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Determinants of Child Health Behaviors in a Disadvantaged Area from a Community Perspective: A Participatory Needs Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040644. [PMID: 29614732 PMCID: PMC5923686 DOI: 10.3390/ijerph15040644] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/24/2018] [Accepted: 03/29/2018] [Indexed: 11/17/2022]
Abstract
Children from disadvantaged areas are hard to reach for interventions aimed at promoting healthy lifestyles. We conducted a participatory needs assessment, in which researchers collaborated with a community in a disadvantaged area in Amsterdam to gain an understanding of the health-related issues of children within this community. Qualitative data was collected through: three to four participatory group meetings with three groups of 9-12-year-old children (n = 5-9 per group); nine interviews with professionals working with youth; two interviews with parents and their children; and informal meetings including 31 parents. All transcriptions or summaries were coded and analyzed. Childhood overweight/obesity was indicated as the main health issue. A lack of physical activity and unhealthy dietary behavior were identified as the main risk factors, with underlying determinants such as culture, habits, finances, and social norms. Identified needs included more supervised, low-priced sports activities at a nearby location and more education on adopting a healthy diet. Our participatory health needs assessment resulted in a comprehensive overview of the most relevant risk factors and determinants of childhood overweight/obesity and needs from the community's perspective. This knowledge aids in the development of better tailored, and thereby potentially more effective, interventions.
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Bates CR, Buscemi J, Nicholson LM, Cory M, Jagpal A, Bohnert AM. Links between the organization of the family home environment and child obesity: a systematic review. Obes Rev 2018. [PMID: 29520946 DOI: 10.1111/obr.12662] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Due to increasingly high rates of child overweight and obesity, it is important to identify risk and protective factors that may inform more effective prevention and intervention. The degree of organization in the family home environment is a studied, but not well-specified, factor that may impact child weight. Prior research on household organization has examined an array of constructs, including family routines, limit setting, household chaos, crowding and the broad home environment. This study systematically reviews literature on organization within the family home environment and weight among children ages 2-12. Six hundred thirty-seven studies were reviewed by four coders for eligibility, and 32 studies were included in the final synthesis. Overall, 84% of studies provided evidence for relations between at least one indicator of organization within the family home environment and child weight. Studies provided compelling evidence across several constructs, suggesting that the relevance of household organization to child weight extends beyond a single indicator. Directions for future work include (i) examining the mediating role of health behaviours, (ii) examining the moderating role of socioeconomic factors, (iii) broadening this evidence base across cultures and nationalities and (iv) integrating constructs to develop a comprehensive model of organization within the home environment.
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Affiliation(s)
- C R Bates
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - J Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - L M Nicholson
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - M Cory
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - A Jagpal
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - A M Bohnert
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
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Garmy P, Clausson EK, Nyberg P, Jakobsson U. Insufficient Sleep Is Associated with Obesity and Excessive Screen Time Amongst Ten-Year-Old Children in Sweden. J Pediatr Nurs 2018; 39:e1-e5. [PMID: 29157744 DOI: 10.1016/j.pedn.2017.11.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 11/12/2017] [Accepted: 11/12/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE This study investigated sleep, television, computer habits, and obesity in school-age children. DESIGN AND METHODS This was a cross-sectional self-report survey of 1260 children in grade 4 (mean age, 10.1) living in southern Sweden (49.1% boys). The heights and weights of 1097 (87.1%) of the children were recorded. Descriptive statistics, bivariate analyses, and multiple logistic regression were employed. RESULTS The median length of self-reported sleep on weeknights was 9.5h. Approximately 40% of the children reported receiving <9h of sleep. The median bedtime was 9PM (21:00). On weekends, the median bedtime was 1 h later, and they delayed getting up by 1.5h. The median time spent watching TV and using a computer was 1 h each. The prevalence of being overweight (including obesity) was 18%. Insufficient sleep (<9h) was associated with being overweight, watching TV, or using a computer for two or more hours each day, difficulty falling asleep, and being tired at school. CONCLUSIONS School-age children who receive less sleep are more likely to be overweight and report excessive television and computer use. A strong and urgent need exists to highlight the importance of healthy sleep and media habits. It is challenging for pediatric nurses and school nurses to teach children and their families about healthy sleep and media habits.
