Date of Award

2014

Degree Type

Thesis

Degree Name

Doctor of Philosophy

School

School of Psychology and Social Science

Faculty

Health, Engineering and Science

First Advisor

Associate Professor Amanda Devine

Second Advisor

Associate Professor Paul Chang

Abstract

Increasing numbers of Australian children are being classified as overweight or obese. Given the health complications associated with excess weight, interventions to prevent children becoming overweight are crucial. Despite literature showing that parents shape their children’s food and exercise habits, no child obesity prevention programs have directly targeted parents. Moreover, although fear appeals have been used across several health promotion areas to change attitudes and behaviours, they have not been incorporated into an obesity preventive program. This study addressed these gaps by testing whether fear-based obesity simulations, targeted at parents as a tool for preventing childhood obesity, was more effective than an educational obesity message. The study was designed in two stages, with the first piloting the effectiveness of the simulations and an obesity message on a small sample of parents. Stage 2 tested a larger sample of parents and incorporated modifications from the pilot. In Stage 1, nine parents were randomly assigned to a Simulation or Education Presentation. Parents completed interviews and questionnaires at three different time points over a week. SPANOVAs revealed no significant improvements in attitudes, intentions, motivations, fears, and knowledge about obesity prevention for the Simulation compared to the Education Presentation. This contrasted to interview findings which indicated that parents found the Simulation Presentation more effective and changed their attitudes and behaviours compared to the Education Presentation. These findings highlighted important outcomes and informed the development of Stage 2. A qualitative approach was more effective in eliciting parental responses to their presentation; the education information may have been “too effective” and masked any impact of the simulations; and potential limitations regarding the insensitivity of the Likert scale, used to measure changes in parent responses to the questionnaire, may have mitigated any significant effects being found. The purpose of Stage 2 was to explore any impact of the simulations only through in depth parent interviews, and to use objective pedometer, food and anthropometric measures to triangulate and enhance the interview findings. Twenty four different parents were assigned to a photo or non-photo group. Parents and children completed interviews, anthropometric measurements, food records, and pedometer counts at three time points over eight weeks. Quantitative analyses found no significant improvements in children’s pedometer scores, food intake, and achievement of activity and diet recommendations, or in parent intention to change their children’s eating and exercise habits for the photo compared to the non-photo group. Many children failed to meet daily food and activity guidelines by the end of the study. This contrasts markedly to interview findings stating that: parents made improvements to their children’s diet and exercise patterns and, for parents who didn’t make changes, this was attributed to perceptions that they were already doing the right thing for their children. This disparity in results revealed an important yet underexplored issue for interventions targeting weight-related lifestyle changes. This focuses on levels of parental awareness about their children’s dietary adequacy and activity levels, and bridging the gap between what one perceives they are doing versus the reality of what is actually happening. This discrepancy may have mitigated any impact of the simulations through a false sense of adequacy and parent risk levels toward their children developing obesity.

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