Acceptability of early childhood obesity prediction models to New Zealand families

Autoři: Éadaoin M. Butler aff001;  José G. B. Derraik aff001;  Marewa Glover aff004;  Susan M. B. Morton aff001;  El-Shadan Tautolo aff001;  Rachael W. Taylor aff001;  Wayne S. Cutfield aff001
Působiště autorů: A Better Start–National Science Challenge, Auckland, New Zealand aff001;  Liggins Institute, University of Auckland, Auckland, New Zealand aff002;  Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden aff003;  School of Health Sciences, College of Health, Massey University, Auckland, New Zealand aff004;  Centre of Research Excellence Indigenous Sovereignty & Smoking, Auckland, New Zealand aff005;  Centre for Longitudinal Research–He Ara ki Mua, The University of Auckland, Auckland, New Zealand aff006;  School of Population Health, University of Auckland, Auckland, New Zealand aff007;  Centre for Pacific Health & Development Research, Auckland University of Technology, Auckland, New Zealand aff008;  Department of Medicine, University of Otago, Dunedin, New Zealand aff009
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article



While prediction models can estimate an infant’s risk of developing obesity at a later point in early childhood, caregiver receptiveness to such information is largely unknown. We aimed to assess the acceptability of these models to New Zealand caregivers.


An anonymous questionnaire was distributed online. The questionnaire consisted of multiple choice and Likert scale questions. Respondents were parents, caregivers, and grandparents of children aged ≤5 years.


1,934 questionnaires were analysed. Responses were received from caregivers of various ethnicities and levels of education. Nearly two-thirds (62.1%) of respondents would “definitely” or “probably” want to hear if their infant was at risk of early childhood obesity, although “worried” (77.0%) and “upset” (53.0%) were the most frequently anticipated responses to such information. With lower mean scores reflecting higher levels of acceptance, grandparents (mean score = 1.67) were more receptive than parents (2.10; p = 0.0002) and other caregivers (2.13; p = 0.021); males (1.83) were more receptive than females (2.11; p = 0.005); and Asian respondents (1.68) were more receptive than those of European (2.05; p = 0.003), Māori (2.11; p = 0.002), or Pacific (2.03; p = 0.042) ethnicities. There were no differences in acceptance according to socioeconomic status, levels of education, or other ethnicities.


Almost two-thirds of respondents were receptive to communication regarding their infant’s risk of childhood obesity. While our results must be interpreted with some caution due to their hypothetical nature, findings suggest that if delivered in a sensitive manner to minimise caregiver distress, early childhood obesity risk prediction could be a useful tool to inform interventions to reduce childhood obesity in New Zealand.

Klíčová slova:

Body Mass Index – Ethnicities – Childhood obesity – Children – Infants – Socioeconomic aspects of health – Surveys


1. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: UNICEF/WHO/World Bank Group Joint child malnutrition estimates. Geneva: WHO; 2017.

2. Shackleton N, Milne BJ, Audas R, Derraik JGB, Zhu T, Taylor RW, et al. Improving rates of overweight, obesity and extreme obesity in New Zealand 4-year-old children in 2010–2016. Pediatr Obes. 2018;13(12): 766–777. doi: 10.1111/ijpo.12260 29271074

3. Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9(5): 474–488. doi: 10.1111/j.1467-789X.2008.00475.x 18331423

4. Pulgaron ER. Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clin Ther. 2013;35(1): A18–32. doi: 10.1016/j.clinthera.2012.12.014 23328273

5. Reilly JJ, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes (Lond). 2011;35(7): 891–898.

6. Pandita A, Sharma D, Pandita D, Pawar S, Tariq M, Kaul A. Childhood obesity: prevention is better than cure. Diabetes Metab Syndr Obes. 2016;9: 83–89. doi: 10.2147/DMSO.S90783 27042133

7. Butler EM, Derraik JGB, Taylor RW, Cutfield WS. Childhood obesity: how long should we wait to predict weight? J Pediatr Endocrinol Metab. 2018;31(5): 497–501. doi: 10.1515/jpem-2018-0110 29668465

8. Butler ÉM, Derraik JGB, Taylor RW, Cutfield WS. Prediction models for early childhood obesity: Applicability and existing issues. Horm Res Paediatr. 2019;90(6): 358–367.