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Affiliation(s)
- Pernilla Garmy
- Department of Health Sciences, Kristianstad University, Sweden; Department of Health Sciences, Clinical Health Promotion Centre, Lund University, Sweden.
| | - Eva K Clausson
- Department of Health Sciences, Kristianstad University, Sweden
| | - Per Nyberg
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - Ulf Jakobsson
- Department of Clinical Sciences in Malmö, Lund University, Sweden; Center for Primary Health Care Research, Lund University/Region Skåne, Sweden
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Lv W, Finlayson G, Dando R. Sleep, food cravings and taste. Appetite 2018; 125:210-216. [PMID: 29447996 DOI: 10.1016/j.appet.2018.02.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 02/07/2018] [Accepted: 02/09/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Taste is influenced by factors from our environment, psychology, and from our own physiological state. The objective of the study was to determine whether sleep influences our sense of taste or our cravings for food. METHOD 57 healthy panelists, predominantly of college age, submitted to sleep tracking, and subsequently underwent a series of sensory tests, using basic prototypic tastants, as well as real foods. Panelists were also evaluated to quantify food cravings, using both the Leeds Food Preference Questionnaire, and the Control of Eating Questionnaire. RESULTS Umami (p = 0.025, F = 5.301) and sour (p = 0.037, F = 4.591) taste were intensified in those rating sleepiness higher, while this group also reported higher implicit wanting for high fat sweet foods (p = 0.011, Wald chi-sq = 14.937). Craving for sweet or savory also associated with a number of measures of taste response to real foods. CONCLUSIONS Results imply that a lack of sleep may induce cravings for unhealthy foods, and that foods high in umami or sour taste may be experienced differently due to alterations in taste function. Results imply that feeding behavior may be influenced by a lack of sleep, acting at least partially through our sense of taste.
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Affiliation(s)
- Wen Lv
- Department of Food Science, Cornell University, Ithaca, NY, USA
| | | | - Robin Dando
- Department of Food Science, Cornell University, Ithaca, NY, USA.
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Gunter KB, Jackson J, Tomayko EJ, John DH. Food insecurity and physical activity insecurity among rural Oregon families. Prev Med Rep 2017; 8:38-41. [PMID: 28840095 PMCID: PMC5560121 DOI: 10.1016/j.pmedr.2017.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/17/2017] [Accepted: 07/31/2017] [Indexed: 11/25/2022] Open
Abstract
Among rural families, rates of both child obesity and household food insecurity (FI) are higher compared to non-rural families. These disparities result from a complex interplay of social and environmental conditions that influence behavior. The Transtheoretical Model suggests individual readiness to change underlies success in modifying obesity-preventing behaviors; however, whether an association between readiness to change obesity-related behaviors and FI status among rural families exists is unknown. We examined the association between readiness to change family-level nutrition and physical activity (PA) behaviors that predict child obesity and family FI status within a sample of rural families to better understand these relationships. Families (n = 144) were recruited from six rural Oregon communities in 2013. Families completed a FI screener and the Family Stage of Change Survey (FSOC), a measure of readiness to change family-level nutrition and PA behaviors associated with obesity. Demographic differences by FI status were explored, and regression was applied to examine relationships between FI and FSOC scores, adjusting for relevant covariates. Among FI families (40.2%), more were non-white (77.8% vs. 22.2%; p = 0.036) and had lower adult education (30.4% vs. 11.8% with > high school degree; p = 0.015) compared to non-FI families. After adjusting for education, race, ethnicity, and eligibility for federal meal programs, readiness to provide opportunities for PA was lower among FI families (p = 0.002). These data highlight a need to further investigate how food insecurity and low readiness to provide PA opportunities, i.e. "physical activity insecurity" may be contributing to the higher obesity rates observed among rural children and families.
