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Do Parents Perceive That Organized Activities Interfere with Family Meals? Associations between Parent Perceptions and Aspects of the Household Eating Environment. J Acad Nutr Diet 2020; 120:414-423. [PMID: 31926771 DOI: 10.1016/j.jand.2019.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 11/07/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Research has related child participation in organized activities to health and academic benefits; however, participation may interfere with family meals. OBJECTIVE Examine whether parents perceive child participation in organized activities to interfere with family meals and how perceptions are related to the household eating environment. DESIGN A cross-sectional analysis was completed using survey data collected in 2015-2016 as part of the Project EAT (Eating and Activity in Teens and Young Adults) cohort study. PARTICIPANTS Survey participants were originally recruited in Minneapolis-St Paul schools in 1998-1999. The analytic subsample of parents (one per household, n=389, 69% female, 31% nonwhite race, mean age=31) had one or more children involved in an organized activity. Approximately 33% of households included a child aged 2 to 5 and no older child; two thirds of households included school-aged children (6 to 18 years). MAIN OUTCOME MEASURES Parents reported family meal frequency, family meal scheduling difficulties, frequency of at-home meal preparation, and their own intake of fast food, fruit, and vegetables. STATISTICAL ANALYSES PERFORMED Analyses compared household environment characteristics reported by parents who perceived low interference between organized activities and family meals to characteristics reported by parents who perceived moderate to high interference from at least one form of activity. Regression models included a dichotomous indicator of interference as the independent variable and were adjusted for parental and household characteristics. RESULTS Among parents with children at any age, moderate to high interference was associated with lower family meal frequency, greater difficulty scheduling family meals, and more fast-food intake (all P≤0.01). The perception of moderate to high interference was more common among parents who reported involvement in both sport and nonsport activities (P<0.001) and those with a school-aged child (P<0.001) vs those with only preschool-aged children. CONCLUSIONS Follow-up research, including qualitative studies, is needed to identify the specific aspects of child participation in organized activities (eg, scheduled time of day) that may interfere with family meals.
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Nishida A, Foo JC, Shimodera S, Nishida A, Okazaki Y, Togo F, Sasaki T. The association of weight status and weight perception with number of confidants in adolescents. PLoS One 2019; 14:e0225908. [PMID: 31800623 PMCID: PMC6892562 DOI: 10.1371/journal.pone.0225908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/14/2019] [Indexed: 11/19/2022] Open
Abstract
Weight status and self-weight perception are related to social relationship issues. Studies have suggested links between non-normal weight status or weight perception and youths having fewer confidants, but these relationships are unclear and remain to be studied. This preliminary cross-sectional study examined the effects of weight status and weight perception on the number of confidants in adolescents. Self-report data from 15,279 grade 7–12 students (54.2% boys) were analyzed. The number of confidants (0–3 or ≥ 4) was examined, according to five weight status categories (underweight, low-normal weight, mid-normal weight (reference), high-normal weight, overweight, with Body Mass Index corresponding to ≤ 18.5, ≤ 20.0, ≤ 22.5, ≤ 25.0 and > 25.0 in adults, respectively), and five weight perception categories (too thin, a bit thin, good (reference), a bit fat, too fat). Boys and girls who were overweight and those who perceived themselves to be too fat were significantly more likely to have few confidants. High-normal weight in girls and self-perception of being a bit fat in boys were also associated with having few confidants. In boys, underweight and self-perception of being too thin were additionally associated with having few confidants. Adolescents with non-normal weight status or weight perception may have fewer confidants and require more social support.
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Affiliation(s)
- Asuka Nishida
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Jerome Clifford Foo
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Shinji Shimodera
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
| | - Atsushi Nishida
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Yuji Okazaki
- Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Fumiharu Togo
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
- * E-mail:
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Corr M, McMullen J, Morgan PJ, Barnes A, Murtagh EM. Supporting Our Lifelong Engagement: Mothers and Teens Exercising ( SOLE MATES); a feasibility trial. Women Health 2019; 60:618-635. [PMID: 31709910 DOI: 10.1080/03630242.2019.1688446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to examine the feasibility of the Supporting Our Lifelong Engagement; Mothers and Teens Exercising (SOLE MATES) program. SOLE MATES, a single-arm six-week feasibility trial, comprised six face-to-face sessions. Participants were mothers (n = 27) with daughters (n = 31) aged 12-16 years. Data were collected in Ireland between January 2018 and March 2018. Feasibility benchmarks examined recruitment, data collection, acceptability, resources and participant responses. The primary outcome was daughters' step counts, measured via sealed pedometer for seven consecutive days at baseline and six weeks. Secondary outcomes included mothers' step counts, measures of communication, co-participation in activity, health-related quality of life and parenting practices. Feasibility benchmarks were reached or exceeded, except for retention. Eligibility rates were 93.4%, and baseline activity levels were low. Program content, measures and facilitators were acceptable, demonstrated through a mean score of 4.14 (SD 0.3) on a 5-point Likert Scale. Daily steps increased in mothers (2,875 increase, p = .009) and daughters (1,393 increase, p = .007). Positive feasibility metrics demonstrated the program's appeal. Participant responses for outcome measures also indicated program success. However, the relatively homogenous sample and relatively poor initial participation rate were study limitations. The intervention should be evaluated in a randomized controlled trial.
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Affiliation(s)
- Méabh Corr
- Department of Arts Education and Physical Education, Mary Immaculate College, University of Limerick , Limerick, Ireland
| | - Jaimie McMullen
- School of Sport and Exercise Science, University of Northern Colorado , Greeley, Colorado, USA
| | - Philip J Morgan
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle , Newcastle, Australia
| | - Alyce Barnes
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle , Newcastle, Australia
| | - Elaine M Murtagh
- Department of Arts Education and Physical Education, Mary Immaculate College, University of Limerick , Limerick, Ireland
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The Effects of Parental Stress on Physical Activity Among Overweight and Obese Hispanic Adolescents: Moderating Role of Family Communication and Gender. J Phys Act Health 2019; 16:952-961. [PMID: 31557723 DOI: 10.1123/jpah.2018-0269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 04/22/2019] [Accepted: 07/22/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Previous literature has shown a negative relationship between parental stress and youth moderate to vigorous physical activity (MVPA). This study examined (1) the relationship between parental stress and adolescent MVPA, (2) the moderating role of family communication on this relationship, and (3) gender differences in these effects among overweight and obese Hispanic adolescents. METHODS Hispanic adolescents (N = 280, 52% female, 13.0 [0.8] y old, 44% obese, 12% severely obese) and their parents (88% female, 44.9 [6.5] y old) completed baseline measures for an efficacy trial. Adolescents self-reported MVPA in minutes per week for work, transportation, and recreation using a validated measure. Multiple regression analyses with interaction terms and multigroup methods were conducted. RESULTS There was a negative effect of parental stress on adolescent MVPA (β = -0.15, t = -2.018, P ≤ .05). This effect was moderated by family communication (β = 0.20, t = 2.471, P = .01), such that the association between parental stress and youth MVPA was stronger for adolescents with low levels of family communication. Furthermore, a multiple group model showed that the interaction was significant for boys (β = 0.27, t = 2.185, P = .03), but not for girls. CONCLUSIONS Findings provide support that addressing parental stress and family communication may help facilitate MVPA among Hispanic boys, the most at-risk group for pediatric obesity.
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Pratt KJ, Ferriby M, Brown CL, Noria S, Needleman B, Skelton JA. Adult weight management patients' perceptions of family dynamics and weight status. Clin Obes 2019; 9:e12326. [PMID: 31232524 PMCID: PMC10179550 DOI: 10.1111/cob.12326] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/07/2019] [Accepted: 05/23/2019] [Indexed: 01/26/2023]
Abstract
Our overall objective was to describe the parent-child, romantic, and family dynamics of adult weight management program (WMP) patients, and associations with children's and partners' weight status. First, we determined if family functioning mediated the effect between parent-child feeding practices and perceived child weight status, and romantic relationship anxiety and avoidance and perceived partner weight status. Second, we assessed if perceived child and partner weight status moderated the associations between family functioning and parent-child feeding practices and romantic relationship anxiety and avoidance, respectively. Patients (N=203) who resided with a child and partner from two WMPs completed assessments of parent-child feeding practices (Child Feeding Questionnaire), romantic relationship anxiety and avoidance (Relationship Structures Questionnaire), family functioning (Family Assessment Device General Functioning Scale), and perceived child and partner weight status. Bivariate analyses determined differences in weight status and relationship dynamics and family functioning, and mediation and moderation analyses were conducted to answer the two research questions. Family functioning was not a mediator between romantic relationship dynamics and partner weight status or parent-child dynamics and child weight status. Lower family functioning was associated with higher parent-child restrictive feeding practices, only among children with overweight/obesity. Similarly, lower family functioning was associated with higher anxiety and avoidance in romantic relationships, only for partners with overweight/obesity. Patients with children and/or partners with overweight/obesity reported more impaired family dynamics and functioning, compared to patients with children and/or partners with a healthy weight status.
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Affiliation(s)
- Keeley J Pratt
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
- Department of Surgery, The Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Megan Ferriby
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
| | - Callie L Brown
- Department of Pediatrics, Wake Forest University, Winston Salem, North Carolina
| | - Sabrena Noria
- Department of Surgery, The Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Bradley Needleman
- Department of Surgery, The Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest University, Winston Salem, North Carolina
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Lebron CN, Lee TK, Prado G, St George SM, Pantin H, Messiah SE. Psychometric properties of an abbreviated Childhood Family Mealtime Questionnaire among overweight and obese Hispanic adolescents. Appetite 2019; 140:169-179. [PMID: 31075325 PMCID: PMC6639035 DOI: 10.1016/j.appet.2019.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022]
Abstract
The current family mealtime literature shows that assessments of the mealtime environment are typically self-report, yet few studies discuss validation techniques or report using validated scales. As such, the current analysis was conducted to validate one of the only published measures to assess the mealtime environment from the adolescent perspective. Specifically, the Childhood Family Mealtime Questionnaire (CFMQ) was evaluated in a sample of 280 overweight and obese Hispanic adolescents to address the need for a validated measure of the family mealtime environment in a demographic that is disproportionately affected by the current obesity epidemic. Results of exploratory and confirmatory factor analyses to evaluate the optimal factor structure, reliability, and validity for a revised, abbreviated CFMQ are presented here. The concurrent validity of the CFMQ was evaluated using correlations between the factor structures and the previously used, culturally appropriate comparable measure of family functioning. Correlations were also computed between factor scores and obesogenic outcomes (fruit and vegetable intake, added sugar intake, and physical activity). Analyses produced a revised, abbreviated version that includes 22 items (reduced from a total of 69 items) and consists of the following 4 factors: family mealtime communication (5 items), family mealtime stress (7 items), appearance weight control (5 items), and mealtime structure (6 items). Cronbach's alphas are reported for reliability. When examining CFMQ concurrent validity with the family functioning latent variable, results showed the family mealtime communication subscale ranked highest. Additionally, the family mealtime communication subscale was associated with all three obesogenic outcomes. This abbreviated CFMQ may be a useful tool for those studying family mealtime environments and their influence on obesity and its associated lifestyle behaviors.
