ARTICLE 1
In “Parental predictors of fruit and vegetable consumption in treatment-seeking overweight children” M L Vanhala, J Laitinen, K Kaikkonen, S Keinanen-Kiukaanniemi, and R Korpelainen explored the role of family dietary behaviors in the design intervention of the effective treatment of childhood obesity. The study involved fifty-four treatment seeking overweight and 65 normal-weight 8-year old kids and their parents. The study accessed the children’s and parents consumption of FBV using a food frequency questionnaire. The study used voluntary recruitment mechanism where willing participants were recruited by school nurses to participate in family-based treatment for overweight kids. The cities target includes Oulu, Rovaniemi, Kemi and Ylivieska all in Northern Finland between 2006 and 2007.
The study utilized the antropometrical measurements of height and weight in order to calculate the BMI of each child. Prior to the measurement the parents through the questionnaire provided education levels, marital and health status. These factors especially education forms the basis of this probe and aided in the derivation of a conclusion on the relationship between education and child obesity.
The study revealed that 50% of overweight children and their mothers ate less FBV less frequently as compared to normal weight children. The study is therefore relevant to our PICO question in that it highlighted the fact that education programs among parents on the role of nutrition and exercise in combating child obesity is paramount to the development of normal weight kids.
A2
Cathrine Shea, John J. M. Dwyer from the department of Family Relations and Applied Nutrition at the University of Guelph, ON, Elizabeth Shaver from Hamilton Public Health Services, and Richard Goy from the department of Family Relation and Applied Nutrition, at the University of Guelph, all carried out a research on the effect of parental feeding behaviors and participation of Children in Organized sports activities and their effect on BMI.
The study majored on pre-school children from 113 parents chosen from four child centers in Ontario in 2003. The study used BMI of the children and relevant questions as per the National Longitudinal Survey of Children and Youth to access physical and sedentary activities. The child feeding questionnaire was used and four factors were derived from parent’s belief in respect to feeding responsibilities. This include perceived feeding responsibility, perceived parent overweight, perceived child overweight and concerns about child overweight. The study concludes that parental perceptions and concerns in relation to child feeding and participation in sports and physical activities are directly dependent on the BMI of Canadian pre-school kids. The study is valid for our PICO question in that it derives the associated dependent variables of child obesity. According to this study, obesity prevention is dependent on application of education based initiatives targeted at parents of young kids to increase knowledge on benefits of nutrition and exercise.
A3
Magdalena Safron, Aleksandra Cislak, Tania Gaspar, and Aleksandra Luszczynska carried out a research on the effect of school-based interventions targeting obesity-related behaviors and body weight change. The study used a systematic search of reviews published between 1990 and 2009 by two reviewers, Health Source and PsycINFO. The study collected 2381 papers with three groups of keywords; age of participant, systematic review design and weight-related behaviors. The study investigates the use of school-based interventions and behavioral and family components. The use of family components did not necessarily involved parents enrolled in education classes and as such did not directly apply to the PICO question. School-based programs indicated in this research involved physical activity and school environmental changes. Therefore the conclusions derived in the study do not have a relation with the PICO question we are investigating.
A4
Lucas C, Carole V. Harris and Andrew S. Bradlyn investigated the relationship between Parental concern and management of childhood obesity. The study used a stratified sample of 1500 parents of children from Kindergarden to 7th grade in West Virginia. The study used interviews from parents chosen in respect to the specific interventions and assessments contained in the West Virginia’s childhood obesity legislation. The study used demographic variables such as child BMI, parent BMI, socio-economic status and parent gender. A host of factors were calculated including factors influencing parents concern about child weight, parents’ actions regarding child physical activity, and parent’s action regarding family diet.
A5
According to Elizabeth McGarvey and et al in the study “Feasibility and Benefits of a Parent-focused Preschool child Obesity Intervention” probed the parental behaviors that prevent child obesity (26%) in children served with Special Supplementary Nutrition Program for WIC. The study used two WIC sites to participate in nonrandomized and controlled one year prospective study to investigate and access parents self-reported changes in behavior among preschool kids. The research was conducted in collaboration with WIC staff from Virginia Department of Health and Virginia University faculty members in development of a “Bright Future in Practice” supervision tool applicable in Northern Virginia. Participants provided a written informed consent to aid in the pretest and posttest study.
The study used a questionnaire as the sole interview tool to test changes in physical activity since there was no proven instrument to measure the activity in kids.
The intervention strategies in use included educational groups, staff reinforcement and community reinforcement. The study found that similar intervention strategies can influence both food-related and activity-related behavior and thus demonstrate the fact that parent’s behavior can promote healthy eating and increased physical activity in preschool children. The study is therefore relevant to the PICO question and is applicable parent scenarios.
A6
Mary .O Hearst, Nancy E Sherwood, Elizabeth Klein, and Keryn Pasch conducted a study to assess parental perceptions of their adolescent’s weight status and named it The ECHO STUDY. The experiment seeks to assess the correlates of parental classification of adolescent weight status using parent’s self report perception data. The ECHO study examined multilevel factors that resulted to obesity in adolescents.
The methodology used involved 375 parent adolescent dyads recruited from membership of Health Partners health plan in the Minneapolis metropolitan area. The target adolescents must be current HP members in 6 to 11 grade in the fall of 2007.
The study revealed that parents play a major role in the health of their children. It is reported that parents with college education were more likely to underestimate their adolescent’s weight status by 31%. Further, the report cited that non-college educated parents were more than 8 times to disqualify overweight adolescents. Parental perception is critical to the health of adolescents. The study is relevant because it underlines the relationship between parent education and the health status of their children.
