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Maternal Perceptions Of Weight Status Of Children Case Study

Maternal Perceptions of Weight Status of Children Maynard et al. 2003

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Previous studies have found that a significant percentage of mothers with overweight preschool children failed to see the child as being overweight. These findings appear dependent on education with mothers with a high school education or less being more likely to misperceive their children's weight than those with a college education.

Such investigations are believed to be directly relevant to the success or prevention of overweight prevention or weight intervention programs as mothers who do not perceive a problem are less likely to take action for their children

(Good discussion point here is that mothers who misclassify children's weight use less negative descriptions of children such as "thick" or "solid")

Researchers wanted to better understand the extent to which mothers misclassify children's weight. Goals of the study were to:

A. Quantify extent to which mothers misclassify children's weight

B. Examine the demographic characteristics for both mother and children regarding misclassifications

C. Look at what factors may determine maternal misclassifications of at risk children

Methods

I. Data came from CDC study Third National Health and Nutrition Study

A. household surveys with caregivers (mothers) from 0-3 months after examination of child

B. Final analyses included 5500 children age 2-11 from a pool of 8309 (inclusion criteria for the study are on the third paragraph of page 1227 if you want to discuss this)

C. Mothers were asked if they thought child was under-over- or about the right weight (this is an ordinal variable given the way it is asked). Responses to the question were compared to child's Body Mass Index (BMI) that was recorded at the time of the examination of child (BMI would be an interval variable). BMI for age was converted to a z-score.

D. Weight classifications for study based on BMI:

1. Children with a BMI > 95th percentile were classified as overweight

2. > 85-95 percentile classified as at risk

3. 5-85 percentile normal

4. < 5 percentile underweight

E. Another important factor to mention is that BMI for age Z-scores were used (standard normal distribution)

F. Other variables and classifications: child's age (interval or ratio), height (interval or ratio), child's weight (interval or ratio), sex (nominal), race (nominal- non-Hispanic white, Hispanic, none-Hispanic Black, Mexican-American), region (nominal-northeast, Midwest, south, west), household poverty income ratio (interval), and mother's BMI (interval).

Variables

Measures of central tendency used in the study: Mean values for maternal BMI; child for age BMI- converted to Z scores, age (interval or ratio), and stature (height, interval...

Relevant points for results:
1. 32.1% of mothers misclassified overweight as child as about right weight

2. For at risk 84.7% for boys and 72.4% for girls perceived them to be about the right weight

3. Mothers were more likely to perceive normal as underweight

4. Logistic Regression analysis indicated that the younger the child and lower child's BMI for age Z score the more likely they would classify an overweight child as about right. This means that younger overweight children were perceived as about right and the less obese that children were the more likely moms overlooked their weight problem.

5. For at risk children the logistic regression indicated that mothers more likely misclassified them as overweight due to their sex (females consider over more often than males), their age (older were more often thought overweight), higher BMI for age z scores, and mother's BMI (the lower the mother's BMI the more likely she considered at risk child being overweight

Overall conclusions

1. Almost 1/3 of mothers failed to classify overweight children as overweight

2. Girls at risk for being overweight were almost three times as likely to be classified by mom as overweight than were boys who were at risk.

3. Ethnic background did not predict misclassification rates

4. Younger children less likely to be classified…

Sources used in this document:
References

Maynard, M.L., Galuska, D.A., Blanck, H.M., & Serdula, M.K. (2003). Maternal perceptions of weight status of children. Pediatrics, 111(5), 1226-1231.
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