9. Redsell SA, Rose J, Weng S, Ablewhite J, Swift JA, Siriwardena AN, et al. Digital technology to facilitate Proactive Assessment of Obesity Risk during Infancy (ProAsk): A feasibility study. BMJ Open. 2017;7(9): e017694. doi: 10.1136/bmjopen-2017-017694 28882926

10. McBride C, Persky S, Wagner L, Faith M, Ward DS. Effects of providing personalized feedback of child’s obesity risk on mothers’ food choices using a virtual reality buffet. Int J Obes. 2013;37(10): 1322.

11. Syrad H, Falconer C, Cooke L, Saxena S, Kessel AS, Viner R, et al. 'Health and happiness is more important than weight': a qualitative investigation of the views of parents receiving written feedback on their child's weight as part of the National Child Measurement Programme. J Hum Nutr Diet. 2015;28(1): 47–55. doi: 10.1111/jhn.12217 26295077

12. Schwartz M. Parental perceptions of body mass index notification: A qualitative study. J Sch Health. 2015;85(10): 714–721. doi: 10.1111/josh.12300 26331754

13. Gillison F, Beck F, Lewitt J. Exploring the basis for parents' negative reactions to being informed that their child is overweight. Public Health Nutr. 2014;17(5): 987–997. doi: 10.1017/S1368980013002425 24060095

14. Dawson AM, Brown DA, Williams SM, Taylor BJ, Ross J, Taylor RW. Parental reactions to weight screening in young children: a randomized controlled trial. Pediatr Obes. 2016: 639–646. doi: 10.1111/ijpo.12195 27863185

15. Bentley F, Swift JA, Cook R, Redsell SA. "I would rather be told than not know"—A qualitative study exploring parental views on identifying the future risk of childhood overweight and obesity during infancy. BMC Public Health. 2017;17(1): 684. doi: 10.1186/s12889-017-4684-y 28851331

16. Rose J, Glazebrook C, Wharrad H, Siriwardena A, Swift JA, Nathan D, et al. Proactive Assessment of Obesity Risk during Infancy (ProAsk): A qualitative study of parents' and professionals' perspectives on an mHealth intervention. BMC Public Health. 2019;19: 294. doi: 10.1186/s12889-019-6616-5 30866879

17. Ministry of Health. New Zealand Health Survey Annual Data Explorer; 2019 [cited 2019 August 27]. Available from:!/explore-indicators.

18. Grimmett C, Croker H, Carnell S, Wardle J. Telling parents their child's weight status: psychological impact of a weight-screening program. Pediatrics. 2008;122(3): e682–688. doi: 10.1542/peds.2007-3526 18762503

19. Jain A, Sherman SN, Chamberlin DLA, Carter Y, Powers SW, Whitaker RC. Why don't low-income mothers worry about their preschoolers being overweight? Pediatrics. 2001;107(5): 1138–1146. doi: 10.1542/peds.107.5.1138 11331699

20. Gomes AI, Barros L, Pereira AI. Predictors of parental concerns about child weight in parents of healthy-weight and overweight 2–6 year olds. Appetite. 2017;108: 491–497. doi: 10.1016/j.appet.2016.11.008 27825942

21. World Bank Group. Individuals using the Internet (% of population) New Zealand; 2019 [cited 2019 August 28]. Available from:

22. Worrall J. Grandparents and whanau/extended families raising kin children in Aotearoa/New Zealand. Auckland, Grandparents Raising Grandchildren Trust New Zealand. 2009.