A7
Kirsten Davison, Janine Jurkowski, Kaigang Li, Sibylle Kranz and Hal A Lawson carried out a study named “A child obesity intervention developed by families: result from a pilot study”. The study probes the effects of community-based participatory research in the development of family centered intervention methods for low-income families.
The study involved 423 children and their families between the age of 2 and 5 in Five Head Start centers in New York and 154 families for evaluation.
The study was conducted in 2009/2011 and involved the development of a pre-post cohort design that contained (1) letters reporting BMI, (2) communication campaign, and (3) nutrition counseling sessions and (4) parent-led programs to improve communication skills, child healthy lifestyle awareness, media literacy and conflict resolution.
The results indicated that children indicated improvements in rate of obesity after intervention period. Trends in physical activity, TV time, and dietary intake improved. In conclusion, the study revealed that parent’s participation in intervention programs increased self-efficacy and promoted healthy living in children. The study is relevant to answer critical factors in the PICO question.
A8
L. Chan, A. M Magarey, L.A. Daniels are the authors of “Maternal Feeding Practices and Feeding Behaviors of Australian Children Aged 12-36 Months”. In this study, the authors explore the parent’s perception of the eating behaviors and related feeding practices of their young children.
Randomly chosen mothers with children ages 1 and three years in South Australia and obtained from central state database were invited to complete a questionnaire. The study show that most parents are afraid about the amount of food given to their children with 15% indicating lack of vegetables in their kids food in the last 24 hours. 80% of the mothers did not promote healthy feeding habits thereby calling for a need to cultivate a culture of healthy feeding preferences and positive practices.
The method used in this study had approval from Flinders University Social and Behavioral Research Ethics Committee and Women’s and Children Hospital Research Ethics Committee. The research did cover the most crucial aspects of child feeding and greater percentages (60%) of the sampled mothers were confident of the feeding practices. However there was cause for alarm for the remaining portion in respect to dietary quality and exposure to fruits and vegetables. The high exposure of non nutritive energy dense foods and limited vegetables has an impact on obesity.
Thus, the research is significant in that it can be used to answer the PICO question in focus.
A9
Comparison of parent cardiovascular knowledge, attitudes, and behavior based on screening and perceived child risks is a research done by Lesly A Cottrell, Valerie Minor, Emily Murphy and Eloise Elliot. It involved questionnaire reports and universal screening procedures obtained for 244 children in 5th up to 9th grade. The Rural Health Education Partnership and the Coronary Artery Risk Detection in Appalachian Communities at West Virginia University under the Support Department of Health and Human Resources. The screening featured students in the county schools where their parents were requested to fill questionnaires using a data obtained from pedometer device used on the child for a period of 6 weeks. The procedures involved were approved by the IRB for The protection of Human Subjects at WVU.
The conclusion of this work noted that parent’s ignorance (60%) about children’s participation in health screenings and prevention programs and intervention is the reason to blame for increased cardiovascular risks in children. Such activities as overweight indicate a child’s unhealthy condition which if reported by the parent, can lead to prevention of cardiovascular diseases. The research in extension indicates that parents enrollment in educational classes can improve their detection skills of up normal kids thereby resulting in better diagnosis and prevention.
A10
Parental Perception on the Efficacy of a Physical Activity Program for Preschoolers is a research by Laura Bellows et al. The group used Four Colorado Head Start centers under the banner Mighty Moves: Fun ways to keep families active and healthy. Research was approved by IRB Colorado State University. Telephone interviews were used to request for consent to participate. 51 completed surveys (52% response rate) were completed and returned. The Mighty Moves program is a social networking framework that has an educational program tailor made to the needs of the audience. The program is successful in increasing physical activity within the home environment for the parent and the children in order to prevent obesity from a tender age.
A11
The Q-Methodology research performed by Noori Akhtar Danesh among other from four universities in Canada studied parent’s perception on the causes of obesity among children. Data was sourced from clinic records of well baby checkups. 33 parents were used in the study classified according to two groups; confident in delivering health nutrition and family physical activity focused.
The research concludes that parent differ in the causes of obesity with 605 citing nutrition and 30% citing physical activity. The former did not identify obesity as a barrier to physical activity.
A12
Eric Hodges “A primer on early childhood Obesity and Parental Influence” discussed the impacts the parents impart on their children’s eating behaviors and physical activity. The paper provides a synopsis of parental influence on etiology of early childhood obesity with focus on factors such as BMI, and SFT. The study highlights that 77% of children with BMI greater that 95th percentile remain obese as adults. It is not relevant to the PICO question in that it does not probe the effect of parent education programs on child’s nutrition and physical activity.
A13
The letter to the Editor by Danielle Landry talks about the clinical role played by nurses in the detection of obesity. It also talks about the approaches used to extend the knowledge to parents to better their understanding of obesity and ways to prevent it. The article is relevant to the PICO question since training of parents in relation to obesity is essential.
A14
Nydjie Payas in his research explored the relationship between mothers BMI, family factors and concern for child’s weight. It uses a cross-sectional analysis of 47 mothers of school-aged children. Most African-American Women (52%) were severely affected by obesity leading to a conclusion that they more concerned about their children’s status. In conclusion, the results show that family community has an influence on the likelihood of child obesity. The study is, therefore relevant to the PICO question.
A15
Danielzik Sandra et al in his research “impact of parental BMI on the manifestation of overweight 5-7 year old children” investigate the impact of parental BMI on the effect of the overall manifestation of 5 to 7 year olds. The study used 3306 children and their parents in Germany. The nutritional state of child in respect with the parent was compared. The parents BMI showed a weak correlation with the child. 7.6/6.3 multivariate regression value for boys and girls was recorded for a child with two obese parents. The study does not sufficiently indicate the relationship between overweight parents and overweight children and requires familial disposition to determine risk groups. AS a result, it is not a valid paper for the PICO question.