BUENAS PRÁCTICAS DE MANUFACTURA

This study evaluated the relationships between parenting factors, adolescent zBMI, and adolescent self-efficacy for dietary intake. The results indicated that among our sample of low-income African American families, parents with greater authoritative parenting style had adolescents with healthier zBMIs and greater self-efficacy for eating a healthy diet. In addition, the results demonstrated that parental feeding practices were also associated with adolescent zBMI and self-efficacy for diet. Adolescents who reported that their parents were more concerned about their eating and weight status had higher zBMIs. Furthermore, adolescents who reported that their parents restricted their access to unhealthy foods had lower self-efficacy for diet, while adolescents with parents who simply monitored their dietary intake had greater self-efficacy to eat nutritiously. Thus, parental control to some extent was positively associated with a healthier self- efficacy score among African American adolescents.

Previous literature has considered authoritative parenting to be associated with beneficial health outcomes, such as healthier adolescent BMI (Collins, Duncanson, & Burrows, 2014; Fuemmeler et al., 2012; Shloim et al., 2015; Sleddens et al., 2011). However, past researchers have failed to adequately represent African American adolescents in their studies. In fact, few studies have focused exclusively on African American adolescents and their families. More so, in most studies African American

families account for less than 20% of the total sample (Fuemmeler et al., 2012; Gable & Lutz, 2000; Berge et al., 2010a;Lane et al., 2013; Hennessy et al., 2010; Kim et al., 2008). Of the past studies, only two studies found an association between authoritative parenting and adolescent BMI (Berge et al., 2010a; 11-18 years, 18.7% African

American; Kim et al., 2008; 13-15 years; 22% minorities). In their longitudinal study, Berge and colleagues (2010) collected data from adolescents (11-18 years, 18.7% African American) over 5 years. Consistent with Berge and colleagues (2010), our study found that greater authoritative parenting was associated with healthier adolescent BMI. Berge and colleagues also found that maternal authoritarian (high control, low warmth) parenting predicted higher adolescent BMI 5 years later for sons, while maternal neglectful parenting predicted higher adolescent BMI in daughters (Berge et al., 2010). Kim and colleagues (2008) included 106 adolescents (13-15 years; 22% minorities) in their cross-sectional study and also found that authoritative parenting was associated with healthier adolescent BMI (Kim et al., 2008). Alternatively, Hennessy and colleagues (2010) included 49% African American youth, but found no association between

parenting style and adolescent BMI. However, Hennessy and colleagues (2010) evaluated this relationship in younger children (6-11 years) rather than adolescents (Hennessy et al., 2010). Taken together, our study is consistent with Berge and colleagues (2010) and Kim and colleagues (2008). However, the present study did not evaluate associations with authoritarian parenting. Importantly, this study expands on previous research by demonstrating that authoritative parenting is associated with healthier BMI in an exclusively African American sample.

Some research on parenting has suggested that authoritarian parenting (low warmth, high control) may be associated with better health-related outcomes in some minority populations (Hill et al., 2007). Specifically, some scholars propose that

authoritarian parenting in response to risky environments (unsafe neighborhoods) may be perceived as nurturing and, in turn, be associated with better adolescent health (Hill et al., 2007). However, the present study found that adolescents who perceived their parents as authoritative had healthier zBMIs. This result is consistent with the overall findings on weight-related benefits of authoritative parenting across predominantly white populations (Berge et al., 2010; Kim et al., 2008; Sleddens et al., 2011). Taken together, these results suggest that authoritative parenting was associated with healthier adolescent weight- status in African American families and that autonomy-supportive parenting styles are important for health promotion in this population. Further research is needed to replicate these findings in other samples of solely African American adolescent populations.

