Caregivers’ perceptions, challenges and service needs related to tackling childhood overweight and obesity: a qualitative study in three districts of Shanghai, China

Abstract Background Childhood overweight and obesity (OWO) has become a major public concern worldwide including in Shanghai, one of the most developed areas of China. Understanding perceptions and challenges of tackling childhood OWO among caregivers of children is critical to provide services in need. Methods A qualitative descriptive study including in-depth interviews with seven parents and six focus group discussions with a total of 32 parents or grandparents of children zero to 6 years of age. Participants lived in three districts of Shanghai and indexed children included both those with OWO or non-OWO children. Data were analyzed using qualitative thematic analysis. Results Caregivers tended to underestimate children’s weight status, and to regard chubby children as a sign of good parental care. Some caregivers even suggested that there were positive effects of childhood overweight. Caregivers identified a number of challenges to prevention of OWO in children, including difficulties in controlling dietary intake or increasing children’s physical activities; discordant views between parents and grandparents, and barriers to accessing professional guidance. Caregivers desired more detailed advice regarding children’s nutrition intake and physical activity, and preferred online approaches. Conclusions Misconceptions regarding childhood overweight were found in caregivers of children in Shanghai. Professional guidance on childhood weight control for caregivers is desired via digital applications such as mobile phone applications and social media.

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Attitudes to childhood overweight and obesity: The limits of cultural explanations

Health Education Journal ◽

10.1177/0017896911419351 ◽

2011 ◽

Vol 71 (6) ◽

pp. 670-677 ◽

Cited By ~ 1

Author(s):

Suparna Chakrabarti ◽

Stephen Abbott

Keyword(s):

Health Promotion ◽

Weight Status ◽

English Language ◽

Qualitative Interviews ◽

Childhood Overweight ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Cross Sectional ◽

Childhood Overweight And Obesity ◽

Majority Population

Objectives: To explore attitudes to and beliefs about childhood overweight and obesity among Bangladeshi mothers and to check maternal perceptions of their children’s weight status. Design: Mixed methods cross-sectional study. Setting: A general practice in East London, UK. Methods: Qualitative interviews with 14 mothers; weighing and measuring 22 children. Results: Mothers were generally aware of broad health promotion messages about diet and exercise, but many tended to under-estimate their children’s weight status. Differences in view did not reflect in any simple way English language skills, and the range of views reflected those in the majority population. Conclusion: Health promotion initiatives should assess individual needs; membership of a Bangladeshi community does not necessarily predict knowledge, beliefs or behaviour, and assumptions that this community is different from others are misleading.

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Determinants of childhood overweight and obesity in China

British Journal Of Nutrition ◽

10.1017/s0007114507280559 ◽

2007 ◽

Vol 97 (1) ◽

pp. 210-215 ◽

Cited By ~ 51

Author(s):

Y. Li ◽

F. Zhai ◽

X. Yang ◽

E. G. Schouten ◽

X. Hu ◽

...

Keyword(s):

Physical Activity ◽

Body Weight ◽

Weight Status ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Overweight Children ◽

Cooking Oil ◽

Low Intensity ◽

Childhood Overweight And Obesity ◽

Body Weight Status

In order to investigate the determinants of childhood overweight and obesity in China, the prevalence of overweight (including obesity) was compared according to different dietary and physical activity patterns and parental body weight status. A total of 6826 children aged 7–17 years from the 2002 China National Nutrition and Health Survey were included in the study. Information for dietary intake was collected using three consecutive 24-h recalls by trained interviewers. The amounts of cooking oil and condiments consumed were weighed. An interview-administered 1-year physical activity questionnaire was used to collect physical activity information. The results showed that the heavier the parental body weight, the higher the overweight prevalence in children. The prevalence ratio increased if parent(s) were overweight and/or obese, up to 12·2 if both parents were obese. Overweight children consumed significantly more dietary energy, protein and fat, but less carbohydrate than their normal weight counterparts. On average, overweight children spent 0·5 h less on moderate/vigorous activities and 2·3 h more on low intensity activities per week. The following prevalence ratios were statistically significant: walking to and from school (0·6); moderate/vigorous activities ≥ 45 min/d (0·8); low intensity physical activities >2 h/d (1·3); the consumption of ≥ 25 g/d cooking oil (1·4); ≥ 200 g/d meat and meat products consumption (1·5); ≥ 100 g/d dairy products (1·8). After adjustment for parental body weight status and socioeconomic status, only cooking oil consumption and walking to and from school remained significantly related to child overweight. In conclusion, parental weight status is an important determinant. Fat intake, low intensity activities and active transport to/from school may be suitable entry points for overweight prevention among Chinese school children.

