Douglas Flora, Clark Julia, Craig Leone, Campbell Jonina, McNeill Geraldine
Public Health Nutrition Research Group, Rowett Institute of Health and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK.
BMC Public Health. 2014 Sep 27;14:1009. doi: 10.1186/1471-2458-14-1009.
The high prevalence of childhood obesity is a concern for policy makers and health professionals, leading to a focus on early prevention. The beliefs and perspectives of parents about early childhood obesity, and their views and opinions about the need for weight management interventions for this age group are poorly understood.
A formative qualitative focus group study with parents of pre-school children took place in eight community-based locations throughout North-East Scotland to explore their ideas about the causes of early childhood obesity, personal experiences of effective weight management strategies, and views about the format and content of a possible child-orientated weight management programme. Study participants were recruited via pre-school nurseries.
Thirty-four mothers (median age 37 years) took part in the study, but only two believed their child had a weight problem. Participants (who focussed primarily on dietary issues) expressed a strong sense of personal responsibility to 'get the balance right' regarding their child's weight, and were generally resistant to the idea of attending a weight management programme aimed at very young children. At the same time, they described a range of challenges to their weight management intentions. These included dealing with intrinsic uncertainties such as knowing when to stop 'demand feeding' for weight gain, and judging appropriate portion sizes - for themselves and their children. In addition they faced a range of extrinsic challenges associated with complex family life, i.e. catering to differing family members dietary needs, food preferences, practices and values, and keeping their 'family food rules' (associated with weight management) when tired or pressed for time.
The findings have important implications for health professionals and policy makers wishing to engage with parents on this issue, or who are currently developing 'family-centred' early childhood weight management interventions. The challenge lies in the fact that mothers believe themselves to be the primary (and capable) agents of obesity prevention in the early years - but, who are at the same time, attempting to deal with many mixed and conflicting messages and pressures emanating from their social and cultural environments that may be undermining their weight management intentions.
儿童肥胖的高患病率引起了政策制定者和健康专家的关注，促使人们将重点放在早期预防上。目前，对于父母关于儿童肥胖的信念和观点，以及他们对该年龄组体重管理干预措施必要性的看法和意见，我们了解得还很少。
在苏格兰东北部的八个社区地点，对学龄前儿童的父母进行了一项形成性定性焦点小组研究，以探讨他们对儿童肥胖原因的看法、有效体重管理策略的个人经验，以及对可能以儿童为导向的体重管理计划的形式和内容的看法。研究参与者通过幼儿园招募。
34位母亲（中位年龄37岁）参与了该研究，但只有两位认为自己的孩子存在体重问题。参与者（主要关注饮食问题）对孩子的体重表示出强烈的个人责任感，认为要“把握好平衡”，并且普遍抵制参加针对幼儿的体重管理计划。与此同时，他们描述了在体重管理意图方面面临的一系列挑战。这些挑战包括应对内在的不确定性，比如知道何时停止为增加体重而进行的“按需喂养”，以及为自己和孩子判断合适的食量。此外，他们还面临着一系列与复杂家庭生活相关的外在挑战，即要满足不同家庭成员的饮食需求、食物偏好、习惯和价值观，以及在疲惫或时间紧迫时遵守他们的“家庭饮食规则”（与体重管理相关）。
这些发现对于希望在这个问题上与家长合作的健康专家和政策制定者，或者目前正在制定“以家庭为中心”的幼儿体重管理干预措施的人具有重要意义。挑战在于，母亲们认为自己是早年预防肥胖的主要（且有能力的）推动者——但与此同时，她们试图应对来自社会和文化环境的许多混杂且相互冲突的信息和压力，而这些可能正在破坏她们的体重管理意图。