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Affiliation(s)
- Cynthia N Lebron
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Tae K Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hilda Pantin
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sarah E Messiah
- School of Public Health Dallas, University of Texas, Dallas, TX, USA
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Relationship between perception of emotional home atmosphere and fruit and vegetable consumption in European adolescents: results from the I.Family survey. Public Health Nutr 2019; 23:53-62. [PMID: 31405404 DOI: 10.1017/s1368980019002234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Consumption of fruits and vegetables (F&V) among adolescents falls below recommendations in many Western countries. The impact of social and emotional aspects of family life on adolescent dietary behaviour may contribute to this, yet remains under-investigated. The present study examines the association between adolescents' perceptions of emotional home atmosphere (EHA) and their F&V consumption frequency. DESIGN An FFQ was used to assess F&V consumption frequency. EHA was assessed by an eight-item measure with three subscales: perceived home warmth, strictness and relational tension. EHA subscales were used as binary variables: a score equal to or above the median value was considered as a higher perception, while a score below the median was considered as a lower perception of the EHA in question. Country differences in meeting the European 5-a-day recommendations were described. Further, the association between EHA and F&V consumption frequency was investigated using multiple linear regression. SETTING Regional examination centres in eight European countries. PARTICIPANTS Adolescents (n 3196) aged 12-18 years. RESULTS The mean F&V consumption frequency was 3·27 (sd 2·84) times/d. Only 16·1 % of boys and 18 % of girls in our study sample met the recommendation of five F&V daily. After controlling for age, sex, education level of the parents and country of origin, perceived home warmth was associated with a 16 (95 % CI 9, 22) % higher F&V consumption frequency (P < 0·001). CONCLUSIONS F&V consumption frequency was suboptimal in the survey areas. Interventions targeting perceived warmth as a component of EHA could potentially have a positive effect on adolescents' dietary behaviour.
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Pratt KJ, Van Fossen CA, Berge JM, Murray R, Skelton JA. Youth weight status and family functioning in paediatric primary care. Clin Obes 2019; 9:e12314. [PMID: 31115182 DOI: 10.1111/cob.12314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 02/03/2023]
Abstract
The purpose of this study is to examine the associations between family functioning and youth overweight and obesity in a sample of primary care paediatric patients. Specially, we hypothesize that caregivers of youth with an overweight/obese weight status will report more impaired family functioning. A cross-sectional descriptive study was conducted with 329 caregivers of youth ages 2 to 18 seen in paediatric primary care. Caregivers completed the Family Assessment Device General Functioning Scale and clinical demographics, including parent-reported youth height and weight to calculate body mass index (BMI). Family functioning was used as a continuous total variable, and as a dichotomous variable based on clinically impaired or healthy family functioning. Analyses included descriptive statistics, Pearson's correlations, and independent t tests. Caregivers who reported impaired family functioning based on the clinical cutoff score were more likely to report that their youth had a higher BMI and BMI z-score. Caregivers with impaired family functioning and who identified as being in two-parent families, with at least a Bachelor's degree, and a moderate to high family income were more likely to report their youth was a higher weight status. Further screening and assessment of family functioning in combination with youth weight status among a larger diverse sample of primary care paediatric patients over time will provide insight into what aspects of family functioning may contribute to maintaining a healthy lifestyle or adopting new health behaviours to prevent and/or treat obesity in youth.
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Affiliation(s)
- Keeley J Pratt
- Department of Human Sciences, Human Development and Family Science Program, Couple and Family Therapy Specialization, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Catherine A Van Fossen
- Department of Human Sciences, Human Development and Family Science Program, Couple and Family Therapy Specialization, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Robert Murray
- Ohio Chapter of the American Academy of Pediatrics, Columbus, Ohio
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Brenner FIT (Families in Training) Program, Brenner Children's Hospital, Wake Forest Baptist Health, Winston-Salem, North Carolina
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Rosemond TN, Blake CE, Shapiro CJ, Burke MP, Bernal J, Adams EJ, Frongillo EA. Disrupted Relationships, Chaos, and Altered Family Meals in Food-Insecure Households: Experiences of Caregivers and Children. J Acad Nutr Diet 2019; 119:1644-1652. [PMID: 31302036 DOI: 10.1016/j.jand.2019.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 05/05/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Regular family meals foster healthy physical and social development of children but often occur less frequently in households experiencing food insecurity. How food insecurity influences the quality of these interactions is not understood well. OBJECTIVE To better understand family meal experiences of caregivers and children living in food-insecure households. DESIGN A qualitative method with cross-sectional sample was used, collecting data using semistructured interview guides. PARTICIPANTS Twenty ethnically diverse caregiver-child (aged 9 to 15 years) dyads in South Carolina were interviewed. STATISTICAL ANALYSIS Data were analyzed using grounded theory in Nvivo 10. RESULTS Food-insecure households described family meals that varied in frequency, location, and quality of foods served, especially during times of food shortages. Interpersonal relationships drove the quality of mealtime interactions for these households. Household chaos not only influenced the frequency and location of meals, but also strained mealtime interactions in households with poor interpersonal relationships. In these homes, household chaos included conflicts with work and afterschool schedules, food shortages, coping with poverty and food insecurity (eg, working extra hours or seeking food assistance), and children visiting multiple homes, particularly when food was limited. All households experienced chaos, but strong interpersonal relationships were described as the primary reason for enjoyable mealtime experiences with few disruptions. CONCLUSIONS Exploring family meal experiences of children in food-insecure households highlights the importance of interpersonal relationships and regular, positive mealtime interactions that may strengthen emotional connections in families to improve child health outcomes.
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Deatrick JA, Klusaritz H, Atkins R, Bolick A, Bowman C, Lado J, Schroeder K, Lipman TH. Engaging With the Community to Promote Physical Activity in Urban Neighborhoods. Am J Health Promot 2019; 33:718-726. [PMID: 30354184 PMCID: PMC6679918 DOI: 10.1177/0890117118807405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE To describe perceptions of physical activity, opinions, on intergenerational approaches to physical activity and a vision for increasing physical activity in an underresourced urban community. APPROACH Focus groups embedded in a large Community-Based Participatory Research Project. SETTING West and Southwest Philadelphia. PARTICIPANTS 15 parents, 16 youth, and 14 athletic coaches; youth were 13 to 18 years old and attended West Philadelphia schools; parents' children attended West Philadelphia schools; and coaches worked in West Philadelphia schools. METHODS Six focus groups (2 youth, 2 parent, and 2 coach) were conducted guided by the Socio-Ecological Model; transcriptions were analyzed using a rigorous process of directed content analysis. RESULTS Factors on all levels of the Socio-Ecological Model influence the perception of and engagement in physical activity for youth and their families. Future strategies to increase engagement in physical activity need to be collaborative and multifaceted. CONCLUSION When physical activity is reframed as a broad goal that is normative and gender-neutral, a potential exists to engage youth and their families over their lifetimes; with attention to cross-sector collaboration and resource sharing, engaging and sustainable intergenerational physical activity interventions can be developed to promote health in underresourced urban communities.
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Affiliation(s)
- Janet A. Deatrick
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Heather Klusaritz
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Rahshida Atkins
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- School of Nursing, Camden, Rutgers University, New Brunswick, NJ, USA
| | - Ansley Bolick
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- National Center for Health Research, Washington, DC, USA
| | - Cory Bowman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Juan Lado
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Ann and Robert H Lurie Children’s Hospital, Chicago, IL, USA
| | - Krista Schroeder
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Terri H. Lipman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Foster BA, Weinstein K, Shannon J. Growing Healthy Together: protocol for a randomized clinical trial using parent mentors for early childhood obesity intervention in a Latino community. Trials 2019; 20:235. [PMID: 31023345 PMCID: PMC6485154 DOI: 10.1186/s13063-019-3342-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 04/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Latino children in the US experience high rates of obesity, increasing their risk of subsequent diabetes. There are few clinical trials among low-income, Latino families to test interventions that account for and address their unique situation. METHODS/DESIGN This trial, conducted in a Head Start (early childhood education) setting, randomly assigns children 2-5 years of age who have obesity by CDC (Centers for Disease Control and Prevention) guidelines (at least 95th percentile body mass index) and their parents to one of three conditions: (1) control, (2) parent mentor with an experimental curriculum, or (3) parent mentor with a standard curriculum (active control). We designed the experimental arm (2) using data from positive deviants: low-income, Latino families who had been successful in moving their child toward a healthy weight. Parent mentors are recruited and trained from the Head Start centers. Parent mentors then facilitate the teaching and coaching of parent-child dyads with weekly interactions over the course of a 6-month period. The primary outcome is change in adjusted body mass index z-score at the end of intervention and at 6 months post-intervention. Secondary outcomes include generalized self-efficacy, dietary intake, the home food environment, and reported physical activity. DISCUSSION This clinical trial contributes to the field by evaluating parent mentoring interventions that are potentially scalable for a population at high risk for continued obesity and subsequent morbidity and mortality. TRIAL REGISTRATION This trial was registered on October 31, 2017 (ClinicalTrials.gov identifier: NCT03330743 ).
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Affiliation(s)
- Byron A. Foster
- School of Medicine, Oregon Health and Science University, 3303 SW Bond Avenue CH16D, Portland, OR 97239 USA
| | - Kelsey Weinstein
- School of Medicine, Oregon Health and Science University, 3303 SW Bond Avenue CH16D, Portland, OR 97239 USA
| | - Jackilen Shannon
- School of Public Health, Oregon Health and Science University and Portland State University, 3181 SW Sam Jackson Park Road GH230, Portland, OR 97239 USA
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Berge JM, Telke S, Tate A, Trofholz A. Utilizing a Board Game to Measure Family/Parenting Factors and Childhood Obesity Risk. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:419-431. [PMID: 30765297 PMCID: PMC6461500 DOI: 10.1016/j.jneb.2018.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 12/09/2018] [Accepted: 12/14/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To describe a direct observational approach (ie, interactive family board game) to measure familyfunctioning and parenting behaviors of relevance to child weight and weight-related behaviors and to examine family functioning and parenting factors from multiple family dyads (eg, siblings, parent-child) and their associations with child weight and weight-related behaviors. DESIGN Cross-sectional, mixed-methods study. SETTING Two home visits were conducted with families 10days apart with a 7-day observational period between home visits. PARTICIPANTS Children (n = 150) aged 5-7years and their families from 1 of 6 racial and ethnic or immigrant and refugee groups, including African American, Hispanic, Hmong, Native American, Somali, and white, participated in the Family Matters study between 2014 and 2016. MAIN OUTCOME MEASURE Child weight status and weight-related behaviors (ie, diet quality, physical activity). ANALYSIS Adjusted logistic and linear regression models with robust SEs were used in analysis. RESULTS Higher family functioning scores across the majority of family dyads were significantly associated with lower child weight status (P < .05). In addition, some family functioning scores were associated with child diet and physical activity, but not consistently. Parenting behavior scores were inconsistently associated with child weight and weight-related outcomes. CONCLUSIONS AND IMPLICATIONS Results suggest that the interactive family board game task is a direct observational approach that researchers can use with family members to measure family functioning and parenting behaviors related to childhood obesity. Future interventions may want to consider including multiple family members in both measurement and intervention development to target childhood obesity.
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Affiliation(s)
- Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN.
| | - Susan Telke
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Allan Tate
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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Dunton GF, Ke W, Dzubur E, O’Connor SG, Lopez NV, Margolin G. Within-Subject Effects of Stress on Weight-Related Parenting Practices in Mothers: An Ecological Momentary Assessment Study. Ann Behav Med 2019; 53:415-425. [PMID: 31222228 PMCID: PMC6438347 DOI: 10.1093/abm/kay053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Stress may compromise parenting practices related to children's dietary intake, physical activity, and sedentary behavior. PURPOSE The current study used Ecological Momentary Assessment (EMA) to examine microtemporal sequences underlying maternal stress and subsequent weight-related parenting practices. METHODS Mothers (n = 199) of children aged 8-12 years participated in two separate 7-day waves of EMA with up to eight randomly prompted surveys per day during children's nonschool time. EMA items assessed stress and weight-related parenting practices. RESULTS When mothers reported experiencing greater stress than usual, they subsequently engaged in less physical activity parenting (e.g., encouraging physical activity; p < .05) and more sedentary screen behavior parenting (e.g., limiting TV/video games; p < .05) over the next 2 hr. CONCLUSIONS Addressing within-day variations in maternal stress may be an important component of parent-focused child obesity prevention interventions.
