Agreement between parental perception of child weight status and actual weight status is similar across different ethnic groups in New Zealand
Kim Meredith-Jones 1 , Sheila Williams 2 , Rachael Taylor 1
+ Author Affiliations
- Author Affiliations
1 Department of Medicine, University of Otago, Dunedin, New Zealand
2 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
3 Correspondence to: Kim Meredith-Jones Department of Medicine, University of Otago, PO Box 56 Dunedin, New Zealand kim.meredith-jones@otago.ac.nz
Journal of Primary Health Care 8(4) 316-324 https://doi.org/10.1071/HC16002
Published: 5 September 2016
Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Accurate parental perception of their child's weight is poor. Accuracy may be influenced by differences in ethnicity but this is currently unknown.
AIM: To determine whether agreement between parental perception of child weight status and actual child weight status differs according to ethnic group (NZ European, Māori, Pacific, Asian), and to investigate whether it is influenced by various demographic and behavioural factors.
METHODS: A total of 1093 children (4–8 years old) attended a weight screening initiative. Parents completed questionnaires on demographics, beliefs about child weight, parenting style, parental feeding practices and social desirability. Actual measured weight status was compared with parental perception of weight status (underweight, normal weight, overweight).
RESULTS: Agreement about child weight status was apparent in 85% of NZ European, 84% of Māori, 82% of Pacific and 88% of Asian children. However, adjusting for chance led to kappas of 0.34, 0.38, 0.41 and 0.53, respectively, indicating only fair-to-moderate agreement. Overall, agreement between measured body mass index and parental perception was not related to ethnic group, child sex and age, maternal age and education, and household deprivation (k ranged from 0.16 to 0.47). However, agreement about weight status was higher in parents who reported higher levels of restrictive feeding than in parents who reported less restriction (P < 0.01) but agreement was only fair.
CONCLUSION: Agreement between parental perception and actual weight status was fair and did not differ between the ethnic groups examined.
KEYWORDS: Ethnicity; parental perception; child; overweight; BMI
References
[1] Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384 766–81.| Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013.Crossref | GoogleScholarGoogle Scholar | 24880830PubMed |
[2] Ministry of Health. Annual update of key results 2013/2014. New Zealand Health Survey. Wellington: Ministry of Health; 2014.
[3] Miller JC, Grant AM, Drummond BF, et al. DXA measurements confirm that parental perceptions of elevated adiposity in young children are poor. Obesity 2007; 15 165–71.
| DXA measurements confirm that parental perceptions of elevated adiposity in young children are poor.Crossref | GoogleScholarGoogle Scholar | 17228044PubMed |
[4] Lundahl A, Kidwell KM, Nelson TD. Parental underestimates of child weight: a meta-analysis. Pediatrics 2014; 133 e689–703.
| Parental underestimates of child weight: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 24488736PubMed |
[5] Carnell S, Edwards C, Croker H, et al. Parental perceptions of overweight in 3–5 y olds. Int J Obes. 2005; 29 353–5.
| Parental perceptions of overweight in 3–5 y olds.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2M7jsFKgtg%3D%3D&md5=ae33a5edc563d4bbae457a1c9872eedfCAS |
[6] Huang JS, Becerra K, Oda T, et al. Parental ability to discriminate the weight status of children: results of a survey. Pediatrics 2007; 120 e112–9.
| Parental ability to discriminate the weight status of children: results of a survey.Crossref | GoogleScholarGoogle Scholar | 17606538PubMed |
[7] Hudson E, McGloin A, McConnon A. Parental weight (mis)perceptions: factors influencing parents’ ability to correctly categorise their child’s weight status. Matern Child Health J. 2012; 16 1801–9.
| Parental weight (mis)perceptions: factors influencing parents’ ability to correctly categorise their child’s weight status.Crossref | GoogleScholarGoogle Scholar | 22139047PubMed |
[8] Moore LC, Harris CV, Bradlyn AS. Exploring the relationship between parental concern and the management of childhood obesity. Matern Child Health J. 2012; 16 902–8.
| Exploring the relationship between parental concern and the management of childhood obesity.Crossref | GoogleScholarGoogle Scholar | 21594667PubMed |
[9] Park MH, Falconer CL, Saxena S, et al. Perceptions of health risk among parents of overweight children: a cross-sectional study within a cohort. Prev Med. 2013; 57 55–9.
| Perceptions of health risk among parents of overweight children: a cross-sectional study within a cohort.Crossref | GoogleScholarGoogle Scholar | 23591440PubMed |
[10] Petricevic N, Puharic Z, Posavec M, et al. Family history and parental recognition of overweight in Croatian children. Eur J Pediatr. 2012; 171 1209–14.
| Family history and parental recognition of overweight in Croatian children.Crossref | GoogleScholarGoogle Scholar | 22415408PubMed |
[11] Adams AK, Quinn RA, Prince RJ. Low recognition of childhood overweight and disease risk among Native-American caregivers. Obes Res. 2005; 13 146–52.
