Child Overweight and Parenting Concern in First Grade: Links to Parental Feeding Behaviors and Parenting Style Hubbs-Tait, L., Topham, G. L., Harrist, A. W., Kennedy, T. S., Ledoux, T., Longoria, A., & Page, M. C. ABSTRACT METHOD RATIONALE P ROCEDURE M EASURES RESULTS HR FUNDING Child height and weight to compute body mass index (BMI) were measured in Fall 2005 or 2006 during baseline data collection for a randomized child overweight intervention. Parents completed questionnaires in Spring 2006 or 2007 and returned them to school or through the mail. 467 parents provided informed consent for children and agreed to complete questionnaires themselves. 457 children completed anthropometric measurement.241,216 Exclusion criterion of BMI < 5 th percentile excluded 13 children (11 boys, 2 girls). Final sample = 444 parents (93.5% mothers) and children: Age: M = 6.95 (.39) Gender: 230 boys, 214 girls This sample comprises cohorts 1 and 2 (wave 1) of the Families and Schools for Health project. Cohort 1-wave1 data on parenting styles and feeding practices appeared in Journal of the American Dietetic Association, July Feeding Practices Subscales and sample items from Child Feeding Questionnaire (CFQ, Birch, Fisher et al., 2001) : Responsibility: How often are you responsible for deciding what your child’s portion sizes are? Restriction: I offer my child her/his favorite foods in exchange for good behavior Pressure to eat: My child should always eat all of the food on her/his plate. Perception of child weight: Your child now is (1) noticeably underweight, (2) underweight, (3) normal, (4) overweight, (5) noticeably overweight. Overweight concern: How concerned are you about your child becoming overweight? Responses from 1- unconcerned to 4 – very concerned. Subscales and sample items from Parent Food Socialization Questionnaire (PFSQ, Cullen, Baranowski et al., 2000): Encourage: How much do you encourage your child to eat vegetables at supper? Model: I eat vegetables at lunch when I am with my child… Parenting Styles Authoritarian, authoritative, and permissive parenting were assessed by the Parenting Styles and Dimensions Questionnaire (PSDQ; Robinson et al., 2001). Internal consistencies of all measures were published in Hubbs-Tait et al. (2008) and ranged from.69 to.91. Child Height and Weight Heights and weights were used to calculate individual BMI, BMI percentile rankings and BMI z-scores using the Epi-Info Software program (release 4.3.0, 2006, CDC Atlanta GA). Recent reports vary in the degree of overlap among the following : parental feeding practices and attitudes, parenting styles, parental perception of child weight, parental concern about child overweight, and actual child weight. In nutrition science research, parental perceptions of child weight have been found to underestimate actual child weight. In contrast, parental concern about child weight and children’s actual weight are highly congruent. In developmental science research, parenting styles have been linked to child obesity or overweight in some studies but not others. In the current report we test differences in parental feeding practices, attitudes, and styles among groups of parents differing in congruence between perceptions of their child’s weight and actual child weight. We also evaluate whether parents of obese children with more realistic perceptions differ in parenting practices, attitudes, or styles. Finally, we evaluate overlap between parental concern about overweight and parenting styles and feeding practices. Divergence in parental perceptions and child weight reality may help explain the lack of success of obesity interventions. DATA ANALYSES D IFFERENCES B ETWEEN P ARENT P ERCEPTION OF C HILDREN ’ S W EIGHT AND C HILD A CTUAL W EIGHT Children’s BMI percentiles were as follows: > 5 th percentile and < 75 th percentile = 255 > 75 th percentile and < 85 th percentile = 63 > 85 th percentile and < 95 th percentile = 66 > 95 th percentile = 60 Parents underestimated actual weight status of children. Numbers of parents perceiving their children as having normal weight are indicated on the pie charts in textboxes and ranged from 23/60 for parents of obese children to 224/ 255 for parents of normal weight children. Analysis of variance comparing the parenting behaviors and styles of the four weight groups of parents who rated their children as normal revealed: No differences in parenting style across the four groups. Significant difference across groups in pressure to eat, with 23 parents of obese children having lowest mean for pressure to eat and differing from the other means of the other three groups, t (1, 366) = 2.75, p =.006 (see Table 1). Significant different across groups in parental concern about child overweight, with 23 parents of obese children showing greatest concern. The linear trend in concern for lowest to highest BMI groups was significant, F (1, 368) = 25.56, p = (see Table 1). Interpretation: Although parental perceptions are not congruent with child weight, differences in pressuring of children to eat and in concern about child overweight suggest that parents’ feeding behavior and emotions are more in line with actual child weight than are their perceptions. n = 63 n = parents saw obese children as underweight (n = 1) or normal weight (n = 23). 