Conlon Beth A, McGinn Aileen P, Lounsbury David W, Diamantis Pamela M, Groisman-Perelstein Adriana E, Wylie-Rosett Judith, Isasi Carmen R
1 Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx, NY.
2 Department of Pediatrics, Children's Health Services , Jacobi Medical Center, Bronx, NY.
Child Obes. 2015 Aug;11(4):394-405. doi: 10.1089/chi.2014.0093.
The home environment, which includes parenting practices, is an important setting in which children develop their health behaviors. We examined the role of parenting practices in the home environment among underserved youth.
We examined baseline data of a family-focused pediatric obesity intervention. Parenting practices (monitoring, discipline, limit setting of soda/snacks [SS] and screen media [SM], pressure to eat, and reinforcement) and availability of fruits/vegetables (FV) and sugar-sweetened beverages (SSBs), family meals, television (TV) watching during meals, TVs in the home, owning active video games/sports equipment, and household food security were assessed in 301 parent/caregivers of overweight/obese children (ages 7-12 years; BMI≥85th percentile). Associations were evaluated using Spearman's rank correlation coefficients and logistic regression models adjusted for potential confounders.
Parents/caregivers (ages 22-67 years) were largely Hispanic/Latino (74.1%), female (92.4%), and reported high levels of limit setting SS and low levels of pressure to eat. Parent age, gender, country of birth, and years living in the United States accounted for differences among several parenting practices. Adjusted logistic regression models identified several statistically significant associations, including: Monitoring was positively associated with availability FV (odds ratio [OR]=2.19; 95% confidence interval [CI], 1.25, 3.82); limit setting SS was inversely associated with availability of SSBs (OR=0.40; 95% CI, 0.21, 0.75); and limit setting SM was inversely associated with TV viewing during family meals (OR=0.51; 95% CI, 0.31, 0.85). Nearly 40% of our population was food insecure, and food insecurity was positively associated with pressure to eat (OR=1.77; 95% CI, 1.01, 3.15).
Parenting practices play an important role in the home environment, and longitudinal studies are needed to examine these associations in the context of family-focused pediatric obesity interventions.
家庭环境，包括养育方式，是儿童形成健康行为的重要场所。我们研究了养育方式在服务不足的青少年家庭环境中的作用。
我们研究了一项以家庭为重点的儿童肥胖干预的基线数据。对301名超重/肥胖儿童（7至12岁；BMI≥第85百分位）的父母/照顾者进行了养育方式（监督、管教、限制汽水/零食[SS]和屏幕媒体[SM]的摄入、进食压力和强化）以及水果/蔬菜（FV）和含糖饮料（SSB）的可得性、家庭用餐情况、用餐时看电视情况、家中电视数量、拥有电子游戏/运动器材情况以及家庭食品安全状况的评估。使用Spearman等级相关系数和针对潜在混杂因素进行调整的逻辑回归模型评估关联。
父母/照顾者（年龄在22至67岁之间）大多为西班牙裔/拉丁裔（74.1%），女性（92.4%），且报告显示限制SS摄入的水平较高，进食压力水平较低。父母的年龄、性别、出生国家以及在美国居住的年限解释了几种养育方式之间的差异。调整后的逻辑回归模型确定了几个具有统计学意义的关联，包括：监督与FV的可得性呈正相关（优势比[OR]=2.19；95%置信区间[CI]，1.25，3.82）；限制SS摄入与SSB的可得性呈负相关（OR=0.40；95%CI，0.21，0.75）；限制SM摄入与家庭用餐时看电视呈负相关（OR=0.51；95%CI，0.31，0.85）。近40%的研究对象存在食品不安全问题，且食品不安全与进食压力呈正相关（OR=1.77；95%CI，1.01，3.15）。
养育方式在家庭环境中起着重要作用，需要进行纵向研究以在以家庭为重点的儿童肥胖干预背景下检验这些关联。
