506 research outputs found

    British and Iranian parents’ and children’s awareness of the child’s weight status, physical activity, sedentary behaviours and fundamental movement skills: A mixed methods approach

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    Childhood obesity (CO) is an epidemic issue in developed and developing countries (e.g. UK as developed and Iran as developing country) which needs to be addressed. Parents’/children’s awareness of weight status and health behaviours of the child are considered an initial step to prevent and mange CO. Thus, the aim of this thesis is to examine and explain parents’ and children’s awareness of the child’s weight status, Physical Activity (PA), Sedentary Behaviour (SB) and Fundamental Movement Skills (FMS) among normal weight and overweight children, in two different countries (i.e. Uk and Iran) with high rate of CO through a mixed method approach. Adopting a sequential explanatory design, this research is conducted in two consecutive phases, including three quantitative studies (using questionnaires) in phase one, following by qualitative study (using interview) in phase two to explain findings of quantitative studies. It should be noted that the studies in this thesis were conducted prior to the covid-19 pandemic. The sample in the three quantitative studies (studies 1-3) consisted of 217 children (aged 8-10 years); 98 British and 119 Iranian as well as their parents. To assess actual weight status, Body Mass Index (BMI) percentile was measured and children were categorised as normal weight (N=71 British & 74 Iranian, if BMI <85th percentile) and overweight (N=27 British & 45 Iranian, if BMI ≥85th percentile). PA, SB (GeneActive accelerometers) and Fundamental Movement Skills (FMS) (Test of Gross Motor Development–2) of children were objectively measured. Verbal and visual tools were applied to assess weight status perception. Questionnaires were used for assessing PA, SB and FMS perception. Results of quantitative studies found that many overweight children and their parents in both countries underestimated the child’s weight status verbally and visually, while British parents and children had lower accuracy than Iranian. In both weight groups Iranian parents, their children and British children overestimated the child’s PA level while British parents accurately perceived it. Iranian children’s overestimation of PA was more than British children. In addition, British parents and their children as well as Iranian normal weight children underestimated the child’s SB while Iranian overweight children were aware of their SB. Iranian parents overestimated SB of their children. Concerning FMS, in both countries parents of normal weight children were aware of the FMS levels of children whereas parents of overweight children and all children themselves were not aware of that. Comparing the two countries in study 3, British overweight children had higher levels of overestimation than Iranian overweight children. The qualitative study (study 4) used semi-structured, face-to-face interviews with 40 parents (20 in each country) who had an 8-10 year old child and were fluent in their respective native languages (English and Farsi). Interviews were recorded, transcribed and analysed thematically. Results of the qualitative study showed that in both countries parents felt responsible for CO and un/healthy behaviours of children, however Iranian parents, attributed the responsibility also to school and government as well. British parents placed less responsibility on these organisations. ‘Denial’ was suggested as a parental reaction to CO, and low activity levels and poor FMS of children which may impact parents’ awareness. There were a variety of reasons for denial but denial to avoid the social stigma attached to CO was raised mainly among Iranian parents while denial due to normalisation of obesity as well as to deflecting parental responsibility was raised more by British parents. While denial of high SB leading to underestimation was discussed by British parents, overestimation of SB was also discussed by Iranian parents as a strategy to encourage children to be more active, to avoid labelling their child as ‘hyperactive’ and also to persuade schools and government to promote PA of children. Nonchalant and positive attitudes towards CO and the notion that children will grow out of it was another parental reaction to CO discussed by parents in both countries. These factors were suggested by parents as potential reasons for parents’ misperception of their child’s weight. Time, cost, convenience, parents’ lack of knowledge (on all aspects of obesity, nutrition, PA, SB and FMS) child’s preference and weight as well as peer pressure were proposed by parents as barriers to behaviour change. Overall, the results of the studies in this thesis showed that parents’ lack of awareness of CO, PA, SB and FMS of children is a critical issue for managing and treating CO and promoting healthy behaviours of children. In this regard, it was also found parents face various barriers that they need to be supported to overcome them suggesting that increasing awareness alone might not be sufficient. CO prevention and management is a shared responsibility that needs a multi-disciplinary multisector approach. In addition, the results of the studies in this thesis showed that to improve efficacy of intervention programs they need to be tailored to countries/cultures

