factors in low-income Mexican-American children. , 1999, Diabetes care.

[15]  D. Galuska,et al.  Maternal perceptions of weight status of children. , 2003, Pediatrics.

[16]  R C Whitaker,et al.  Why don't low-income mothers worry about their preschoolers being overweight? , 2001, Pediatrics.

[17]  Patricia Dolan Mullen,et al.  Treating tobacco use and dependence: clinical practice guideline , 2000 .

[18]  K. Flegal,et al.  Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. , 2004, JAMA.

[19]  M. Goolsby,et al.  Treating Tobacco Use and Dependence , 2008, Pediatrics.

[20]  W. Chumlea,et al.  Tracking of body mass index in children in relation to overweight in adulthood. , 1999, The American journal of clinical nutrition.

[21]  Obert,et al.  PREDICTING OBESITY IN YOUNG ADULTHOOD FROM CHILDHOOD AND PARENTAL OBESITY , 2000 .

[22]  K. Christoffel,et al.  Risk factors for overweight in five- to six-year-old Hispanic-American children: A pilot study , 2004, Journal of Urban Health.

[23]  R C Whitaker,et al.  Maternal perceptions of overweight preschool children. , 2000, Pediatrics.