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Published online June 29, 2009
PEDIATRICS Vol. 124 No. 1 July 2009, pp. 151-158 (doi:10.1542/peds.2008-2892)
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ARTICLE

Parental Confidence in Making Overweight-Related Behavior Changes

Elsie M. Taveras, MD, MPHa, Kathleen Mitchell, MDb, Steven L. Gortmaker, PhDc

a Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
b Harvard Vanguard Medical Associates, Boston, Massachusetts
c Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts

BACKGROUND: Confidence is an important construct for behavioral change; higher levels of confidence, or self-efficacy, increase the likelihood that a person will change a health behavior even when faced with obstacles.

OBJECTIVE: To identify parent, child, and clinician characteristics associated with higher parental confidence in their ability to make overweight-related behavior changes for their family.

METHODS: We interviewed 446 parents of children, aged 2 to 12 years, with a BMI of ≥85th percentile and surveyed their pediatric clinicians (N = 75). The main outcome was parental confidence in their ability to make overweight-related behavior changes. We derived a continuous parental confidence score from 6 questions (Cronbach's {alpha} = 0.72) regarding parental confidence in limiting television viewing, removing televisions from children's bedrooms, reducing fast-food intake, reducing sugar-sweetened beverage intake, increasing physical activity, and improving overall eating patterns for their family. We used multiple linear regression to predict the effects of parent, child, and clinician characteristics on the parents' confidence scores.

RESULTS: The mean (SD) score on the parental confidence scale was 13.0 (3.5), and the range was 0.0 to 24.0. In multivariable analyses, parents who said their clinicians assessed their confidence (41%; β = 0.73 [95% confidence interval: 0.04–1.42]) or who said that their clinicians assessed their readiness to change (35%; β =0.80 [95% confidence interval: 0.10–1.49]) reported higher levels of confidence compared with parents whose clinicians did not assess confidence or readiness to change.

CONCLUSIONS: Clinician assessment of parental confidence and readiness to change was associated with higher parent confidence in making changes to keep their child from being overweight.

Key Words: obesity • behavior change • parents • primary care • self-efficacy

Abbreviations: HVMA—Harvard Vanguard Medical Associates • CI—confidence interval

Accepted Feb 5, 2009.


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