Child and Parent Readiness to Change in a Clinical Sample of Obese Youth

Parent and child readiness to change have been identified as emerging areas informing pediatric obesity interventions. The purpose of this study was to increase understanding of child and parent readiness to change in obese youth by examining how these constructs are related to demographic variables, as well as to psychosocial functioning, in a sample of obese youth presenting for weightmanagement treatment. A secondary aim was to examine consistency between parent and child readiness to change. Two hundred twenty-eight 7to 17-year-old children and their parents participated during the child’s initial assessment at a multidisciplinary weightmanagement clinic. Demographic variables included in analyses were child Body Mass Index, parent Body Mass Index, child age, child gender, child race, and family income. Children completed measures of quality of life, depression, social anxiety, internalizing and externalizing symptoms, and readiness to change. Parents completed assessments of children’s quality of life, children’s internalizing and externalizing symptoms, and parents’ own readiness to change. The child’s Body Mass Index was significantly related to both parent and child readiness to change. There was also a significant positive relation between child readiness to change and the child’s own report of social anxiety symptoms, as well as a curvilinear relation with internalizing symptoms, such as depression. In addition to the child’s Body Mass Index, parent readiness to change was positively related to the child’s age and was higher in African American parents than in European American parents. Race moderated the relation between parent readiness to change and health-related quality of life, internalizing symptoms, and externalizing problems. Parents and children were discordant in their ratings of readiness to change, with parents tending to report higher levels; the child’s Body Mass Index moderated the relation between parent and child report of readiness to change. Clinical implications and future directions are discussed. INDEX WORDS: Pediatric, Obesity, Readiness to change, Transtheoretical model, Stages of change, Psychosocial functioning, Health-related quality of life, Social anxiety, Depression, Internalizing behavior, Externalizing behavior CHILD AND PARENT READINESS TO CHANGE IN A CLINICAL SAMPLE OF OBESE YOUTH