Parental Perceptions of Overweight Counseling in Primary Care: The Roles of Race/ethnicity and Parent Overweight

Authors

  • Elsie M. Taveras,

    Corresponding author
    1. Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA
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  • Steven L. Gortmaker,

    1. Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts, USA
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  • Kathleen F. Mitchell,

    1. Harvard Vanguard Medical Associates, Watertown, Massachusetts, USA
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  • Matthew W. Gillman

    1. Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA
    2. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
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(Elsie_Taveras@harvardpilgrim.org)

Abstract

Objective: To examine parental perceptions of primary care efforts aimed at childhood obesity prevention

Methods and Procedures: We interviewed 446 parents of children, aged 2–12 years, with an age- and sex-specific BMI ≥85th percentile; interviews occurred within 2 weeks of their child's primary care visit. We assessed parental ratings of the nutrition and physical activity advice received. Using children's clinical heights and weights and parents' self-reported heights and weights, we classified children into three categories: BMI 85th–94th percentile without an overweight parent, BMI 85th–94th percentile with an overweight parent (adult BMI ≥25 kg/m2), and BMI ≥95th percentile.

Results: In multivariate analyses, compared to parents of children with BMI ≥95th percentile, overweight parents with children whose BMI was 85th–94th percentile were more likely to report receiving too little advice on nutrition and physical activity (odds ratio (OR) 3.05; 95% confidence interval (CI) 1.49, 6.25) and to rate as poor or fair the quality of advice they received (OR 2.23; 95% CI 1.18, 4.24). Independently, African-American (OR 2.55; 95% CI 1.18, 5.51) and Hispanic/Latino (OR 2.78; 95% CI 1.27, 6.10) parents were more likely than white parents to rate as poor or fair the quality of advice they received.

Discussion: Parental overweight is associated with low subjective ratings of overweight counseling in pediatric primary care. Our findings of poorer perceived quality among racial/ethnic minority parents need further investigation.

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