Caregiver Perception of Weight Status in 5-Year-Old Children From a Community of High Socioeconomic Deprivation in New Zealand.

Background: Early childhood obesity is highly prevalent in Aotearoa New Zealand (NZ). Little is known about caregiver perception of children's weight status among those living in areas of high socioeconomic deprivation, particularly Maori and Pacific children. Aims: To explore caregiver perception of weight status among children starting school in areas of high socioeconomic deprivation and examine potential associations between the child's body mass index (BMI) z-score and their caregiver's perception of their child's body size or health. Methods: Participants were 5-year-old children living in a community of high socioeconomic deprivation and their caregivers. Children had their weight and height measured. BMI z-scores were calculated according to World Health Organization standards. Caregivers were asked to assess their child's BMI and health status, and choose a silhouette that best represented their child's body size. Results: One hundred and six children (>75% Maori or Pacific) were included. Over half (58%) had overweight or obesity, with only 16% correctly perceived by their caregiver as overweight. These children tended to have higher BMI z-scores than those not correctly perceived as overweight. Caregivers chose larger silhouettes to represent children's body sizes as children's BMI z-scores increased. There was no discernible association between children's BMI z-scores and caregiver perception of children's health. Conclusions: Caregivers appeared to judge their child's body size in comparison to other children. The normalization of childhood obesity and infrequent caregiver recognition of this condition in children in communities with a high prevalence may impact the uptake and efficacy of intervention initiatives.

The prevalence of refractive error and visual impairment among New Zealand children in a community with significant socioeconomic disadvantage: is current preschool vision screening effective?

AIM: To examine the prevalence of refractive error and visual impairment and evaluate the efficacy of B4 School Check (B4SC) vision screening, in a cohort of predominantly New Zealand Maori and Pacific children from a community with socioeconomic disadvantage. METHOD: A cross-sectional investigation of children in the Welcome-to-School study. Participants received a comprehensive eye examination at six to seven years of age. Refractive error and amblyopia were identified and compared with B4SC vision screening results. RESULTS: One-hundred and fourteen children were assessed: 21.9% Maori, 57.9% Pacific and 20.2% Other. Over 30% of children had significant refractive error. Eighty-nine percent received a B4SC; 26.3% of children who passed the B4SC had significant refractive error. Seven children (6.1%) had amblyopia risk factors: none passed the B4SC, four were referred, one was identified for rescreening and two were not screened. CONCLUSION: Refractive errors were common in this cohort. For those screened, the B4SC was effective at identifying children with amblyopia risk factors but poor at detecting refractive errors potentially affecting academic performance. The efficacy of the programme was limited by the number of children screened, inequity of screening and the mismatch between the aims of the vision screening test and the overall rationale for the B4SC.