36 saw obese children as overweight or noticeably overweight. We compared the 24 underestimators with the 36 more accurate parents in terms of parenting styles and feeding practices (see Table 2). This project is supported by OCAST Grant HR to Amanda W. Harrist, Melanie Page, Glade Topham, Lenka Humenikova Shriver, and Laura Hubbs-Tait, College of Human Environmental Sciences, Oklahoma State University and USDA-CSREES Grant to Amanda W. Harrist, Tay S. Kennedy, Glade Topham, Laura Hubbs-Tait, and Melanie Page. For further information about the FiSH Project, contact For further information about this poster, contact OBESE OVERWEIGHT S AMPLE P ERCEPTION D IFFERENCES A MONG P ARENTS OF O BESE C HILDREN Data analyses included: Chi square analyses – to construct pie charts One-way analysis of variance – to evaluate differences in parenting styles and feeding practices Logistic regression – to evaluate which feeding practices increased odds of obesity and overweight Consistent with Krebs et al. (2007) > 85 th %tile and < 95 th = overweight > 95 th percentile = obese Classifications used here: > 5 th %tile and < 75 th = normal > 75 th %tile and < 85 th = borderline overweight Table 1. Item means and standard deviations for weight groups * p <.05, *** p <.001 Logistic regressions compared 60 parents of obese children with the other 384 parents. For each increase of 1 in parental Restriction, child odds of obesity increased by Restriction Exp(b) = 2.72 (95% CI of 1.65, 4.49), p = Logistic regressions were conducted comparing the 66 parents of overweight children with parents of all children with BMI < 85 th percentile. For each increase of 1 in parental Restriction, child odds of obesity increased by Restriction Exp(b) = 2.03 (95% CI of 1.28, 3.22), p =.003 When parents of obese children who view them as normal are compared to parents of children in other weight groups, the major differences are in overweight concern and pressure to eat. Although parents of obese children say that they see their children as normal in weight, these two variables suggest otherwise and offer potential channels for behavior change. When parents of obese children who view them as normal are compared to parents of obese children who view them as overweight, the underestimating parents also report themselves as feeling more responsible for feeding their child and for their child’s eating behaviors. They also report greater modeling of eating fruits and vegetables and lower concern about their child’s overweight. This pattern suggests that these parents may be more defensive or resistant about interventions to change family eating behaviors and may help explain lack of success in obesity and overweight interventions. When parents of obese children who view them as normal are compared to parents of children in other weight groups, the major differences are in overweight concern and pressure to eat. Although parents of obese children say that they see their children as normal in weight, these two variables suggest otherwise and offer potential channels for behavior change. When parents of obese children who view them as normal are compared to parents of obese children who view them as overweight, the underestimating parents also report themselves as feeling more responsible for feeding their child and for their child’s eating behaviors. They also report greater modeling of eating fruits and vegetables and lower concern about their child’s overweight. This pattern suggests that these parents may be more defensive or resistant about interventions to change family eating behaviors and may help explain lack of success in obesity and overweight interventions. P ERCEPTION D IFFERENCES A MONG P ARENTS OF O BESE C HILDREN C ORRELATIONS Perception and Concern: r =.419 Perception and Pressure: r = Concern and Authoritarian: r =.109 Concern and Restriction: r =.256 Concern and Pressure: r = Perception and Concern: r =.419 Perception and Pressure: r = Concern and Authoritarian: r =.109 Concern and Restriction: r =.256 Concern and Pressure: r = Participants were 444 children and parents participating in wave 1 of the Families and Schools for Health (FiSH) project. Parents completed questionnaires and children’s heights and weights were measured during baseline data collection for a randomized child overweight intervention. The current report examines parental feeding practice and style differences for parents with greater and less convergence in perception of child weight status and child actual status. Compared to parents of obese children who saw them as overweight, parents of obese children who perceived them as normal weight felt more responsible for child eating, reported more modeling of eating fruits and vegetables, and reported less concern about child overweight. Results are interpreted as suggesting that parents who underestimate child weight may be more resistant to overweight interventions for their children. CONCLUSIONS Wave 1 Child Weight Status Groups