    Parental Perceptions of Children’s Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017

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    Introduction: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child’s weight status. The purpose of this study was to measure parental perceptions of their child’s weight status and to identify predictors of potential parental misperceptions. Methods: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children’s weight status as “underweight,” “normal weight,” “a little overweight,” or “extremely overweight.” We categorized children’s (6–9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child’s weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of parents categorized their child’s weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child’s weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child’s weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28–1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26–1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98–1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99–1.24). Overall, parents’ BMI was not strongly associated with the underestimation of children’s weight status, but there was a stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors that influence parental perceptions of their child’s weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents’ knowledge and perceptions, as well as the sociocultural contexts in which children and families live.The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding by: Albania: World Health Organization through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Bulgaria: Ministry of Health, National Center of Public Health and Analyses, World Health Organization Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and World Health Organization Regional Office for Europe; Czechia: Grants AZV MZČR 17-31670 A and MZČR – RVO EÚ 00023761; Denmark: Danish Ministry of Health; France: French Public Health Agency; Georgia: World Health Organization; Ireland: Health Service Executive; Italy: Ministry of Health; Istituto Superiore di sanità (National Institute of Health); Kazakhstan: Ministry of Health of the Republic of Kazakhstan and World Health Organization Country Office; Latvia: n/a; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and World Health Organization; Malta: Ministry of Health; Montenegro: World Health Organization and Institute of Public Health of Montenegro; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support of Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; Russia (Moscow): n/a; San Marino: Health Ministry; Educational Ministry; Social Security Institute; the Health Authority; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Tajikistan: World Health Organization Country Office in Tajikistan and Ministry of Health and Social Protection; and Turkmenistan: World Health Organization Country Office in Turkmenistan and Ministry of Health. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated.info:eu-repo/semantics/publishedVersio

    Sex-based differences in weight misperception and its related factors among Korean children and adolescents : the Korea National Health and Nutrition Examination Survey, 2009-2013

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    보건대학원/박사The purpose of this study was to quantify the extent of parental misperception of their child’s weight, and to explore sex-based differences in socio-demographic factors associated with parental misperception among Korean children. Data on 3,228 children aged 6-11 years were collected from the Korea Health and Nutrition Examination Survey (KNHANES) datasets (2009-2013). The generalized logit model was used to explore sex-based differences in socio-demographic factors associated with parental misperception. Overall, 27.4% of parents of boys and 23.7% of parents of girls misclassified their child’s weight status. Parents of both boys and girls were more likely to underestimate rather than overestimate their child’s weight. Parental misperception was associated with socio-demographic factors such as age, BMI, place of residence, maternal perception of their own weight, and parental obesity. Particularly, parental obesity was a significant variable only among girls. Understanding parental misperception patterns depending on sex might be the initial step towards desirable interventions for weight control. Another purpose was to quantify the extent of weight misperception, to explore sex-based differences in socio-demographic factors associated with weight misperception, and to examine sex-based differences in the relationship between weight misperception and health-related factors among Korean adolescents. We selected data on 3,385 adolescents aged 12-18 years from the KNHANES datasets (2009-2013). The generalized logit model was used to explore the relationship between weight misperception and socio-demographic factors, and separate logistic regression models were fitted to examine the association between weight misperception and health-related factors. Overall, 26.2% of boys and 27.9% of girls misclassified their weight status. Both boys and girls were more likely to overestimate rather than underestimate their weight. Particularly, girls were more than four-times more likely to overestimate rather than underestimate their weight. Weight misperception was associated with socio-demographic factors, such as gender, age, BMI, household income, maternal education level, place of residence, and number of family members. Household income was linked to weight overestimation and underestimation among boys. Maternal education level, place of residence, and number of family members were significant variables among girls. Weight overestimation was related to inappropriate weight control practice among girls. However, among boys, both weight underestimation and overestimation were associated with inappropriate weight control practice. Vigorous exercise was negatively associated with weight overestimation only among boys. Drinking experience was also positively associated with weight overestimation among girls. Based on understanding the characteristics of sex-based differences in weight misperception patterns and their association with health-related factors, individualized intervention programs according to sex could be devised for adolescents and their parents.ope

