Parental attitudes and perceptions regarding the gravity of childhood overweight

Childhood overweight is an increasing concern in the United States. Surveys and focus groups were used to investigate parental concerns, attitudes, and knowledge related to childhood overweight; to assess their willingness to support efforts to moderate the trend; and to suggest areas of focus for interventions. Surveys were administered to parents of second graders, and anthropometric measurements were collected of second graders (n = 169 matched surveys and measurements). Surveys assessed parental concern for overweight, parental control over child feeding, attitudes towards potential causes of overweight, and support for potential mediating efforts. Parents of children considered at risk for overweight (age and gender specific body mass index (BMI) equal to or above the 85th percentile) and parents of children not at risk for overweight expressed similar levels of concern about health/developmental issues, control over child feeding, and attitudes towards contributors to overweight and moderators of overweight. Parents of children at risk for overweight were more likely to attribute overweight to dietary factors, whereas parents of children not at risk for overweight were more likely to attribute overweight to sedentary activity. Logistic regression models to investigate effects of demographic characteristics, family structure, parental control over child feeding, and parental belief in the primary cause of overweight indicated that income is a strong predictor of children's weight status; effects of other variables in the model are mediated through income. Parental control over children's food intake was not a predictor of weight status. Focus groups (n = 4) with teachers (n = 11) and parents (n = 16) indicated that time, convenience, cost, and food preferences are barriers to nutritious eating and affect foods parents offer to children. Differences between income groups were observed, with low-income parents being more concerned with reducing waste and being more responsive to the food preferences of their children in an effort to reduce waste of food. Middle/high income parents offered a variety of foods to their children and encouraged them to try new foods. Focus group participants were supportive of a school nutrition policy with some reservations. Efforts to increase awareness about causes of overweight and to act upon parent-supported mediators of overweight in the environment and school setting may improve the diet and physical activity habits of families and children.