Maternal and Child Health Journal

, Volume 21, Issue 5, pp 1156–1165 | Cite as

Parenting Self-Efficacy, Parent Depression, and Healthy Childhood Behaviors in a Low-Income Minority Population: A Cross-Sectional Analysis

  • William J. Heerman
  • Julie Lounds Taylor
  • Kenneth A. Wallston
  • Shari L. Barkin


Objectives Childhood obesity prevention and treatment depends, in part, on parents acting as agents of change for their children. Our objective was to measure the associations between parenting self-efficacy, parent depressive symptoms, and preschool child behaviors that support healthy growth. Methods We performed a cross-sectional analysis of baseline data from a randomized controlled trial. Parenting self-efficacy was measured using a 5-item version of the Parenting Sense of Competence (PSOC-5) scale (α= 0.8). Parent depressive symptoms were measured using the Center for Epidemiological Studies-Depression (CESD) scale. Child outcomes included diet (24 h diet recall), physical activity (accelerometry), sleep (parent-report), and media use during meals (parent-report). We performed separate multiple linear regressions for each outcome controlling for other covariates. Results The sample consisted of 601 parent–child pairs. Median child age was 4.3 (IQR 3.6–5.1) years; median child body mass index (BMI) percentile was 79.1% (IQR 66.8–88.5%); 90% of children were Hispanic/Latino, and 6% of children were non-Hispanic Black. Median parent age was 31.5 (IQR 27.6–36.0) years; 22% of parents met criteria for depression. Parenting self-efficacy (median PSOC-5 25; IQR 24–28) was negatively correlated with depressive symptoms (ρ = −0.16; p < 0.001). In adjusted models, higher parenting self-efficacy was associated with duration of child’s sleep and fewer meals eaten in front of a TV (p < 0.001). There was a significant interaction of parenting self-efficacy and parental depressive symptoms on child sleep duration (p < 0.001). Parenting self-efficacy and depressive symptoms were not significantly associated with child physical activity or child diet. Conclusions In this minority population, higher parenting self-efficacy was associated with longer child sleep and fewer meals in front the TV, but parent depressive symptoms mitigated that protective effect for child sleep duration.


Pediatric obesity Self-efficacy Parenting Depression 



This research was supported by Grants U01 HL103620 and U01 Hl103561 with additional support from the remaining members of the COPTR Consortium (U01 HL103622, U01 HD068890, U01 HL103629) from the National Heart, Lung, and Blood Institute and the Eunice Kennedy Shriver National Institute of Child Health and Development and the Office of Behavioral and Social Sciences Research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, And Blood Institute, the National Institutes of Health, or the National Institute of Child Health and Development. Additional funding was from the following Grants from the National Institute of Diabetes and Digestive and Kidney Diseases: P30DK050456 and P30DK092924. Dr. Heerman’s time was supported by a T32 Grant from the NICHD (5T32HD060554) and a K12 Grant from the AHRQ (1K12HS022990). Data were managed through REDCap, which is supported from NCATS (UL1 TR000445). Collection of diet data was supported by NORC Grant number NIH DK56350.

Compliance with Ethical Standards

Conflict of interest

None of the authors have any competing interests to declare.