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Affiliation(s)
- Genevieve F Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
- Department of Psychology, Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California
| | - Wangjing Ke
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
| | - Eldin Dzubur
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
| | - Sydney G O’Connor
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
| | - Nanette V Lopez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
| | - Gayla Margolin
- Department of Psychology, Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California
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64
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Hausken SES, Lie HC, Lien N, Sleddens EFC, Melbye EL, Bjelland M. The reliability of the general functioning scale in Norwegian 13-15-year-old adolescents and association with family dinner frequency. Nutr J 2019; 18:20. [PMID: 30917827 PMCID: PMC6437966 DOI: 10.1186/s12937-019-0447-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 03/21/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Family environment is crucial to the development of health behaviors into adolescence and adulthood. The aims of this study were (1) to explore the reliability of the General Functioning Scale (GFS) among Norwegian 13-15-year-olds, and (2) to assess whether family functioning reported by adolescents was associated with family dinner frequency. METHODS In total 440 secondary-school students were invited to participate in this cross-sectional web-based questionnaire survey, with 54 participating in the test-retest study. Test-retest and internal consistency were assessed for the 12-item GFS-scale. Associations between family functioning and family dinner frequency were tested using multiple logistic regression. RESULTS The GFS had high internal consistency (corrected item-total correlations ranging from 0.40 to 0.65, Cronbach's α = 0.85), and excellent test-retest reliability (intra-class correlation coefficient = 0.83). In the logistic regression model, a higher score on GFS (poorer family functioning) was associated with a reduced likelihood of having dinner together on a daily basis (i.e., 6-7 times per week, OR = 0.36, CI = 0.20-0-64) after adjusting for age, gender, ethnicity, living situation and parental education level. CONCLUSIONS The GFS had high reliability. As poorer family functioning was associated with less frequent family dinners, the family environment may be an important (contextual) target to influence adolescent health behaviors. It would be of interest to further explore the role of family functioning in relation to adolescents' dietary habits, besides shared family meals, and to reveal the mechanisms underlying such relationships.
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Affiliation(s)
- Solveig E S Hausken
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.O.Box 1046, Blindern, NO-0316, Oslo, Norway.
| | - Hanne C Lie
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.O.Box 1046, Blindern, NO-0316, Oslo, Norway
| | - Ester F C Sleddens
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elisabeth L Melbye
- Faculty of Social Sciences, Norwegian School of Hotel Management, University of Stavanger, Stavanger, Norway
| | - Mona Bjelland
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.O.Box 1046, Blindern, NO-0316, Oslo, Norway
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Walton K, Haycraft E, Jewell K, Breen A, Randall Simpson J, Haines J. The Family Mealtime Observation Study (FaMOS): Exploring the Role of Family Functioning in the Association between Mothers' and Fathers' Food Parenting Practices and Children's Nutrition Risk. Nutrients 2019; 11:nu11030630. [PMID: 30875873 PMCID: PMC6472050 DOI: 10.3390/nu11030630] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/11/2019] [Indexed: 12/12/2022] Open
Abstract
This cross-sectional study explores associations between mothers’ and fathers’ food parenting practices and children’s nutrition risk, while examining whether family functioning modifies or confounds the association. Home observations assessed parents’ food parenting practices during dinnertime (n = 73 families with preschoolers). Children’s nutrition risk was calculated using NutriSTEP®. Linear regression models examined associations between food parenting practices and NutriSTEP® scores. An interaction term (family functioning × food parenting practice) explored effect modification; models were adjusted for family functioning to explore confounding. Among mothers, more frequent physical food restriction was associated with higher nutrition risk in their children (β = 0.40 NutriSTEP® points, 95% Confidence Interval (CI) = 2.30, 7.58) and among both mothers and fathers, positive comments about the target child’s food were associated with lower nutrition risk (mothers: β = −0.31 NutriSTEP® points, 95% CI = −0.54, −0.08; fathers: β = −0.27 NutriSTEP® points, 95% CI = −0.75, −0.01) in models adjusted for parent education and child Body Mass Index (BMI) z-score. Family functioning did not modify these associations and they remained significant after adjustment for family functioning. Helping parents to use positive encouragement rather than restriction may help to reduce their children’s nutrition risk.
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Affiliation(s)
- Kathryn Walton
- Department of Translational Medicine, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada.
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK.
| | - Kira Jewell
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Andrea Breen
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Janis Randall Simpson
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Jess Haines
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada.
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Condessa LA, Chaves OC, Silva FM, Malta DC, Caiaffa WT. Sociocultural factors related to the physical activity in boys and girls: PeNSE 2012. Rev Saude Publica 2019; 53:25. [PMID: 30810662 PMCID: PMC6390671 DOI: 10.11606/s1518-8787.2019053000516] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 04/10/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE: To verify in male and female Brazilian adolescents the association of demographic, psychosocial, behavioral and sociocultural characteristics with the regular practice of physical activity. METHODS: The sample consisted of 109,104 adolescents from all Brazilian states attending the 9th year of elementary education in 2012. The response variable was the regular practice of physical activity (300+ minutes/week). The explanatory variables were grouped into four fields: demographic, psychosocial, behavioral and sociocultural. The Poisson regression was stratified by sex to evaluate the association. RESULTS: The prevalence of active adolescents was 20.2%, higher in boys (27.9%) than in girls (13.1%). It was observed a greater practice of physical activity in boys of lower age group, children of mothers with higher schooling, who consumed healthy foods such as beans, fruits, vegetables, and milk, as well as among those with family supervision. At the same time, unhealthy habits such as insomnia and alcohol consumption were also positively associated with physical activity. In girls, greater physical activity was observed among those who lived with mothers and whose mothers had higher schooling. In addition to family supervision, the practice of physical activity in girls was also positively associated with the frequency of meals with their parents. However, as in boys, insomnia and alcohol consumption were associated with an increase in the practice of physical activity. CONCLUSIONS: One-fifth of adolescents practice physical activity regularly, demonstrating the need for specific public policies to increase the percentage of active young people in the country. Maternal schooling, healthy eating habits and family supervision were associated with regular physical activity in boys and girls, evidencing the importance of the family for the acquisition of healthy habits in this age group.
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Affiliation(s)
- Luciano Antonacci Condessa
- Instituto Federal Fluminense de Educação, Ciência e Tecnologia. Itaperuna, RJ, Brasil.,Universidade Federal de Minas Gerais. Faculdade de Medicina. Observatório de Saúde Urbana de Belo Horizonte. Belo Horizonte, MG, Brasil
| | - Otaviana Cardoso Chaves
- Universidade Federal de Minas Gerais. Faculdade de Medicina. Observatório de Saúde Urbana de Belo Horizonte. Belo Horizonte, MG, Brasil
| | - Fernanda Marcelina Silva
- Universidade Federal de Minas Gerais. Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto. Belo Horizonte, MG, Brasil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Waleska Teixeira Caiaffa
- Universidade Federal de Minas Gerais. Faculdade de Medicina. Observatório de Saúde Urbana de Belo Horizonte. Belo Horizonte, MG, Brasil
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67
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Heredia NI, Wilkinson AV, Forman MR, Christie IC, Wang J, Daniel CR, Zhao H, Bondy ML, Strong LL. Longitudinal associations of family functioning with body mass index in Mexican-origin adolescents living in the U.S. Prev Med 2019; 118:309-316. [PMID: 30419254 PMCID: PMC6467205 DOI: 10.1016/j.ypmed.2018.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 11/16/2022]
Abstract
Mexican-origin adolescents have a high prevalence of obesity. Research is needed to understand how family context may shape adolescent BMI. This study examined longitudinal associations of family functioning variables with the Centers for Disease Control and Prevention's modified BMI z-score (BMIaz) in 1175 Mexican-origin adolescents, and explored interactions with acculturation. Adolescents (50% female, aged 11-13 y in 2005-06) were identified from an ongoing cohort study of Mexican-origin adults in Houston, TX, and were assessed three times from 2005-06 to 2010-11. In multivariate linear mixed models stratified by gender, we assessed longitudinal associations of family cohesion and family conflict with adolescent BMIaz and explored interactions with language acculturation. We disaggregated the between- (mean) and within-person (individual deviation) components of family cohesion and family conflict to assess the effects on BMIaz. Approximately one-third of adolescents were obese at baseline, and BMIaz declined during the study. In girls, higher mean family cohesion and conflict were associated with steeper declines in BMIaz. Parental linguistic acculturation modified the relationship between within-person deviation in family cohesion and BMIaz in girls, such that high parental U.S. acculturation was associated with a stronger inverse association. There were no significant associations in boys. These findings highlight the potential importance of the family context to female adolescent BMI and the promise of addressing family context in obesity-related interventions.
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Affiliation(s)
- Natalia I Heredia
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
| | - Anna V Wilkinson
- University of Texas Health Science Center, Michael & Susan Dell Center for Healthy Living, Austin, TX, United States of America.
| | - Michele R Forman
- Department of Nutrition Science, College of Health and Human Science, Purdue University, West Lafayette, IN, United States of America.
| | - Israel C Christie
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, United States of America; Baylor College of Medicine, Houston, TX, United States of America.
| | - Jian Wang
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
| | - Carrie R Daniel
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
| | - Hua Zhao
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
| | - Melissa L Bondy
- Baylor College of Medicine, Houston, TX, United States of America.
| | - Larkin L Strong
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
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68
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Niermann CYN, Gerards SMPL, Kremers SPJ. Conceptualizing Family Influences on Children's Energy Balance-Related Behaviors: Levels of Interacting Family Environmental Subsystems (The LIFES Framework). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122714. [PMID: 30513788 PMCID: PMC6313966 DOI: 10.3390/ijerph15122714] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/23/2018] [Accepted: 11/28/2018] [Indexed: 01/15/2023]
Abstract
Healthy or unhealthy behavioral patterns develop and are maintained in a family context. The importance of the family environment for children’s and adolescents’ energy balance-related behaviors (EBRBs) has been shown previously. However, the way different family environmental factors are interrelated and interact with personal factors (e.g., motivation) are not well understood. Furthermore, the majority of studies have focused on the parent-child subsystem. However, there are family-level socialization dynamics that affect the development of a healthy lifestyle beyond the impact of parenting behaviors. The current paper aims to synthesize theoretical and empirical literature on different types of family influences. The Levels of Interacting Family Environmental Subsystems (LIFES) framework incorporates family influences on three levels (immediate, proximal, distal) and of three subsystems (individual, parent-child, family), relates them to each other and postulates potential paths of influence on children’s EBRBs. Several studies examining specific sections of the framework provide empirical support for LIFES’ propositions. Future studies should place their research in the context of the interrelationship of different family environmental influences. A better understanding of the interrelated influences would enhance the understanding of the development and maintenance of overweight and obesity among children and is crucial for the development of effective interventions.
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Affiliation(s)
- Christina Y N Niermann
- Department of Sport Science, University of Konstanz, P.O. Box 30, 78457 Konstanz, Germany.
| | - Sanne M P L Gerards
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
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69
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St George SM, Messiah SE, Sardinas KM, Poma S, Lebron C, Tapia MI, Velazquez MR, Pantin H, Prado G. Familias Unidas for Health and Wellness: Adapting an Evidence-Based Substance Use and Sexual Risk Behavior Intervention for Obesity Prevention in Hispanic Adolescents. J Prim Prev 2018; 39:529-553. [PMID: 30291486 PMCID: PMC6585459 DOI: 10.1007/s10935-018-0524-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe the adaptation of Familias Unidas, an evidence-based substance use and sexual risk behavior intervention, for obesity prevention in Hispanic adolescents. Intervention developers and experts in pediatric obesity, exercise physiology, dietetics, and the local parks system provided input for changes. Hispanic families also provided input through a series of 21 focus groups conducted before, during, and after an initial pilot test of the adapted intervention. After transcribing audiotaped sessions, we used a general inductive approach and Dedoose qualitative software to derive themes. Results indicated the need for improved health-related family functioning, enhanced nutrition education and skill building, increased family engagement in physical activity, and stronger links between family and environmental supports. Parents who participated in the pilot test expressed high enthusiasm for hands-on nutrition training and reported improvements in family functioning. Adolescents liked outdoor physical activities but wanted parents to be more engaged in joint physical activity sessions. The adapted intervention maintains fidelity to Familias Unidas' core theoretical elements and overall structure, but also includes content focused on physical activity and nutrition, adolescent participation in physical activity sessions led by park coaches, and joint parent-adolescent participation in physical activity and nutrition skill-building activities.
