Parental beliefs on the early identification of future overweight risk and the development of a scale to assess parental engagement in prevention

Parents play a crucial role in the prevention of child obesity but to date, little is understood regarding their beliefs about overweight and obesity in early childhood and how these may influence receptiveness to engage in preventative interventions. The primary aim of this research project was to identify factors influencing engagement and to develop a new psychometric scale to measure parental engagement in obesity prevention. To address the research aims, a two-phase mixed methods design was employed. In study one, 20 parents of infants under one were individually interviewed, using an inductive and interpretive qualitative approach. Thematic analysis resulted in three themes: 1) the identification of infant overweight and future risk, 2) the consequences of infant overweight status, and 3) parental attributions of causality, responsibility, and control. Study one findings, along with existing research and theory, informed the development of salient constructs for inclusion within a new scale: The Parental Engagement in Obesity Prevention (PEOP) scale. Exploratory factor analysis was performed within a sample of 282 mothers and a stable four-factor solution was identified. Confirmatory factor analysis in a new sample of 446 mothers confirmed the structure and demonstrated acceptable levels of reliability. The PEOP has 19-items and measures four conceptually unique factors influencing parental engagement: fear of judgement about infant weight; perceived consequences of infant overweight; maternal drive to feed; and self-efficacy in identifying infant overweight. The absolute scores from the four subscales indicate that mothers within this study sample did not fear judgement about their infants’ weight and felt confident in recognising if their own infant was or was becoming overweight. However, potential negative influences on engagement included a strong drive to feed their infant and a poor perception of the health consequences and implications of infant overweight. The study provides new insight and a valid and reliable measure of parental engagement. Use of the scale in practice will support identification of parents less likely to engage in prevention so that perceived barriers can be minimised.