Division of Developmental/Behavioral Pediatrics and Psychology, Department of Pediatrics, Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH.
Francis Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH.
J Dev Behav Pediatr. 2018 Feb/Mar;39(2):126-135. doi: 10.1097/DBP.0000000000000507.
Weight-related quality of life (WRQOL) is a type of health-related QOL that may serve as a patient-reported outcome of the potential burden of overweight. The present study uses structural equation modeling path analysis methods to examine body mass index (BMI) and other potential predictors of WRQOL components among adolescents who were overweight/obese from predominantly low-income, urban households.
Baseline data were obtained from 360 participants (10-13 year olds; 57.8% female; 76.7% black; average BMI of 27.12) and their parents/legal guardians from a randomized, controlled, treatment trial. Youth completed measures of WRQOL, depressive symptoms, and family/friend social support for healthy eating. Parents completed measures of demographics and child social problems.
The initial model included BMI, gender, parent education, family/friend social support for healthy eating, child social problems, body esteem and social life WRQOL, and depressive symptoms. The final model fit the data well (χ = 27.738; df = 16; p = .034). Higher BMI was indirectly related to lower social life and body esteem WRQOL through greater social problems. Physical comfort and family relations WRQOL were unrelated to BMI and were not included. Lower social life and body esteem related to more depressive symptoms. Family/friend discouragement for healthy eating was associated with lower body esteem; also, family discouragement was related to lower social life.
Body mass index may not directly relate to WRQOL but may be associated through other factors, including child social problems. Interventions should screen for and treat mood and social problems and address family/friend support for healthy eating.
与体重相关的生活质量(WRQOL)是一种健康相关的生活质量,它可能是超重潜在负担的患者报告结果。本研究使用结构方程建模路径分析方法,检验了来自以低收入为主的城市家庭的超重/肥胖青少年的体重指数(BMI)和其他潜在预测因子与 WRQOL 成分之间的关系。
从一项随机对照治疗试验中获取了 360 名参与者(年龄 10-13 岁;57.8%为女性;76.7%为黑人;平均 BMI 为 27.12)及其父母/法定监护人的基线数据。青少年完成了 WRQOL、抑郁症状和家庭/朋友健康饮食社会支持的测量。父母完成了人口统计和儿童社会问题的测量。
初始模型包括 BMI、性别、父母教育、家庭/朋友健康饮食社会支持、儿童社会问题、身体自尊和社会生活 WRQOL 以及抑郁症状。最终模型很好地拟合了数据(χ=27.738;df=16;p=0.034)。较高的 BMI 通过更大的社会问题与较低的社会生活和身体自尊 WRQOL 呈间接相关。身体舒适度和家庭关系 WRQOL 与 BMI 无关,因此未包含在内。较低的社会生活和身体自尊与更多的抑郁症状有关。家庭/朋友对健康饮食的劝阻与较低的身体自尊有关;此外,家庭劝阻与较低的社会生活有关。
体重指数可能不会直接与 WRQOL 相关,而是可能通过其他因素相关,包括儿童社会问题。干预措施应筛查和治疗情绪和社会问题,并解决家庭/朋友对健康饮食的支持。