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Affiliation(s)
- Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1009, Miami, FL, 33136, USA.
| | - Sarah E Messiah
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1009, Miami, FL, 33136, USA
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Krystal M Sardinas
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sofia Poma
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1009, Miami, FL, 33136, USA
| | - Cynthia Lebron
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1009, Miami, FL, 33136, USA
| | - Maria I Tapia
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1009, Miami, FL, 33136, USA
| | - Maria Rosa Velazquez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1009, Miami, FL, 33136, USA
| | - Hilda Pantin
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1009, Miami, FL, 33136, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1009, Miami, FL, 33136, USA
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Walton K, Horton NJ, Rifas-Shiman SL, Field AE, Austin SB, Haycraft E, Breen A, Haines J. Exploring the Role of Family Functioning in the Association Between Frequency of Family Dinners and Dietary Intake Among Adolescents and Young Adults. JAMA Netw Open 2018; 1:e185217. [PMID: 30646382 PMCID: PMC6324390 DOI: 10.1001/jamanetworkopen.2018.5217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Eating meals, particularly dinner, with family members has been associated with improved dietary intake among youths. However, existing studies have not examined how family functioning may moderate or confound this association. OBJECTIVE To examine whether level of family functioning is associated cross-sectionally with frequency of family dinners and dietary intake among a US national sample of adolescents and young adults. DESIGN, SETTING, AND PARTICIPANTS Data from the 2011 questionnaire in the Growing Up Today Study 2 were used for this cross-sectional study. Linear regression models examined the extent to which family dinner frequency was associated with self-reported intake of fruits and vegetables, sugar-sweetened beverages, fast food, and takeout food among 2728 adolescents and young adults (age, 14-24 years). To explore effect modification by family functioning, an interaction term for family functioning and family dinner frequency was included for each dietary outcome. To explore confounding, models adjusted for family functioning were run. All models were stratified by sex and included participant age, educational attainment of mother's spouse or partner, and family structure as covariates. Statistical analysis was conducted between January 1, 2017, and August 31, 2018. MAIN OUTCOMES AND MEASURES Dietary intake measured by consumption of fruits and vegetables, sugar-sweetened beverages, takeout food, and fast food; family dinner frequency per week; and family functioning. RESULTS Among the 2728 participants, there were 1559 female and 1169 male participants who were 14 to 24 years of age (mean [SD] age, 19.4 [1.9] years) and were living with their parents in 2011. Most participants (2453 of 2649 [92.6%]) identified as white. More frequent family dinners were associated with higher-quality dietary intake regardless of level of family functioning; interactions between family functioning and family dinner frequency were not significant. Associations between family meal frequency and dietary intake outcomes did not change substantively when adjusting for family functioning. In adjusted models, more frequent family dinners were associated with higher intakes of fruits (female participants: β, 0.09 servings/d; 95% CI, 0.04-0.15 servings/d; male participants: β, 0.07 servings/d; 95% CI, 0.01-0.12 servings/d) and vegetables (female participants: β, 0.21 servings/d; 95% CI, 0.12-0.30 servings/d; male participants: β, 0.19 servings/d; 95% CI, 0.09-0.30 servings/d), and lower intakes of fast food (female participants: β, -0.04 times/wk; 95% CI, -0.07 to 0.00 times/wk; male participants: β, -0.10 times/wk; 95% CI, -0.15 to -0.04 times/wk) and takeout foods (female participants: β, -0.04 times/wk; 95% CI, -0.07 to -0.01 times/wk; male participants: β, -0.06 times/wk; 95% CI, -0.10 to -0.02 times/wk). More frequent family dinners were associated with lower intake of sugar-sweetened beverages for male participants only (β, -0.07 servings/d; 95% CI, -0.13 to -0.02 servings/d). CONCLUSIONS AND RELEVANCE More frequent family dinners are associated with healthful dietary intakes among youths, regardless of level of family functioning. Family dinners may be an appropriate intervention target for improving dietary intake among youths.
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Affiliation(s)
- Kathryn Walton
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Nicholas J. Horton
- Department of Mathematics and Statistics, Amherst College, Amherst, Massachusetts
| | - Sheryl L. Rifas-Shiman
- Harvard Pilgrim Health Care Institute, Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
| | - Alison E. Field
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - S. Bryn Austin
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Andrea Breen
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
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Van Fossen CA, Pratt KJ, Murray R, Skelton JA. Family Functioning in Pediatric Primary Care Patients. Clin Pediatr (Phila) 2018; 57:1549-1557. [PMID: 30095008 DOI: 10.1177/0009922818793347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to pilot a brief measure of family functioning (Family Assessment Device-General Functioning [FAD_GF]) with caregivers of children aged 2 to 18 years, seen for routine pediatric primary care visits. METHODS This study evaluated the psychometric properties of the FAD_GF in a pediatric primary care sample of 400 families. Confirmatory factor analysis was used to validate the FAD_GF using R, and WLSMV was used to estimate missing variables. RESULTS The FAD_GF was found to be reliable with this sample, α = .90. The model fit was χ2(54) = 56.44, P = .38, with root mean square error of approximation = .01 and comparative fit index = .99. The 12 items were significantly predicted by family functioning, and family functioning explained more than 20% of the variance in the items, R2 > .25. Overall, 12.6% (n = 46) of families were identified as having clinically impaired family functioning. DISCUSSION The FAD_GF provides clinicians the ability to make evidence-informed decisions regarding referrals to family therapists.
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Affiliation(s)
| | - Keeley J Pratt
- 1 The Ohio State University, Columbus, OH, USA.,2 The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Robert Murray
- 3 Ohio Chapter of the American Academy of Pediatrics, Columbus, OH, USA
| | - Joseph A Skelton
- 4 Wake Forest School of Medicine, Winston-Salem, NC, USA.,5 Brenner Children's Hospital, Wake Forest Baptist Health, Winston-Salem, NC, USA
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Niermann CYN, Spengler S, Gubbels JS. Physical Activity, Screen Time, and Dietary Intake in Families: A Cluster-Analysis With Mother-Father-Child Triads. Front Public Health 2018; 6:276. [PMID: 30324100 PMCID: PMC6172305 DOI: 10.3389/fpubh.2018.00276] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/06/2018] [Indexed: 01/27/2023] Open
Abstract
Background: The co-occurrence of multiple health behaviors such as physical activity, diet, and sedentary behavior affects individuals' health. Co-occurence of different health behaviors has been shown in a large number of studies. This study extended this perspective by addressing the co-occurrence of multiple health behaviors in multiple persons. The objective was to examine familial health behavioral patterns by (1) identifying clusters of families with similar behavior patterns and (2) characterizing the clusters by analyzing their correlates. Methods: Cross-sectional data were collected from 198 families (mother, father, and child). Mothers, fathers, and children completed questionnaires assessing health related behaviors (physical activity, consumption of “healthy” and “unhealthy” foods, and screen time), the perception of Family Health Climate (regarding physical activity and nutrition) and demographics. Twelve variables (four health behaviors of three family members) were included in a cluster analysis conducted with Ward's Method and K-means analysis. Chi-square tests and analyses of variance were performed to characterize the family clusters regarding their demographics and their perception of Family Health Climate. Results: Three clusters of families with specific behavioral patterns were identified: “healthy behavior families” with levels of physical activity and consumption of healthful foods above average and levels of media use and consumption of sweets below average; “unhealthy behavior families” with low levels of consumption of healthful foods and high levels of screen time; “divergent behavior families” with unhealthier behavioral patterns in parents and healthier screen time and eating behaviors combined with low physical activity levels in children. Family Health Climate differed between family clusters with most positive ratings in “healthy behavior families” and least positive ratings in “unhealthy behavior families.” “Divergent behavior families” rated the nutrition climate nearly as high as “healthy behavior families” while they rated the physical activity climate nearly as low as the “unhealthy behavior families.” Conclusions: The study shows that co-occurrence of multiple health behaviors occurs on the family level. Therefore, focusing the family as a whole instead of individuals and targeting aspects related to the Family Health Climate in interventions could result in benefits for both children and adults and enhance effectivity of intervention programs.
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Affiliation(s)
| | - Sarah Spengler
- Department of Sport and Health Science, Technical University of Munich, Munich, Germany
| | - Jessica S Gubbels
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
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Rahman A, Fulda KG, Franks SF, Fernando SI, Habiba N, Muzaffar O. How often parents make decisions with their children is associated with obesity. BMC Pediatr 2018; 18:311. [PMID: 30253768 PMCID: PMC6156975 DOI: 10.1186/s12887-018-1283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 09/16/2018] [Indexed: 12/05/2022] Open
Abstract
Background Evidence supports that better parental involvement and communication are related to reduced obesity in children. Parent-child collaborative decision-making is associated with lower BMI among children; while child-unilateral and parent-unilateral decision-making are associated with overweight children. However, little is known about associations between joint decision-making and obesity among Hispanic youth. The purpose of this analysis was to determine the relationship between parent-child decision making and obesity in a sample of predominantly Hispanic adolescents. Methods Data from two studies focused on risk for type II diabetes were analyzed. A total of 298 adolescents 10–14 years of age and their parent/legal guardian were included. Parents completed questionnaires related to psychosocial, family functioning, and environmental factors. Multiple logistic regression was used to determine the association between obesity (≥ 95th percentile for age and gender), the dependent variable, and how often the parent felt they made decisions together with their child (rarely/never, sometimes, usually, always), the primary independent variable. Covariates included gender, age, ethnicity, total family income, and days participated in a physical activity for at least 20 min. ORs and 95% CIs were calculated. Results Adolescent participants were predominantly Hispanic n = 233 (78.2%), and approximately half n = 150 (50.3%) were female. In multivariate analyses, adolescents who rarely/never made decisions together with their family had significantly higher odds (OR = 3.50; 95% CI [1.25–9.83]) of being obese than those who always did. No association was observed between either those who sometimes make decisions together or those who usually did and those that always did. Conclusions Parents and children not making decisions together, an essential aspect of parent-child communication, is associated with increased childhood obesity. The results of our study contribute to evidence of parental involvement in decision-making as an important determinant of adolescent health. Further studies should explore temporal relationships between parenting or communication style and obesity.
