Sometimes, not only children with chronic conditions need self-management training, but their parents to do as well. An example centers on childhood obesity. A study by Guilfoyle and colleagues documented parenting stress in caregivers of treatment-seeking youth with obesity. They also examined whether parenting stress is a predictor of pediatric health indicators, including body mass index and weight or obesity-specific health-related quality of life. Youth (5-18 years) and their caregivers who came to a pediatric medical weight management program for an initial visit completed several self-report questionnaires that assessed demographics, parenting stress, and weight or obesity-specific health-related quality of life. The youth's height and weight were measured by trained clinic nurses and abstracted from the patient medical records. The study staff measured caregiver's height and weight. Participants included 120 caregivers and their youth (mean age = 11.0, 65.8% female, and 50% African-American). At treatment initiation, caregivers were primarily obese (mean body mass index = 35.8). One fifth of caregivers of school-aged children (18%) had clinically increased levels of parenting stress, and 25% reported increased spousal discord specific to parenting. Parenting stress did not significantly predict youth body mass index. However, parenting stress significantly predicted obesity-specific parent-proxy health-related quality of life for school-aged children, but not self-reported obesity-specific health-related quality of life.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that given that caregivers are critical components of pediatric weight management interventions, those with clinically increased levels of parenting stress would likely benefit from problem-solving interventions and anticipatory guidance to address common obstacles when fostering healthier lifestyles for their youth.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT OR PARENT: Initial self-management programs for other chronic conditions were effective because they involved both parents and children. In this case, the former would not only learn about childhood obesity and ways to assist their children to control the condition, but the latter would learn specific skills to reduce their weight. The focus would be on the children, but parents could learn ways to reinforce the children for their successful performance in losing weight.

SM Guilfoyle et al. Parenting Stress Impacts Obesity-Specific Health-Related Quality of Life in a Pediatric Obesity Treatment-Seeking Sample. Journal of Developmental and Behavioral Pediatrics, 2010;31:17-25.