Parental recall of doctor communication of weight status: national trends from 1999 through 2008

Abstract

Objective: To examine time trends in parental reports of health professional notification of childhood overweight over the last decade and to determine the characteristics most associated with such notification.

Design: Secondary data analysis using χ(2) tests to examine the relationships between multiple factors on the reports of parents and/or caregivers (hereinafter "parents") and logistic regression for multivariate analysis.

Setting: National Health and Nutrition Examination Survey, 1999 through 2008.

Participants: Parents of 4985 children aged 2 to 15 years with body mass index (BMI) in the 85th percentile or higher based on measured height and weight.

Main outcome measures: Affirmative answer to the following question: "Has a doctor or health professional ever told you that your child is overweight?"

Results: During 1999 through 2008, 22% of parents of children with BMIs in the 85th percentile or higher reported having been told by a doctor or health professional that their child was overweight; recall of notification was actually more likely among nonwhite and poor children. This percentage increased from 19.4% to 23.2% from the 1999-2004 period and further accelerated in the 2007-2008 period to 29.1%. The time trend persisted in multivariate analyses, with significantly more parents reporting having been told in 2007 through 2008 than in 1999 through 2000.

Conclusion: Fewer than one-quarter of parents of overweight children report having been told that their child was overweight. While reports of notification have increased over the last decade (perhaps because of [1] revised definitions of overweight and obesity, [2] increased concern about children with BMIs in the 85th to 95th sex- and age-specific percentiles, or [3] improved recall by parents), further research is necessary to determine where and why communication of weight status breaks down.

Figure 1

Percentages of overweight children whose parents reported that a health care provider told them that their child was overweight, by demographic characteristics. P values from Wald tests were adjusted for survey design and differences in reporting.

Figure 2

Percentage of parents who reported that a health care provider told them that their child was overweight, by year and weight category. Weight categories are defined as follows: very obese, higher than 99th body mass index (BMI) percentile; obese, from the 95th to the 99th BMI percentile; and overweight, from the 85th to the 94th BMI percentile. P values from Wald tests were adjusted for survey design and differences across time within each weight category.