The Moderating Effect of Coping on Stress and Childhood Obesity-Related Health Behaviors among Non-Hispanic Black Caregivers

Elizabeth Prout Parks; Shiriki Kumanyika; Reneé H Moore; E Thomaseo Burton; Timothy Khalil; Lisa M Lewis; Frances K Barg; Andrew C Pool; Yasmeen Bruton; David B Sarwer; Anne E Kazak

doi:10.1007/s40615-025-02408-7

The Moderating Effect of Coping on Stress and Childhood Obesity-Related Health Behaviors among Non-Hispanic Black Caregivers

J Racial Ethn Health Disparities. 2025 Apr 2. doi: 10.1007/s40615-025-02408-7. Online ahead of print.

Authors

Elizabeth Prout Parks^{1

2

3}, Shiriki Kumanyika³, Reneé H Moore^{4

5}, E Thomaseo Burton^{6

7

8}, Timothy Khalil^{1

2}, Lisa M Lewis⁹, Frances K Barg^{3

10

11}, Andrew C Pool¹², Yasmeen Bruton², David B Sarwer¹³, Anne E Kazak^{14

15}

Affiliations

¹ Health & Wellbeing Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
² Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
³ Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁴ Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
⁵ Biostatistics Collaboration Center, Drexel University, Philadelphia, PA, USA.
⁶ Health & Wellbeing Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA. burtonet@chop.edu.
⁷ Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. burtonet@chop.edu.
⁸ Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA. burtonet@chop.edu.
⁹ School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
¹⁰ Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA.
¹¹ Department of Anthropology, University of Pennsylvania, Philadelphia, PA, USA.
¹² Center for Parent and Teen Communication, Craig-Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
¹³ Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA.
¹⁴ Nemours Children's Health, Wilmington, DE, USA.
¹⁵ Department of Pediatrics, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.

PMID: 40172803
DOI: 10.1007/s40615-025-02408-7

Abstract

Child health behaviors and weight status may be affected by caregivers' perception and experience of stress. However, little is known about the influence of caregiver coping strategies on childhood overweight and obesity, particularly among non-Hispanic Black caregivers. This study examined associations among specific caregiver stress types (i.e., general, parenting, race-related), child weight status, and health-related behaviors (i.e., intake of fruits and vegetables, consumption of fast food, engagement in physical activity) as well as the moderating effect of caregiver coping strategies. In addition to general coping, the study examined the role of religious coping. This cross-sectional study included 157 non-Hispanic Black caregiver and child (aged 3-7 years) dyads; all caregivers identified as Christian Protestant. Logistic regression models were fit to explore the associations among caregiver stress and child outcomes and to investigate moderation effects of caregiver coping. Models were adjusted for sociodemographic covariates. Association between parenting stress and child weight status was significantly moderated by acceptance coping while the relationship between general stress and child sugary drink intake was moderated by emotional coping. The combination of three stress types was significantly associated with increased child fast food intake. Future research should examine specific coping strategies to address varying levels and types of stress experienced by caregivers from minoritized backgrounds.

Keywords: Child health; Parent stress; Race-related stress; Religious coping; Weight status.