23. Statistics NZ. Grandparents lend a hand for childcare; 2017 [cited 2019 February 8]. Available from:

24. Exeter DJ, Zhao J, Crengle S, Lee A, Browne M. The New Zealand Indices of Multiple Deprivation (IMD): A new suite of indicators for social and health research in Aotearoa, New Zealand. PLoS One. 2017;12(8): e0181260. doi: 10.1371/journal.pone.0181260 28771596

25. Ministry of Health. HISO 10001:2017 Ethnicity Data Protocols. Wellington: Ministry of Health; 2017.

26. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85: 660–667. doi: 10.2471/BLT.07.043497 18026621

27. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl. 2006;450: 76–85. 16817681

28. Craig LCA, Clark J, McNeill G. Views of parents on routine measurements of children's growth in schools. Proc. Nutr. Soc. Vol 692010: E444.

29. Falconer CL, Park MH, Croker H, Skow A, Black J, Saxena S, et al. The benefits and harms of providing parents with weight feedback as part of the national child measurement programme: a prospective cohort study. BMC Public Health. 2014; 14:549. doi: 10.1186/1471-2458-14-549 24888972

30. Goodell LS, Pierce MB, Bravo CM, Ferris AM. Parental perceptions of overweight during early childhood. Qual Health Res. 2008;18(11): 1548–1555. doi: 10.1177/1049732308325537 18849515

31. Bell LK, Perry RA, Prichard I. Exploring grandparents' roles in young children's lifestyle behaviors and the prevention of childhood obesity: An Australian perspective. J Nutr Educ Behav. 2018;50(5): 516–521. doi: 10.1016/j.jneb.2017.12.007 29449153

32. Tapera R, Harwood M, Anderson A. A qualitative Kaupapa Maori approach to understanding infant and young child feeding practices of Maori and Pacific grandparents in Auckland, New Zealand. Public Health Nutr. 2017;20(6): 1090–1098. doi: 10.1017/S1368980016002950 27829473

33. Pearce A, Li L, Abbas J, Ferguson B, Graham H, Law C. Is childcare associated with the risk of overweight and obesity in the early years? Findings from the UK Millennium Cohort Study. Int J Obes (Lond). 2010;34(7): 1160–1168.

34. Tanskanen AO. The association between grandmaternal investment and early years overweight in the UK. Evolu Psychol. 2013;11(2): 417–425.

35. Morgan PJ, Young MD. The influence of fathers on children’s physical activity and dietary behaviors: Insights, recommendations and future directions. Curr Obes Rep. 2017;6(3): 324–333. doi: 10.1007/s13679-017-0275-6 28762103

36. Research NZ. Awareness, use and perceived effectiveness of Government-funded programmes and services aimed at preventing and reducing child obesity in New Zealand: A consumer perspective. 2013.

37. Heimuli J, Sundborn G, Rush E, Oliver M, Savila F. Parental perceptions of their child's weight and future concern: the Pacific Islands Families Study. Pac Health Dialog. 2011;17(2): 33–49. 22675803

38. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2): 179–211.

39. Rosenstock IM. Historical origins of the health belief model. Health Educ Monogr. 1974;2(4): 328–335.

40. Redsell SA, Atkinson P, Nathan D, Siriwardena AN, Swift JA, Glazebrook C. Parents' beliefs about appropriate infant size, growth and feeding behaviour: implications for the prevention of childhood obesity. BMC Public Health. 2010;10(1): 711.

41. Appleton J, Fowler C, Brown N. Parents' views on childhood obesity: qualitative analysis of discussion board postings. Contemp Nurse. 2017;53(4): 410–420. doi: 10.1080/10376178.2017.1358650 28728473

42. Pocock M, Trivedi D, Wills W, Bunn F, Magnusson J. Parental perceptions regarding healthy behaviours for preventing overweight and obesity in young children: a systematic review of qualitative studies. Obes Rev. 2010;11(5): 338–353. doi: 10.1111/j.1467-789X.2009.00648.x 19780989

Článek vyšel v časopise


2019 Číslo 12
Nejčtenější tento týden