PARENTAL PERCEPTIONS OF WEIGHT-RELATED INFORMATION: HOW PROVIDER-PARENT COMMUNICATION INFLUENCES DECISION MAKING AND CHILD HEALTH OUTCOMES

Purpose: Although parents see pediatric healthcare providers as trusted sources of information about child weight-related topics, the extent to which this information influences parental decision making, and the resulting impact on weight-related outcomes, is unknown.

Method: Parents of preschoolers (N=291) completed two surveys, one year apart. Measures assessed parent perceptions of the number of weight-related behavioral recommendations provided during well-child visits, whether the provider discussed the risks and consequences of being overweight, satisfaction with the quantity and quality of information, the influence the information had on their decision making, and the frequency of children’s weight-related behaviors (food consumption, physical activity, and TV viewing). Children were weighed and measured each year to calculate BMI percentile. Hierarchical multivariate regression was used to examine how perceptions about information provision and usefulness at Time 1 predicted changes in child BMI and weight-related behaviors one year later. Regressions controlled for demographic characteristics and parent BMI.

Result: At Time 1 and Time 2 the median number of weight-related recommendations received was 3, out of the 13 suggested by the American Academy of Pediatrics. More than 25% of parents did not receive any weight-related recommendations at Time 1 (improving by 2.5% one year later), and only 2.2% of parents reported receiving all 13. The number of weight-related recommendations, however, did not significantly predict any weight-related outcomes once other informational variables were included. Stronger parental beliefs that the weight-related advice received from their providers influenced the decisions they made for their child/household predicted significant decreases in child TV viewing time (β=-.15, p<0.05) and BMI percentile (β=-.16, p<0.01). Discussion about the risks and consequences of being overweight had mixed results, predicting anticipated decreases in unhealthy food consumption (β=-.12, p<0.05), but increases in TV viewing (β=.14, p<0.05) and BMI percentile (β=.14, p<0.01). Satisfaction with information quality predicted increases in child physical activity (β=.25, p<0.05), while satisfaction with information quantity predicted significant decreases (β=-.22, p<0.05).

Conclusion: Results indicate that the mere provision of weight-related information may not affect health outcomes. Risk communication (particularly in the form of scare tactics) should be used with caution. Effective communication strategies for addressing child weight-related topics should be tailored to families’ informational needs, preferences, existing behaviors, and backgrounds—paying particular attention to message quality and usefulness for parental decision making.