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How is children’s weight status assessed for early identification of overweight and obesity? – Narrative review of programs for weight status assessment

Journal of Child Health Care ◽

10.1177/1367493518759238 ◽

2018 ◽

Vol 22 (3) ◽

pp. 486-500 ◽

Cited By ~ 7

Author(s):

Kamila Davidson ◽

Helen Vidgen ◽

Elizabeth Denney-Wilson ◽

Lynne Daniels

Keyword(s):

Early Identification ◽

Weight Status ◽

School Setting ◽

Childhood Overweight ◽

The United States ◽

Overweight And Obesity ◽

Stakeholder Collaboration ◽

Childhood Overweight And Obesity ◽

Routine Identification ◽

Status Assessment

Assessment of a child’s weight status is the first step in the management of childhood overweight and obesity. We reviewed routine assessment programs to inform early and routine identification of childhood overweight and obesity to address this global health issue. Twelve electronic databases were searched (Scopus, Web of Science, Wiley, ScienceDirect, PsycINFO, PsycARTICLES, PsycEXTRA, CINAHL, Primary Search, MEDLINE, ERIC, Academic Search Elite) for universal programs for weight status assessment of children aged 4–12 in Organization for Economic Co-operation and Development – countries, which included more than one assessment and parents receiving feedback. Of 1638 papers found via database searches, and 18 additional records identified through other sources, 26 were included. Reference to five countries’ programs for weight status assessment was found in the results: Australia, Sweden, the Netherlands, the United Kingdom and the United States. All of these programs were implemented in a school setting. Lack of services, stakeholder collaboration, parental awareness and engagement and government funding need to be improved for this health check to be undertaken as a part of an ongoing program. This review is about the implementation of similar programs. Early identification of risk for overweight and obesity allows families that require help to connect with available health services.

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Measured Parental Weight Status and Familial Socio-Economic Status Correlates with Childhood Overweight and Obesity at Age 9

PLoS ONE ◽

10.1371/journal.pone.0043503 ◽

2012 ◽

Vol 7 (8) ◽

pp. e43503 ◽

Cited By ~ 75

Author(s):

Eimear Keane ◽

Richard Layte ◽

Janas Harrington ◽

Patricia M. Kearney ◽

Ivan J. Perry

Keyword(s):

Weight Status ◽

Economic Status ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Socio Economic Status ◽

Childhood Overweight And Obesity

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Effectiveness of parent-centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: A Systematic Review.

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/01938924-201008161-00003 ◽

2010 ◽

Vol 8 (Supplement) ◽

pp. 1-12

Author(s):

James Bray ◽

Clare Collins ◽

Philip Morgan ◽

Tracy Burrows

Keyword(s):

Systematic Review ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Community Settings ◽

Childhood Overweight And Obesity ◽

Prevention And Treatment

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OP55 Childhood overweight and obesity at the start of primary school: external validation of pregnancy and early-life prediction models

10.1136/jech-2020-ssmabstracts.54 ◽

2020 ◽

Author(s):

N Ziauddeen ◽

PJ Roderick ◽

G Santorelli ◽

J Wright ◽

NA Alwan

Keyword(s):

Primary School ◽

Early Life ◽

Life Prediction ◽

Prediction Models ◽

External Validation ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Childhood Overweight And Obesity

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Tracking implementation within a community-led whole of system approach to address childhood overweight and obesity in south west Sydney, Australia

BMC Public Health ◽

10.1186/s12889-021-11288-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nicola Maitland ◽

Karen Wardle ◽

Jill Whelan ◽

Bin Jalaludin ◽

Doug Creighton ◽

...

Keyword(s):

Stakeholder Engagement ◽

System Approach ◽

Action Plan ◽

Complex Interventions ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Community Members ◽

Childhood Overweight And Obesity ◽

Working Groups ◽

Implementation Data

Abstract Background Obesity is a chronic disease that contributes to additional comorbidities including diabetes, kidney disease and several cancers. Change4Campbelltown implemented a ‘whole of system’ approach to address childhood overweight and obesity. We present methods to track implementation and stakeholder engagement in Change4Campbelltown. Methods Change4Campbelltown aimed to build capacity among key leaders and the broader community to apply techniques from systems thinking to develop community-led actions that address childhood obesity. Change4Campbelltown comprised development of a stakeholder-informed Causal Loop Diagram (CLD) and locally-tailored action plan, formation of key stakeholder and community working groups to prioritise and implement actions, and continuous monitoring of intervention actions. Implementation data included an action register, stakeholder engagement database and key engagement activities and were collected quarterly by the project management team over 2 years of reporting. Results Engagement activities increased level of community engagement amongst key leaders, the school-sector and community members. Community-led action increased as engagement increased and this action is mapped directly to the primary point of influence on the CLD. As action spread diversified across the CLD, the geographical spread of action within the community increased. Conclusions This paper provides a pragmatic example of the methods used to track implementation of complex interventions that are addressing childhood overweight and obesity.

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