Parenting Behaviors And Obesogenic Behaviors And Their Clustering:A Cross-section Study From 11 Cities In Middle And Lower Reaches Of Yangtze River

ObjectivesTo investigate the prevalence and distribution of 5 obesogenic behaviors and their clustering among preschool children in 11 cities from the middle and lower reaches of the Yangtze River.To examine the association between parenting behaviors and 5obesogenic behaviors and their clustering in preschool children and whether the association between parenting behavior dimensions and preschoolers’obesogenic behaviors and their clustering was different across parents.MethodsBetween October and November 2017,a school-based cross-section study was conducted in Anhui,Hubei and Jiangsu Provinces,which located in middle and lower reaches of Yangtze River in China.11 cities included Hefei,Anqing,Tongling,Wuhu,Maanshan,Yangzhou,Zhenjiang,Xuzhou,Wuhan,Ezhou,Songzi were randomly selected in three provinces.A total of 27 987 children aged from 3-6 years old from109 kindergartens were enrolled in this study.Ultimately,the data from 27 200preschoolers were used for data analysis,and the effective response rate was 97.19%.Of children,51.4%were male,21.9%were 3 years old,32.1%were 4 years old,33.6%were 5 years old,and 12.5%were 6 years old.Five obesogenic behaviors include insufficient physical activity（PA,<60 min/day）,longer screen time（ST,>120min/day）,frequent take-away/fast-food（T/F,≥3 times/wssk）intake,frequent sugar-sweetened beverages（SSBs,≥3 times/week）intake and insufficient sleep duration（SD,<10 hours/day）,which were collected in self-administered questionnaires and classified according to relevant standards.Three or more"obesogenic behaviors"was defined as"obesogenic behavior clustering".The child’s age,gender,place of residence,only child or not and the age of the parents,their education and body type,family economic status and other information were also included in this questionnaire.Parental parenting behavior was evaluated by the Parent BehaviorInventory（PBI）,whichisdivided intosupportive/engageand hostile/coercive.Total score of every dimension was calculated and then transformed into 3 categories by P₂₅5 and P₇₅.Pearson’s chi-square was employed to compare the prevalence of obesogenic behaviors by demographics characteristics.Associations between parenting behaviors and obesogenic behaviors and their clustering were examined using binary Logistic regression models.Ratio of two odds ratios（RORs）was used to examined whether the association between parenting behavior dimensions and obesogenic behaviors and their clustering was different across parents.ResultsThe Cronbach’αand the split-half coefficients of PBI,supportive/engaged dimensionsandhostile/coercivedimensionswereall>0.7.Paternal supportive/engaged was significantly associated with father’s education,maternal supportive/engaged was significantly associated with mother’s education,maternal hostile/coercive was significantly associated with mother’s education（P<0.001）.The factor analysis showed that all items in the support/participation dimension were as same as the original scale,the hostile/coercive dimension were slightly different from the original scale.The item 9 and 19 are separately divided into the third dimension.The prevalence of longer SD,insufficient PA,frequent T/F food intake,frequent SSBs intake,insufficient ST,and behavioral clustering were 31.1%,21.6%,16.9%,25.0%,15.7%,and 8.2%respectively.Univariate analysis showed that longer SD was significantly associated with children’s age,gender,region of residence,family economic status,only child or not,parental education,age,father’s body shape,and mother’s body shape（P<0.05）;Insufficient PA was significantly associated with children’s age,region of residence,only child or not,parental education,age and body type（P<0.05）;Frequent T/F intake was significantly associated with children’s age,region of residence,family economic status,only child or not,parental education,age and body type（P<0.05）;Frequent SSBs intake was significantly associated with children’s region of residence,family economic status,only child or not,parental education and age（P<0.05）;Insufficient SD was significantly associated with children’s age,region of residence,parental education,age and maternal body shape（P<0.05）.The clustering of behaviors was significantly associated with children’s age,region of residence,only child or not,parental education and age and maternal body shape（P<0.05）.Logistic regression analysis showed that parental higher supportive/engaged parenting behaviors reduced the risk of longer ST（Paternal:OR=0.71,95%CI:0.66⁰.77;Maternal:OR=0.64,95%CI:0.60⁰.70）,insufficient PA（Paternal:OR=0.77,95%CI:0.70⁰.83;Maternal:OR=0.72,95%CI:0.66⁰.79）,insufficient SD（Paternal:OR=0.79,95%CI:0.72⁰.87;Maternal:OR=0.71,95%CI:0.65⁰.79）and their clustering（Paternal:OR=0.69,95%CI:0.61⁰.78;Maternal:OR=0.64,95%CI:0.57⁰.73）among preschoolers.In addition,maternal higher supportive/engaged parenting behaviors also reduced the risk of frequent SSBs intake（OR=0.91,95%CI:0.84⁰.99）.For the dimension of hostile/coercive,parental higher hostile/coercive parenting behaviors increased the risk of longer ST（Paternal:OR=1.34,95%CI:1.24¹.45;Maternal:OR=1.35,95%CI:1.25¹.46）,frequent T/F intake（Paternal:OR=1.54,95%CI:1.41¹.70;Maternal:OR=1.57,95%CI:1.42¹.72）,frequent SSBs intake（Paternal:OR=1.16,95%CI:1.07¹.26;Maternal:OR=1.25,95%CI:1.15¹.36）,insufficient SD（Paternal:OR=1.35,95%CI:1.22¹.49;Maternal:OR=1.31,95%CI:1.18¹.44）and their clustering（Paternal:OR=1.54,95%CI:1.35¹.74;Maternal:OR=1.78,95%CI:1.56².04）among preschoolers.In addition,maternal higher hostile/coercive parenting behaviors also increased the risk of insufficient PA（OR=1.15,95%CI:1.06¹.25）.And paternal parenting behaviors had similarly effects on all five obesogenic behaviors and their clustering compared with maternal parenting behaviors（all P<0.05）,after calculating 6 pairs of ROR values.ConclusionFindings suggest that parenting behaviors may play an important role related to preschoolers’obesogenic behaviors and their clustering.In general,parental supportive/engaged was negatively associated with preschoolers’obesogenic behaviors and their clustering,parental hostile/coercive was positively associated with these behaviors and clustering.Father and mother may make similar contribution to these behaviors and their clustering.