In the present study, authoritative parenting was also found to be positively associated with adolescents’ self-efficacy to eat nutritiously. Specifically, adolescents who reported that their parents practiced an authoritative parenting style had greater self- efficacy to eat healthfully. This finding indicates that warm and nurturing parenting was associated with greater adolescent self-confidence and self-regulation specific to diet. This study is the first to assess the relationship between authoritative parenting and adolescent diet-specific self-efficacy. However, literature has demonstrated that self- efficacy and self-regulation are critical for healthy adolescent development and are related to a multitude of positive health outcomes, including healthy weight (Blair & Diamond, 2008; Calkins & Fox, 2002; Francis & Susman, 2009; Pennington, Snyder, &

Roberts, 2007; Seeyave et al., 2009; Tsukayama, Duckworth, & Toomey, 2008). For example, in their longitudinal study, Tsukayama and colleagues (2010) evaluated weight status in 844 adolescents (15 years; 10% African American). They found that adolescents with greater self-regulation were less likely to become overweight in early adulthood (Tsukayama et al., 2010). In another longitudinal study, Francis and Susman (2009) found that failure to self-regulate in early childhood was related to excessive weight gain in early adolescence (Francis and Susman, 2009). In addition, Seeyave and colleagues (2009) found that self-regulation during early childhood was predictive of overweight risk during adolescence. Specifically, children who were unable to delay gratification at age 4 were more likely to be overweight at age 11 in a primarily white sample (Seeyave et al., 2009). In addition, previous literature has asserted that autonomy-supportive parenting creates a nurturing environment for adolescents, which supports positive health and development (Wilson et al., 2017; Bandura, 2004; Biglan et al., 2013). For instance, autonomy-supportive parenting may foster the development of the autonomy,

competence, and relatedness, which are considered basic human needs (Ryan & Deci, 2000). Taken together, the results from the present study have implications for understanding the importance of parenting in self-efficacy and self-regulation development in African American adolescents.

A novel contribution of this study is its assessment of parental feeding practices in an adolescent population. This study is only the second study to assess this relationship in an entirely African American sample (Burton et al., 2017; 12-19 years, 100% African American). In the present study, parental feeding practices were related to both adolescent zBMI and adolescent self-efficacy for eating a healthy diet. Notably,

adolescents who reported that their parents were more concerned about their eating and weight had greater zBMIs. This result is consistent with previous studies, including Burton and colleagues’ (2017) study with African American adolescents (Burton et al., 2017; Gray et al., 2010; Holland et al., 2014; Kaur et al., 2006; Schmidt et al., 2017). Burton and colleagues (2017) included 212 adolescents (12-19 years; 100% African American) in their cross-sectional study. Consistent with the present study, they found that high parental concern was related to higher BMI in adolescents (Burton et al., 2017). Greater parental concern was related to higher BMI in a number of studies with a subset of African American participants (Kaur et al., 2006; Gray et al., 2010). Holland and colleagues (2014) found similar associations in their randomized controlled trial with 170 adolescents (7-11 years; 17.1% African American). Their results indicated that after a family-based weight loss intervention, decreased parental concern was associated with decreased youth BMI (Holland et al., 2014). In contrast to the present research, these studies enrolled youth of various weight-statuses (underweight, normal, overweight, obese). One possible factor in the relationship between parental concern and adolescent BMI is parent-adolescent interactions. Consistent with past research, the results of the present study suggest that greater parental concern about adolescent eating behaviors may be associated with poorer weight-related outcomes in African American adolescents. Further longitudinal research is needed to determine causality.

In this study, parental feeding practices were also associated with adolescent self- efficacy to eat nutritiously. Notably, this study is the first to assess the relationship between parental feeding practices and adolescent diet-specific self-efficacy. Results indicated that adolescents who reported that their caregiver restricted their access to

unhealthy foods (parental restriction) had lower self-efficacy for diet, whereas

adolescents who indicated their caregivers monitored (parental monitoring) their dietary intake had greater self-efficacy for diet. Though the relationship between parental feeding practices and adolescent self-efficacy has not previously been studied, past research has demonstrated that parental restriction is associated with other adolescent health-related outcomes, such as BMI (Blisset & Bennett, 2013; Burton et al., 2017; Gray et al., 2010; Holland et al., 2014; Kaur et al., 2006; Loth et al., 2013; Towner et al., 2015).

Specifically, research has indicated that greater parental restriction of adolescent diet was associated with greater adolescent BMI. For instance, Burton and colleagues (2017) found that parental restriction of their adolescents’ diet was associated with higher BMI in 212 African American adolescents (12-19 years; 100% African American). However, this was the only study to assess this relationship in an entirely African American sample (Burton et al., 2017). Kaur and colleagues (2006) assessed this relationship in a diverse sample of 260 adolescents and also found that greater parental restriction was associated with higher adolescent BMI (10-19 years; 55% African American). This finding is

consistent with other studies where African American adolescents accounted for less than half the sample (Gray et al., 2010; Holland et al., 2014; Loth et al., 2013; Towner et al., 2015). Although the present study did not find these associations with adolescent zBMI, it demonstrated that parental restriction and parental monitoring were significantly related to self-efficacy in this solely African American adolescent population.

