Parental Perceptions of Weight Management in Children: A Pilot Study Open Access

Lupi, Jenna Louise (2013)

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Background: In 2009-2010 16.9% of children and adolescents in the U.S. were considered obese. Overweight and obesity in children are associated with a number of health risks including diabetes, heart disease, breathing problems, and depression. Primary care practitioners (PCPs) can play a role in childhood weight management by monitoring Body Mass Index (BMI) and providing behavioral guidance to families. Despite expert recommendations for PCP involvement, understanding of parental opinions of the PCP's role is limited. The Health Belief Model was used to assess parental perceptions of their role and the PCP's role in childhood weight management.

Methods: Structured interviews were conducted with parents of children aged 3-12 visiting a pediatric clinic in metro-Atlanta for sick visits between August-November 2012. Interview topics included perceptions of: weight and associated problems, child weight status and concerns, and PCP role and previous experiences with PCPs for weight management. Interviews were coded qualitatively and analyzed thematically.

Results: Sixty-nine interviews were completed in a mostly Caucasian, college-educated sample. Nine major themes were identified including: Defining Overweight and Obesity, Health Implications of Weight, Indicators of Weight Problems, Concern about Weight, PCP's Role in Identifying Weight Problems, Family Behavioral Changes, PCP's Role in Weight Management, Experiences with Pediatric Weight Management, and Perceptions of Registered Dietitian (RD) Involvement. Parents were most interested in receiving tailored nutrition information from PCPs. Although parents did not always define their child as overweight, many parents of overweight children expressed concern. Parents were interested in learning more about BMI, expressing confusion about the term. A challenge identified to including PCPs in weight management was a lack of knowledge of available services.

Conclusion: Parents recognize PCPs as partners in childhood weight management. As previously recommended, PCPs should provide BMI information and weight counseling. They should also ensure parents understand BMI and its potential role in identifying weight problems. PCPs should partner with local public health practitioners to develop materials with tailored nutrition information, as well as guides to services offered within the practice and in the community. Parents were open to working with RDs, and partnerships with RDs could help parents with specific nutritional questions.

Table of Contents


The Childhood Obesity Epidemic...1

Addressing the Epidemic and the Role of Primary Care Physicians (PCP)...2

The Role of PCPs in Weight Management - Challenges, Suggestions, and Solutions...5

Challenges with Coverage of PCP Weight Management...7


Parental Perceptions of Identifying Weight Problems in Children...10

Parental Perceptions of the Role of PCPs in Weight Management...11

Parental Perceptions of PCP Weight Management Methods...13

Study Rationale and Theory...14

Research Question...15


Study Design...17

Participants and Recruitment...17

Data Collection...18




Participant Characteristics...23

Key Themes Identified from Parent Interviews...24

Defining Overweight and Obesity ...28

Implications of Weight...29

Indicators of a Weight Problem ...29

Parental Concerns about Weight...32

PCP's Role in Identifying Weight Problems ...34

Family Behavioral Changes ...35

PCP's Role in Weight Management...37

Experiences with PCP Weight Management...39

Perceptions of RD Involvement...40


Strengths and Limitations...48





Appendix A. Health Belief Model Constructs with Associated Study Questions...55

Appendix B: Semi-Structured Interview Guide...56

Appendix C. Consent Form...65

Appendix D. Qualitative Codes by Question...68


Table 1. Expert Recommendations for PCP Role in Pediatric Weight Management...3

Table 2. Characteristics of Parents and Children Included in Study...23

Table 3. Themes, Key Messages, and Quotations...25

Table 4. Recommendations for PCPs and Implications for Public Health Practitioners...46

Table 5. Health Belief Model Constructs...47

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