Fitwits ^TM Leads to Improved Parental Recognition of Childhood Obesity and Plans to Encourage Change

Abstract

Introduction: Brief tools are needed to help physicians and parents reach consensus on body mass index (BMI) categories for children and to discuss health-improving behaviors. This study tested the Fitwits TM intervention with interactive flashcards and before and-after surveys to improve parents' perceptions of children's BMI status.Methods: We enrolled 140 parents and their 9-to 12-year-old children presenting for well child care, regardless of BMI status, scheduled with 53 Fitwits-trained physicians. The Fitwits tool guided a conversation with all parent-child dyads regarding understanding BMI, nutrition, activity, and portion sizes. A survey addressed BMI category perceptions before and after the intervention, requested 2 goal selections, and included open-ended comment areas.Results: Fifty-three percent of children were overweight or obese. The primary outcome variable was the rate of correct parental identification of their child's weight status (underweight, healthy, overweight, or obese). The survey before the intervention resulted in 50.0% correct BMI category designations. This changed to 60.6% correct perceptions after the intervention, with movement between correct overweight (34.5% to 51.7%) and obese (4.4% to 24.4%) categories. Secondary outcome variables included specific behavior change goals and the qualitative responses of parents, children, and physicians to the intervention. Parent-child dyads predominantly commented favorably and chose (75.8%) goals corresponding to Fitwits card suggestions.Conclusions: An improvement was observed in parental ability to identify the correct BMI category after the intervention during a preadolescent well child visit. Parent underrecognition of overweight/ obese children was also observed. Most parent comments were appreciative of the physician interaction,

Plating up appropriate portion sizes for children: a systematic review of parental food and beverage portioning practices

“…Most quantitative studies were observational (12/14) and used questionnaires , portion size estimation or portioning tasks , a home meal portioning observation or a computer‐assisted interview . Remaining quantitative studies (2/14) were experimental in design but reported data from baseline questionnaires . Qualitative studies used either focus groups or interviews and analysed data using content analysis methods (12/14) or grounded theory .…”

“…surveyed parents (79% female) of low to middle socioeconomic status during a routine child health assessment . Seventy‐five per cent reported the portion sizes eaten by their child (aged 9–12 years) as ‘about right’, compared with 23% as ‘too much’ . Most (53%) of children were overweight or obese .…”

“…Seventy‐five per cent reported the portion sizes eaten by their child (aged 9–12 years) as ‘about right’, compared with 23% as ‘too much’ . Most (53%) of children were overweight or obese . Asante et al .…”

Childhood Obesity and Parental Weight Perceptions: An Update

“…Moreover, in addition to addressing and recognizing early concerns and assessing the accuracy of parental weight perceptions, delivering these strategies successively over extended periods of time is likely to prove especially successful. In this regard, Edwards et al, 40 found the Fitwits TM intervention with interactive flashcards and before and-after surveys to significantly improve the accuracy of parents' perceptions of their children's body mass status.…”

Improving Family Medicine with Thoughtful Research

“…Given the extent of our childhood obesity problem, it is wonderful to see a relatively simple, straightforward intervention 7 that helps parents understand their child's level of obesity and changes behavior. For more background information, see also previous JABFM articles about Fitwits 8,9…”