    Weight status of children aged 2-5 years old, attending a paediatric outpatient clinic and its association with parental feeding style and parental perceptions of weight status

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    Background: A child’s weight status can allow health care professionals to assess their developmental growth. A child having a low or high weight for height could be due to an imbalance in nutrient intake occurring. It is important to balance dietary intake and physical activity to maintain a healthy weight status. Excessive consumption of food can lead to an overweight/obese weight status which is linked to non-communicable diseases. Parental feeding style can directly impact a child’s set of eating behaviours. Therefore, parents have a strong influence over a child’s growth pattern. In addition, parental awareness of childhood obesity is reported to be poor which could be a barrier to interventions. Aim: To determine; (1) the weight status of children aged 2-5 years attending Sligo University Hospital (SUH); (2) current parental feeding styles being utilised; (3) whether parents were able to correctly classify their own weight status and that of their child and if this was associated with parental misclassification of their own weight status and (4) whether parents are interested in further information in this area, and what form this information/guidance should take. Method: A cross-sectional study was conducted in a paediatric outpatient department between September 2018 and May 2019. Data collected included anthropometric measurements and demographic information as well as a validated parental feeding style questionnaire. Data analysis was conducted using SPSS version 24. Statistical significance was set at p \u3c.05. Results: Fifty parents and children were recruited. 72% of children were classified as having a normal weight status, 22% an overweight status and 6% an obese weight status. No parent correctly classified a child as having an overweight status. No association was found between parental misclassification of a child’s weight status and their own weight status. The majority of parents used an encouragement feeding style. 84% of parents reported to be interested in obtaining healthy lifestyle information. The preferred method of receiving this information is in the form of a leaflet. Discussion/Conclusion: The childhood overweight and obesity rates within this cohort are slightly above the national rates for childhood obesity. Parental awareness of childhood overweight/obesity was found to be poor as illustrated in previous studies. Interventions need to be implemented to improve parental classification of a child’s weight status. Parents expressed an interest in receiving health education material in this setting