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Affiliation(s)
- Katherine B. Gunter
- College of Public Health and Human Sciences, Oregon State Univerity, 2631 SW Campus Way, Corvallis, OR 97331, USA
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Martin-Biggers J, Quick V, Zhang M, Jin Y, Byrd-Bredbenner C. Relationships of family conflict, cohesion, and chaos in the home environment on maternal and child food-related behaviours. MATERNAL AND CHILD NUTRITION 2017; 14:e12540. [PMID: 28994511 DOI: 10.1111/mcn.12540] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/25/2017] [Accepted: 09/11/2017] [Indexed: 11/29/2022]
Abstract
This study examined how food-related behaviours differed in mothers and their preschool children by levels of family functioning (cohesion and conflict) and household disorganization (chaos). A nationally representative sample of mothers of preschoolers completed an online survey assessing food-related behaviours of themselves and their children. Maternal and child diet, eating behaviours, and health status; household availability of fruits/vegetables, salty/fatty snacks, and sugar-sweetened beverages; family mealtime atmosphere; and family conflict, cohesion, and household chaos were assessed with valid, reliable scales. Cluster analyses assigned families into low, middle, and high conflict, cohesion, and chaos groups. Participants (n = 550) were 72% White, and 82% had some post-secondary education. Regression analysis examining the association of cluster grouping levels on diet-related behaviour measures revealed that positive home environments (i.e., low family conflict, high family cohesion, and low household chaos) were associated with healthier food-related behaviours (e.g., increased fruits/vegetables intake), whereas negative home environments (i.e., high family conflict, low family cohesion, and high household chaos) were associated with unhealthy food-related behaviours (e.g., greater % total calories from fat) even after controlling for sociodemographic and related behavioural factors. Findings suggest family functioning and household chaos are associated with food-related behaviours. This frequently overlooked component of family interaction may affect intervention outcomes and objectives of educational and interventional initiatives.
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Affiliation(s)
- Jennifer Martin-Biggers
- Department of Nutritional Sciences, Rutgers University, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Virginia Quick
- Department of Nutritional Sciences, Rutgers University, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Man Zhang
- Department of Food Science, Rutgers University, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Yanhong Jin
- Department of Agricultural, Food and Resource Economics, Rutgers University, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, The State University of New Jersey, New Brunswick, New Jersey, USA
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Parenting Self-Efficacy, Parent Depression, and Healthy Childhood Behaviors in a Low-Income Minority Population: A Cross-Sectional Analysis. Matern Child Health J 2017; 21:1156-1165. [PMID: 28092060 DOI: 10.1007/s10995-016-2214-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives Childhood obesity prevention and treatment depends, in part, on parents acting as agents of change for their children. Our objective was to measure the associations between parenting self-efficacy, parent depressive symptoms, and preschool child behaviors that support healthy growth. Methods We performed a cross-sectional analysis of baseline data from a randomized controlled trial. Parenting self-efficacy was measured using a 5-item version of the Parenting Sense of Competence (PSOC-5) scale (α= 0.8). Parent depressive symptoms were measured using the Center for Epidemiological Studies-Depression (CESD) scale. Child outcomes included diet (24 h diet recall), physical activity (accelerometry), sleep (parent-report), and media use during meals (parent-report). We performed separate multiple linear regressions for each outcome controlling for other covariates. Results The sample consisted of 601 parent-child pairs. Median child age was 4.3 (IQR 3.6-5.1) years; median child body mass index (BMI) percentile was 79.1% (IQR 66.8-88.5%); 90% of children were Hispanic/Latino, and 6% of children were non-Hispanic Black. Median parent age was 31.5 (IQR 27.6-36.0) years; 22% of parents met criteria for depression. Parenting self-efficacy (median PSOC-5 25; IQR 24-28) was negatively correlated with depressive symptoms (ρ = -0.16; p < 0.001). In adjusted models, higher parenting self-efficacy was associated with duration of child's sleep and fewer meals eaten in front of a TV (p < 0.001). There was a significant interaction of parenting self-efficacy and parental depressive symptoms on child sleep duration (p < 0.001). Parenting self-efficacy and depressive symptoms were not significantly associated with child physical activity or child diet. Conclusions In this minority population, higher parenting self-efficacy was associated with longer child sleep and fewer meals in front the TV, but parent depressive symptoms mitigated that protective effect for child sleep duration.
