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Войти в исследования Obesity science & practice · 2026
Proximal and Distal Factors Associated With Obesity in Childhood: An Exploratory Structural Equation Model.
СтатьяНазвание и аннотация: Перевод в очереди
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Skelton Joseph A, Rhodes Erinn T, Hampl Sarah E, Eneli Ihuoma, Ip Edward H, SIT Study Research Group
Аннотация
BACKGROUND: Obesity in childhood is complex; structural equation modeling (SEM) offers an approach to ascertain complicated relationships between weight and proximal (health behaviors, child health) and distal (family/household, community) variables. The objective of the study was to use SEM to map the influence of different etiological clusters on obesity in childhood.
METHODS: Secondary analysis of baseline data from patients and parents enrolled in a multi-site study of pediatric weight management was conducted. The primary outcome was weight status (utilizing percentage above the 95th percentile BMI, %95BMI). SEM was used to evaluate the influences of variables proximal and distal to child weight within the context of the Ecological Model of obesity in childhood.
RESULTS: Complete data on 375 child-parent dyads were imputed. Proximal factors (child stress and mobility, parent BMI) were significantly related to %95BMI; some distal factors (family level) did not have a direct effect on %95BMI, but did indirectly through proximal factors (such as child stress). Other distal factors (neighborhood deprivation represented by the Area Deprivation Index) were significantly related to %95BMI and family-level factors.
CONCLUSIONS: Except for the distal factor of neighborhood deprivation, proximal factors were the drivers of weight status. Distal factors did have indirect effects via proximal factors. SEM provides a means to investigate the complex contributors to childhood obesity, and could identify key leverage points for intervention.
METHODS: Secondary analysis of baseline data from patients and parents enrolled in a multi-site study of pediatric weight management was conducted. The primary outcome was weight status (utilizing percentage above the 95th percentile BMI, %95BMI). SEM was used to evaluate the influences of variables proximal and distal to child weight within the context of the Ecological Model of obesity in childhood.
RESULTS: Complete data on 375 child-parent dyads were imputed. Proximal factors (child stress and mobility, parent BMI) were significantly related to %95BMI; some distal factors (family level) did not have a direct effect on %95BMI, but did indirectly through proximal factors (such as child stress). Other distal factors (neighborhood deprivation represented by the Area Deprivation Index) were significantly related to %95BMI and family-level factors.
CONCLUSIONS: Except for the distal factor of neighborhood deprivation, proximal factors were the drivers of weight status. Distal factors did have indirect effects via proximal factors. SEM provides a means to investigate the complex contributors to childhood obesity, and could identify key leverage points for intervention.