| 1. |
- Bohman, Benjamin, et al.
(author)
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Infrequent attention to dietary and physical activity behaviours in conversations in Swedish child health services
- 2013
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In: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 102:5, s. 520-524
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Journal article (peer-reviewed)abstract
- Aim: To investigate conversations between nurses and parents in Swedish child health services and to assess to what extent attention is directed towards dietary and physical activity behaviours in children.Methods: Twenty-three nurses audio-recorded one session each. Recordings were assessed and topics were classified according to predetermined categories.Results: The three most frequent topics of conversation concerned physical examinations of the child (30% of session time), talking to the child to establish or maintain contact and interest (15%), and development of language skills (12%). Dietary habits came on fourth place (10%), and physical activity ranked 14 (4%).Conclusion: Attention to dietary and physical activity behaviours in children is infrequent in Swedish child health services. Concern is raised about the efficacy of prevention efforts against childhood obesity.
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| 2. |
- Bohman, Benjamin
(author)
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Motivation and health behavior in the prevention of childhood obesity
- 2013
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Doctoral thesis (other academic/artistic)abstract
- The objectives of the present thesis were to investigate self-efficacy and motivational interviewing as motivational frameworks for health behavior change in the prevention of childhood obesity, and to explore child health services as a setting for childhood obesity prevention. Specifically, the thesis aimed to (a) develop a measure of parental self-efficacy for promoting healthy physical activity and dietary behaviors in children and assess its psychometric properties, (b) evaluate the effects of a training program in childhood obesity prevention on self-efficacy in nurses in child health services, (c) evaluate the effects of a training program in motivational interviewing on proficiency in nurses in child health services, and (d) investigate the frequency of conversation about dietary and physical activity behaviors in children in child health services. In Study I, using exploratory and confirmatory factor analyses, the evaluation showed that a new measure of parental self-efficacy had adequate psychometric properties in a sample of 2232 mothers with 3-year-old children, including construct and discriminant validity, internal consistency (α = .87), and test-retest reliability (r = .82). Study II used multiple linear regression analysis and dependent t-tests with Bonferroni correction to examine the effects of training in methods of preventing childhood obesity on efficacy beliefs in nurses in child health services. The study had a randomized controlled design with an intervention group (n = 22) and a control group (n = 38). Results showed that efficacy beliefs in intervention nurses had increased at post assessment relative to control nurses (β = 14.70, p < .001). Study III used dependent t-tests and multiple linear regression analysis to evaluate the effects of training in motivational interviewing on proficiency in a sample of nurses in child health services (n = 36). Skillfulness had not been acquired in this sample from pre to post training (ps ≥ .05). In Study IV, conversations between nurses (n = 23) and parents in child health services were assessed to what extent conversations focused on child health behaviors. Using descriptive statistics, it was found that attention to these behaviors was infrequent, with dietary behaviors ranking fourth and physical activity on rank 14 among topics of conversation. In summary, self-efficacy is a useful framework, and motivational interviewing a potentially useful framework in childhood obesity prevention. Efficacy beliefs were adequately assessed in parents of small children and nurses in child health services, and increased in nurses as a result of training. However, motivational interviewing proved to be a difficult method to learn, and conversations in child health services did not focus to any greater extent on dietary and physical activity behaviors in children.
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| 3. |
- Bohman, Benjamin, et al.
