BACKGROUND AND OBJECTIVE: Parental perceptions of their children' s weight play an important role in obesity prevention and treatment. The objective of this study was to determine the proportion of parents worldwide who underestimate their children' s weight and moderators of such misperceptions. METHODS:Original studies published to January 2013 were chosen through literature searches in PUBMED, PSYCHINFO, and CINAHL databases. References of retrieved articles were also searched for relevant studies. Studies were published in English and assessed parental perceptions of children' s weight and then compared perceptions to recognized standards for defining overweight based on anthropometric measures. Data were extracted on study-level constructs, child-and parent-characteristics, procedural characteristics, and parental underestimates separately for normal-weight and overweight/obese samples. Pooled effect sizes were calculated using random-effects models and adjusted for publication bias. Moderators were explored using mixed-effect models.RESULTS: A total of 69 articles (representing 78 samples; n = 15 791) were included in the overweight/obese meta-analysis. Adjusted effect sizes revealed that 50.7% (95% confidence interval 31.1%-70.2%) of parents underestimate their overweight/obese children' s weight. Significant moderators of this effect included child' s age and BMI. A total of 52 articles (representing 59 samples; n = 64 895) were included in the normal-weight meta-analysis. Pooled effect sizes indicated that 14.3% (95% confidence interval 11.7%-17.4%) of parents underestimate their children' s normal-weight status. Significant moderators of this effect included child gender, parent weight, and the method (visual versus nonvisual) in which perception was assessed. CONCLUSIONS:Half of parents underestimated their children' s overweight/obese status and a significant minority underestimated children' s normal weight. Pediatricians are well positioned to make efforts to remedy parental underestimates and promote adoption of healthy habits. Ms Lundahl conceptualized the study, coded the original studies, conducted the meta-analyses, and drafted the initial manuscript; Ms Kidwell coded a portion of the original studies, reviewed and revised the manuscript, and approved the final manuscript as submitted; and Dr Nelson contributed to the conceptualization of the study, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.www.pediatrics.org/cgi

The widespread successful implementation of evidence-based practices (EBPs) into community mental health settings will require a thorough understanding of practitioner attitudes toward these approaches. This study reports on the results of two community mental health practitioner focus groups investigating attitudes toward EBPs, perceived challenges to implementing EBPs, and recommendations for researchers interested in facilitating EBP use in community settings. The participants were child and adolescent mental health professionals (N=19) from two community mental health centers. The focus groups were taped, transcribed and coded for themes. Major themes included concerns regarding the applicability of some research supporting EBPs, a desire for a greater emphasis on the therapeutic relationship, and the need for flexibility within treatment protocols. Themes are discussed within the context of the recent movement toward implementing EBPs in community settings and recent research related to focus group themes.

In light of the recent movement toward evidence-based practice (EBP) in mental health services, practitioner adoption of EBPs in clinical settings has emerged as an important area for study. This paper reports on the results of a national online survey of mental health practitioners in an attempt to identify correlates of self-reported EBP use in practice. The survey consisted of 214 mental health practitioners from 15 states drawn from a diverse set of clinical settings and representing a variety of theoretical orientations. The results indicated that practitioner training (i.e., taking a class in EBPs), the perceived openness of the clinical setting toward EBPs, and the practitioner's attitudes toward treatment research were significant predictors of self-reported EBP use. The relationship between clinical setting and EBP use was partially mediated by attitudes toward treatment research. Negative attitudes toward treatment research partially mediated the relationship between practitioner training and self-reported EBP use. The findings are presented within the context of efforts to increase EBP use in clinical settings and implications for clinical training, treatment research, and EBP dissemination efforts are discussed.

Obesity is associated with headache frequency and disability in the pediatric headache population. For children who are overweight, weight loss can contribute to a reduction in headaches over time. Clinicians should consider child weight status in providing care for pediatric headache.