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Affiliation(s)
- Adrita Rahman
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN, 55454, USA
| | - Kimberly G Fulda
- North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA. .,Department of Family Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Susan F Franks
- North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.,Department of Family Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Shane I Fernando
- North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.,Department of Pediatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Nusrath Habiba
- Department of Pediatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Omair Muzaffar
- North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.,Department of Family Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
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74
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Didericksen KW, Berge JM, Hannan PJ, Harris SM, MacLehose RF, Neumark-Sztainer D. Mother-father-adolescent triadic concordance and discordance on home environment factors and adolescent disordered eating behaviors. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2018; 36:338-346. [PMID: 29389146 PMCID: PMC6070425 DOI: 10.1037/fsh0000325] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION This study utilizes triadic data to examine the association between mother-father-adolescent concordance (agreement) and discordance (disagreement) on home environment factors (i.e., parental encouragement of dieting, family functioning) and adolescent unhealthy weight control behaviors and binge eating. METHOD A subsample of adolescent-mother-father triads (n = 833; adolescents ages 10-22) from two coordinated population-based studies (EAT 2010 and F-EAT) were used. Poisson regression analysis was used to estimate the relative risks of each eating disordered behavior. RESULTS Triads were more concordant (range 9-42%) than discordant (range 4-24%). Triadic agreement that parents did not encourage dieting was associated with a lower risk of adolescent eating disordered behaviors in some triadic combinations. Additionally, triadic concordance on high family functioning was also associated with a lower risk of adolescent eating disordered behaviors among some triadic combinations. DISCUSSION Results suggest that triadic concordance on healthy home environment factors is associated with fewer adolescent disordered eating behaviors in some triads. Family based interventions may want to consider focusing on strategies to help move mother-father-adolescent triads closer on seeing the home environment more similarly. Future research is needed on triadic concordance/discordance and disordered eating behaviors to confirm study results and to inform the development of family based interventions. (PsycINFO Database Record
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Affiliation(s)
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Peter J Hannan
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Steven M Harris
- Family Social Science, College of Education and Human Development, University of Minnesota
| | - Richard F MacLehose
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
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75
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Pratt KJ, Skelton JA. Family Functioning and Childhood Obesity Treatment: A Family Systems Theory-Informed Approach. Acad Pediatr 2018; 18:620-627. [PMID: 29654905 PMCID: PMC8111666 DOI: 10.1016/j.acap.2018.04.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 02/28/2018] [Accepted: 04/04/2018] [Indexed: 01/21/2023]
Abstract
Childhood obesity recommendations advise providers to use family-based care for the treatment of youth and adolescent obesity. Family-based care, defined as the inclusion of a caregiver and a youth, is commonly conducted through behavioral interventions that target the dietary and physical activity behaviors of the attending parent-youth dyads. However, focusing on behaviors isolated to the parent and youth neglects the rest of the family members, and the larger rules, routines, communication, and dynamics in the family. Family-based interventions grounded in family systems theory (FST) target family dynamics to influence weight-related behaviors through higher-level changes in the family. The utility of using FST in childhood obesity treatment has not been extensively conceptualized or applied. Few outcome studies have reported on variables representative of FST, and even fewer FST interventions have been conducted. Because of the lack of detail on the application of FST to childhood obesity treatment, providers are left with little clarity on how to use FST in clinical encounters. We provide the background and evidence for use of FST, detail how families organize around weight-related behaviors that contribute to obesity, and on the basis of their organization, what type of treatment might be beneficial, FST-informed or family-based behavioral interventions. Finally, a suggested family-based clinical algorithm is provided detailing the use of FST through assessment, intervention, and follow-up that can be refined over time by providers and researchers committed to viewing obesity in the context of the family and family dynamics.
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Affiliation(s)
- Keeley J. Pratt
- Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio; Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Joseph A. Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC; Brenner FIT (Families In Training) Program, Brenner Children’s Hospital, Wake Forest Baptist Health, Winston-Salem, NC; Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC
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76
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Loth KA, Uy M, Neumark-Sztainer D, Fisher JO, Berge JM. A qualitative exploration into momentary impacts on food parenting practices among parents of pre-school aged children. Appetite 2018; 130:35-44. [PMID: 30059769 DOI: 10.1016/j.appet.2018.07.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/23/2018] [Accepted: 07/25/2018] [Indexed: 01/17/2023]
Abstract
Food parenting practices have been identified as a potentially significant correlate of weight status and weight-related behaviors in children. The extent to which food parenting practices fluctuate across time and context is not well known. In particular, situational factors are thought to shape the types of food parenting practices used in the moment, but the nature of those factors remain unclear. In this paper data from interviews with parents (n = 40) of preschoolers was used to: 1) describe parents' day-to-day lived experiences of food parenting within the broad theoretical domains of coercive control, structure and autonomy support; 2) identify salient momentary factors that influence use of these food parenting practices; and 3) understand how these momentary factors impact the use of different types of food parenting practices. The feeding practices described by parents align well with the three overarching themes described within the literature: coercive control, autonomy support, and structure. Parents described using a combination of practices from within each of these domains; they also indicated that their feeding practices were easily influenced by momentary factors that impacted their food parenting within and across eating occasions. For the most part, parents described momentary factors (e.g. schedule changes, parental stress, child behavior) that shifted them away from structure and autonomy support feeding practices, towards indulgent and coercive feeding practices. Researchers should be aware of the likely interplay between different types of feeding practices as well as the potential that momentary factors may shift parents from one type of practice towards another. The use of novel data collection methods, such as ecological momentary assessment, that allow for exploration of food parenting practices as dynamic, rather than static, behaviors should be explored.
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Affiliation(s)
- Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Marc Uy
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Jennifer Orlet Fisher
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
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77
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Rahkar Farshi M, Valizadeh L, Zamanzadeh V, Rssouli M, Lopez V, Cleary M. Perceptions of Iranian parents towards the paternal role in raising adolescent children. Nurs Health Sci 2018; 20:479-485. [PMID: 29971930 DOI: 10.1111/nhs.12538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/19/2018] [Accepted: 04/29/2018] [Indexed: 11/30/2022]
Abstract
In Iran, as in other nations, adolescence can be a challenging period for both parents and their children. Typically, mothers assume the main role of parenting, which can have a negative impact either directly or indirectly on paternal involvement, or conversely, play a positive role of mediation between fathers and their adolescent children. In the present study, we report on a qualitative study conducted in 2016 that explored the perceptions of Iranian parents toward the paternal role in raising adolescent children. Twenty three mothers and fathers of adolescent children were interviewed to explore their views and experiences with paternal roles in raising adolescent children. Four themes emerged from the data: (i) limited father-child interactions; (ii) mother-led parenting; (iii) father-child conflict; and (iv) united front parenting. The findings suggest that mothers maintain a prime role in parenting, but that the involvement of fathers can have a negative or positive impact on adolescent development, depending on the level and quality of that involvement. Strategies need to be explored for how parents can best support one another to engage in the development of adolescent children.
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Affiliation(s)
- Mahni Rahkar Farshi
- Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Valizadeh
- Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Department of Medical-Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mryam Rssouli
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Violeta Lopez
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michelle Cleary
- School of Health Sciences, University of Tasmania, Sydney, NSW, Australia
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78
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Bell DC, Bell LG. Accuracy of Retrospective Reports of Family Environment. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:1029-1040. [PMID: 29915516 PMCID: PMC6003663 DOI: 10.1007/s10826-017-0948-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Retrospective reports of family environments are often the only way to collect data concerning the influence of a child's experience in the family on later development. However, the accuracy of retrospective measures can be problematic because of social desirability or potential failures of memory. The purpose of this study is to compare retrospective and prospective measures of family environment. In this unique study, 198 parents and 241 adolescent children (mean age 15.7) described their family environment, and then 25 years later completed retrospective reports. We test the effects of memory, positivity, gender, and generation on retrospective reports, as well as testing the ability of prospective and retrospective measures to predict adult well-being and adult-child/elder-parent relationships. Results show moderate correlations of .30 - .45 between prospective and retrospective measures. In examining the relative effectiveness of prospective and retrospective measures to predict later life outcomes, we find that retrospective reports of the family environment most validly capture influences on the child in domains of strong emotional content but are less successful in cognitive domains.
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Affiliation(s)
- David C Bell
- Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Linda G Bell
- Indiana University Purdue University Indianapolis, Indianapolis, IN
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79
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Lebron CN, Lee TK, Park SE, St George SM, Messiah SE, Prado G. Effects of parent-adolescent reported family functioning discrepancy on physical activity and diet among Hispanic youth. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2018; 32:333-342. [PMID: 29698007 PMCID: PMC5922788 DOI: 10.1037/fam0000386] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research has shown that family functioning has been positively associated with physical activity and dietary intake, both of which are obesity-related risk factors. The most widely practiced methodological approach to assessing this construct in empirical studies relies on either parent or adolescent report. Yet, discrepancy in parent and adolescent report of family functioning may provide a fuller understanding of the effects of this construct on obesity-related health outcomes. This is especially important among Hispanics, a population that suffers from disproportionately high rates of obesity and its health-related consequences. The purpose of this study was to examine whether, and to what extent, parent-adolescent discrepancies in family functioning are associated with physical activity, and fruit and vegetable and added sugar intake. We estimated discrepancy scores between parents and adolescents (n = 280 dyads) in family functioning. Then, using structural equation modeling, we tested the effect of family functioning discrepancy on adolescent reports of physical activity, fruits and vegetables intake, and added sugar intake. After controlling for adolescent's gender and BMI, family functioning discrepancy was significantly associated with reduced physical activity (β = -.14*, 95% CI ([-.26, -.05]) and fruits and vegetables intake (β = -.22*, 95% CI [-.38, -.09]) such that the larger the discrepancy between parent and youth reported family functioning, the fewer days of adolescent physical activity and the poorer the fruits and vegetables intake. Our findings provide insight for the role of the family in Hispanic adolescent health outcomes and rationale for capturing rich data to better understand that role. (PsycINFO Database Record
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Affiliation(s)
- Cynthia N Lebron
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Tae Kyoung Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Sung Eun Park
- School of Education and Human Development, University of Miami
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Sarah E Messiah
- Messiah, Mailman Center for Child Development, University of Miami Miller School of Medicine
| | - Guillermo Prado
- Division of Prevention Science and Community Health, University of Miami
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80
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House BT, Shearrer GE, Boisseau JB, Bray MS, Davis JN. Decreased eating frequency linked to increased visceral adipose tissue, body fat, and BMI in Hispanic college freshmen. BMC Nutr 2018; 4:10. [PMID: 32153874 PMCID: PMC7050920 DOI: 10.1186/s40795-018-0217-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 02/19/2018] [Indexed: 11/11/2022] Open
Abstract
Background To investigate the relationship between eating frequency and specific adiposity markers in a potentially high-risk and understudied population of Hispanic college freshmen. Methods This study included 92 Hispanic college freshmen (18–19 y). The following cross-sectional data were collected: height, weight, waist circumference, body mass index (BMI), dietary intake, body composition, physical activity, hepatic fat, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Results Infrequent eaters ate 44% less often (2.5 ± 0.2 vs. 4.5 ± 0.8, p ≤ 0.01) and consumed 27% more calories per EO (p ≤ 0.01), while consuming 21% less kcals per day (p ≤ 0.01) compared to frequent eaters. Infrequent eaters had 8% higher BMIs (24.8 ± 4.4 vs. 22.9 ± 3.2 kg/m2) (p = 0.02), 60% higher BMI z-scores (0.5 ± 1.0 vs. 0.2 ± 1.0, p = 0.03), 21% higher VAT (298.3 ± 153.8 vs. 236.8 ± 78.2 ml, p = 0.03), 26% higher SAT (1150.1 ± 765.4 vs. 855.6 ± 494.6 ml, p = 0.03), and 8% higher total body fat (27.6 ± 10.8 vs. 25.3 ± 8.8%, p = 0.04) compared to frequent eaters while showing no significant difference in physical activity. These findings seem to be driven by females more than males. Conclusions These findings suggest that infrequent eating is related to increased adiposity in Hispanic college freshmen, despite a decreased daily energy intake and no significant differences in physical activity. Yet, more research is needed to understand the underlying mechanisms of these findings, as well as investigate any potential causal relationship between eating frequency and adiposity in Hispanic youth.
