Parent-reported health status of overweight and obese Australian primary school children: a cross-sectional population survey

Introduction: Childhood overweight/obesity is associated with poor physical and psychosocial health in clinical samples. However, there is little information on the health status of overweight and obese children in the community, who now represent a large proportion of the child population. We examined parent-reported child health and well-being and parent concern about child weight by body mass index (BMI) category in a population sample of primary school children.

Design: A stratified two-stage random cluster sample of 24 primary schools representative of the state of Victoria, Australia.

Measures: BMI (weight/height2) transformed to normalised Z-scores using the 1990 UK Growth Reference; the Child Health Questionnaire (CHQ), a 13-scale 50-item parent-completed measure of health and well-being; parent self-reported height and weight; parent concern about child's weight.

Results: Data were available for 2863 children aged 5-13 y (50.5% male), of whom 17% were overweight and 5.7% obese. Using logistic regression analyses with 'normal weight' as the referent category, obese boys were at greater risk of poor health (ie <15th centile) on seven of the 12 CHQ scales: Physical Functioning (odds ratio (OR) 2.8), Bodily Pain (OR 1.8), General Health (OR 3.5), Mental Health (OR 2.8), Self Esteem (OR 1.8), Parent Impact¾Emotional (OR 1.7) and Parent Impact¾Time (OR 1.9). Obese girls were at greater risk of poor health on only two scales: General Health (OR 2.1) and Self Esteem (OR 1.8). Forty-two percent of parents with obese children and 81% with overweight children did not report concern about their child's weight. Parents were more likely to report concern if the child was obese (OR 21.3), overweight (OR 3.5) or underweight (OR 5.4) than normal weight (P<0.05). Concern was not related to child gender, parental BMI or parental education after controlling for child BMI. Perceived health and well-being of overweight/obese children varied little by weight category of the reporting parent (overweight vs non-overweight).

Conclusions: Parents were more likely to report poorer health and well-being for overweight and obese children (particularly obese boys). Parental concern about their child's weight was strongly associated with their child's actual BMI. Despite this, most parents of overweight and obese children did not report poor health or well-being, and a high proportion did not report concern. This has implications for the early identification of such children and the success of prevention and intervention efforts.

Including the siblings of youth substance abusers in a parent-focused intervention : a pilot test of the best plus program

Substance use is common among young people and can escalate into significant problems for affected individuals and their families. Family responses can influence the course of youth substance use and its consequences for family members, including parents and siblings. Family-level interventions developed to date have neglected the important role that siblings can play. This article describes a pilot test of an intervention designed to assist parents and siblings affected by youth substance use and related problems. The BEST Plus intervention consisting of professionally-led, multifamily groups sequenced over eight sessions is described with reference to the intended therapeutic processes. Professionally observed and self-reported changes for family participants including siblings suggested that the program had a beneficial therapeutic impact. This evaluation of early impacts suggests the BEST Plus program
offers a promising means of assisting families to respond to substance use problems in young people.

Parent cognitions and parent-infant interaction: the relationship with development in the first 12 months

This study examined parent cognitions and parent-infant interaction in terms of their contribution to infant development in the first 12 months. With a sample of 95 mother-infant dyads, results using structural equation modelling confirmed the expected finding that parent-infant interaction mediates the association between parent cognitions and infant development. An unexpected finding was that the direct association between parent cognitions and infant development was stronger than the direct association between parent-infant interaction and infant development. These findings are discussed with regard to the implications for preventative and early intervention models.

Discrepancy between expected and actual child support payments : predicting the health and health-related quality of life of children living in low-income, single-parent families

Objective Although the amount and frequency of child support payments received by single parents are often erratic and fluctuate, no study to date has quantitatively explored how the discrepancy between expected and actual payments relates to child health. This study aims to examine whether the discrepancy between expected and actual child support payments predicts a range of child health outcomes, including global health, health-related quality of life, involvement in activities and parental psychological distress.