  1. Appelhans, B. M., Fitzpatrick, S. L., & Li, H., et al. (2014). The home environment and childhood obesity in low-income households: Indirect effects via sleep duration and screen time. BMC Public Health, 14, 1160. doi: 10.1186/1471-2458-14-1160.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  3. Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W.H. Freeman.Google Scholar
  4. Bell, J. F., & Zimmerman, F. J. (2010). Shortened nighttime sleep duration in early life and subsequent childhood obesity. Archives of Pediatrics & Adolescent Medicine, 164(9), 840–845. doi: 10.1001/archpediatrics.2010.143.CrossRefGoogle Scholar
  5. Beydoun, M. A., & Wang, Y. (2010). Pathways linking socioeconomic status to obesity through depression and lifestyle factors among young US adults. Journal of Affective Disorders, 123(1–3), 52–63. doi: 10.1016/j.jad.2009.09.021.CrossRefPubMedGoogle Scholar
  6. Bohman B, Nyberg G, & Sundblom E, et al. (2013). Validity and reliability of a parental self-efficacy instrument in the healthy school start prevention trial of childhood obesity. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 41(4), 392–396. doi: 10.1177/1090198113515243.CrossRefGoogle Scholar
  7. Casey, P., Goolsby, S., & Berkowitz, C., et al. (2004). Maternal depression, changing public assistance, food security, and child health status. Pediatrics, 113(2), 298–304.CrossRefPubMedGoogle Scholar
  8. Coleman, P. K., & Karraker, K. H. (2000). Parenting self-efficacy among mothers of school-age children: Conceptualization, measurement, and correlates. Family Relations, 49(1), 13–24. doi:Doi: 10.1111/J.1741-3729.2000.00013.X.CrossRefGoogle Scholar
  9. Cousins, J. H., Rubovits, D. S., & Dunn, J. K., et al. (1992). Family versus individually oriented intervention for weight loss in Mexican American women. Public Health Reports (Washington, D. C.: 1974), 107(5), 549–555.Google Scholar
  10. El-Sheikh, M., Kelly, R. J., & Bagley, E. J., et al. (2012). Parental depressive symptoms and children’s sleep: The role of family conflict. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 53(7), 806–814. doi: 10.1111/j.1469-7610.2012.02530.x.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Everson, S. A., Maty, S. C., & Lynch, J. W., et al. (2002). Epidemiologic evidence for the relation between socioeconomic status and depression, obesity, and diabetes. Journal of Psychosomatic Research, 53(4), 891–895.CrossRefPubMedGoogle Scholar
  12. Falbe, J., Rosner, B., & Willett, W. C., et al. (2013). Adiposity and different types of screen time. Pediatrics, 132(6), e1497–e1505. doi: 10.1542/peds.2013-0887.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Gibaud-Wallston J.,& Wandersman L.P. (1978). development and utility of the parenting sense of competence scale. American Psychological Association; August; Toronto, Canada.Google Scholar
  14. Gibaud-Wallston, J. (1978) Self-esteem and situational stress: Factors related to sense of competence in new parents. Dissertation Abstracts International, 39(1–B), 30.Google Scholar
  15. Gilbody, S., Bower, P., & Fletcher, J., et al. (2006). Collaborative care for depression: A cumulative meta-analysis and review of longer-term outcomes. Archives of Internal Medicine, 166(21), 2314–2321. doi: 10.1001/archinte.166.21.2314.CrossRefPubMedGoogle Scholar
  16. Gilmore, L., & Cuskelly, M. (2009). Factor structure of the parenting sense of competence scale using a normative sample. Child: Care, Health and Development, 35(1), 48–55. doi: 10.1111/j.1365-2214.2008.00867.x.Google Scholar
  17. Goodman, E., & Whitaker, R. C. (2002). A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics, 110(3), 497–504.CrossRefPubMedGoogle Scholar