    Physical activity: improving assessment tools and behavior in children

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    2014 Summer.Adequate physical activity (PA) is a critical component of chronic disease prevention and a healthy lifestyle. Unfortunately, studies suggest that US children do not meet the recommended 60 minutes of PA per day. However, recent advances in measurement techniques are enabling researchers to gather more detailed objective PA data, allowing for an improved understanding of children's PA accumulation and patterns. This information will enable researchers and policy makers to better design and evaluate interventions aimed at increasing PA, ultimately reducing the prevalence of chronic disease. These ongoing advances in objective PA monitoring devices call for studies to test and refine the methods by which PA data are processed and interpreted. Specifically, although these novel PA devices and methods (e.g., accelerometers and activity intensity classification methodologies) are being calibrated and validated using laboratory protocols, their accuracy in estimating children's free-living PA has not been well-established. Additionally, given the well-established sporadic nature of children's activity, it is critical to measure activity during very short time intervals (i.e., 1-2 second bouts), requiring devices that can record and store acceleration data at a relatively high-resolution (e.g. 30-100 Hz). Importantly, though many intervention studies have been conducted with the goal of increasing daily PA, none have used high frequency acceleration data to examine the accumulation of PA in a free-living setting, nor to evaluate the effectiveness of these PA interventions. However, the need to do so is widely recognized among the PA monitoring community. Therefore, the following dissertation describes a series of experiments with the overall aim of improving PA measurement tools and behaviors in children. In the first study (Chapter 2), we attempt to establish cutpoints to distinguish between sedentary, light, moderate and vigorous activity using a novel wrist-mounted accelerometry device. We also examine the effects of various bout lengths (periods of consecutive seconds of activity above the moderate threshold) on the estimated MVPA accumulation. Moderately accurate cutpoints resulted (~70-75% accuracy). We also found very high estimates of daily MVPA (>300 minutes). Because of the high estimates of daily MVPA as well as the relative difficulty in distinguishing between light and moderate activity by the confusion matrix, we began to further investigate the effects of the specific processing methodologies we used. This led us to the second study (Chapter 3), whereby we attempted to investigate the ability of three different processing methodologies to accurately detect MVPA. In this study, we applied three different processing methodologies (band pass filtered: BPEN, unfiltered: ENMO, and low pass filtered: LPENMO) to three separate independent samples of children: a calibration sample, a direct observation (classroom/recess) sample, and a multi-day, free-living sample. Results from this study suggested that BPEN is likely overestimating MVPA. ENMO and LPENMO both appeared to accurately detect MVPA compared to direct observation data (~85%). Because of these relatively good accuracies, and because low pass filtering is considered a best practice in signal processing, we elected to move forward with the low pass filtering methodology. Once we had established a methodology that we felt accurately detected MVPA, we were able to process and analyze data from the IPLAY (Intervention of PhysicaL Activity in Youth) study. IPLAY is a large-scale, school-based intervention aimed at increasing activity through either curriculum intervention (SPARK), environmental intervention (renovated playgrounds), or the combination of the two (see Chapter 4 for a more detailed description of the intervention). Results revealed no differences in lunch recess, school day or full day MVPA between the groups. In addition, relatively high estimates of daily MVPA resulted (~140 minutes), as well as a lack of effect of BMI z-score on MVPA accumulation. The combination of these studies adds a significant contribution to the literature around PA in children. Specifically, the investigation into processing methodologies demonstrates how critical this step is in being able to interpret acceleration data. It also provides a framework for other investigators to process acceleration data, with the goal of producing comparable results. The evaluation of the IPLAY study suggests the need for additional opportunities for children to be active during the day. The high estimates of daily MVPA suggest the need to further investigate how/when activity is being accumulated. Finally, an investigation into whether the PA guidelines ought to be re-established given novel methodologies for quantifying PA is warranted

    Enhancing cognitive behavioral therapy for childhood anxiety disorders: a parent manual

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    Anxiety disorders are among the most common psychiatric disorders affecting children and adolescents. In the past several decades, great advances have been made in the treatment of these disorders. While many psychopharmacological and psychotherapeutic treatments exist, Cognitive Behavioral Therapy (CBT) is currently the treatment approach with the most empirical support. Based on a large evidence-base, several CBT manuals have been developed for the treatment of anxiety disorders in children. While research on incorporating parents into these treatments is mixed, parent involvement is widely recommended in these treatments as well as in unmanualized CBT treatment. Although some self-help books and manual-specific guides for parents exist, there is no current manual that provides parents with information and guidance to facilitate their involvement in both manualized and unmanualized CBT for child anxiety disorders. The current project involved the development of a manual for parents whose children (ages 8-13 years) are involved in CBT treatment for Separation Anxiety Disorder, Generalized Anxiety Disorder, Specific Phobia, and Social Phobia. The resulting manual was informed by a review of the literature on child anxiety, CBT treatments for anxiety, and the roles parents may play in CBT. The manual consists of introductory psychoeducation on anxiety and CBT followed by six chapters on the major components of CBT for anxiety. In addition to descriptions of these components, each chapter includes instructions on how parents can be involved to facilitate their child’s treatment. Following a discussion of strengths, limitations, and potential modifications to the current manual, plans for evaluating the efficacy of the manual as well as disseminating it to parents are described

    Parenting in poor health: Examining associations between parental health, prescription drug use, and child maltreatment

