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A mixed methods analysis of maternal response to children's consumption of a palatable food: differences by child weight status.
Pesch, MH, Viechnicki, GB, Appugliese, DP, Kaciroti, N, Rosenblum, KL, Miller, AL, Lumeng, JC
Pediatric obesity. 2019;(3):e12474
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Abstract
BACKGROUND Little is known about how mothers respond to their child eating palatable foods. OBJECTIVES The objectives of the study are to examine maternal behaviours when children are presented with a large portion of energy-dense palatable food in an experimental setting and to examine differences by child weight status. METHODS Mother-child dyads (N = 37) (mean child age 70.8 months) participated in a videotaped eating protocol with cupcakes. Anthropometrics were measured. Videos were analysed using discourse analysis and were reliably coded for the presence or absence of the most salient theme. Analysis of variance examined theme presence by child and mother weight status. RESULTS Mothers disavowed responsibility for their child's eating. Mothers were observed to roll their eyes at the child, throw their hands up in exasperation and distance themselves both physically and emotionally when the child ate the cupcakes voraciously or with high enjoyment. Mothers of children with obesity (vs recommended weight) engaged in more counts of disavowal (p = 0.01). CONCLUSIONS Mothers of children with obesity distanced themselves from their child, seeming to disavow responsibility for the child's eating of 'junk food'. Mothers may respond to their child's seemingly gluttonous eating by disavowing responsibility due to the stigma of being a parent of a child with obesity.
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The Fit Study: Design and rationale for a cluster randomized trial of school-based BMI screening and reporting.
Madsen, KA, Linchey, J, Ritchie, L, Thompson, HR
Contemporary clinical trials. 2017;:40-46
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Abstract
BACKGROUND In the U.S., 25 states conduct body mass index (BMI) screening in schools, just under half of which report results to parents. While some experts recommend the practice, evidence demonstrating its efficacy to reduce obesity is lacking, and concerns about weight-related stigma have been raised. METHODS/DESIGN The Fit Study is a 3-arm cluster-randomized trial assessing the effectiveness of school-based BMI screening and reporting in reducing pediatric obesity and identifying unintended consequences. Seventy-nine elementary and middle schools across California were randomized to 1 of 3 Arms: 1) BMI screening and reporting; 2) BMI screening only; or 3) no BMI screening or reporting. In Arm 1 schools, students were further randomized to receive reports with BMI results alone or both BMI and fitness test results. Over 3 consecutive years, staff in schools in Arms 1 and 2 will measure students' BMI (grades 3-8) and additional aspects of fitness (grades 5-8), and students in grades 4-8 in all Arms will complete surveys to assess weight-based stigmatization. Change in BMI z-score will be compared between Arm 1 and Arm 2 to determine the impact of BMI reporting on weight status, with sub-analyses stratified by report type (BMI results alone versus BMI plus fitness results) and by race/ethnicity. The potential for BMI reports to lead to weight-based stigma will be assessed by comparing student survey results among the 3 study Arms. DISCUSSION This study will provide evidence on both the benefit and potential unintended harms of school-based BMI screening and reporting.