Methods This study used results from the Longitudinal Study of Australian Children, which included a sample of parents of children aged 4–5 years (n = 4983). The questionnaire was completed by the parent who spent the most time with the child and knew the child best. From the 4983 families, 332 low-income single parents reliant on welfare with a formal or informal child support order in place were identified.

Results After controlling for income, the discrepancy between expected and actual child support predicted school functioning, conduct problems, total mental health problems and involvement in activities. Discrepancy between expected and actual child support payments did not predict the remaining health-related quality of life domains, mental health domains, global child health or parental psychosocial distress.

Conclusion This was the first study to examine how the discrepancy between expected and actual child support payments relates to child health, providing important data on the effectiveness of the child support system for children's well-being. These findings highlight the potential impact of the discrepancy on school functioning, conduct problems, total mental health problems and involvement in activities.

Parent's views of the importance of making changes in settings where children spend time to prevent obesity

Aim : To examine the kinds of changes parents would like to see in those settings where children spend time (kindergartens and schools, child care centres and after-school care facilities, and the local neighbourhood) in policies and practices that impact on children’s risk of obesity, and to establish whether parents might be willing to advocate for changes in these settings.

Materials and Methods : 175 parents from five randomly selected primary schools and five randomly selected kindergartens located in suburbs of metropolitan Melbourne completed a questionnaire in which they rated the importance of a number of potential changes to promote healthy eating and increase physical activity in their children.

Results : Parents of children in kindergarten most commonly rated changes to the eating environment as important. In contrast, parents of primary school children believed changes related to both eating and physical activity in school were important. Ninety-five per cent of parents of kindergarten children and 89% of parents of primary school children believed it was possible for parents to bring about change to provide more opportunities for their child to eat more healthily and be more physically active. One in four parents reported that they had thought about or had tried to bring about changes in their community.

Conclusions : The findings suggest that mobilising parents to take an active role in advocating for change in those settings that have the potential to shape their children’s physical activity and eating behaviours may be feasible.

The influence of child support and welfare on single parent families

Many single parent families in Australia are on low-incomes and many depend on Centrelink Parenting Payments as their main source of income which is comparatively low to meet their basic living costs. The impact of low income on child health and social inclusion is discussed.

Parent management training, comorbidity, and treatment of children with oppositional defiant disorder

This study found that Parent Management Training was a successful treatment for promary school aged children who were referred to a mental health clinic and diagnosed with Oppositional Defiant Disorder. The positive outcome was not affected by the child having comorbid disorders. These findings have relevance to the clinical field.

Utility of parent training for child behaviour difficulties

Focuses on parent training for child behaviour difficulties and includes four case studies providing a detailed assessment, formulation and evaluation of the treatment. The reports illustrate the utility of parent training alone and in combination with other psychological therapies and pharmacotherapy in the treatment of different childhood disorders.

Manualised treatment and dropout : a study of parent training

Parents who dropped out of manualised parent training programs for children with externalising behaviour disorders were interviewed retrospectively and compared prospectively with parents who continued in these programs. Parents who dropped out tended to feel more overwhelmed by their situation, because their child's behaviour problems were more severe, they had single parent status or had more than one child with difficulties.

The role of attachment in current and future parent caregiving

Few studies have investigated how attachment bonds between older parents and their adult children influence adult children’s provision of care and older parents’ seeking of support from kin. The aim of this study was to investigate how the attachment orientations of adult children (N = 119) and older parents (N = 148) predict family caregiving and perceptions of carer burden. Across both samples (that were unrelated), attachment dimensions were associated with current and future caregiving and care receiving and perceptions of carer burden, even when accounting for demographic variables, parental dependence and filial obligation. Specifically, attachment avoidance was associated negatively with adult children’s future care of parents and positively with burden. In contrast, attachment anxiety was positively associated with older parents’ seeking current support, perceptions of carer burden, and intentions to seek future support.