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    RationaleChild maltreatment and problematic parenting are related to negative outcomes for children. Poor parental health could be a risk factor for problematic parenting through several mechanisms: 1) inadequate emotional regulation and coping; 2) impairment of parental capacity; and, 3) impairment of the parent-child relationship. ObjectiveThis study examines relationships between self-rated parental health, prescription drug use, and a broad array of negative parenting outcomes. MethodsA sample of general population parents of children aged ten and younger was recruited from 30 mid-sized cities in California (n = 681). Weighted mixed-effects negative binomial and logistic regression models were used to examine associations between poor parental health, prescription drug use and child maltreatment (physical abuse, supervisory neglect, and physical neglect), and problematic parenting (psychological aggression and corporal punishment). ResultsParents in poor health used physical abuse, corporal punishment, and psychological aggression more frequently and had higher odds of supervisory neglect. Parents who were taking more prescription medications had higher odds of physical neglect. Exploratory analyses suggested that prescriptions for certain medical conditions both increased and decreased the risk of problematic parenting. ConclusionsPoor health and prescription drug use are not uncommon and present largely under-recognized risk factors for a spectrum of adverse parenting outcomes. Our study provides additional evidence that parents in poor health are at heightened risk of negative parenting, and need targeted intervention supports to support family well-being

    Cyberbullying, School Violence, and Youth Suicide

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    The frequency of occurrences of cyberbullying among school aged children and its co-occurrence with school violence and risk factors associated with youth suicide have been quantified in numerous national studies in recent years. However, the degree to which school administrators, school teachers, and school counselors at the middle school and high school levels are aware of these national statistics regarding cyberbullying has not been thoroughly researched. The Secondary School Educator.s Cyberbully Awareness Survey was developed to assess educator awareness of cyberbullying. Secondary school educators in this study were found to have inadequate awareness of the national statistics regarding cyberbullying, underestimating the number of secondary school students that cyberbullying affects and underestimating the linkages between cyberbullying and physical aggression, physical injury and carrying a weapon to school while overestimating the likelihood that students who are cyberbullied will attempt suicide. Underestimation of the problem of cyberbullying and its association with school violence at the local school level can have dire and sometimes deadly consequences at school and in the community. As well, lack of appropriate preparation for and response to the problem of cyberbullying at the local school level may result in risk of liability and litigation

    Women's Reasons to Seek Bariatric Surgery and Their Expectations on the Surgery Outcome - a Multicenter Study from Five European Countries

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    Purpose Understanding patients' reasons for having bariatric surgery and their expectation on surgery outcomes is important to provide the best clinical practice and reduce unrealistic expectations. It is unknown if reasons and expectations differ between countries. We aimed to investigate the reasons for seeking bariatric surgery and expectations of surgical outcomes among patients in five European countries. Methods In total, 250 women accepted for bariatric surgery were recruited: 50 women each from Finland, Germany, Norway, Sweden, and the Netherlands. Participants ranked 14 reasons for seeking surgery, and reported the three primary reasons. They also reported expectations on weight loss and impact of surgery vs. lifestyle on weight loss outcomes. Results Mean age and body mass index were 42.9 +/- 11.5 years and 45.1 +/- 6.2 kg/m(2), respectively. Weight loss and improved co-morbidity were ranked as the most important reasons. Participants expected to lose between 70.8 and 94.3% of their excessive weight. The expected impact of surgery as a driver of weight loss was higher in Germany and the Netherlands compared to in Finland, Norway, and Sweden where participants expected lifestyle changes to also have an impact. Conclusion Weight loss and improved co-morbidities were the main reasons for undergoing bariatric surgery. Expectations on weight loss were generally very high, but expectations of surgery vs. lifestyle as the main driver of weight loss differed between countries. While some patients understand the importance of lifestyle change and maintenance of a healthy lifestyle after surgery in order to obtain a successful weight loss, other may need additional counselling.Peer reviewe
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