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Affiliation(s)
- Benjamin T House
- Department of Nutritional Sciences, University of Texas (BTH, GES, JBB, MSB, JND), 103 W 24th St, Austin, TX 78712 USA
| | - Grace E Shearrer
- Department of Nutritional Sciences, University of Texas (BTH, GES, JBB, MSB, JND), 103 W 24th St, Austin, TX 78712 USA
| | - Jessica B Boisseau
- Department of Nutritional Sciences, University of Texas (BTH, GES, JBB, MSB, JND), 103 W 24th St, Austin, TX 78712 USA
| | - Molly S Bray
- Department of Nutritional Sciences, University of Texas (BTH, GES, JBB, MSB, JND), 103 W 24th St, Austin, TX 78712 USA
| | - Jaimie N Davis
- Department of Nutritional Sciences, University of Texas (BTH, GES, JBB, MSB, JND), 103 W 24th St, Austin, TX 78712 USA
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81
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Abu Baker NN, Al-Ali N, Al-Ajlouni R. Attitudes of Jordanian Adolescent Students Toward Overweight and Obesity. Open Nurs J 2018; 12:15-25. [PMID: 29456780 PMCID: PMC5806175 DOI: 10.2174/1874434601812010015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/04/2017] [Accepted: 12/24/2017] [Indexed: 11/22/2022] Open
Abstract
Background Obesity is a serious public health problem especially among adolescents. Understanding adolescents' attitudes toward obesity and healthy lifestyle is a crucial step to develop effective health programs to treat and prevent obesity. Objectives To examine the attitudes toward overweight and obesity among Jordanian adolescent students and to identify the components of obesity prevention program that the students perceive as important. Methods A sample of 1000 students in 8th to 10th grades was randomly selected from 16 schools in Irbid, Jordan. A self-reported questionnaire including attitude related questions was used in a descriptive, cross-sectional study. Results Generally, the students expressed positive attitudes toward obesity; which means that their attitudes were consistent with societal norms in terms of health and social functioning (mean= 3.5, SD=0.39). Furthermore, the students expressed positive attitudes toward lifestyle; which means that their attitudes were consistent with healthy behaviors (mean=3.7, SD=0.58). However, boys had significantly more positive attitudes than girls (p=0.04). The prevalence of overweight and obesity was 23.8%, while obese and non-obese students had similar attitudes toward lifestyle and obesity. Finally, around 20% to 30% of students desired a prevention program out of school time shared with their families and friends and involves eating healthy food and getting more exercise. Conclusion More efforts are needed to build effective obesity prevention programs that focus on eating healthy diet and getting more exercise considering gender differences.
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Affiliation(s)
- Nesrin N Abu Baker
- Faculty of Nursing, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Nahla Al-Ali
- Faculty of Nursing, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ranyah Al-Ajlouni
- Princess Salma Faculty of Nursing, Al-Albayt University, Mafraq 2, Jordan
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82
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Xie H, Caldwell LL, Loy S, Robledo M. A Qualitative Study of Latino Grandparents’ Involvement in and Support for Grandchildren’s Leisure Time Physical Activity. HEALTH EDUCATION & BEHAVIOR 2017; 45:781-789. [DOI: 10.1177/1090198117742441] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Latino grandparents are often involved in rearing of grandchildren. However, their roles in promoting Latino children’s leisure time physical activity (LTPA) have been largely overlooked by researchers. Aim. The purpose of this study is to examine Latino grandparents’ involvement in and support for grandchildren’s (age 2-12) LTPA as well as issues facing Latino grandparents. Method. Participants included 53 Latino grandparents who lived with/cared for or used to live with/care for grandchildren of 2 to 12 years old in three low-income areas of Los Angeles County. Data were collected using 4 semistructured focus groups and 26 semistructured interviews. Transcribed data were systematically and iteratively coded and analyzed. Results. Latino grandparents perceived various benefits of physical activity to their grandchildren’s physical and mental health, and supported grandchildren’s LTPA directly and indirectly. The direct support included doing physical activity with grandchildren, taking grandchildren to places for physical activities, verbally asking grandchildren to do physical activities, and rewarding grandchildren for doing physical activities. The indirect support was made through providing suggestions to parents. Mothers usually regulated Latino grandparents’ involvement in or support for grandchildren’s LTPA and tended to promote a maternal lineage. Some Latino grandparents reported barriers to supporting grandchildren’s LTPA, including lack of information, access to affordable and safe LTPA facilities/programs, transportation, money, and time. Conclusions. Latino grandparents are advocates for grandchildren’s LTPA and support grandchildren’s LTPA directly and indirectly. It may be promising to develop interventions to increase Latino grandparents’ competency in supporting grandchildren’s LTPA.
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Affiliation(s)
- Hui Xie
- California State University, Northridge, CA, USA
| | | | - Steven Loy
- California State University, Northridge, CA, USA
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83
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Martínez-Martínez A, Castro-Sánchez M, Rodríguez-Fernández S, Zurita-Ortega F, Chacón-Cuberos R, Espejo-Garcés T. Violent behaviour, victimization, self-esteem and physical activity of Spanish adolescents according to place of residence: a structural equation model / Conducta violenta, victimización, autoestima y actividad física de adolescentes españoles en función del lugar de residencia: un modelo de ecuaciones estructurales. INTERNATIONAL JOURNAL OF SOCIAL PSYCHOLOGY 2017. [DOI: 10.1080/02134748.2017.1385242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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84
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Reed M, Julion W, McNaughton D, Wilbur J. Preferred intervention strategies to improve dietary and physical activity behaviors among African-American mothers and daughters. Public Health Nurs 2017. [PMID: 28639382 DOI: 10.1111/phn.12339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to identify cultural- and age-appropriate intervention strategies to improve dietary and physical activity (PA) behaviors in African-American adolescent daughters and their mothers. DESIGN AND SAMPLE A convergent parallel mixed methods design with interactive quantitative and qualitative measures was used. Twenty-four 9th- and 10th-grade African-American daughters from a large urban high school and their mothers participated. MEASURES Measures included the 2013 Youth Risk Behavior Surveillance System dietary and PA questions, 2013 Behavioral Risk Factor Surveillance System dietary and PA questions, and BMI. Focus group questions covered preferred intervention formats and strategies for delivering a dietary and PA intervention. RESULTS Fifty-five percent of daughters and 92% of mothers were overweight/obese. Mothers tended to prefer the group format (mothers/daughters together or mothers together) for delivering a dietary and PA intervention, while the daughters' delivery preferences were mixed. Top mother/daughter dyad strategy preferences for both dietary and PA were goal setting and use of rewards/prizes. CONCLUSIONS These findings suggest several dietary and PA obesity intervention strategies that can guide obesity prevention efforts for African-American daughters and their mothers.
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Affiliation(s)
- Monique Reed
- College of Nursing, Rush University, Chicago, IL, USA
| | - Wrenetha Julion
- Department of Women, Children and Family Nursing, Rush University, Chicago, IL, USA
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85
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Smith SL, DeGrace B, Ciro C, Bax A, Hambrick A, James J, Evans A. Exploring families' experiences of health: contributions to a model of family health. PSYCHOL HEALTH MED 2017; 22:1239-1247. [PMID: 28425318 DOI: 10.1080/13548506.2017.1319069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Child health and developmental outcomes are influenced by the health of the family and the context created. Research suggests symptoms of poor family health (e.g. suboptimal family interactions, parenting stress) yet there is limited understanding of the factors which contribute to robust family health which may unveil opportunities for targeted intervention and family health promotion. The present study examined families' experiences of family health and factors contributing to family health. We performed a qualitative study using constructivist grounded theory methods to guide our understanding of family health for families with typically developing children aged 5-18. Interviews were conducted in family homes and all members were invited to participate. Data from interviews were transcribed, coded, thematically analyzed, and verified with select families. Ten families, including 10 mothers, 8 fathers, and 15 children participated in the study. Participants described family health as a process of balance, living purposefully, and sharing experiences together in alignment with family identity. Mediating family health were processes of awareness and reflection, and adapting, adjusting, and changing in response to family life including external stress factors. Results highlight the possibility for healthcare practitioners to facilitate families' self-reflection and awareness about their health in order to mediate family health development.
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Affiliation(s)
- Sarah L Smith
- a Department of Rehabilitation Sciences , University of Oklahoma Health Science Center , Oklahoma City , OK , USA
| | - Beth DeGrace
- a Department of Rehabilitation Sciences , University of Oklahoma Health Science Center , Oklahoma City , OK , USA
| | - Carrie Ciro
- a Department of Rehabilitation Sciences , University of Oklahoma Health Science Center , Oklahoma City , OK , USA
| | - Ami Bax
- b College of Medicine , University of Oklahoma Health Science Center , Oklahoma City , OK , USA
| | - Andrea Hambrick
- a Department of Rehabilitation Sciences , University of Oklahoma Health Science Center , Oklahoma City , OK , USA
| | - Jennifer James
- a Department of Rehabilitation Sciences , University of Oklahoma Health Science Center , Oklahoma City , OK , USA
| | - Alexandra Evans
- a Department of Rehabilitation Sciences , University of Oklahoma Health Science Center , Oklahoma City , OK , USA
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Ochoa A, Berge JM. Home Environmental Influences on Childhood Obesity in the Latino Population: A Decade Review of Literature. J Immigr Minor Health 2017; 19:430-447. [PMID: 28005241 PMCID: PMC5334210 DOI: 10.1007/s10903-016-0539-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Latinos are the largest and fastest-growing ethnically diverse group in the United States. Latino children are also among the most overweight and obese ethnic groups of children in the United States. Research over the last decade has identified the home environment as a key influence on the diet and physical activity of children. To summarize cross-sectional and longitudinal research that has identified factors within the home environment of Latino families that are associated with childhood obesity and to provide recommendations for future research and intervention development with Latino families. A decade review from 2005 to 2015 was conducted. Studies identifying factors within the home environments of Latino families that were associated with childhood obesity were examined. Five main factors were identified across the literature as home environment factors that are associated with childhood obesity in Latino children. These factors included: parental influences (e.g., parent feeding practices, modeling), screen time, physical activity/sedentary behavior, socioeconomic status/food security and sleep duration. The current review identified several home environment factors that may contribute to the disparities in childhood obesity for Latino children. Results from this review such as, focusing on decreasing controlling parent feeding practices, and increasing parent modeling of healthy behaviors and child sleep duration, can be used in developing culturally-specific interventions for Latino children.
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Affiliation(s)
- Alejandra Ochoa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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87
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Bailey-Davis L, Poulsen MN, Hirsch AG, Pollak J, Glass TA, Schwartz BS. Home Food Rules in Relation to Youth Eating Behaviors, Body Mass Index, Waist Circumference, and Percent Body Fat. J Adolesc Health 2017; 60:270-276. [PMID: 27889403 PMCID: PMC5326588 DOI: 10.1016/j.jadohealth.2016.09.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/09/2016] [Accepted: 09/22/2016] [Indexed: 01/16/2023]
Abstract
PURPOSE To investigate agreement and associations between parent and youth acknowledgment of home food rules, youth eating behaviors, and measures of body composition and excess weight. METHODS Parent-youth dyads (N = 413) completed the "rules for eating at home" scale (Active Where Survey) and reported dietary intake. Trained research staff obtained anthropometric data. Linear regression analyses separately evaluated relationships between youth and parent acknowledgment of rules and youth-reported eating behaviors and anthropometric outcomes. Food rules were evaluated as a 12-item scale and individually. RESULTS Score on the food rule scale was positively associated with fruit and vegetable servings by youth acknowledgment only (β = .09, p = .006), and not with anthropometric outcomes. The rule "no desserts except fruit" was positively associated with fruit and vegetable servings by youth (β = .72, p = .002) and parent (β = .53, p = .03) acknowledgment. The rules "no second helpings at meals" and "limited fast food" were positively associated with body mass index z-score by youth (β = .38, p = .002; β = .32, p = .02, respectively) and parent (β = .74, p < .001; β = .41, p = .006, respectively) acknowledgment, with similar results for waist circumference z-score and percent body fat. CONCLUSIONS Inverse associations between specific food rules and healthful eating behaviors but positive associations with anthropometric outcomes suggest potentially bidirectional relationships between food rule implementation and youth weight. Future studies should disentangle how food rules guide youth behavior in the context of youth weight status.
