Youth weight status and family functioning in paediatric primary care

Abstract

Summary The purpose of this study is to examine the associations between family functioning and youth overweight and obesity in a sample of primary care paediatric patients. Specially, we hypothesize that caregivers of youth with an overweight/obese weight status will report more impaired family functioning. A cross‐sectional descriptive study was conducted with 329 caregivers of youth ages 2 to 18 seen in paediatric primary care. Caregivers completed the Family Assessment Device General Functioning Scale and clinical demographics, including parent‐reported youth height and weight to calculate body mass index (BMI). Family functioning was used as a continuous total variable, and as a dichotomous variable based on clinically impaired or healthy family functioning. Analyses included descriptive statistics, Pearson's correlations, and independent t tests. Caregivers who reported impaired family functioning based on the clinical cutoff score were more likely to report that their youth had a higher BMI and BMI z‐score. Caregivers with impaired family functioning and who identified as being in two‐parent families, with at least a Bachelor's degree, and a moderate to high family income were more likely to report their youth was a higher weight status. Further screening and assessment of family functioning in combination with youth weight status among a larger diverse sample of primary care paediatric patients over time will provide insight into what aspects of family functioning may contribute to maintaining a healthy lifestyle or adopting new health behaviours to prevent and/or treat obesity in youth.

Adult weight management patients' perceptions of family dynamics and weight status

“…The Family Assessment Device‐General Functioning Scale (FAD GF) was used to measure the current level of family functioning, or the overall family emotional environment . The FAD GF is reliable ( α = .72‐.92) and has significant construct and criterion validity in both clinical and non‐clinical samples, including patients with obesity and in weight management . The FAD GF has a clinical cut‐off score which notes clinically impaired (≥2.0) or healthy family functioning (<2.0).…”

“…38 The FAD GF is reliable (α = .72-.92 [22][23][24]39 ) and has significant construct and criterion validity in both clinical and non-clinical samples, including patients with obesity and in weight management. 25,28,40 The FAD GF has a clinical cut-off score which notes clinically impaired (≥2.0) or healthy family functioning (<2.0 24 ). The FAD GF was used both as a continuous variable and as a dichotomous variable in our analyses.…”

Validation of the Childhood Family Mealtime Questionnaire in Mexican Adolescents with Obesity and Their Caregivers

“…This, in turn, sheds light on the family dynamics that influence the nutrition and health status of adolescents. Recognizing the barriers and facilitators within family dynamics related to mealtimes is essential for designing and implementing interventions tailored to the individual needs and family context of each patient, as recommended by current clinical practice guidelines [7,9,32]. Psychosocial factors, notably family behaviors, play a pivotal role in both the development and persistence of obesity.…”

“…In 2007, Barlow et al [7] proposed that comprehensive strategies incorporating family-based interventions, as well as changes in weight-related behaviors rather than weight loss goals, can lead to sustained improvements in medical and psychosocial outcomes for children and adolescents living with obesity. Numerous studies have delved into how family behaviors associated with lifestyle, such as diet, physical activity, feeding practices, parental roles, health care support, and parenting style, may influence the weight of adolescents [4,5,[8][9][10][11]. However, only a limited number of studies have explored the impact of broader family environmental factors, such as family functioning during mealtimes or the quality of the relationship between parents and adolescents, on the body composition and lifestyle of adolescents [6,12,13].…”

CHAOS in the Home Environment and Child Weight-Related Outcomes

“…Positive parenting behaviors (eg, warmth, sensitivity to children's emotions, monitoring, and consistency [3][4][5][6] ) contribute to several positive child outcomes (eg, child self-regulation) and are important to examine with regard to child weight-related outcomes. [7][8][9][10][11][12] Parenting behaviors evaluated in the literature thus far include overall parenting style (ie, authoritarian, authoritative, permissive, or neglectful [13][14][15][16] ), parent feeding practices (for example, pressuring to eat, restricting certain foods or amounts, 8,17,18 and family members' behaviors around family meals. 19,20 There are other aspects of the home environment.…”