Parental Predictions and Perceptions Regarding Long-Term Childhood Obesity-Related Health Risks

Abstract

Objective: To assess how parents perceive long-term risks for developing obesity-related chronic health conditions.

Methods: A Web-based nationally representative survey was administered to 502 US parents with a 5- to 12-year-old child. Parents reported whether their child was most likely to be at a healthy weight or overweight, and the probability that their child would develop hypertension, heart disease, depression, or type 2 diabetes in adulthood. Responses of parents of children with overweight and obesity were compared to those of healthy-weight children using multivariate models.

Results: The survey had an overall response rate of 39.2%. The mean (SD) unadjusted parent predicted health risks were 15.4% (17.7%), 11.2% (14.7%), 12.5% (16.2%), and 12.1% (16.1%) for hypertension, heart disease, depression, and diabetes, respectively. Despite underperceiving their child's current body mass index class, parents of children with obesity estimate their children to be at greater risk for obesity-related health conditions than parents of healthy-weight children by 5 to 6 percentage points. Having a family history of a chronic disease, higher quality of care, and older parent age were also significant predictors of estimating higher risk probabilities.

Conclusions: Despite evidence that parents of children who are overweight may not perceive these children as being overweight, parents unexpectedly estimate greater future risk of weight-related health conditions for these children. Focusing communication about weight on screening for and reducing the risk of weight-related diseases may prove useful in engaging parents and children in weight management.

Keywords: cardiovascular disease; childhood obesity; diabetes; mental health; risk assessment; risk communication; risk perception.

Figure 1. Visual analog scale

Parents were asked, “What do you think the chance is that [CHILD] will have [DISEASE] at age [PARENT’S CURRENT AGE]?” for each of the four health conditions on a visual analog scale (pictured). The scale reported numbers in terms of percentages and proportions and parents were able to see exactly what number they had chosen using the slider (any integer from 0 to 100) in the box underneath the scale.

Figure 2. Marginal difference in parent-predicted child health risk by BMI class (mean and 95% CI)

Regression models examining the relationship between parent-predicted risk and child current BMI were adjusted for, family history of disease, residence in an MSA, quality of healthcare, parent BMI class, parent age, parent race, and census region.

Appendix Figure 1

Parent perception of risk likelihood by child BMI class (unadjusted) (A) Hypertension (B) Heart Disease (C) Type 2 Diabetes (D) Depression