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Affiliation(s)
- Lisa Bailey-Davis
- Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, Pennsylvania.
| | - Melissa N Poulsen
- Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, Pennsylvania; Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Annemarie G Hirsch
- Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, Pennsylvania
| | - Jonathan Pollak
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Thomas A Glass
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Brian S Schwartz
- Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, Pennsylvania; Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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88
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Winkler MR, Moore ED, Bennett GG, Armstrong SC, Brandon DH. Parent-adolescent influences on everyday dietary practices: Perceptions of adolescent females with obesity and their mothers. MATERNAL AND CHILD NUTRITION 2017; 13. [PMID: 28097807 DOI: 10.1111/mcn.12416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 11/29/2022]
Abstract
Parents demonstrate an important influence on adolescent obesity and dietary behavior; yet, family-based obesity interventions continue to exhibit limited success among adolescents. To further inform family-based approaches for adolescent obesity treatment, we examined the perceptions of adolescent females with obesity and their mothers of the influences experienced within the parent-adolescent relationship that affect everyday dietary practices. We conducted six focus group interviews (three adolescent female and three mother) among 15 adolescent (12-17 years old) females with obesity and 12 of their mothers. Content analysis techniques were used to analyze the transcribed interviews. Adolescent females with obesity discussed a diverse set of parental influences (controlling, supporting and cultivating, overlooking and tempting, acquiescing, providing, attending, and not providing and avoiding) on their daily dietary practices. Among mother focus groups, mothers discussed specific intentional and unintentional types of influences from children that affected the food and drink they consumed, prepared, and acquired. Findings provide a fuller view of the varied social influences on everyday dietary practices within the parent-adolescent relationship. They indicate the importance of examining both parent-to-child and child-to-parent influences and begin to illuminate the value of attending to the social circumstances surrounding dietary behaviors to strengthen family-based obesity treatment approaches.
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Affiliation(s)
- Megan R Winkler
- School of Nursing, Duke University, Durham, North Carolina, USA
| | | | - Gary G Bennett
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | | | - Debra H Brandon
- School of Nursing, Duke University, Durham, North Carolina, USA.,School of Medicine, Duke University, Durham, North Carolina, USA
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89
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Zeller MH, Hunsaker S, Mikhail C, Reiter-Purtill J, McCullough MB, Garland B, Austin H, Washington G, Baughcum A, Rofey D, Smith K. Family factors that characterize adolescents with severe obesity and their role in weight loss surgery outcomes. Obesity (Silver Spring) 2016; 24:2562-2569. [PMID: 27753228 PMCID: PMC5379472 DOI: 10.1002/oby.21676] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/13/2016] [Accepted: 07/18/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To comprehensively assess family characteristics of adolescents with severe obesity and whether family factors impact weight loss outcomes following weight loss surgery (WLS). METHODS Multisite prospective data from 138 adolescents undergoing WLS and primary caregivers (adolescent: Mage = 16.9; MBMI = 51.5 kg/m2 ; caregiver: Mage = 44.5; 93% female) and 83 nonsurgical comparators (NSComp: adolescent: Mage = 16.1; MBMI = 46.9 kg/m2 ; caregiver: Mage = 43.9; 94% female) were collected using standardized measures at presurgery/baseline and at 1 and 2 years. RESULTS The majority (77.3%) of caregivers had obesity, with rates of caregiver WLS significantly higher in the WLS (23.8%) versus NSComp group (3.7%, P < 0.001). Family dysfunction was prevalent (≈1 in every two to three families), with rates higher for NSComp than the WLS group. For the WLS group, preoperative family factors (i.e., caregiver BMI or WLS history, dysfunction, social support) were not significant predictors of adolescent weight loss at 1 and 2 years postoperatively, although change in family functioning over time emerged as a significant correlate of percent weight loss. CONCLUSIONS Rates of severe obesity in caregivers as well as family dysfunction were clinically noteworthy, although not related to adolescent weight loss success following WLS. However, change in family communication and emotional climate over time emerged as potential targets to optimize weight loss outcomes.
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Affiliation(s)
- Meg H. Zeller
- Cincinnati Children’s Hospital Medical Center, Cincinnati OH
| | - Sanita Hunsaker
- Cincinnati Children’s Hospital Medical Center, Cincinnati OH
| | - Carmen Mikhail
- Texas Children’s Hospital, Houston, TX
- Baylor College of Medicine, Houston, TX
| | | | | | - Beth Garland
- Texas Children’s Hospital, Houston, TX
- Baylor College of Medicine, Houston, TX
| | | | - Gia Washington
- Texas Children’s Hospital, Houston, TX
- Baylor College of Medicine, Houston, TX
| | | | - Dana Rofey
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Kevin Smith
- Nationwide Children’s Hospital, Columbus, OH
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90
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Berge JM, Hanson C, Draxten M. Perspectives About Family Meals from Racially/Ethnically and Socioeconomically Diverse Households With and Without an Overweight/Obese Child. Child Obes 2016; 12:368-76. [PMID: 27045737 PMCID: PMC5041584 DOI: 10.1089/chi.2015.0215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Several quantitative studies have found a protective association between family meal frequency and child and adolescent weight and weight-related behaviors (e.g., healthy dietary intake, less disordered eating behaviors). However, limited qualitative research has been conducted to understand more in depth about family meal-level characteristics (e.g., rules, responsibilities, and interpersonal dynamics) that may be risk or protective factors for child weight and weight-related behaviors. The current study aimed to identify family meal-level characteristics within racially/ethnically and socioeconomically diverse households that were similar and/or different between households with and without an overweight/obese child. METHODS The current study is a qualitative study including 118 parents of children ages 6-12 who participated in the Family Meals, LIVE! STUDY Parents (92% female) were from racially/ethnically (87% minority) and socioeconomically (73% <$35,000 per year) diverse households. Parents were individually interviewed during a home visit. Data were stratified by child weight status (i.e., normal weight vs. overweight/obese) and analyzed using deductive and inductive content analysis. RESULTS Qualitative results showed some similarities and some differences in family meal-level characteristics by child weight status that may provide insight into past research showing significant associations between family meal frequency and child weight and weight-related behaviors. Similar themes between families with and without an overweight/obese child included: family meals provide more healthful food; rules about manners; meal planning; and involving children in meal preparation. Themes that were different between families with and without an overweight/obese child included: connection and communication; "clean your plate rule"; electronic devices; and child behavior problems. CONCLUSIONS Findings from the current study may be useful for developing interventions for racially/ethnically and socioeconomically diverse households with and without an overweight/obese child to be delivered through family meals.
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Affiliation(s)
- Jerica M. Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Carrie Hanson
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Michelle Draxten
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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91
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Berge JM, Pratt K, Miller L. Weight conversations in romantic relationships: What do they sound like and how do partners respond? FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2016; 34:213-220. [PMID: 27505071 PMCID: PMC5025371 DOI: 10.1037/fsh0000223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The limited research examining weight conversations (i.e., conversations about weight, body shape, or size) in adult romantic relationships has shown associations between engaging in these conversations and disordered eating behaviors, overweight/obesity, and psychosocial problems in adults. Given the potential harmful consequences of these conversations, it is important to gather more rich qualitative data to understand how weight talk is experienced in romantic relationships and how romantic partners respond to these conversations. METHODS Adults (n = 118; mean age 35 years) from a cross-sectional study were interviewed in their homes. The majority of adults (90% female; mean age = 35 years) were from minority (64% African American) and low-income (<$25,000/year) households. Qualitative data were analyzed using inductive content analysis. RESULTS Sixty-five percent of participants reported that weight conversations were occurring in their romantic relationships. Qualitative themes included the following: (a) Weight conversations were direct and focused on physical characteristics; (b) weight conversations included joking or sarcastic remarks; (c) weight conversations focused on "we" and being healthy; (d) weight conversations occurred after watching TV or movies, as a result of insecurities in oneself, as length of the relationship increased, or as partners aged; and (e) partners responded to weight conversations by feeling insecure or by engaging in reciprocal weight conversations with their romantic partner. DISCUSSION Weight conversations were prevalent in romantic relationships, with some conversations experienced as negative and some positive. Qualitative themes from the current study should be confirmed in quantitative studies to inform future intervention research targeting weight conversations in romantic relationships. (PsycINFO Database Record
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Affiliation(s)
- Jerica M. Berge
- University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN
| | - Keeley Pratt
- The Ohio State University, Human Development and Family Science, Columbus, OH
| | - Laura Miller
- University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN
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92
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Davids EL, Ryan J, Yassin Z, Hendrickse S, Roman NV. Family structure and functioning: Influences on adolescents psychological needs, goals and aspirations in a South African setting. JOURNAL OF PSYCHOLOGY IN AFRICA 2016. [DOI: 10.1080/14330237.2016.1208929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Eugene Lee Davids
- Child & Family Studies Programme, Department of Social Work, University of the Western Cape, South Africa
| | - Jill Ryan
- Child & Family Studies Programme, Department of Social Work, University of the Western Cape, South Africa
| | - Zeenat Yassin
- Child & Family Studies Programme, Department of Social Work, University of the Western Cape, South Africa
| | - Suzette Hendrickse
- Child & Family Studies Programme, Department of Social Work, University of the Western Cape, South Africa
| | - Nicolette Vanessa Roman
- Child & Family Studies Programme, Department of Social Work, University of the Western Cape, South Africa
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93
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Nanney MS, Shanafelt A, Wang Q, Leduc R, Dodds E, Hearst M, Kubik MY, Grannon K, Harnack L. Project BreakFAST: Rationale, design, and recruitment and enrollment methods of a randomized controlled trial to evaluate an intervention to improve School Breakfast Program participation in rural high schools. Contemp Clin Trials Commun 2016; 3:12-22. [PMID: 27141531 PMCID: PMC4850496 DOI: 10.1016/j.conctc.2015.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Marilyn S Nanney
- Department of Family Medicine & Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware Street SE, Minneapolis, Minnesota 55414 USA
| | - Amy Shanafelt
- Department of Family Medicine & Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware Street SE, Minneapolis, Minnesota 55414 USA
| | - Qi Wang
- Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, 717 Delaware St SE, Suite 140, Minneapolis, Minnesota 55414 USA
| | - Robert Leduc
- Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, 717 Delaware St SE, Suite 140, Minneapolis, Minnesota 55414 USA
| | - Ellen Dodds
- Department of Family Medicine & Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware Street SE, Minneapolis, Minnesota 55414 USA
| | | | - Martha Y Kubik
- School of Nursing, PHS Room 5-140 WDH, 308 Harvard St SE, University of Minnesota, Minneapolis, Minnesota 55455 USA
| | - Katherine Grannon
- Department of Family Medicine & Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware Street SE, Minneapolis, Minnesota 55414 USA
| | - Lisa Harnack
- Department of Epidemiology and Community Health, University of Minnesota, West Bank Office Building 1300 S. Second Street, Suite 300 Minneapolis, Minnesota 55454 USA
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94
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McCullough MB, Robson SM, Stark LJ. A Review of the Structural Characteristics of Family Meals with Children in the United States. Adv Nutr 2016; 7:627-40. [PMID: 27422500 PMCID: PMC4942858 DOI: 10.3945/an.115.010439] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Family meals are associated with a range of positive outcomes among children and adolescents. There is inconsistency, however, in the way in which studies have defined and measured family meals. Therefore, a systematic review of the literature was conducted to determine how studies describe family meals with the use of structural characteristics. The current review focused on studies in the United States that included children ages 2-18 y. A total of 33 studies were identified that characterized family meals with the use of ≥1 of the following structural features: frequency or mean number of family meals per week, length of family meal, people present at meal, and where meals occurred. No study characterized family meals by using all 4 family meal features, whereas most studies (81%) characterized family meals by using frequency or mean number of meals per week. Findings not only provide an initial understanding of the structural features used to define family meals but also point to the importance of developing a more comprehensive, sensitive assessment that can accurately capture the complex and multidimensional nature of family meals.
