title: Joint influence of individual choices, parenting practices, and physician advice on adolescent obesity, Nebraska, 2008.
abstract: BACKGROUND
  Reducing childhood obesity remains a public health priority given its high prevalence and its association with increased risk of adult obesity and chronic diseases. The objective of this study was to examine the joint influence of multiple risk factors on adolescent overweight status.
  
  
  METHODS
  We conducted a random-digit-dialed telephone survey of adolescents aged 12 to 19 years in fall 2008 in a Midwestern city in Nebraska. On the basis of survey data for 791 youths aged 12 to 18 years, we conducted latent class analysis to group youths by the joint occurrence of dietary behavior, physical activity, parenting practices, and physician advice. We then examined the association between the groups and overweight status by using logistic regression, controlling for age, sex, race/ethnicity, and parent and family information.
  
  
  RESULTS
  Youths were clustered into 3 groups. Group I (52%) were youths with healthy dietary behavior and physical activity, less permissive parenting practices, and physician advice; Group II (30%) were youths with moderately healthy dietary behavior and physical activity, less permissive parenting practices, and no physician advice; and Group III (18%) were youths with unhealthy dietary behavior and physical activity, permissive parenting practices, and physician advice. Youths in Groups I and II were less likely to be overweight than youths in Group III.
  
  
  CONCLUSIONS
  Youths with healthier behavior and less permissive parenting practices were less likely to be overweight. Study findings highlight the need to address obesity risk factors among youths with unhealthy dietary behavior, inadequate exercise, permissive parenting practices, and some physician advice. Tailored interventions should be used to target youths with different obesity risk factors.
authors.affiliation: Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE 68198-4350. E-mail: hongmeiwang@unmc.edu.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Wang
authors.affiliation: University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Jungyoon
authors.initials: J
authors.lastname: Kim
authors.affiliation: University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Dejun
authors.initials: D
authors.lastname: Su
authors.affiliation: Creighton University, Omaha, Nebraska. At the time this article was written, Dr. Xu was affiliated with the University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Liyan
authors.initials: L
authors.lastname: Xu
authors.affiliation: University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Li-Wu
authors.initials: LW
authors.lastname: Chen
authors.affiliation: City University of New York School of Public Health, New York, New York. At the time this article was written, Dr. Huang was affiliated with the University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Terry T-K
authors.initials: TT
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D002648:Child; D002755:Choice Behavior; D005192:Family Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009329:Nebraska / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D016487:Parenting; D010820:Physicians; D012931:Social Environment; D055815:Young Adult