The role of grandparents in childhood obesity in China - evidence from a mixed methods study.
The role of grandparents in childhood obesity in China - evidence from a mixed methods study.
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DOI：
10.1186/s12966-015-0251-z
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发表时间：
2015-06-30
期刊：
影响因子：
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通讯作者：
Cheng KK
中科院分区：
文献类型：
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作者：
Li B;Adab P;Cheng KK
目前关于家庭环境对儿童肥胖影响的文献主要基于西方人群，并且主要集中在父母的作用上。本研究旨在探讨祖父母对中国小学学龄儿童肥胖发展的影响。在中国南方两个城市的四个社会经济差异明显的小学社区进行了一项混合方法研究。定性研究（17个焦点小组和4个个人访谈）涉及学校附近的父母、祖父母、学校工作人员和食品零售商（n = 99），并探讨了儿童肥胖的已知原因。横断面研究调查了儿童客观测量的体重状况和报告的健康行为之间的关系，以及祖父母在家庭中的存在和角色。该研究包括每所学校随机选择的三个三年级（8至10岁）班级的儿童（n = 497）。祖父母通常被认为是造成儿童肥胖的原因，因为他们有不恰当的看法（例如，肥胖的孩子是健康的，照顾得很好）、知识（例如，与肥胖有关的疾病只会发生在成年人身上；饮食中能量/脂肪含量越高，食物越有营养）和行为（例如，过度喂养和纵容孩子不做家务）。祖父母与父母之间以及祖父母与学校教师之间相互冲突的儿童保育信念和做法被认为破坏了促进儿童健康行为的努力。在横断面研究中，主要由祖父母照顾的儿童更容易超重/肥胖（调整后OR = 2.03; 95% CI = 1.19 ~ 3.47）；与主要由父母或其他成年人照顾的儿童相比，摄入更多含糖饮料和不健康零食（B = 2.13, 95% CI = 0.87至3.40）。与没有祖父母生活在一起的儿童相比，与两位或两位以上祖父母生活在一起的儿童更容易超重/肥胖（调整后or = 1.72; 95% CI = 1.00至2.94）。祖父母参与照顾孩子是造成中国儿童肥胖的一个重要因素。未来的预防干预措施应包括针对祖父母的策略。
The current literature on the influences of family environment on childhood obesity is predominantly based on western populations and has focused on the role of parents. This study examined the influence of grandparents on the development of obesity among Chinese primary school aged children. A mixed methods study was conducted in four socioeconomically distinct primary school communities in two cities of southern China. The qualitative study (17 focus groups and four personal interviews) involved parents, grandparents, school staff, and food retailers in the vicinity of the schools (n = 99) and explored perceived causes of childhood obesity. The cross-sectional study examined the association between children’s objectively measured weight status and reported health behaviours, and the presence and role of grandparents in the household. It included children from three randomly selected third grade (8 to 10 years) classes from each school (n = 497). Grandparents were commonly perceived to contribute to childhood obesity through inappropriate perception (e.g. fat children are healthy and well cared for), knowledge (e.g. obesity related diseases can only happen in adults; the higher the dietary energy/fat content, the more nutritious the food), and behaviour (e.g. overfeeding and indulging through excusing the children from household chores). Conflicting child care beliefs and practices between grandparents and parents, and between grandparents and school teachers, were felt to undermine efforts to promote healthy behaviours in children. In the cross-sectional study, children who were mainly cared for by their grandparents were more likely to be overweight/obese (adjusted OR = 2.03; 95 % CI = 1.19 to 3.47); and to consume more sugar-added drinks and unhealthy snacks (B = 2.13, 95 % CI = 0.87 to 3.40), than children who were mainly cared for by their parents or other adult. Children who lived with two or more grandparents in the household were more likely to be overweight/obese than children who did not live with any grandparent (adjusted OR = 1.72; 95 % CI = 1.00 to 2.94). Involvement of grandparents in childcare is an important factor contributing to childhood obesity in China. Future preventive interventions should include strategies that target grandparents.