Results of the present study also indicated that adolescents who reported their caregivers simply monitored (parental monitoring) their dietary intake had greater self- efficacy for diet. Interestingly, parental monitoring was only associated with adolescent

BMI in one previous study (Burton et al., 2017) and these findings were in the opposite direction whereby greater monitoring with younger African American adolescents was associated with higher BMI. However, literature suggests that greater parental monitoring may support healthy development of self-regulation and self-efficacy in adolescents (Birch et al., 2001a; Golan, 2006; Kitzman et al., 2010; Wilson et al., 2015). Taken together, the associations between parental feeding practices and adolescent dietary self- efficacy could have broader implications for adolescent weight-status. However, further research is needed to provide further evidence and determine the direction of these relationships in longitudinal and interventional studies.

Limitations of the present study should be considered when interpreting these results. This study examined cross-sectional data from an ongoing randomized control trial, which prevents interpretation of directionality in the conclusions. It should be noted that study sample has limited variability, as all adolescents were overweight or obese and were African American. Thus, results of the current study may not be generalizable to families with normal-weight adolescents or families of non-African American decent.

Overall, the present study provides novel perspectives to existing literature. It is one of the first studies to assess relationships between parenting style, parental feeding practices, adolescent weight-status, and adolescent self-efficacy for diet in a solely African American adolescent population. Specifically, this study adds to the understanding of authoritative parenting in minority populations, such as African

American families. In addition, it builds on developmental literature that emphasizes the importance of parenting styles and practices during adolescence in African American families (Smetana et al., 2004). More so, the results of this study suggest that the parent-

adolescent relationship should be considered in future weight-related parenting interventions.

References

Alia, K. A., Wilson, D. K., St. George, S. M., Schneider, E., & Kitzman-Ulrich, H. (2013). Effects of parenting style and parent-related weight and diet on adolescent weight status. Journal of Pediatric Psychology, 38(3), 321–329.

https://doi.org/10.1093/jpepsy/jss127

Bandura, A. (2004). Health promotion by social cognitive means. Health Education and Behavior, 31(2), 143–164. https://doi.org/10.1177/1090198104263660

Baumrind, D. (1971). Current patterns of parental authority. Developmental Psychology. US: American Psychological Association. https://doi.org/10.1037/h0030372

Baumrind, D. (1972). An exploratory study of socialization effects on black children: Some black–white comparison. Child Development, 43, 261–267.

Berge, J. M., Wall, M., Loth, K., & Neumark-Sztainer, D. (2010). Parenting Style as a Predictor of Adolescent Weight and Weight-Related Behaviors. Journal of

Adolescent Health, 46(4), 331–338. https://doi.org/10.1016/j.jadohealth.2009.08.004 Berge, Meyer, C. S., Loth, K., MacLehose, R., & Neumark-Sztainer, D. (2015).

Parent/Adolescent Weight Status Concordance and Parent Feeding Practices.

Pediatrics, 136(3), e591–e598. https://doi.org/10.1542/peds.2015-0326

Biglan, A., Flay, B. R., Embry, D. D., & Sandler, I. N. (2013). NIH Public Access, 67(4), 257–271. https://doi.org/10.1037/a0026796.The

Birch, L. L., Fisher, J. O., Grimm-Thomas, K., Markey, C. N., Sawyer, R., & Johnson, S. L. (2001). Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite, 36, 201–210. https://doi.org/10.1006/appe.2001.0398

Blair, C., & Diamond, A. (2008). Biological processes in prevention and intervention: The promotion of self-regulation as a means of preventing school failure.