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Brazendale K, Beets MW, Weaver RG, Pate RR, Turner-McGrievy GM, Kaczynski AT, Chandler JL, Bohnert A, von Hippel PT. Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis. Int J Behav Nutr Phys Act 2017; 14:100. [PMID: 28747186 PMCID: PMC5530518 DOI: 10.1186/s12966-017-0555-2] [Citation(s) in RCA: 340] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/19/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Although the scientific community has acknowledged modest improvements can be made to weight status and obesogenic behaviors (i.e., physical activity, sedentary/screen time, diet, and sleep) during the school year, studies suggests improvements are erased as elementary-age children are released to summer vacation. Emerging evidence shows children return to school after summer vacation displaying accelerated weight gain compared to the weight gained occurring during the school year. Understanding how summer days differ from when children are in school is, therefore, essential. DISCUSSION There is limited evidence on the etiology of accelerated weight gain during summer, with few studies comparing obesogenic behaviors on the same children during school and summer. For many children, summer days may be analogous to weekend days throughout the school year. Weekend days are often limited in consistent and formal structure, and thus differ from school days where segmented, pre-planned, restrictive, and compulsory components exist that shape obesogenic behaviors. The authors hypothesize that obesogenic behaviors are beneficially regulated when children are exposed to a structured day (i.e., school weekday) compared to what commonly occurs during summer. This is referred to as the 'Structured Days Hypothesis' (SDH). To illustrate how the SDH operates, this study examines empirical data that compares weekend day (less-structured) versus weekday (structured) obesogenic behaviors in U.S. elementary school-aged children. From 190 studies, 155 (~80%) demonstrate elementary-aged children's obesogenic behaviors are more unfavorable during weekend days compared to weekdays. CONCLUSION In light of the SDH, consistent evidence demonstrates the structured environment of weekdays may help to protect children by regulating obesogenic behaviors, most likely through compulsory physical activity opportunities, restricting caloric intake, reducing screen time occasions, and regulating sleep schedules. Summer is emerging as the critical period where childhood obesity prevention efforts need to be focused. The SDH can help researchers understand the drivers of obesogenic behaviors during summer and lead to innovative intervention development.
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Affiliation(s)
- Keith Brazendale
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, 1st Floor Suite, Room 131, Columbia, SC 29208 USA
| | - Michael W. Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, 1st Floor Suite, Room 131, Columbia, SC 29208 USA
| | - R. Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, 1st Floor Suite, Room 131, Columbia, SC 29208 USA
| | - Russell R. Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, 1st Floor Suite, Room 131, Columbia, SC 29208 USA
| | - Gabrielle M. Turner-McGrievy
- Department of Health Promotion, Education and Behavior, University of South Carolina, 915 Greene Street, Columbia, SC 29201 USA
| | - Andrew T. Kaczynski
- Department of Health Promotion, Education and Behavior, University of South Carolina, 915 Greene Street, Columbia, SC 29201 USA
| | - Jessica L. Chandler
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, Charleston, SC 29425 USA
| | - Amy Bohnert
- Department of Psychology, Loyola University Chicago, 1032 West Sheridan Road, Chicago, IL 60626 USA
| | - Paul T. von Hippel
- The University of Texas at Austin, Lyndon B. Johnson School of Public Affairs, 2300 Red River Street, Austin, TX 78712 USA
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Spilsbury JC, Patel SR, Morris N, Ehayaei A, Intille SS. Household chaos and sleep-disturbing behavior of family members: results of a pilot study of African American early adolescents. Sleep Health 2017; 3:84-89. [PMID: 28346162 PMCID: PMC5373486 DOI: 10.1016/j.sleh.2016.12.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/30/2016] [Accepted: 12/23/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Although disorganized, chaotic households have been linked to poorer sleep outcomes, how household chaos actually manifests itself in the behaviors of others around the bedtime of a child or adolescent is not well understood. OBJECTIVE To determine whether household chaos was associated with specific, nightly sleep-disturbing activities of adolescents' family members. DESIGN Longitudinal study. PARTICIPANTS Twenty-six African American or multiethnic early adolescent (ages 11-12 years) and parent dyads, recruited from local schools and social-service agencies in greater Cleveland, OH. MEASUREMENTS Over 14 days, each night at bedtime, adolescents identified family-member activities keeping them awake or making it difficult to sleep by using a smart phone-administered survey. Household organization was assessed via parent-completed, validated instruments. A generalized linear mixed model examined associations between each activity and household-organization measures. RESULTS Adjusted for the effect of school being in session the next day, an increasingly chaotic household was associated with increased odds of household members disturbing adolescents' efforts to fall asleep by watching TV/listening to music (odds ratio [OR]=1.8, 95% confidence interval [CI]=1.2-3.2), phoning/texting (OR=1.7, 95% CI =1.2-2.9), or having friends/relatives over visiting at the home (OR=1.6, 95% CI =1.0-3.0). Conversely, a more chaotic household was associated with decreased odds of adolescents reporting that "nothing" was keeping them awake or making it more difficult to sleep (OR=0.6, 95% CI =0.4-0.8). Enforced sleep rules were inconsistently associated with sleep-disturbing behaviors. CONCLUSION Improving early-adolescent sleep may benefit from considering the nighttime behavior of all household members and encouraging families to see that improving early-adolescent sleep requires the household's participation.
