Musaad Salma M A, Speirs Katherine E, Hayes Jenna T, Mobley Amy R, Fitzgerald Nurgul, Jones Blake L, VanBrackle Angela, Sigman-Grant Madeleine
Family Resiliency Center, Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2031 Doris Kelley Christopher Hall, 904 W. Nevada, Urbana, IL 61801, USA.
Department of Family Studies and Human Development, Norton School of Family and Consumer Sciences, University of Arizona, 650 N Park Ave, 315-L McClelland Park, Tucson, AZ, 85721-0078, USA.
Appetite. 2017 May 1;112:260-271. doi: 10.1016/j.appet.2017.01.035. Epub 2017 Feb 1.
Multi-level factors act in concert to influence child weight-related behaviors. This study examined the simultaneous impact of variables obtained at the level of the home environment (e.g., mealtime ritualization), parent (e.g., modeling) and child (e.g., satiety responsiveness) with the outcomes of practicing healthy and limiting unhealthy child behaviors (PHCB and LUCB, respectively) in a low-income U.S.
This was a cross sectional study of caregivers of preschool children (n = 432). Caregivers were interviewed using validated scales. Structural equation modeling was used to examine associations with the outcomes. Adjusting for study region, demographics and caregiver's body mass index, we found significant associations between PHCB and higher mealtime ritualizations (β: 0.21, 95% confidence interval [CI]: 0.11; 0.32, more parental modeling (β: 0.39, 95% CI: 0.27; 0.49) and less parental restrictive behavior (β: -0.19, 95% CI: -0.29; -0.10). More parental covert control (β: 0.44, 95% CI: 0.35; 0.54), more parental overt control (β: 0.14, 95% CI: 0.03; 0.25) and less parental permissive behavior (β: -0.25, 95% CI: -0.34; -0.09) were significantly associated with LUCB. Findings suggest the synergistic effects of mealtime ritualizations and covert control at the environmental-level and parental modeling, overt control, restrictive and permissive behavior at the parent-level on the outcomes. Most factors are modifiable and support multidisciplinary interventions that promote healthy child weight-related behaviors.
多层次因素共同作用以影响儿童与体重相关的行为。本研究在美国低收入地区考察了家庭环境层面（如用餐仪式化）、父母层面（如行为示范）和儿童层面（如饱腹感反应）的变量对儿童健康行为实践和不健康行为限制（分别为PHCB和LUCB）结果的同时影响。
这是一项对学龄前儿童照料者（n = 432）的横断面研究。使用经过验证的量表对照料者进行访谈。采用结构方程模型来检验与结果的关联。在调整研究地区、人口统计学特征和照料者体重指数后，我们发现PHCB与更高的用餐仪式化程度（β：0.21，95%置信区间[CI]：0.11；0.32）、更多的父母行为示范（β：0.39，95% CI：0.27；0.49）以及更少的父母限制行为（β：-0.19，95% CI：-0.29；-0.10）之间存在显著关联。更多的父母隐性控制（β：0.44，95% CI：0.35；0.54）、更多的父母显性控制（β：0.14，95% CI：0.03；0.25）以及更少的父母放任行为（β：-0.25，95% CI：-0.34；-0.09）与LUCB显著相关。研究结果表明，环境层面的用餐仪式化和隐性控制以及父母层面的行为示范、显性控制、限制和放任行为对结果具有协同效应。大多数因素是可改变的，并支持促进儿童健康体重相关行为的多学科干预措施。
