Abstract 1368: Parenting considerations in the management of overweight and obese childhood ALL survivors.
Authors: Huang Jeannie S. , Terrones Laura , Chang Maria , Dillon Lindsay 
Published: August 2014

BACKGROUND: Childhood acute lymphoblastic leukemia (ALL) survivors are at a higher risk for obesity and overweight than even the general pediatric population. Obesity risk has been linked to certain parenting (permissive and authoritarian) styles and to lack of parental support for weight-related behaviors. We thus sought to evaluate the potential contribution of parenting behaviors and styles to weight related issues and depression among overweight and obese children who have survived ALL.

METHODS: Surveys on parenting styles, behaviors, communication styles, and parental support for weight management behaviors were performed by the primary parents of overweight and obese youth recruited for a clinical trial of a weight management program among childhood ALL survivors aged 8-18 years at three tertiary care pediatric institutions. In addition, the Childhood Depression Inventory was performed by the recruited children and baseline demographics from both children and parents were collected. Distribution and correlation analyses of survey results and collected baseline data were performed.

RESULTS: Thirty five overweight (20%) and obese (80%) children recruited to date comprised 43% male, median (IQR) age of 13 (10,16) years, median BMI % of 98 (95,99)% and 89% Hispanic. The corresponding primary parent population consisted of 89% women, median age of 42 (38,48) years, median BMI of 33 (28,40) kg/m2 (60% obese, 26% overweight), and 89% Hispanic. While the majority (97%) of parents reported an authoritative parenting style, there were variations in the amount of permissive and dysfunctional parenting reported. Parenting verbosity in reaction to misbehavior was moderately associated with increased baseline child BMI percentile (r=0.37, p=0.03). Authoritarian parenting style moderately correlated with parental support for physical activity (specifically walking and biking) for the entire cohort (r=0.36, p=0.03). However, overall, parenting styles did not specifically correlate with support for weight management behaviors or with age and gender-matched child BMI percentiles. Parental over-reactivity correlated with higher child depression rating scores (r=0.35, p=0.04) while parental granting of autonomy was associated with lower depression rating scores (r=-0.35, p&lt;0.04) in the cohort.

DISCUSSION: We did not observe a preponderance of parenting styles associated with greater weight status in children among overweight and obese youth with ALL. However, specific parenting styles and behaviors were related to child weight status, parental weight management support, and depression ratings among overweight and obese ALL child survivors. These data confirm the important role of parents in weight management among young childhood ALL survivors.

Citation Format: Jeannie S. Huang, Laura Terrones, Maria Chang, Lindsay Dillon. Parenting considerations in the management of overweight and obese childhood ALL survivors. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1368. doi:10.1158/1538-7445.AM2013-1368