Iñiguez Ingrid Rivera, Yap Jason, Mager Diana R
Department of Agricultural, Food and Nutritional Science, University of Alberta;
Division of Pediatric Gastroenterology and Nutrition, Stollery Children's Hospital; ; Department of Pediatrics, University of Alberta, Edmonton, Alberta.
Paediatr Child Health. 2014 May;19(5):e24-9. doi: 10.1093/pch/19.5.e24.
Nonalcoholic fatty liver disease (NAFLD) affects 30% of obese children globally. The main treatment for NAFLD is to promote gradual weight loss through lifestyle modification. Very little is known regarding parental perspectives about the barriers and facilitators that influence the ability to promote healthy lifestyle behaviours in children with NAFLD.
To explore and describe parental perspectives regarding barriers to and facilitators of implementing lifestyle modification in children with NAFLD.
A mixed-methods approach, including qualitative methodology (focus groups) and validated questionnaires (Lifestyle Behaviour Checklist), was used to assess parental perceptions regarding barriers to and facilitators of lifestyle change in parents of children with healthy body weights (control parents) and in parents of children with NAFLD (NAFLD parents).
NAFLD parents identified more problem behaviours related to food portion size and time spent in nonsedentary physical activity, and lower parental self-efficacy than parents of controls (P<0.05). Major barriers to lifestyle change cited by NAFLD parents were lack of time, self-motivation and role modelling of healthy lifestyle behaviours. In contrast, control parents used a variety of strategies to elicit healthy lifestyle behaviours in their children including positive role modelling, and inclusion of the child in food preparation and meal purchasing decisions, and perceived few barriers to promoting healthy lifestyles. Internet sources were the main form of nutrition information used by parents.
Lifestyle modification strategies focused on promoting increased parental self-efficacy and parental motivation to promote healthy lifestyle behaviour are important components in the treatment of obese children with NAFLD.
非酒精性脂肪性肝病（NAFLD）影响着全球30%的肥胖儿童。NAFLD的主要治疗方法是通过生活方式改变来促进体重逐渐减轻。关于父母对影响NAFLD儿童健康生活方式行为促进能力的障碍和促进因素的看法，我们知之甚少。
探讨并描述父母对NAFLD儿童实施生活方式改变的障碍和促进因素的看法。
采用混合方法，包括定性方法（焦点小组）和经过验证的问卷（生活方式行为清单），以评估体重正常儿童的父母（对照父母）和NAFLD儿童的父母（NAFLD父母）对生活方式改变的障碍和促进因素的看法。
NAFLD父母比对照父母识别出更多与食物份量大小和非久坐体力活动时间相关的问题行为，且父母自我效能更低（P<0.05）。NAFLD父母提到的生活方式改变的主要障碍是缺乏时间、自我激励以及健康生活方式行为的榜样作用。相比之下，对照父母采用多种策略促使孩子养成健康生活方式，包括积极树立榜样、让孩子参与食物准备和购买食物的决策，并且认为促进健康生活方式几乎没有障碍。互联网资源是父母使用的主要营养信息形式。
关注提高父母自我效能和促进健康生活方式行为的父母动机的生活方式改变策略，是治疗患有NAFLD的肥胖儿童的重要组成部分。
