Nakiya N Showell1, Jamie Perin2, Corinna Koebnick3, Jennifer Jimenez3, Ismael Gonzalez2, Lisa Ross DeCamp4, Rachel L J Thornton2. 1. Department of Pediatrics, Johns Hopkins University School of Medicine (NN Showell, J Perin, I Gonzalez, and RLJ Thornton), Baltimore, Md. Electronic address: nshowel1@jhmi.edu. 2. Department of Pediatrics, Johns Hopkins University School of Medicine (NN Showell, J Perin, I Gonzalez, and RLJ Thornton), Baltimore, Md. 3. Department of Research & Evaluation, Kaiser Permanente Research (C Koebnick and J Jimenez), Pasadena, Calif. 4. Department of Pediatrics, ACCORDS (Adult and Child Consortium for Health Outcomes Research and Delivery Science), University of Colorado School of Medicine and Children's Hospital Colorado (LR DeCamp), Aurora, Colo; Latino Research and Policy Center, Colorado School of Public Health, CU Denver Lawrence Street Center (LR DeCamp), Denver, Colo.
Abstract
OBJECTIVE: Examine racial/ethnic differences in parent activation and associations with child obesity risk behaviors in low-income families. METHODS: Cross-sectional survey study of 300 low-income Black, Latinx, and White parents of patients aged 2 to 5 years receiving primary care within 2 health care systems (Systems 1 & 2). In-person and phone surveys were conducted. Parent activation, defined as parents' knowledge, confidence, and willingness to act concerning their child's health, was measured using the standardized 13-item Parent Patient Activation Measure (P-PAM). Differences in parent activation by race/ethnicity were assessed using analysis of variance. Multivariate regression analyses were used to test associations between parent activation and child obesity risk behaviors. RESULTS: In pooled unadjusted analyses, Latinx parents had significantly lower activation compared to Black parents (P = .023), but these differences were no longer statistically significant after adjusting for other sociodemographic characteristics (P = .06). Higher activation was associated with slightly greater odds of consuming ≥ 5 daily servings of fruits and vegetables for System 2 only (odds ratio: 1.04, 95% confidence interval: 1.01, 1.07). Associations between parental activation and child screen time or physical activity were not significant. CONCLUSIONS: Findings highlight potential measurement limitations of the P-PAM including the inability of the measure to capture barriers to health system navigation and cultural and linguistic considerations. Further attention to the nuanced interplay between parental activation and contextual and sociodemographic risk factors (eg, food availability, immigrant status, economic opportunity, language proficiency) should be considered in the development of early childhood obesity interventions in primary care settings.
OBJECTIVE: Examine racial/ethnic differences in parent activation and associations with child obesity risk behaviors in low-income families. METHODS: Cross-sectional survey study of 300 low-income Black, Latinx, and White parents of patients aged 2 to 5 years receiving primary care within 2 health care systems (Systems 1 & 2). In-person and phone surveys were conducted. Parent activation, defined as parents' knowledge, confidence, and willingness to act concerning their child's health, was measured using the standardized 13-item Parent Patient Activation Measure (P-PAM). Differences in parent activation by race/ethnicity were assessed using analysis of variance. Multivariate regression analyses were used to test associations between parent activation and child obesity risk behaviors. RESULTS: In pooled unadjusted analyses, Latinx parents had significantly lower activation compared to Black parents (P = .023), but these differences were no longer statistically significant after adjusting for other sociodemographic characteristics (P = .06). Higher activation was associated with slightly greater odds of consuming ≥ 5 daily servings of fruits and vegetables for System 2 only (odds ratio: 1.04, 95% confidence interval: 1.01, 1.07). Associations between parental activation and child screen time or physical activity were not significant. CONCLUSIONS: Findings highlight potential measurement limitations of the P-PAM including the inability of the measure to capture barriers to health system navigation and cultural and linguistic considerations. Further attention to the nuanced interplay between parental activation and contextual and sociodemographic risk factors (eg, food availability, immigrant status, economic opportunity, language proficiency) should be considered in the development of early childhood obesity interventions in primary care settings.
Authors: Elsie M Taveras; Steven L Gortmaker; Katherine H Hohman; Christine M Horan; Ken P Kleinman; Kathleen Mitchell; Sarah Price; Lisa A Prosser; Sheryl L Rifas-Shiman; Matthew W Gillman Journal: Arch Pediatr Adolesc Med Date: 2011-04-04
Authors: Elsie M Taveras; Matthew W Gillman; Ken Kleinman; Janet W Rich-Edwards; Sheryl L Rifas-Shiman Journal: Pediatrics Date: 2010-03-01 Impact factor: 7.124
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