How Parents Talk about Weight: Qualitative Content Analysis Using a Randomized Experiment Study Design.

Objective: Pediatric weight bias is pervasive, can come from within the family, and is associated with poor body image and unhealthy eating behaviors in children that can persist into adulthood. Methods: Parents (N=367) were randomly assigned to read an information sheet describing the causes (biological, environmental, or personal responsibility) and consequences (short-term or long-term) of obesity. Parents then wrote an explanation of obesity to their child in their own words. Two researchers coded responses to identify themes. Parents also completed an implicit attitude test about child obesity. Results: Parents, overall, used their information sheet to explain the causes and consequences of obesity to their child. Neither explicit nor implicit attitudes about child obesity were associated with themes in parents' explanations. Parents of children with higher weights were less likely to mention diet as a cause and more likely to mention long-term and psychological consequences. Mothers were more likely to describe sedentariness as a cause and physical and psychological health consequences, while fathers were more likely to describe biological causes of obesity. Conclusions: Our findings suggest that brief education materials can influence parent communication. Thus, developing education materials and testing communication-related interventions for parents is a promising direction for further research.