Development and Psychopathology, 20(03), 899–911. https://doi.org/10.1017/S0954579408000436

Blissett, J., & Bennett, C. (2013). Cultural differences in parental feeding practices and children’s eating behaviours and their relationships with child BMI: A comparison of Black Afro-Caribbean, White British and White German samples. European Journal of Clinical Nutrition, 67(2), 180–184. https://doi.org/10.1038/ejcn.2012.198 Burton, E. T., Wilder, T., Beech, B. M., & Bruce, M. A. (2017). Caregiver feeding

practices and weight status among African American adolescents: The Jackson Heart KIDS Pilot Study. Eating Behaviors, 27, 33–38.

https://doi.org/10.1016/j.eatbeh.2017.11.002

Calkins, S. D., & Fox, N. A. (2002). Self-regulatory processes in early personality

development: A multilevel approach to the study of childhood social withdrawal and aggression. Development and Psychopathology, 14(03), 477–498.

https://doi.org/10.1017/S095457940200305X

Collins, C., Duncanson, K., & Burrows, T. (2014). A systematic review investigating associations between parenting style and child feeding behaviours. Journal of Human Nutrition and Dietetics, 27(6), 557–568. https://doi.org/10.1111/jhn.12192 Connell, S., & Francis, L. (2014). NIH Public Access. Health Psychology, 33(8), 757–

764.

Faith, M. S., Scanlon, K. S., Birch, L. L., Francis, L. A., & Sherry, B. (2004). Parent-- child feeding strategies and their relationships to child eating and weight status.

Obes Res, 12. https://doi.org/10.1038/oby.2004.212

Fisher, J. O., & Birch, L. L. (1999). Restricting Access to Foods and Children’s Eating.

Appetite, 32(3), 405–419. https://doi.org/https://doi.org/10.1006/appe.1999.0231 Francis, L. A., & Susman, E. J. (2009). Self-regulation and rapid weight gain in children

from age 3 to 12 years. Archives of Pediatrics and Adolescent Medicine, 163(4), 297–302. https://doi.org/10.1001/archpediatrics.2008.579

Fuemmeler, Bernard F.; Yang, Chongming; Costanzo, Phil; Hoyle, Rick H.; Siegler, Ilene; Williams Redford B.; Østbye, T. (2012). Parenting Styles and Body Mass Index Trajectories From Adolescence to Adulthood, 31(4), 441–449.

https://doi.org/10.1037/a0027927.Parenting

Fuemmeler, B. F., Yang, C., Costanzo, P., Hoyle, R. H., Siegler, I. C., Williams, R. B., & Østbye, T. (2012). Parenting styles and body mass index trajectories from

adolescence to adulthood. Health Psychology, 31(4), 441–449. https://doi.org/10.1037/a0027927

Gable, S., & Lutz, S. (2000). Household, Parent, and Child Contributions to Childhood Obesity. Family Relations, 49(3), 293–300.

Gevers, D. W. M., Kremers, S. P. J., de Vries, N. K., & van Assema, P. (2014).

Clarifying concepts of food parenting practices. A Delphi study with an application to snacking behavior. Appetite, 79, 51–57.

https://doi.org/10.1016/j.appet.2014.04.002

Glickman, D., Parker, L., Sim, L. J., Del, H., & Cook, V. (2012). Accelerating Progress in Obesity Prevention : Solving the Weight of the Nation.

Golan, M., & Crow, S. (2004). Parents Are Key Players in the Prevention and Treatment of Weight-related Problems. Nutrition Reviews, 62(1), 39–50.

https://doi.org/10.1301/nr.2004.jan.39?50

Gray, W. N., Janicke, D. M., Wistedt, K. M., & Dumont-Driscoll, M. C. (2010). Factors associated with parental use of restrictive feeding practices to control their

children’s food intake. Appetite, 55(2), 332–337. https://doi.org/10.1016/j.appet.2010.07.005

Gruber, K. J., & Haldeman, L. A. (2009). Using the family to combat childhood and adult obesity. Preventing Chronic Disease, 6(3), A106. https://doi.org/A106 [pii]

Hennessy, E., Hughes, S. O., Goldberg, J. P., Hyatt, R. R., & Economos, C. D. (2010). Parent behavior and child weight status among a diverse group of underserved rural families. Appetite, 54(2), 369–377.

https://doi.org/https://doi.org/10.1016/j.appet.2010.01.004

Hill, N. E., Bromell, L., Tyson, D. F., & Flint, R. (2007). Developmental Commentary : Ecological Perspectives on Parental Influences During Adolescence Developmental Commentary : Ecological Perspectives on Parental Influences During Adolescence,

36(3), 367–377. https://doi.org/10.1080/15374410701444322

Holland, J. C., Kolko, R. P., Stein, R. I., Welch, R. R., Perri, M. G., Schechtman, K. B., … Wilfley, D. E. (2014). Modifications in parent feeding practices and child diet during family-based behavioral treatment improve child zBMI. Obesity, 22(5), 119– 126. https://doi.org/10.1002/oby.20708

