Evaluating Parents and Adult Caregivers as ‘Agents of Change’ for Treating Obese Children – Evidence for Parent Behavior Change Strategies and Research Gaps: A Scientific Statement from the American Heart Association

Circulation 125.9 (2012): 1186-1207

36 Pages Posted: 30 Jul 2014

See all articles by Myles Faith

Myles Faith

University of North Carolina (UNC) at Chapel Hill

Linda Van Horn

Northwestern University

Lawrence Appel

Johns Hopkins University - Bloomberg School of Public Health

Lora Burke

University of Pittsburgh

Jo Ann Carson

University of Texas Medical Branch-Galveston, Clinical Nutrition

Harold Franch

Emory University

John Jakicic

University of Pittsburgh

Tanja Kral

University of Pennsylvania - School of Nursing

Angela Odoms-Young

University of Illinois at Chicago - Kinesiology and Nutrition

Brian Wansink

Retired

Judith Wylie-Rosett

Yeshiva University - Albert Einstein College of Medicine

Date Written: March 21, 2011

Abstract

This Scientific Statement addresses Parents and Adult Caregivers (PACs) as ‘agents of change’ for obese children. Evidence is reviewed to support the notion that PACs can leverage behavior change and reduce positive energy balance in obese youth, and research opportunities for the field are discussed. The Statement has three specific aims: First, the core behavior change strategies for PACs as used in family-based treatment programs are reviewed. These strategies reduce childhood overweight compared to no treatment or nutrition education alone, although their limited potency is recognized. Second, the strength of evidence is evaluated for the hypothesis that greater parental ‘involvement’ in treatment is associated with greater reductions in child overweight. Drawing upon randomized clinical trials that varied the degree/nature of parental involvement, and observational analyses that assessed parental adherence to behavioral strategies, we report limited and inconsistent support. For example, only 17% of the intervention studies reported differential improvements in child overweight as function of parental involvement after treatment. On the other hand, greater parental adherence predicted better child weight outcomes after 2 and 5 years in certain studies. Third, research gaps identified throughout this review process are delineated and new opportunities for the field are proposed. For example, the assessment of refined parenting phenotypes, cultural tailoring of interventions, examination of family relationships, and incorporating new technologies in treatment represent topics needing further study. A conceptual model is proposed to guide research on understanding the determinants of parental feeding and physical-activity parenting practices. The Statement strives to innovate the scope and potency of PAC treatments for childhood obesity.

Suggested Citation

Faith, Myles and Van Horn, Linda and Appel, Lawrence and Burke, Lora and Carson, Jo Ann and Franch, Harold and Jakicic, John and Kral, Tanja and Odoms-Young, Angela and Wansink, Brian and Wylie-Rosett, Judith, Evaluating Parents and Adult Caregivers as ‘Agents of Change’ for Treating Obese Children – Evidence for Parent Behavior Change Strategies and Research Gaps: A Scientific Statement from the American Heart Association (March 21, 2011). Circulation 125.9 (2012): 1186-1207, Available at SSRN: https://ssrn.com/abstract=2473812

Myles Faith

University of North Carolina (UNC) at Chapel Hill ( email )

102 Ridge Road
Chapel Hill, NC NC 27514
United States

Linda Van Horn

Northwestern University ( email )

2001 Sheridan Road
Evanston, IL 60208
United States
312-908-8938 (Phone)

Lawrence Appel

Johns Hopkins University - Bloomberg School of Public Health ( email )

615 North Wolfe Street
Baltimore, MD 21205
United States
410-955-4156 (Phone)
410-955-0476 (Fax)

Lora Burke

University of Pittsburgh ( email )

135 N Bellefield Ave
Pittsburgh, PA 15260
United States

Jo Ann Carson

University of Texas Medical Branch-Galveston, Clinical Nutrition ( email )

Galveston, TX 77555
United States

Harold Franch

Emory University ( email )

201 Dowman Drive
Atlanta, GA 30322
United States

John Jakicic

University of Pittsburgh ( email )

135 N Bellefield Ave
Pittsburgh, PA 15260
United States

Tanja Kral

University of Pennsylvania - School of Nursing ( email )

Philadelphia, PA
United States

Angela Odoms-Young

University of Illinois at Chicago - Kinesiology and Nutrition ( email )

1200 W Harrison St
Chicago, IL 60607
United States

Brian Wansink (Contact Author)

Retired ( email )

607-319-0123 (Phone)

Judith Wylie-Rosett

Yeshiva University - Albert Einstein College of Medicine ( email )

Jack and Pearl Resnick Campus
1300 Morris Park Avenue
Bronx, NY 10461
United States

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