Foster Byron Alexander, Farragher Jill, Parker Paige, Hale Daniel E
Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Child Obes. 2015 Jun;11(3):281-8. doi: 10.1089/chi.2014.0098. Epub 2015 Apr 17.
Positive deviance methodology has been applied in the developing world to address childhood malnutrition and has potential for application to childhood obesity in the United States. We hypothesized that among children at high-risk for obesity, evaluating normal weight children will enable identification of positive outlier behaviors and practices.
In a community at high-risk for obesity, a cross-sectional mixed-methods analysis was done of normal weight, overweight, and obese children, classified by BMI percentile. Parents were interviewed using a semistructured format in regard to their children's general health, feeding and activity practices, and perceptions of weight.
Interviews were conducted in 40 homes in the lower Rio Grande Valley in Texas with a largely Hispanic (87.5%) population. Demographics, including income, education, and food assistance use, did not vary between groups. Nearly all (93.8%) parents of normal weight children perceived their child to be lower than the median weight. Group differences were observed for reported juice and yogurt consumption. Differences in both emotional feeding behaviors and parents' internalization of reasons for healthy habits were identified as different between groups.
We found subtle variations in reported feeding and activity practices by weight status among healthy children in a population at high risk for obesity. The behaviors and attitudes described were consistent with previous literature; however, the local strategies associated with a healthy weight are novel, potentially providing a basis for a specific intervention in this population.
积极偏差方法已在发展中世界用于解决儿童营养不良问题，在美国也有应用于儿童肥胖问题的潜力。我们假设，在肥胖高危儿童中，评估体重正常的儿童将有助于识别积极的异常行为和做法。
在一个肥胖高危社区，对按BMI百分位数分类的体重正常、超重和肥胖儿童进行了横断面混合方法分析。采用半结构化形式对家长就其孩子的总体健康状况、喂养和活动习惯以及体重认知进行了访谈。
在得克萨斯州下里奥格兰德河谷的40个家庭中进行了访谈，这些家庭主要是西班牙裔（87.5%）。各群体之间的人口统计学特征，包括收入、教育程度和食品援助使用情况没有差异。几乎所有（93.8%）体重正常儿童的家长都认为他们的孩子体重低于中位数。在报告的果汁和酸奶消费方面观察到了群体差异。情绪性喂养行为和家长对健康习惯原因的内化在各群体之间也存在差异。
我们发现在肥胖高危人群中，健康儿童按体重状况报告的喂养和活动习惯存在细微差异。所描述的行为和态度与先前的文献一致；然而，与健康体重相关的当地策略是新颖的，可能为针对该人群的特定干预提供基础。
