Last week I had a well care visit with an 8 year old boy and a 13 year old girl. Their dad brought them in, not because he is the primary caregiver, and not because he is a single dad, and not because their mom was at work or school: he brought them because he is their father. He knew about their school work, their after school activities and all about their lives. He was worried about his daughter’s weight, and had enrolled her in 3x/week karate classes, which she loves and eagerly described to me, from her progress in attaining different belts to her newly discovered strength. He was worried about his son’s and daughter’s school work, and had a homework plan that included supervision and daily reading and checking in with the teachers. He was thrilled with his son’s extraordinary athletic prowess as a sprinter, and “could not believe” that he wasn’t allowed to compete in grade level school-wide races because he beat the 6th graders – “I was so mad, doc!”
Shortly after my clinical encounter with this highly engaged father who cares deeply about his children’s physical health and weight, I read an article recently released in Pediatrics, Father Involvement in Pediatric Obesity Treatment and Prevention: A Systematic Review by Dr. Philip Morgan and colleagues. What a contrast! These authors found so few published obesity treatment and prevention studies that included fathers that their review of necessity focused on the paucity of father involvement, rather than the actual results of the studies. Among the 80 studies that included one parent (with 71 [89%] reporting which parent participated), mothers were the involved family member in 93%, fathers in just 6% and another family member in 1%. Among RCTs (randomized controlled studies) in which both parents could join, very few studies (8%) even reported whether the father participated. A single RCT targeted fathers exclusively! The authors examined multiple potential factors including setting, year, targeted behavior and other variables to look for any clues that would associate with father involvement – no spoilers here for you.
Most importantly, the authors note that there is no signal from the literature that this profound dearth of fathers in the pediatric obesity prevention and treatment trials literature has yet been identified as an issue or a research gap. The public health literature is bursting at the seams with old and new studies that document the critical importance of fathers to children’s health and development among families of all racial, ethnic and socioeconomic levels.1-3 It is clearly time to jump start a new generation of pediatric obesity treatment and prevention trials that embrace, include and even target fathers as the parent and leader for the index child – what a great way to share time together in support of developing a strong paternal relationship and good health.
1. The Importance of Fathers in the Health Development of Children. US Department of Health and Human Services. <https://www.childwelfare.gov/pubPDFs/fatherhood.pdf> accessed 12/21/2016.
2. The Fragile Families and Child Wellbeing Study. Research Briefs: Fatherhood & Father Involvement. < http://www.fragilefamilies.princeton.edu/briefsFFI> accessed 12/21/2016.
3. Fatherhood E-learning Module. Office of Adolescent Health. US Department of Health and Human Services. < https://www.hhs.gov/ash/oah/resources-and-publications/learning/fatherhood/index.html> accessed 12/21/2016.
