Real or ideal? Parental perception of child weight status and its implications for changes in the home environment

Introduction: Parental perception of child weight status has an important role in counteracting the growing childhood obesity trajectory. Parents who accurately perceive their child\u27s weight status are more likely to support healthy behaviors promoting adequate nutrition and physical activity. However, few studies have examined parental perception of child weight status among children older than preschool age and minority populations, such as Hispanics, or used theoretical frameworks to assess parental perception of child weight status. The purpose of this study was to assess parental perception of child weight status and examine these perceptions within the context of the stages of change model to determine their implications for parent readiness to change the home environment. ^ Methods: A cross sectional secondary data analysis was conducted to examine accuracy of parental perception, parent satisfaction with child weight status, and stage of readiness to change the home environment. ^ Study Sample: A total of 219 parents of children 9-14 years of age who participated in the South Texas Parent Diabetes Prevention Trial (STPDPT) and completed a baseline survey were included in this study. ^ Results: Most parents perceived both a normal weight body size to be ideal for a child and an adult. Misperception occurred among 70% of parents as they perceived their overweight children to possess a normal body size. Parents of normal weight children were more likely to have accurate perceptions of child weight status. Parents satisfied with their child\u27s weight status were more likely to select a middle weight status as ideal for an adult, X2 (2, N=277) = 13.65, p = .001. Accuracy of parental perception, parent satisfaction with child weight status, child weight, and the interaction between parental perception and ideal adult weight status significantly predicted parent stage of readiness to promote fruit and vegetable consumption in the home environment, X 2 (7, N = 269) = 16.85, p\u3c.01. Parents who accurately perceived their child\u27s weight status and perceived a middle weight adult body size as ideal were 3.28 times more likely to be in the action/maintenance stages of change compared to parents with inaccurate perceptions of their child\u27s weight status. ^ Conclusion: Contrary to previous studies, most parents in this predominantly Hispanic sample perceived a healthy child body size as ideal. However, parents do not accurately perceive their child\u27s weight status, particularly parents of overweight or obese children. Increasing the accuracy of parental perceptions is a critical first step to impact behaviors associated with healthy child weight status by increasing parent concern; thus influencing parent progression through the stages of readiness to change the home environment. Future research should examine factors associated with parent stage of readiness to change the home environment.