  18. Grossklaus, H., & Marvicsin, D. (2014). Parenting efficacy and its relationship to the prevention of childhood obesity. Pediatric Nursing, 40(2), 69–86.PubMedGoogle Scholar
  19. Guenther, P. M., Casavale, K. O., & Reedy, J., et al. (2013). Update of the healthy eating index: HEI-2010. Journal of the Academy of Nutrition and Dietetics, 113(4), 569–580. doi: 10.1016/j.jand.2012.12.016.CrossRefPubMedGoogle Scholar
  20. Gundersen, C., Lohman, B. J., & Garasky, S., et al. (2008). Food security, maternal stressors, and overweight among low-income US children: Results from the National Health and Nutrition Examination Survey (1999–2002). Pediatrics, 122(3), e529–e540. doi: 10.1542/peds.2008-0556.CrossRefPubMedGoogle Scholar
  21. Harrell, F. E. (2001). Regression modeling strategies: With applications to linear models, logistic regression, and survival analysis. New York: Springer.CrossRefGoogle Scholar
  22. Hernandez-Valero, M. A., Wilkinson, A. V., & Forman, M. R., et al. (2007). Maternal BMI and country of birth as indicators of childhood obesity in children of Mexican origin. Obesity, 15(10), 2512–2519. doi: 10.1038/oby.2007.298.CrossRefPubMedGoogle Scholar
  23. Huang, T. T., Drewnowski, A., Kumanyika, S. K., & Glass, T. A. (2009). A systems-oriented multilevel framework for addressing obesity in the 21st century. Preventing Chronic Disease, 6(3), 78.Google Scholar
  24. Johnston, C., & Mash, E. J. (1989). A Measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology, 18(2), 167–175.CrossRefGoogle Scholar
  25. Jones, T. L., & Prinz, R. J. (2005). Potential roles of parental self-efficacy in parent and child adjustment: A review. Clinical Psychology Review, 25(3), 341–363. doi: 10.1016/j.cpr.2004.12.004.CrossRefPubMedGoogle Scholar
  26. Keller, P. S., Kouros, C. D., & Erath, S. A., et al. (2014). Longitudinal relations between maternal depressive symptoms and child sleep problems: The role of parasympathetic nervous system reactivity. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 55(2), 172–179. doi: 10.1111/jcpp.12151.CrossRefPubMedGoogle Scholar
  27. Knutson, K. L. (2012). Does inadequate sleep play a role in vulnerability to obesity? American Journal of Human Biology: The Official Journal of the Human Biology Council, 24(3), 361–371. doi: 10.1002/ajhb.22219.CrossRefGoogle Scholar
  28. Koch, F. S., Sepa, A., & Ludvigsson, J. (2008). Psychological stress and obesity. The Journal of Pediatrics, 153(6), 839–844. doi: 10.1016/j.jpeds.2008.06.016.CrossRefPubMedGoogle Scholar
  29. Lewinsohn, P. M., Seeley, J. R., & Roberts, R. E., et al. (1997). Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychology and Aging, 12(2), 277–287.CrossRefPubMedGoogle Scholar
  30. Liu, J. H., Jones, S. J., & Sun, H., et al. (2012). Diet, physical activity, and sedentary behaviors as risk factors for childhood obesity: An urban and rural comparison. Childhood Obesity, 8(5), 440–448. doi: 10.1089/chi.2012.0090.CrossRefPubMedGoogle Scholar
  31. Mills, S. D., Malcarne, & V. L., Fox, R. S., et al. (2014). Psychometric evaluation of the brief acculturation scale for hispanics. Hispanic Journal of Behavioral Sciences, 36(2), 164–174. doi: 10.1177/0739986314526697.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Moussavi, S., Chatterji, S., & Verdes, E., et al. (2007). Depression, chronic diseases, and decrements in health: Results from the World Health Surveys. Lancet, 370(9590), 851–858. doi: 10.1016/S0140-6736(07)61415-9.CrossRefPubMedGoogle Scholar
  33. Ogden, C. L., Carroll, M. D., & Kit, B. K., et al. (2014). Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA: The Journal of the American Medical Association, 311(8), 806–814. doi: 10.1001/jama.2014.732.CrossRefPubMedGoogle Scholar
