How can we help parents recognise unhealthy body weight in their children?

儿童肥胖症是一个重要的全球公共卫生问题，确定有效的预防策略仍然是一个优先事项。父母是培养其子女健康相关行为的核心，在制定和实施预防战略方面发挥着关键作用。然而，许多研究表明，与儿童健康体重的指导相比，父母没有意识到他们的孩子超重。例如，我们以前的NPRI资助的工作表明，超过2/3的超重儿童的父母描述他们的孩子在7岁时是“正常体重”。有证据表明，父母倾向于使用他们的孩子看起来如何与其他可能更超重的人相比，以确定他们的体重状况。因此，在儿童超重的高流行率的背景下，这意味着父母依赖极端情况作为参考点，他们对“超重”的理解可能已经发生了转变。解决父母的看法与儿童实际体重状况之间的差异很重要。如果父母不认为他们的孩子超重，他们就不太可能对孩子的生活方式做出适当的改变。然而，有证据表明，如果父母认为孩子的体重是一个健康问题，他们更有可能做出这样的改变。因此，增加父母对OW儿童的了解，以及增加他们对儿童超重的健康后果的了解是一个值得探索的策略。国家儿童测量计划（NCMP）目前测量所有接收和6年级儿童的体重状况。家长们通过信件得知调查结果，但传闻证据表明，这些信件往往不受欢迎，也不能促进采取适当的行动。另一种常见的监测儿童生长的方法是使用生长图表，但它们的有用性是值得怀疑的，因为还不清楚一般人群是否理解它们。这项多阶段研究旨在解决改善告知父母孩子体重状况的策略的必要性。它将开发和测试工具，以提高父母正确评估孩子体重状况（符合NCMP标准）的能力，并增加他们对儿童超重对健康后果的了解。身体形象量表是从体重不足到肥胖的身体形状的视觉图像。现有的身体形象尺度不对应于英国常用的超重的任何截止值，如NCMP所采用的。在第一阶段，我们将使用便携式3D身体扫描技术，从800名儿童获得身体扫描。身体扫描将用于生成接收和6岁儿童的年龄和性别特定身体图像量表。在第二阶段，将广泛征求家长的意见，以进一步制定身体形象量表，作为提高家长识别儿童超重的能力的一种方法，并制定支持信息，以增加家长对儿童超重后果的认识。将开发两种提供工具的方法（基于纸张和基于网络）。在第三阶段，将对工具、辅助信息和两种交付方法进行可行性研究。我们会透过举办焦点小组，征询家长对已发展的方法的意见和经验，并利用所得的结果，改善各方面的工作。最后，在第四阶段，将对2040个家庭进行一项随机对照试验，以测试该工具是否有效，以及哪种提供方法在提高父母对儿童超重的认识和对其后果的理解方面最有效。研究小组的政策和从业人员合作伙伴将确保研究结果可直接用于实践，并将支持国家肥胖研究中心的工作。天文台和NHS的选择。

Childhood obesity is an important public health problem worldwide and identifying effective preventive strategies remains a priority. Parents are central to the development of their child's health-related behaviours and play a key role in both the development and implementation of prevention strategies. However, many studies show that parents do not recognise when their child is overweight compared with guidance on healthy body weights for children. For example, our previous NPRI funded work showed that over 2/3rdsof parents of overweight children described their child as being of 'normal weight' at 7 years. Evidence indicates that parents tend to use how their children look compared with others who may be more overweight to identify their weight status. Thus in the context of a high prevalence of childhood overweight, this means that parents rely on extreme cases as a reference point and a shift in their understanding of what 'overweight' means is likely to have occurred.Addressing the difference between parents' perceptions and actual child weight status is important. If parents do not perceive their child as overweight they are unlikely to make appropriate changes to their child's lifestyle. However there is evidence that parents are more likely to make such changes if they perceive their child's weight as being a health problem. So increasing parents' knowledge of what an OW child does look like, plus increasing their knowledge about the health consequences of childhood overweight is a strategy worth exploring.The National Child Measurement Programme (NCMP) currently measures weight status in all Reception and Year 6 children. Parents are informed of the results by letter but anecdotal evidence suggests that the letters are often not well received and do not to promote appropriate action. Another common method of monitoring children's growth is the use of growth charts, but their usefulness is questionable because it is unclear whether the general population understands them.This multistage study aims to address the need for improving strategies for informing parents about their child's weight status. It will develop and test tools to improve parents' ability to correctly assess their child's weight status (in line with NCMP criteria) as well to increase their knowledge of the health consequences of childhood overweight.Body image scales are visual images of body shapes ranging from underweight to obese. Existing body image scales do not correspond to any cut-offs for overweight commonly used in the UK such as those employed by the NCMP. In stage 1 we will use portable 3D body scanning technology to obtain body scans from 800 children. The body scans will be used to produce age and gender specific body image scales for Reception and Year 6 aged children. In stage 2 parents will be consulted extensively to further develop the body image scales as a method to improve parents' ability to recognise overweight in children and to develop supporting information to increase parental knowledge of the consequences of childhood overweight. Two methods of delivering the tool will be developed (paper based and web based). In stage 3 a feasibility study of the tool, supporting information, and the two methods of delivery will be conducted. Parents' views and experiences of the developed methods will be sought by conducting focus groups and the findings will be used to improve all aspects. Finally, in stage 4, a cluster randomised control trial will be conducted with 2040 families to test whether the tool is effective and which method of delivery is most effective in improving parental recognition of childhood overweight and understanding of its consequences.Policy and practitioner partners in the study team will ensure that the study outputs are directly transferable to practice and will support the work of the National Obesity Observatory and NHS Choices.