Department of Pediatrics, Johns Hopkins University School of Medicine (NN Showell, J Perin, I Gonzalez, and RLJ Thornton), Baltimore, Md.
Department of Pediatrics, Johns Hopkins University School of Medicine (NN Showell, J Perin, I Gonzalez, and RLJ Thornton), Baltimore, Md.
Acad Pediatr. 2022 Jul;22(5):761-768. doi: 10.1016/j.acap.2021.11.008. Epub 2021 Nov 16.
Examine racial/ethnic differences in parent activation and associations with child obesity risk behaviors in low-income families.
Cross-sectional survey study of 300 low-income Black, Latinx, and White parents of patients aged 2 to 5 years receiving primary care within 2 health care systems (Systems 1 & 2). In-person and phone surveys were conducted. Parent activation, defined as parents' knowledge, confidence, and willingness to act concerning their child's health, was measured using the standardized 13-item Parent Patient Activation Measure (P-PAM). Differences in parent activation by race/ethnicity were assessed using analysis of variance. Multivariate regression analyses were used to test associations between parent activation and child obesity risk behaviors.
In pooled unadjusted analyses, Latinx parents had significantly lower activation compared to Black parents (P = .023), but these differences were no longer statistically significant after adjusting for other sociodemographic characteristics (P = .06). Higher activation was associated with slightly greater odds of consuming ≥ 5 daily servings of fruits and vegetables for System 2 only (odds ratio: 1.04, 95% confidence interval: 1.01, 1.07). Associations between parental activation and child screen time or physical activity were not significant.
Findings highlight potential measurement limitations of the P-PAM including the inability of the measure to capture barriers to health system navigation and cultural and linguistic considerations. Further attention to the nuanced interplay between parental activation and contextual and sociodemographic risk factors (eg, food availability, immigrant status, economic opportunity, language proficiency) should be considered in the development of early childhood obesity interventions in primary care settings.
探讨低收入家庭中父母激活程度的种族/民族差异及其与儿童肥胖风险行为的关联。
对在 2 个医疗系统（系统 1 和系统 2）中接受初级保健的 2 至 5 岁患者的 300 名低收入黑种人、拉丁裔和白人父母进行横断面调查研究。采用面对面和电话调查方式进行。父母激活程度用标准化的 13 项父母患者激活度量表（P-PAM）衡量，定义为父母对子女健康的知识、信心和行动意愿。采用方差分析评估种族/民族之间父母激活程度的差异。采用多元回归分析检验父母激活程度与儿童肥胖风险行为之间的关联。
在未调整的汇总分析中，拉丁裔父母的激活程度明显低于黑种人父母（P=0.023），但在调整其他社会人口特征后，这些差异不再具有统计学意义（P=0.06）。较高的激活程度与系统 2 中儿童食用≥5 份每日推荐蔬果的几率略有增加相关（比值比：1.04，95%置信区间：1.01，1.07）。父母激活程度与儿童屏幕时间或体力活动之间的关联不显著。
研究结果突出了 P-PAM 可能存在的测量局限性，包括该测量无法捕捉到健康系统导航的障碍以及文化和语言方面的考虑。在制定初级保健环境中的儿童肥胖干预措施时，应进一步关注父母激活程度与背景和社会人口风险因素（如食物供应、移民身份、经济机会、语言熟练程度）之间的微妙相互作用。