| Low recognition of childhood overweight and disease risk among Native-American caregivers.Crossref | GoogleScholarGoogle Scholar | 15761174PubMed |
[12] Myers S, Vargas Z. Parental perceptions of the preschool obese child. Pediatr Nurs. 2000; 26 23–30.
| 1:STN:280:DC%2BD383otFCisw%3D%3D&md5=cba689f29dc2cf37181539298d743b93CAS | 12026313PubMed |
[13] Young-Hyman D, Herman LJ, Scott DL, Schlundt DG. Care giver perception of children’s obesity-related health risk: a study of African American families. Obes Res. 2000; 8 241–8.
| Care giver perception of children’s obesity-related health risk: a study of African American families.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvjtlyntg%3D%3D&md5=38bc0806fdedd22cb79a32ad541429ebCAS | 10832767PubMed |
[14] Taylor RW, Brown D, Dawson AM, et al. Motivational interviewing for screening and feedback and encouraging lifestyle changes to reduce relative weight in 4–8 year old children: design of the MInT study. BMC Public Health. 2010; 10 271–82.
| Motivational interviewing for screening and feedback and encouraging lifestyle changes to reduce relative weight in 4–8 year old children: design of the MInT study.Crossref | GoogleScholarGoogle Scholar | 20497522PubMed |
[15] Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC Growth Charts: United States. Adv Data. 2000; 8 190–27.
[16] McCarthy HD, Cole TJ, Fry T, et al. Body fat reference curves for children. Int J Obes. 2006; 30 598–602.
| Body fat reference curves for children.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD287nsFymug%3D%3D&md5=4bade0640e18ea7c7b2c8b9cf5eccee7CAS |
[17] White P, Gunston J, Salmon C, et al. Atlas of socioeconomic deprivation in New Zealand NZDep2006. Wellington, New Zealand: Ministry of Health; 2008.
[18] Arnold DS, O’Leary SG, Wolff LS, Acker MM. The Parenting Scale: a measure of dysfunctional parenting in discipline situations. Psychol Assess. 1993; 5 137–44.
| The Parenting Scale: a measure of dysfunctional parenting in discipline situations.Crossref | GoogleScholarGoogle Scholar |
[19] Haszard JJ, Williams SM, Dawson AM, et al. Factor analysis of the comprehensive feeding practices questionnaire in a large sample of children. Appetite 2013; 62 110–8.
| Factor analysis of the comprehensive feeding practices questionnaire in a large sample of children.Crossref | GoogleScholarGoogle Scholar | 23207187PubMed |
[20] Reynolds W. Development of reliable and valid short forms of the Marlowe-Crowne Social Desirability Scale. J Clin Psychol. 1982; 38 119–25.
| Development of reliable and valid short forms of the Marlowe-Crowne Social Desirability Scale.Crossref | GoogleScholarGoogle Scholar |
[21] Dawson AM, Brown DA, Cox A, et al. Using motivational interviewing for weight feedback to parents of young children. J Paediatr Child Health. 2014; 50 461–70.
| Using motivational interviewing for weight feedback to parents of young children.Crossref | GoogleScholarGoogle Scholar | 24617494PubMed |
[22] Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33 159–74.
| The measurement of observer agreement for categorical data.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE2s7jsFWqtA%3D%3D&md5=d04b91d0e72a7a4792cb73b7a1fd2cadCAS | 843571PubMed |
[23] Lipsitz S, Parzen M, Fitzmaurice G, Klar N. A two-stage logistic regression model for analyzing inter-rater agreement. Psychometrika 2003; 68 289–98.
| A two-stage logistic regression model for analyzing inter-rater agreement.Crossref | GoogleScholarGoogle Scholar |
[24] Taylor RW, Williams SM, Dawson AM, et al. What factors influence uptake into family-based obesity treatment after weight screening? J Pediatr. 2013; 163 1657–62.e1.
| What factors influence uptake into family-based obesity treatment after weight screening?Crossref | GoogleScholarGoogle Scholar | 24075623PubMed |
[25] Controller and Auditor-General. Evolving approach to combating child obesity. Wellington, New Zealand: Controller and Auditor-General; 2013.
