The family-home environment and its association with the emergence, persistence, and remission of weight gain in mid-childhood

Pearce, Matthew David 2024. The family-home environment and its association with the emergence, persistence, and remission of weight gain in mid-childhood. PhD Thesis, CARDIFF UNIVERSITY. Item availability restricted.

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Abstract

Background: The home environment is important in the aetiology of childhood obesity with parents and carers playing a significant role in socialising their children and navigating the obesogenic environment. Whilst research shows that the prevalence of obesity doubles between the ages of 4/5 and 10/11 years, evidence suggests that small proportion of children with excess weight return to a healthy weight status by the age of 10/11years. The purpose of this research was to investigate key home and family factors, motivations of parents and its relationship with the emergence, persistence, and remission of weight gain amongst children during mid-childhood. Methods This thesis adopted a mixed methods approach using a multi-method sequential explanatory design. Firstly, an online survey was distributed to parents in Gloucestershire whose children were measured in 2019/20 aged 10/11 years via the National Child Measurement Programme (NCMP). The Family Nutrition and Physical Activity (FNPA) questionnaire was used to assess the home environment. Associations between the descriptive data (deprivation, gender, age), total FNPA, FNPA subdomains and weight, was conducted using logistic regression and Pearson’s correlation. Secondly, parents were identified for the qualitative component through purposive sampling where children had achieved a positive shift in weight status between the two time points (4/5 and 10/11 years). Five in-depth semi-structured interviews were conducted, with thematic analysis undertaken to map responses by parents against the Theoretical Domains Framework (Cane, 2012) to understand how their child’s behaviour and weight outcomes may have been influenced within the context of the family home environment and wider community. Results A total of 719 participants were surveyed. Of those, 179 matched data records included biometric data for children at 4/5 and 10/11 years. A significant proportion of adults (64.7%) incorrectly perceived their overweight or obese child to be a healthy weight. The total FNPA score significantly predicted an increased risk for being obese at 10/11 age and weight gain between the two timepoints. When adjusting for independent variables, children with a total score in the lowest FNPA tertile (higher risk family environment and behaviours) had an odds ratio of 5.28 (95% CI=1.39–20.07) for being at risk of obesity and 3.39 (95% CI=1.10–10.43) for gaining significant weight (BMI z-score ≥ 0.6) between the two timepoints. Analysis of the FNPA subdomains revealed the sedentary/media domain predictive of excess weight at xiii 10/11 years. From the qualitative study, 16 themes across 7 TDF were identified as potential positive influences on child behaviour and weight outcomes including physical activity levels, sibling influence, child involvement in food, child wellbeing and active school and community environments. Conclusion Whilst acknowledging the multiple levels of influence on child overweight and obesity, the home environment remains an important setting in children’s development. The findings indicate that the family home environment is a key predictor of weight status and weight change in children aged 10/11 years old, which implies that preventative interventions should be implemented early in the life-course with a focus on the home environment. Further research should be undertaken to understand the underlying mechanisms for why some children manage to resolve their weight status to a healthy weight during mid childhood

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Healthcare Sciences
Date of First Compliant Deposit:	2 May 2024
Last Modified:	14 May 2024 14:23
URI:	https://orca.cardiff.ac.uk/id/eprint/168586

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