title: Primary-Care Weight-Management Strategies: Parental Priorities and Preferences.
abstract: OBJECTIVE
  To examine parental perspectives/rankings of the most important weight-management clinical practices and to determine whether preferences/rankings differ when parents disagree that their child is overweight.
  
  
  METHODS
  We performed mixed-methods analysis of a 32-question survey of parents of 2- to 18-year-old overweight children assessing parental agreement that their child is overweight, the single most important thing providers can do to improve weight status, ranking American Academy of Pediatrics-recommended clinical practices, and preferred follow-up interval. Four independent reviewers analyzed open-response data to identify qualitative themes/subthemes. Multivariable analyses examined parental rankings, preferred follow-up interval, and differences by agreement with their child's overweight assessment.
  
  
  RESULTS
  Thirty-six percent of 219 children were overweight, 42% obese, and 22% severely obese; 16% of parents disagreed with their child's overweight assessment. Qualitative analysis of the most important practice to help overweight children yielded 10 themes; unique to parents disagreeing with their children's overweight assessments was "change weight-status assessments." After adjustment, the 3 highest-ranked clinical practices included, "check for weight-related problems," "review growth chart," and "recommend general dietary changes" (all P < .01); parents disagreeing with their children's overweight assessments ranked "review growth chart" as less important and ranked "reducing screen time" and "general activity changes" as more important. The mean preferred weight-management follow-up interval (10-12 weeks) did not differ by agreement with children's overweight assessments.
  
  
  CONCLUSIONS
  Parents prefer weight-management strategies that prioritize evaluating weight-related problems, growth-chart review, and regular follow-up. Parents who disagree that their child is overweight want changes in how overweight is assessed. Using parent-preferred weight-management strategies may prove useful in improving child weight status.
authors.affiliation: Department of Pediatrics, UT Southwestern Medical Center and Children's Health System of Texas, Dallas, Tex; Division of General Internal Medicine, Department of Medicine, UT Southwestern Medical Center, Dallas, Tex. Electronic address: Christy.Turer@UTSouthwestern.edu.
authors.forename: Christy Boling
authors.initials: CB
authors.lastname: Turer
authors.affiliation: School of Medicine, UT Southwestern, Dallas, Tex.
authors.forename: Carla
authors.initials: C
authors.lastname: Upperman
authors.affiliation: Division of General Internal Medicine, Department of Medicine, UT Southwestern Medical Center, Dallas, Tex.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Merchant
authors.affiliation: School of Medicine, UT Southwestern, Dallas, Tex.
authors.forename: Sergio
authors.initials: S
authors.lastname: Montaño
authors.affiliation: Medica Research Institute, Minneapolis, MN.
authors.forename: Glenn
authors.initials: G
authors.lastname: Flores
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D034462:Dissent and Disputes; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D050177:Overweight / Q000628:therapy; D010290:Parents; D057240:Patient Preference; D063766:Pediatric Obesity / Q000628:therapy*; D010372:Pediatrics; D011320:Primary Health Care; D011795:Surveys and Questionnaires
keywords: childhood obesity; parents; primary care; weight management