PhD in Nursing Science Program

Parental Perceptions of Body Weight in Toddlers and Preschool Children

Dissertation under the direction of Professor Thomas H. Cook

Approximately 14% of US preschoolers are overweight. Examining parental perceptions of child body weight is crucial because successful prevention and treatment of childhood obesity is linked to parental awareness of child body weight. Although studies have demonstrated that parents of toddlers and preschoolers have incorrect perceptions of their child’s body weight, little is known about factors that may be associated with these perceptions. The purpose of this study was to examine relationships between parental perceptions of toddler and preschool child body weight and psychosocial factors such as parental efficacy, health literacy, and level of concern for child weight. Research questions included: 1) what is the parent’s perception of the toddler or preschool child’s body weight? and 2) what factors are associated with the accuracy of parental perceptions of the toddler or preschool child’s body weight? Participants for this descriptive-correlational study were solicited at a pediatrician's office and a WIC clinic. Parental participants completed four surveys and answered two open-ended questions. Quantitative analyses included descriptive statistics, correlations, and regression analyses. Answers to open-ended questions were analyzed using content analysis.

Over one-third of the children in the sample were at risk for overweight or already overweight. However, less than six percent of parents felt their child had an elevated body weight. Furthermore, less than one-third of parents in the study were concerned that their child would become overweight or need to diet later in life. Results from logistic regression analyses demonstrated that the parent’s health literacy level was a statistically significant predictor of the accuracy of their perceptions regarding their child’s body weight (p<.05). However, the parent’s concern regarding child weight and perceived level of efficacy did not significantly predict the accuracy of their perceptions. Content analyses revealed that parents are often uncertain how to define healthy or unhealthy body weights in children. Parents in the study often relied on subjective observations to determine the appropriateness of child body weight, but many were open to counseling and education from medical professionals, Internet resources, and other objective sources.