AuthorKenny Morales Rodriguez
Kenny Morales Rodriguez, MSIV; Alma Guerrero, MD
Is Caregiver Concordance on Feeding Practices, Among Latino Mothers, Fathers, and Grandmothers Associated with Child BMI Percentile? A Longitudinal Study
Background: A limitation of many early childhood obesity interventions is their exclusive focus on mothers or a single caregiver. This limitation overlooks the important role other family members have in influencing and shaping many obesogenic behaviors in young children. Family members, can also indirectly influence child weight-related behaviors by undermining maternal dietary practices in the home, and through role modeling of healthy dietary and physical activity habits. Identifying whether concordance/discordance between caregivers on dietary and feeding practices is related to early childhood obesity risk can help inform more effective strategies for early childhood obesity interventions.
Objective: To assess the degree of similarity or differences in attitudes related to child weight-related behaviors (i.e. family meals, feeding practices) among caregivers and whether it is associated with child dietary practices and weight status.
Methods: A four-week program was developed in English and Spanish for mothers, fathers, and grandmothers of preschool children. The “hybrid” program combined weekly one-hour in-person sessions with multi-media messages sent by mobile phone that included video clips, interactive prompts, strategies, and tips to support evidence-based and age-appropriate behavior changes. A convenience sample of Latino families with children age two- to five-years old were recruited from WIC and Early Education Centers in East Los Angeles. Child and caregiver height and weight were measured, and caregiver surveys of child dietary intake were collected at baseline, 1- and 6-month post-baseline. Changes in child’s dietary and BMI, as well as caregiver BMI, were examined using a mixed effects linear regression model.
Parental concordance/discordance was evaluated by using a discordance scale of 21 questions. Parenting dietary practices was defined as a three-level categorical variable: both parents endorsed the behavior/characteristic (ie, concordance), neither parent endorsed the behavior/characteristic (ie, concordance), or they disagreed (ie, discordance). Multivariable regression will be used to examine the association between caregiver concordance on feeding practices and child BMI percentile. An unadjusted model will be completed, as well as models adjusting for child’s sex, age, and parent BMI.
Results: The study sample included 49 unique low-income Latino families (49 mothers, 40 fathers, 18 grandmothers, and 54 children). All caregivers enrolled in the study lived in East Los Angeles, and over 90% were of Mexican descent. Approximately 90% of the participants reported residing in low-income households. The average age of children in the study was 45 months, and approximately half were overweight or obese. Post intervention data showed healthier dietary practices and a reduction in child’s BMI and BMI percentile at 6-months post-baseline compared to baseline measurements. High discordance variable in mother showed a positive association with child’s BMI percentile. Though there was a level of discordance among fathers and grandmothers, there was no association with child’s BMI percentile.
Conclusion: The results of the study show that a greater perception of disagreement about feeding practices by the mother is associated with higher BMI percentile in the child. This supports existings literature demostrating that parent's concordance on familial and parental factors is protective against childhood obesity.