(author)
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Psychometric Properties of a New Measure of Parental Self-Efficacy for Promoting Healthy Physical Activity and Dietary Behaviors in Children
- 2013
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In: European Journal of Psychological Assessment. - : Hogrefe Publishing Group. - 1015-5759 .- 2151-2426. ; 29:4, s. 291-298
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Journal article (peer-reviewed)abstract
- There is a lack of validated measures of parental self-efficacy (PSE) covering both physical activity and dietary behaviors in children which can be used to prevent childhood obesity. This study developed a new measure of PSE for promoting healthy physical activity and dietary behaviors in children and assessed its psychometric properties. Participants were mothers (n = 2,232) with 3-year-old first-born children living in Stockholm, Sweden. The mothers responded to questionnaires measuring PSE, locus of control, and self-esteem. Exploratory factor analysis yielded a three-factor structure, interpreted as PSE for promoting healthy dietary behaviors in children (Factor 1), PSE for limit-setting of unhealthy dietary or physical activity behaviors in children (Factor 2), and PSE for promoting healthy physical activity behaviors in children (Factor 3). The factor model was supported by confirmatory factor analysis. The internal consistency and test-retest reliability of the new PSE measure were high; discriminant validity was adequate. The Parental Self-Efficacy for Promoting Healthy Physical Activity and Dietary Behaviors in Children Scale (PSEPAD) shows promise as a valuable instrument in childhood obesity prevention.
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| 4. |
- Bohman, Benjamin, et al.
(author)
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Validity and Reliability of a Parental Self-Efficacy Instrument in the Healthy School Start Prevention Trial of Childhood Obesity.
- 2014
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In: Health Education & Behavior. - : SAGE Publications. - 1090-1981 .- 1552-6127. ; 41:4, s. 392-6
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Measures of parental self-efficacy (PSE) for healthy dietary or physical activity (PA) behaviors in children have been used in several studies; however, further psychometric validation of PSE for these behaviors is needed. The purpose of the present study was to evaluate the psychometric properties of a new PSE instrument.METHODS: Mothers (n = 162) of 6-year-old children in the Healthy School Start prevention trial of childhood obesity responded to the instrument and a parent-report questionnaire on diet and PA in children. In addition, PA was objectively assessed by accelerometry.RESULTS: Exploratory factor analysis yielded a structure composed of three factors of PSE for dietary and PA behaviors in children, and PSE was associated with parent-report of these behaviors. Internal consistency was good.DISCUSSION: Preliminary support of the validity and reliability of the PSE instrument was provided. The measure may be useful in prevention and treatment trials of childhood obesity.
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| 5. |
- Doring, Nora, et al.
(author)
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Primary prevention of childhood obesity through counselling sessions at Swedish child health centres : design, methods and baseline sample characteristics of the PRIMROSE cluster-randomised trial
- 2014
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14:335
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Journal article (peer-reviewed)abstract
- Background: Childhood obesity is a growing concern in Sweden. Children with overweight and obesity run a high risk of becoming obese as adults, and are likely to develop comorbidities. Despite the immense demand, there is still a lack of evidence-based comprehensive prevention programmes targeting pre-school children and their families in primary health care settings. The aims are to describe the design and methodology of the PRIMROSE cluster-randomised controlled trial, assess the relative validity of a food frequency questionnaire, and describe the baseline characteristics of the eligible young children and their mothers. Methods/Design: The PRIMROSE trial targets first-time parents and their children at Swedish child health centres (CHC) in eight counties in Sweden. Randomisation is conducted at the CHC unit level. CHC nurses employed at the participating CHC received training in carrying out the intervention alongside their provision of regular services. The intervention programme, starting when the child is 8-9 months of age and ending at age 4, is based on social cognitive theory and employs motivational interviewing. Primary outcomes are children's body mass index and waist circumference at four years. Secondary outcomes are children's and mothers' eating habits (assessed by a food frequency questionnaire), and children's and mothers' physical activity (measured by accelerometer and a validated questionnaire), and mothers' body mass index and waist circumference. Discussion: The on-going population-based PRIMROSE trial, which targets childhood obesity, is embedded in the regular national (routine) preventive child health services that are available free-of-charge to all young families in Sweden. Of the participants (n = 1369), 489 intervention and 550 control mothers (75.9%) responded to the validated physical activity and food frequency questionnaire at baseline (i.e., before the first intervention session, or, for children in the control group, before they reached 10 months of age). The food frequency questionnaire showed acceptable relative validity when compared with an 8-day food diary. We are not aware of any previous RCT, concerned with the primary prevention of childhood obesity through sessions at CHC that addresses healthy eating habits and physical activity in the context of a routine child health services programme.
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