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Affiliation(s)
- Mary Beth McCullough
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and
| | - Shannon M Robson
- Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; and,Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE
| | - Lori J Stark
- Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; and
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95
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Blewitt C, Bergmeier H, Macdonald JA, Olsson CA, Skouteris H. Associations between parent-child relationship quality and obesogenic risk in adolescence: a systematic review of recent literature. Obes Rev 2016; 17:612-22. [PMID: 27125464 DOI: 10.1111/obr.12413] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/12/2016] [Accepted: 02/12/2016] [Indexed: 01/17/2023]
Abstract
Adolescence is a period of significant cognitive, social and physiological change, presenting unique risk factors for weight gain. Childhood obesity research has traditionally focused on the influence of parent-level factors on children's eating and weight status. Increasingly, emphasis is turning towards the reciprocal nature of the parent-child relationship and its influence on health behaviour. A systematic literature review was conducted to investigate the relationship between parent-child relationship quality (defined as the felt emotional bond between parent and child) and obesogenic risk (weight status, eating attitudes and behaviours, level of physical activity and sedentary behaviour) in adolescence; 26 papers were included in the review. The results neither support nor challenge an association between parent-child relationship quality and weight, with study design flaws and limited measurement of the parent-child relationship precluding robust conclusions. The review does however suggests that several aspects of the parent-child relationship are important in understanding eating attitudes and behaviours, including the felt emotional bond between the parent and child, the child's perception of how much the parent cares for them and the mother's sensitivity towards the child. The need for further longitudinal research into the association between parent-child relationship quality and obesity risk across this developmental period is discussed.
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Affiliation(s)
- Claire Blewitt
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
| | - Heidi Bergmeier
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia.,Murdoch Childrens Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia.,Murdoch Childrens Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Helen Skouteris
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
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96
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Haines J, Rifas-Shiman SL, Horton NJ, Kleinman K, Bauer KW, Davison KK, Walton K, Austin SB, Field AE, Gillman MW. Family functioning and quality of parent-adolescent relationship: cross-sectional associations with adolescent weight-related behaviors and weight status. Int J Behav Nutr Phys Act 2016; 13:68. [PMID: 27301414 PMCID: PMC4908682 DOI: 10.1186/s12966-016-0393-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 06/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about how factors within the general family environment are associated with weight and related behaviors among adolescents/young adults. METHODS We studied 3768 females and 2614 males, 14-24 years old in 2011, participating in the Growing Up Today Study 2. We used generalized mixed models to examine cross-sectional associations of family functioning and quality of mother- and father-adolescent relationship with adolescent/young adult weight status, disordered eating, intake of fast food and sugar-sweetened beverages, screen time, physical activity, and sleep duration. In all models, we included participant's age and family structure. RESULTS Eighty percent of participants reported high family functioning and 60% and 50% of participants reported high-quality mother and father relationship, respectively. Among both males and females, high family functioning was associated with lower odds of disordered eating (adjusted odds ratio [AOR] females = 0.53; 95% Confidence Interval [CI] = 0.45-0.63; AOR males = 0.48; CI = 0.39-0.60), insufficient physical activity, i.e., less than 1 h/day, (AOR females = 0.74; CI = 0.61-0.89; AOR males = 0.73; CI = 0.58-0.92), and insufficient sleep, i.e., less than 7 h/day, (AOR females = 0.56; CI = 0.45-0.68; AOR males = 0.65; CI 0.5-0.85). High family functioning was also associated with lower odds of being overweight/obese (AOR = 0.73; CI = 0.60-0.88) and eating fast food one or more times/week (AOR = 0.74; CI = 0.61-0.89) among females only. Among females, high-quality mother and father relationship were both associated with lower odds of being overweight/obese and disordered eating, eating fast food, and insufficient sleep and the magnitude of associations were similar for mother and father relationship quality (AOR range 0.61-0.84). Among males, high-quality mother and father relationship were both associated with lower odds of disordered eating, insufficient physical activity and insufficient sleep, but only father relationship quality was associated with lower odds of overweight/obesity. CONCLUSIONS Adolescents/young adults reporting high family functioning and more positive relationships with their parents reported better weight-related behaviors. For weight status, females appear to be affected equally by the quality of their relationship with both parents, whereas males may be more affected by their relationship with fathers.
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Affiliation(s)
- Jess Haines
- Department of Family Relations and Applied Nutrition, Room 226, Macdonald Stewart Hall, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2 W1, Canada.
| | - Sheryl L Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Nicholas J Horton
- Department of Mathematics and Statistics, Amherst College, Amherst, USA
| | - Ken Kleinman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, USA
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, USA
| | - Kirsten K Davison
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Kathryn Walton
- Department of Family Relations and Applied Nutrition, Room 226, Macdonald Stewart Hall, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2 W1, Canada
| | - S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Alison E Field
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Matthew W Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
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97
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Shanafelt A, Hearst MO, Wang Q, Nanney MS. Food Insecurity and Rural Adolescent Personal Health, Home, and Academic Environments. THE JOURNAL OF SCHOOL HEALTH 2016; 86:472-80. [PMID: 27122147 PMCID: PMC4852387 DOI: 10.1111/josh.12397] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/02/2015] [Accepted: 01/31/2016] [Indexed: 05/25/2023]
Abstract
BACKGROUND Food-insecure (FIS) adolescents struggle in school and with health and mental health more often than food-secure (FS) adolescents. Rural communities experience important disparities in health, but little is known about rural FIS adolescents. This study aims to describe select characteristics of rural adolescents by food-security status. METHODS Baseline analysis using data from a randomized trial to increase school breakfast participation (SBP) in rural Minnesota high schools. Students completed a survey regarding food security, characteristics, and home and school environments. Schools provided academic data and staff measured height and weight. Food security was dichotomized as FS vs FIS. Bivariate analysis, multivariate linear/logistic regression, and testing for interaction of food security and sex were performed. RESULTS Food-insecure adolescents reported poorer health, less exercise, had lower grades, and higher SBP (p < .01). Food-insecure adolescents reported marginally fewer barriers (p = .06) and more benefits of breakfast (p = .05). All associations except reported benefits remained significant after adjustment. Interactions were identified with girls' grade point average and with boys' caloric and added sugar intake. CONCLUSIONS Negative associations among food insecurity and positive youth development are identified in our sample. Policy and environmental strategies should address the complexities of these associations, including exploration of the role of school meals.
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Affiliation(s)
- Amy Shanafelt
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN 55414.
| | | | - Qi Wang
- University of Minnesota, Clinical and Translational Science Institute, Minneapolis, MN 55414.
| | - Marilyn S Nanney
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN 55414.
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98
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Machluf Y, Fink D, Farkash R, Rotkopf R, Pirogovsky A, Tal O, Shohat T, Weisz G, Ringler E, Dagan D, Chaiter Y. Adolescent BMI at Northern Israel: From Trends, to Associated Variables and Comorbidities, and to Medical Signatures. Medicine (Baltimore) 2016; 95:e3022. [PMID: 27015176 PMCID: PMC4998371 DOI: 10.1097/md.0000000000003022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The increasing prevalence of abnormal body mass index (BMI), mainly obesity, is becoming a significant public health problem. This cross-sectional study aimed to provide a comprehensive view of secular trends of BMI, and the associated socio-demographic variables and comorbidities among adolescents with abnormal BMI. Individuals of the study population were born mainly between 1970 and 1993, and were examined at 16 to 19 years of age during the years 1987 to 2010, at 1 conscription center in the northern district of Israel.The study population included 113,694 adolescents. Univariate and multivariable logistic regression models were used to investigate the associations between BMI categories, socio-demographic variables, and medical conditions.A downward trend in the prevalence of normal BMI among both male and female adolescents was obtained, while trends of overweight and obesity (in both genders) and underweight (only among females) rose. Socio-demographic variables such as religion, education, family-related parameters, residential environment, country of birth, and origin were all associated with different risks for abnormal BMI. Obesity was associated with higher risk for hyperlipidemia, endocrine disorders (only in males), knee disorders, and hypertension type I + II (in both genders). Overweight was associated with knee disorders (only in females). Underweight, exclusively in males, was associated with increased risk for endocrine disorders, proteinuria, and cardiac disorders. Hierarchical clustering analysis revealed the intricate relations between gender, BMI, and medical signatures. It brought to light novel clusters of diseases that were abundant among populations having above-normal BMI or underweight males. Furthermore, above-normal BMI was associated with a lower rate of cardiac anomalies and scoliosis/kyphosis, whereas being underweight was associated with a lower risk for hypertension and flat foot.This study provides a reliable and in-depth view of secular trends in height, weight, and BMI of male and female adolescents. It supports previous associations between abnormal BMI and demographic variables and comorbidities, while uncovering novel associations, mainly regarding medical signatures of each gender-BMI group. This might lead to better monitoring, early detection, prevention, and treatment of various conditions associated to abnormal BMI categories and gender groups.
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Affiliation(s)
- Yossy Machluf
- From the Medical Corps, Israel Defense Forces (IDF) (YM, DF, AP, ER, DD, YC), Tel HaShomer; The Weizmann Institute of Science (YM, RR), Rehovot; Shaare Zedek Medical Center (DF, RF, GW), Jerusalem; Schneider Children Medical Center (AP), Petach Tikvah; Assaf Harofeh Medical Center (OT), Zerifin; Israel Center for Disease Control (TS), Ministry of Health, Tel Aviv; Sackler School of Medicine (TS), Tel Aviv University, Tel Aviv, Israel
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Understanding the relationship between family communication and the development of weight stigma. HEALTH PSYCHOLOGY REPORT 2016. [DOI: 10.5114/hpr.2016.57682] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
<b>Background</b><br />
This study examined the relationship between family communication and weight stigma. The Family Communication Patterns Theory was used as a framework to explain the relationships between two dimensions of family communication (i.e., conversation orientation and conformity orientation) and antifat attitudes (i.e., physical unattractiveness and weight blame).<br />
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<b>Participants and procedure</b><br />
A total of 585 college-aged participants completed an on-line questionnaire. We used the following instruments: body mass index (BMI), Antifat Attitudes Scale (AFAT), Revised Family Communication Patterns Scale (RFCP).<br />
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<b>Results</b><br />
Significant relationships were found between the two dimensions of family communication and antifat attitudes. Conversation orientation was negatively associated with antifat attitudes and conformity orientation was positively associated with antifat attitudes. In addition, pluralistic families were less likely to stigmatize the overweight and obese by demonstrating less discrimination with physical attraction and personal weight blame.<br />
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<b>Conclusions</b><br />
These findings highlight the important association between family communication and antifat attitudes. Families that endorse a pluralistic family type (i.e., high conversation orientation and low conformity orientation) appear to engage in the least amount of discrimination with regard to weight stigma. These families are not only less discriminating of others, they perhaps bring about more awareness and information to family members as compared to other family types.
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100
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Breakfast frequency among adolescents: associations with measures of family functioning. Public Health Nutr 2016; 19:1552-64. [PMID: 26865294 DOI: 10.1017/s1368980016000112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To investigate (i) associations between adolescents' frequency of breakfast and family functioning (close relations to parents, quality of family communication and family support) and (ii) if any observed associations between breakfast frequency and family functioning vary by sociodemographic factors. DESIGN School-based cross-sectional study. Students completed a web-based questionnaire. Associations were estimated by multilevel multivariate logistic regression. SETTING Danish arm of the Health Behaviour in School-aged Children study, 2014. SUBJECTS Adolescents aged 13 and 15 years (n 3054) from a random sample of forty-one schools. RESULTS Nearly one-quarter of the adolescents had low breakfast frequency. Low breakfast frequency was associated with low family functioning measured by three dimensions. The OR (95 % CI) of low breakfast frequency was 1·81 (1·40, 2·33) for adolescents who reported no close relations to parents, 2·28 (1·61, 3·22) for adolescents who reported low level of quality of family communication and 2·09 (1·39, 3·15) for adolescents who reported low level of family support. Joint effect analyses suggested that the odds of low breakfast frequency among adolescents with low family functioning compared with high family functioning were highest among adolescents being girls, immigrants and living in other than a traditional family structure. CONCLUSIONS Low breakfast frequency was associated with low family functioning measured by close relations to parents, quality of family communication and family support. Further, analyses suggested that the associations were more pronounced among girls, immigrants and adolescents from other family structure than traditional. The study highlights the importance of the family setting in promoting regular breakfast frequency among adolescents.
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