The Correlation Between Parental Perceptions and Readiness to Change with Participation in a Pediatric Obesity Program Serving a Predominantly Black Urban Community: A Retrospective Cohort Study.

BACKGROUND: This study assessed whether maternal BMI and perceptions about weight and reported level of readiness to change was correlated with compliance to a pediatric lifestyle modification program targeting a hard-to-reach urban population with a high prevalence of severe obesity. METHODS: The Parental Readiness Questionnaire (PRQ) was administered to the child's mother at program entry. The PRQ consisted of forty-seven multiple-choice and 10-point Likert scale questions regarding family demographics, exercise and eating habits, attitudes about health, body image, and weight, and the desire to improve nutrition and physical activity. Analysis was performed on PRQs of participants to compare parental perceptions and readiness for change with compliance to program requirements. Analysis was conducted on 596 questionnaires and compliance was categorized into three groups based on attendance to follow-up visits. RESULTS: Significant differences were found between short-term and long-term follow-up groups in regards to parental perception of one's health as well as the health, weight, and body image of their child. Differences were found in perceptions of one's own weight and body image as well as the health of one's self and child between the group with a maternal BMI < 35 and the group with a maternal BMI ≥ 35. A lower maternal BMI was associated with a better perception of one's own weight, body image, and health, as well as the health of the child. CONCLUSION: Positive parental perceptions on weight were correlated with improved compliance to a pediatric lifestyle modification program.

Designing a group therapy program for coping with childhood weight bias.

Research indicates that the negative psychosocial consequences of childhood obesity may reflect the degree of weight bias and mistreatment affecting the child. Even though comprehensive practice models evolve over time, the intense distress of these children calls for more timely intervention. Using a modification of social research and development methodology, a short-term group therapy approach using cognitive and behavioral methods was designed. Questionnaires were developed to assess both the child's and the parents' perceptions of the frequency, circumstances, and responses to being teased. At the end of the program, all of the children and parents showed proficiency in describing and demonstrating the coping strategies in the curriculum. A two-year follow-up found that most of the children reported fewer episodes of teasing. This article demonstrates the use of intervention research methodology to rapidly design and implement a preliminary approach to help children with severe obesity cope with weight-related teasing. Although this program needs further empirical testing and refinement before it can be more widely deployed, it represents an important initiative in responding to the distress of children who are victimized because of obesity.

Integrating pediatric obesity treatment into clinical practice.

Childhood obesity has reached epidemic proportions in the United States and other industrialized nations. Despite the significant psychosocial consequences, mental health professionals have been reluctant to provide direct treatment for these children and their parents. The author proposes a practice model for agency, clinic, and private settings, with the mental health practitioner as primary clinician. On the basis of intervention research methodology, the model presents consensus generalizations and clinical applications for evaluation and treatment. A typology of diagnostic profiles with corresponding strategies for combining diet, activity, and mental health interventions is included.