Engaging parents and children in designing child health research

Preventive Medicine 51 (2010) 101–102

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Preventive Medicine

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This Month in Preventive Medicine

Engaging parents and children in designing child health research

0091-7435/$ – see front mdoi:10.1016/j.ypmed.2010

Two papers in this month's issue of Preventive Medicine deal with parental influences on theirchildren's health behavior.

Hingle et al. (2010) reviewed the literature on improving child dietary intake to identify thetypes of parent involvement that were implemented in the included studies. “Indirect” parentinvolvement strategies comprised provision of information not requiring a parental response (e.g.,newsletters, tip sheets with nutrition information sent to the home throughmail, email, or with thechild); invitations to parents and children to participate in study-sponsored activities (e.g., FamilyFun Nights/Health Fairs with nutrition topics); and communications directed at children and/ortheir parent(s) intended to involve parents in intervention activities (e.g. “try this at home”). On theother hand, parent involvement strategies were deemed “direct” when the parents' presence wasrequested at nutrition education sessions (e.g., didactic or workshop format), or for family behaviorcounseling or parent training sessions. They concluded that there are not enough studies todetermine whether parental involvement enhanced the effectiveness of dietary intervention, andthat direct strategies for involving parents were more effective than indirect ones, except when thechildren were responsible for engaging their parents.

Springer et al. (2010) investigated the cross-sectional association of parental television (TV)rules and compliance with the American Academy of Pediatrics' (AAP) recommendations of≤2 h oftelevision per day in a primarily Hispanic sample of elementary school children living on the U.S.side of the Texas–Mexico border. They also considered the potential modifying effects of the child'shome environment (i.e., parental TV watching, parent at home after school, and TV in the parents'/child's bedroom) on their TV watching behavior. They concluded that having parental TV limits isone strategy for reducing their children's TV watching that merits further investigation.

The general impression conveyed is that parents' involvement has no dramatic effect on theirchildren's health behavior. But whether the proper way to involve parents was fully explored andutilized in these studies remains unclear. Rather, it appears that the “involved” parents were justanother component upon which the various researchers did or could intervene, with their rolebeing essentially defined and circumscribed by the research protocol. As far as we could tell, few tonone of them seem to have co-involved parents in the design of the study. This is surprising because,after all, who knows better than parents the context in which the intervention is going to take placeand the type of constraints that the experiments may face? Indeed, parents are likely to have somevery valuable ideas on what may or what may not work. This is sometimes referred to asqexperiential knowledgeq (Fazey et al., 2005). Incorporating the experiential knowledge of parentscould enrich community-based interventions by adding an insider perspective to the external,experimental design proposed by the researchers.

Indeed, collecting parents' opinions and input at the study design stage can actually make adifference. Some examples where such an approach based on parent focus groups has beenutilized to good effect are the recent studies of Andrews et al. (2010), De Bock et al. (2010), andSonneville et al. (2009). On the other hand, most current community intervention projects appearto neglect this dimension which could potentially open brand new perspectives on child healthpromotion/disease prevention. Besides involving parents, it may be important to look at theseissues through the eyes of children, too, as suggested in the studies of Haerens et al. (2009) andWaller et al. (2005).

More generally, we feel that the type of work that Roz Lasker has been promoting aiming at“giving people who have been excluded from decision making an influential voice about issues thataffect their lives” (Lasker and Guidry, 2009, p. 6) should be extended to “ordinary” citizens and tohealth research. We would be thrilled to open the columns of PM to community interventionprojects for improving children's health behavior that engage parents’ and eventually children’sinput into their study designs.

atter © 2010 Published by Elsevier Inc..06.016

102 This Month in Preventive Medicine

References

Andrews, K.R., Silk, K.S., Eneli, I.U., 2010. Parents as health promoters: a theory of planned behavior perspective on theprevention of childhood obesity. J. Health Commun. 15, 95–107.

De Bock, F., Fischer, J.E., Hoffmann, K., Renz-Polster, H., 2010. A participatory parent-focused intervention promoting physicalactivity in preschools: design of a cluster-randomized trial. BMC Public Health 10, 49 (http://www.biomedcentral.com/1471-2458/10/49).

Fazey, I., Fazey, J.A., Fazey, D.M.A., 2005. Learning More Effectively from Experience. Ecol. Soc. 10, 4 (http://dspacesub.anu.edu.au:8080/jspui/bitstream/10440/524/1/Fazey_Learning2005.pdf).

Haerens, L., De Bourdeaudhuij, I., Barba, G., Eiben, G., Fernandez, J., Hebestreit, A., Kovács, E., Lasn, H., Regber, S., et al., 2009.Developing the IDEFICS community-based intervention program to enhance eating behaviors in 2- to 8-year-oldchildren: findings from focus groups with children and parents. Health Educ. Res. 24, 381–393.

Hingle, M.D., O'Connor, T.M., Dave, J.M., Baranowski, T., 2010. Parental involement in interventions to improve child dietaryintake: A systematic review. Prev. Med. 51, 35–39.

Lasker, R.D., Guidry, J.A., 2009. Engaging the community in Decision making: Case studies tracking participation,voice andinfluence. McFarland & Co, Jefferson, NC, USA.

Sonneville, K.R., La Pelle, N., Elsie M Taveras, E.M., MatthewWGillman,M.W., Prosser, L.A., 2009. Economic and other barriersto adopting recommendations to prevent childhood obesity: results of a focus group study with parents. BMC Pediatrics9, 81 (http://www.biomedcentral.com/1471-2431/9/81).

Springer, A.E., Kelder, S.H., Barroso, C.S., Drenner, K.L., Shegog, R., Ranjit, N., Hoelscher, D.M., 2010. Parental influences ontelevision watching among children living on the Texas-Mexico border. Prev. Med. 51, 21–39.

Waller, H., Eiser, C., Heller, S., Knowles, J., Price, K., 2005. Adolescents' and their parents' views on the acceptability and designof a new diabetes education programme: a focus group analysis. Child Care Health Dev. 31 (3), 283–289.

Alfredo MorabiaCenter for the Biology of Natural Systems, Queens College – CUNY,

163-03 Horace Harding Expressway, Flushing, NY 11365, USA

Michael C. Costanza6 Newbury Close, Rushden, Northamptonshire NN10 0EU, UK

E-mail address: Preventive.Medicine@qc.cuny.edu.