[26] Contento IR, Basch C, Zybert P. Body image, weight, and food choices of Latina women and their young children. J Nutr Educ Behav. 2003; 35 236–48.
| Body image, weight, and food choices of Latina women and their young children.Crossref | GoogleScholarGoogle Scholar | 14521823PubMed |
[27] Towns N, D’Auria J. Parental perceptions of their child’s overweight: an integrative review of the literature. J Pediatr Nurs. 2009; 24 115–30.
| Parental perceptions of their child’s overweight: an integrative review of the literature.Crossref | GoogleScholarGoogle Scholar | 19268233PubMed |
[28] Reilly JJ, Methven E, McDowell ZC, et al. Health consequences of obesity. Arch Dis Child. 2003; 88 748–52.
| Health consequences of obesity.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3szpvFOjtw%3D%3D&md5=c9a768bf73f1b6334446a9882033707dCAS | 12937090PubMed |
[29] Jain A, Sherman SN, Chamberlin DAL, et al. Why don’t low-income mothers worry about their preschoolers being overweight? Pediatrics 2001; 107 1138–46.
| Why don’t low-income mothers worry about their preschoolers being overweight?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M3ptVCnsA%3D%3D&md5=8f15df4e30d01a998d2813863f356123CAS | 11331699PubMed |
[30] Eckstein KC, Mikhail LM, Ariza AJ, et al. Parents’ perceptions of their child’s weight and health. Pediatrics 2006; 117 681–90.
| 16510647PubMed |
[31] De La O A, Jordan KC, Ortiz K, et al. Do parents accurately perceive their child’s weight status? J Pediatr Health Care 2009; 23 216–21.
| Do parents accurately perceive their child’s weight status?Crossref | GoogleScholarGoogle Scholar | 19559989PubMed |
[32] Baughcum AE, Chamberlin LA, Deeks CM, et al. Maternal perceptions of overweight preschool children. Pediatrics 2000; 106 1380–6.
| Maternal perceptions of overweight preschool children.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M%2FltVOrsg%3D%3D&md5=685c5342d422affd9f251007031e6cdeCAS | 11099592PubMed |
[33] Chaparro MP, Langellier BA, Kim LP, Whaley SE. Predictors of accurate maternal perception of their preschool child’s weight status among Hispanic WIC participants. Obesity 2011; 19 2026–30.
| Predictors of accurate maternal perception of their preschool child’s weight status among Hispanic WIC participants.Crossref | GoogleScholarGoogle Scholar | 21546937PubMed |
[34] Gray WN, Janicke DM, Wistedt KM, Dumont-Driscoll MC. Factors associated with parental use of restrictive feeding practices to control their children’s food intake. Appetite 2010; 55 332–7.
| Factors associated with parental use of restrictive feeding practices to control their children’s food intake.Crossref | GoogleScholarGoogle Scholar | 20633586PubMed |
[35] Yilmaz R, Erkorkmaz U, Ozcetin M, Karaaslan E. How does parents’ visual perception of their child’s weight status affect their feeding style? Nutr Hosp 2013; 28 741–6.
| 23848098PubMed |
[36] Keller KL, Olsen A, Kuilema L, et al. Predictors of parental perceptions and concerns about child weight. Appetite 2013; 62 96–102.
| Predictors of parental perceptions and concerns about child weight.Crossref | GoogleScholarGoogle Scholar | 23207190PubMed |
[37] Faith MS, Berkowitz RI, Stallings VA, et al. Parental feeding attitudes and styles and child body mass index: prospective analysis of a gene-environment interaction. Pediatrics 2004; 114 e429–36.
| Parental feeding attitudes and styles and child body mass index: prospective analysis of a gene-environment interaction.Crossref | GoogleScholarGoogle Scholar | 15466068PubMed |
[38] Birch LL, Fisher JO, Davison KK. Learning to overeat: maternal use of restrictive feeding practices promotes girls’ eating in the absence of hunger. Am J Clin Nutr. 2003; 78 215–20.
| 1:CAS:528:DC%2BD3sXlvF2isrY%3D&md5=4bebe2bd03eafbcc54e13c593f62fa88CAS | 12885700PubMed |
[39] Campbell K, Andrianopoulos N, Hesketh K, et al. Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study. Appetite 2010; 55 84–8.
| Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study.Crossref | GoogleScholarGoogle Scholar | 20420869PubMed |
[40] Farrow CV, Blissett J. Controlling feeding practices: cause or consequence of early child weight? Pediatrics 2008; 121 e164–9.
| 18166535PubMed |
[41] Swinburn BA, Ley SJ, Carmichael HE, Plank LD. Body size and composition in Polynesians. Int J Obes Relat Metab Disord. 1999; 23 1178–83.
| Body size and composition in Polynesians.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2Fkslaluw%3D%3D&md5=bdde84fcd9d0fdec950157bcc31de77aCAS | 10578208PubMed |
[42] Taylor RW, Brooking L, Williams SM, et al. Body mass index and waist circumference cutoffs to define obesity in indigenous New Zealanders. Am J Clin Nutr 2010; 92 390–7.
| Body mass index and waist circumference cutoffs to define obesity in indigenous New Zealanders.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXhtFWmsrbP&md5=f7f5b6d3998bd02fe163d111ca77da2eCAS | 20504973PubMed |
[43] Statistics New Zealand. New Zealand in profile: 2015. Wellington, New Zealand; Statistics New Zealand; 2015.
