Psychosocial factors in nutrition education for hypercholesterolemic children

The goals were to assess psychosocial effects of labeling children as hyper cholesterolemic and to measure changes in child well-being as a function of participation in nutrition education interventions. Older (6-10 years old) and younger (4-6 years old) children with (>4.55 mmol/l; >176 mg/dL) and w ithout elevated total cholesterol levels were identified by cholesterol scr eening. Psychosocial function (self-esteem, perceived dietary competence, h ealth beliefs, parental control of eating) was assessed and at-risk childre n were randomized into a home-based, self-contained nutrition education pro gram (the Parent-Child Autotutorial, or PCAT program), dietary counseling w ith a registered dietician, or an at-risk control group. At three, six, and twelve months following baseline, children's psychosocial functioning agai n was assessed; parents also provided data at baseline, three months, and t welve months. Analyses of data from 189 at-risk and 74 not-at-risk children revealed that: (a) Older hypercholesterolemic children reported poorer hea lth beliefs than non-labeled children; (b) Older girls in nutrition educati on programs reported lower self-esteem than control group girls; (c) Older children's feeling of efficacy at choosing a healthful diet were positively related to their health beliefs and self-esteem; (d) Younger children's re ports of parents' dietary control were negatively related to children's fee lings of acceptance; and (e) Parents of older children in the PCAT program reported increases over time in children's ability to choose a healthful di et. The quasi-experimental design means that conclusions about negative lab eling effects should be drawn cautiously, but the evidence suggests that ed ucation interventions can have an impact on child efficacy and potentially child adjustment. Factors associated with adverse reactions to labeling (pa rental control or feelings of efficacy) should be taken into account in the development of intervention programs for children.