Modifiable family factors among treatment-seeking families of children with high body mass index: report of a pilot study.

PURPOSE: The purpose of this pilot study was to explore parenting style and other potential family and social indicators of an obesogenic or weight-promoting family environment. Modifiable factors were sought on which to base a nursing behavioral intervention that could be combined with diet and exercise to reduce youth weight. METHODS: Twenty-eight parents and their 9- to 18-year-old children who were seeking care for overweight responded to in-home surveys to characterize parenting style (warmth/responsiveness and control). We also examined the extent to which parent modeling of health behavior, child feeding practices, parent knowledge of nutrition, and family social characteristics differed by the control aspect of parenting style. RESULTS: Nearly all youth and parents reported substantial parental love (responsiveness), suggesting little variability in the warmth aspect of parenting style. In contrast, considerable variability was found in the control (moderate versus high) aspect of parenting style. Large effect sizes indicated that mothers with moderate control perceived their lifetime weight to be higher, had more concern about their youth's weight (p = .03), had better knowledge of nutrition, and had a lower body mass index (p = .02) than did mothers with high (firm or restrictive) control. Moderate effect sizes indicated that mothers with moderate control demonstrated better modeling behavior, higher perception of youth weight, practiced less pressure to eat, and had youth with lower body mass index and percent body fat than did mothers with high (firm or restrictive) control. Families who volunteered for the study kept their data gathering appointments, but we recommend a recruitment period of more than 4 months and the inclusion of several referral sites. DISCUSSION: Further study of how parent control is related to youth overweight and how appropriate control can be achieved among families with teens who are overweight is recommended.

How do treatment-seeking overweight youth and their parents describe weight promoting factors in their family?

The aim of this pilot study is to describe youth and parents' perceptions of potential weight-promoting factors among families seeking treatment for youth overweight. We identified 2 important gaps in the vast multidisciplinary literature: (a) a lack of studies addressing both the youth and the parent perceptions about family factors that are potentially weight-promoting and (b) a lack of interventions that community health nurses could deliver specifically targeting families seeking treatment for overweight youth. Focus group data were content analyzed. Broad themes included: (a) mixed messages, (b) food and exercise as battleground, (c) problem solving, and (d) social aspects of youth overweight. We conclude that youth and parents could benefit from community health nursing interventions to implement healthcare professionals' recommendations incorporating all family members and creating and maintaining an accepting and demanding family climate.