Huffman, L. E., Wilson, D. K., Kitzman-Ulrich, H., Lyerly, J. E., Gause, H. M., &

Resnicow, K. (2016). Associations between culturally relevant recruitment strategies and participa nt interest, enrollment and generalizability in a weight-loss

intervention for african American families. Ethnicity and Disease, 26(3), 295–304. https://doi.org/10.18865/ed.26.3.295

Huffman, L. E., Wilson, D. K., Van Horn, M. L., & Pate, R. R. (2017). Associations Between Parenting Factors, Motivation, and Physical Activity in Overweight African American Adolescents. Annals of Behavioral Medicine.

https://doi.org/10.1007/s12160-017-9919-8

Humenikova, L., & Gates, G. E. (2008). Social and Physical Environmental Factors and Child Overweight in a Sample of American and Czech School-aged Children: A Pilot Study. Journal of Nutrition Education and Behavior, 40(4), 251–257. https://doi.org/10.1016/j.jneb.2007.06.008

Jackson, C., Henriksen, L., & Foshee, V. A. (1998). The Authoritative Parenting Index: Predicting Health Risk Behaviors Among Children and Adolescents. Health Education & Behavior, 25(3), 319–337.

https://doi.org/10.1177/109019819802500307

Jackson, S., Kimiecik, J., Ford, S., & Marsh, H. (1998). Psychological Correlates of Flow in Sport. Journal of Sport & Exercise Psychology.

https://doi.org/10.1177/017084068800900203

Kaur, H., Li, C., Nazir, N., Choi, W. S., Resnicow, K., Birch, L. L., & Ahluwalia, J. S. (2006). Confirmatory factor analysis of the child-feeding questionnaire among parents of adolescents. Appetite, 47(1), 36–45.

https://doi.org/10.1016/j.appet.2006.01.020

Kim, M.-J., McIntosh, W. A., Anding, J., Kubena, K. S., Reed, D. B., & Moon, G.-S. (2008). Perceived parenting behaviours predict young adolescents’ nutritional intake and body fatness. Maternal & Child Nutrition, (2008), 287–303.

https://doi.org/10.1111/j.1740-8709.2008.00142.x

Kitzman-Ulrich, H., Wilson, D. K., St. George, S. M., Lawman, H., Segal, M., &

Fairchild, A. (2010). The integration of a family systems approach for understanding youth obesity, physical activity, and dietary programs. Clinical Child and Family Psychology Review, 13(3), 231–253. https://doi.org/10.1007/s10567-010-0073-0 Kremers, S. P. J., Brug, J., De Vries, H., & Engels, R. C. M. E. (2003). Parenting style

and adolescent fruit consumption. Appetite, 41(1), 43–50. https://doi.org/10.1016/S0195-6663(03)00038-2

LeCuyer, E. A., & Swanson, D. P. (2017). A Within-Group Analysis of African American Mothers’ Authoritarian Attitudes, Limit-Setting and Children’s Self- Regulation. J Child Fam Stud, 26(3), 833–842. https://doi.org/10.1007/s10826-016- 0609-0.

LeCuyer, E. A., Swanson, D. P., Cole, R., & Kitzman, H. (2011). Effect of African- and European-American maternal attitudes and limit-setting strategies on children’s self- regulation. Research in Nursing and Health, 34(6), 468–482.

Loth, K. A., MacLehose, R. F., Fulkerson, J. A., Crow, S., & Neumark-Sztainer, D. (2013). Food-Related Parenting Practices and Adolescent Weight Status: A Population-Based Study. Pediatrics, 131(5), e1443–e1450.

https://doi.org/10.1542/peds.2012-3073

O’Dea, J. A., & Wilson, R. (2006). Socio-cognitive and nutritional factors associated with body mass index in children and adolescents: Possibilities for childhood obesity prevention. Health Education Research, 21(6), 796–805.

https://doi.org/10.1093/her/cyl125

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, M. (2014). Prevalence of Childhood and Adult Obesity in the United States, 2011–2012. Jama, 311(8), 806–814. https://doi.org/10.1001/jama.2014.732.Prevalence

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, M. (2016). Prevalence of Childhood