  34. Ohan, J. L., Leung, D. W., & Johnston, C. (2000). The parenting sense of competence scale: Evidence of a stable factor structure and validity. Canadian Journal of Behavioural Science, 32(4), 251–261.CrossRefGoogle Scholar
  35. Pate, R. R., Almeida, M. J., & McIver, K. L., et al. (2006). Validation and calibration of an accelerometer in preschool children. Obesity, 14(11), 2000–2006. doi: 10.1038/oby.2006.234.CrossRefPubMedGoogle Scholar
  36. Patel, S. R., & Hu, F. B. (2008). Short sleep duration and weight gain: A systematic review. Obesity, 16(3), 643–653. doi: 10.1038/oby.2007.118.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Po’e, E. K., Heerman, W. J., & Mistry, R. S., et al. (2013). Growing Right Onto Wellness (GROW): A family-centered, community-based obesity prevention randomized controlled trial for preschool child-parent pairs. Contemporary Clinical Trials, 36(2), 436–449. doi: 10.1016/j.cct.2013.08.013.CrossRefPubMedGoogle Scholar
  38. Rogers, H. H., & Matthews, J. J. (2004). The parenting sense of competence scale: Investigation of the factor structure, reliability, and validity for an Australian Sample. Australian Psychologist, 39(1), 88–96.CrossRefGoogle Scholar
  39. Shrewsbury, V., & Wardle, J. (2008). Socioeconomic status and adiposity in childhood: A systematic review of cross-sectional studies 1990–2005. Obesity, 16(2), 275–284. doi: 10.1038/oby.2007.35.CrossRefPubMedGoogle Scholar
  40. Simpson, S. M., Krishnan, L. L., & Kunik, M. E., et al. (2007). Racial disparities in diagnosis and treatment of depression: A literature review. The Psychiatric Quarterly, 78(1), 3–14. doi: 10.1007/s11126-006-9022-y.CrossRefPubMedGoogle Scholar
  41. Snell, E. K., Adam, E. K., & Duncan, G. J. (2007). Sleep and the body mass index and overweight status of children and adolescents. Child Development, 78(1), 309–323. doi: 10.1111/j.1467-8624.2007.00999.x.CrossRefPubMedGoogle Scholar
  42. Stewart, R. C. (2007). Maternal depression and infant growth: A review of recent evidence. Maternal & Child Nutrition, 3(2), 94–107. doi: 10.1111/j.1740-8709.2007.00088.x.CrossRefGoogle Scholar
  43. Tandon, P. S., Zhou, C., & Sallis, J. F., et al. (2012). Home environment relationships with children’s physical activity, sedentary time, and screen time by socioeconomic status. The International Journal of Behavioral Nutrition and Physical Activity, 9, 88. doi: 10.1186/1479-5868-9-88.CrossRefPubMedPubMedCentralGoogle Scholar
  44. Taveras, E. M., Gillman, M. W., & Kleinman, K., et al. (2010). Racial/ethnic differences in early-life risk factors for childhood obesity. Pediatrics, 125(4), 686–695. doi: 10.1542/peds.2009-2100.CrossRefPubMedGoogle Scholar
  45. Taveras, E. M., Mitchell, K., & Gortmaker, S. L. (2009). Parental confidence in making overweight-related behavior changes. Pediatrics, 124(1), 151–158. doi: 10.1542/peds.2008-2892.CrossRefPubMedGoogle Scholar
  46. Wittayanukorn, S., Qian, J., & Hansen, R. A. (2014). Prevalence of depressive symptoms and predictors of treatment among U.S. adults from 2005 to 2010. General Hospital Psychiatry, 36(3), 330–336. doi: 10.1016/j.genhosppsych.2013.12.009.CrossRefPubMedGoogle Scholar
  47. Wrotniak, B. H., Epstein, L. H., & Paluch, R. A., et al. (2004). Parent weight change as a predictor of child weight change in family-based behavioral obesity treatment. Archives of Pediatrics & Adolescent Medicine, 158(4), 342–347. doi: 10.1001/archpedi.158.4.342.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • William J. Heerman
    • 1
  • Julie Lounds Taylor
    • 1
    • 2
  • Kenneth A. Wallston
    • 3
  • Shari L. Barkin
    • 1
  1. 1.Division of General PediatricsVanderbilt University Medical CenterNashvilleUSA
  2. 2.Vanderbilt Kennedy CenterNashvilleUSA
  3. 3.School of NursingVanderbilt University Medical CenterNashvilleUSA

Personalised recommendations