Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
CT Children's Medical Center, University of Connecticut School of Medicine, Hartford, CT 06106 2, USA.
Nutrients. 2019 Jul 18;11(7):1641. doi: 10.3390/nu11071641.
Clinical settings need rapid yet useful methods to screen for diet and activity behaviors for brief interventions and to guide obesity prevention efforts. In an urban pediatric emergency department, these behaviors were screened in children and parents with the 33-item Pediatric-Adapted Liking Survey (PALS) to assess the reliability and validity of a Healthy Behavior Index (HBI) generated from the PALS responses. The PALS was completed by 925 children (average age = 11 ± 4 years, 55% publicly insured, 37% overweight/obese by Body Mass Index Percentile, BMI-P) and 925 parents. Child-parent dyads differed most in liking of vegetables, sweets, sweet drinks, and screen time. Across the sample, child and parent HBIs were variable, normally distributed with adequate internal reliability and construct validity, revealing two dimensions (less healthy-sweet drinks, sweets, sedentary behaviors; healthy-vegetables, fruits, proteins). The HBI showed criterion validity, detecting healthier indexes in parents vs. children, females vs. males, privately- vs. publicly-health insured, and residence in higher- vs. lower-income communities. Parent's HBI explained some variability in child BMI percentile. Greater liking of sweets/carbohydrates partially mediated the association between low family income and higher BMI percentile. These findings support the utility of PALS as a dietary behavior and activity screener for children and their parents in a clinical setting.
临床环境需要快速而有用的方法来筛选饮食和活动行为，以便进行简短干预，并指导肥胖预防工作。在城市儿科急诊室，通过 33 项儿科适应喜好调查（PALS）对这些行为进行了筛查，以评估从 PALS 反应中生成的健康行为指数（HBI）的可靠性和有效性。925 名儿童（平均年龄= 11 ± 4 岁，55%有公共保险，37%超重/肥胖，BMI 百分位数，BMI-P）和 925 名父母完成了 PALS。儿童-父母对子在喜欢蔬菜、甜食、甜饮料和屏幕时间方面差异最大。在整个样本中，儿童和父母的 HBI 各不相同，呈正态分布，内部可靠性和结构有效性充足，揭示了两个维度（不健康-甜饮料、甜食、久坐行为；健康-蔬菜、水果、蛋白质）。HBI 具有标准有效性，在父母与子女、女性与男性、私人与公共健康保险之间以及居住在高收入与低收入社区之间检测到更健康的指数。父母的 HBI 解释了儿童 BMI 百分位数的一些可变性。对甜食/碳水化合物的喜爱程度越高，家庭收入越低与 BMI 百分位数越高之间的关联就越强。这些发现支持了 PALS 在临床环境中作为儿童及其父母的饮食行为和活动筛查工具的效用。