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Affiliation(s)
- James C Spilsbury
- Case School of Medicine, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106.
| | - Sanjay R Patel
- School of Medicine, University of Pittsburgh, 3459 Fifth Ave, Pittsburgh, PA 15213
| | - Nathan Morris
- Case School of Medicine, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106
| | - Aida Ehayaei
- College of Engineering, Northeastern University, 360 Huntington Ave, Boston, MA 02115
| | - Stephen S Intille
- College of Computer and Information Science, Northeastern University, 360 Huntington Ave, Boston, MA 02115
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Schaefer SE, Gomez-Camacho R, Martinez L, Sadeghi B, German JB, de la Torre A. Social and Environmental Determinants of Child Physical Activity in a Rural Mexican-Origin Community. J Community Health 2017; 41:409-16. [PMID: 26516017 DOI: 10.1007/s10900-015-0111-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
California's rural agricultural communities face an increased burden of obesity and metabolic disease. The present objective is to define the social and environmental influences to child obesity and physical activity within Mexican-origin communities in California's Central Valley. A range of data (anthropometric, socioeconomic, demographic, cultural and environmental) were collected on more than 650 children enrolled in Niños Sanos, Familia Sana. Physical activity data were gathered from a subsample of children 4-7 years of age (n = 148) via accelerometer. Cross sectional analyses explored the relationship between BMI and physical activity and the influence of numerous social and environmental variables. In this sample 45 % of children were determined to be overweight or obese. Boys had a higher daily average moderate-to-vigorous physical activity than girls (p = 0.008). Chi square analyses showed weight status was associated with activity level in girls (p = 0.03) but not boys. Multivariate regression revealed several social and environmental indicators influenced BMI and physical activity (p = 0.004). In this population of school-age children of Mexican-origin, girls may benefit more from targeted efforts to increase MVPA. Family and community support systems may also boost child participation in physical activities.
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Affiliation(s)
- Sara E Schaefer
- Foods for Health Institute, University of California, Davis, 2141 Robert Mondavi Institute, North, One Shields Avenue, Davis, CA, 95616, USA.
| | - Rosa Gomez-Camacho
- Center for Transnational Health, University of California, Davis, Davis, CA, USA
| | - Lisa Martinez
- Center for Transnational Health, University of California, Davis, Davis, CA, USA
| | | | - J Bruce German
- Foods for Health Institute, University of California, Davis, 2141 Robert Mondavi Institute, North, One Shields Avenue, Davis, CA, 95616, USA
- Department of Food Science and Technology, University of California, Davis, Davis, CA, USA
| | - Adela de la Torre
- Department of Chicano(a) Studies, University of California, Davis, Davis, CA, USA
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Boles RE, Halbower AC, Daniels S, Gunnarsdottir T, Whitesell N, Johnson SL. Family Chaos and Child Functioning in Relation to Sleep Problems Among Children at Risk for Obesity. Behav Sleep Med 2017; 15:114-128. [PMID: 26745822 PMCID: PMC4938783 DOI: 10.1080/15402002.2015.1104687] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study evaluated the influence of child and family functioning on child sleep behaviors in low-income minority families who are at risk for obesity. A cross-sectional study was utilized to measure child and family functioning from 2013 to 2014. Participants were recruited from Head Start classrooms while data were collected during home visits. A convenience sample of 72 low-income Hispanic (65%) and African American (32%) families of preschool-aged children were recruited for this study. We assessed the association of child and family functioning with child sleep behaviors using a multivariate multiple linear regression model. Bootstrap mediation analyses examined the effects of family chaos between child functioning and child sleep problems. Poorer child emotional and behavioral functioning related to total sleep behavior problems. Chaos associated with bedtime resistance significantly mediated the relationship between Behavioral and Emotional Screening System (BESS) and Bedtime Resistance. Families at high risk for obesity showed children with poorer emotional and behavioral functioning were at higher risk for problematic sleep behaviors, although we found no link between obesity and child sleep. Family chaos appears to play a significant role in understanding part of these relationships. Future longitudinal studies are necessary to establish causal relationships between child and family functioning and sleep problems to further guide obesity interventions aimed at improving child sleep routines and increasing sleep duration.
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Warren C, Riggs N, Pentz MA. Executive function mediates prospective relationships between sleep duration and sedentary behavior in children. Prev Med 2016; 91:82-88. [PMID: 27477059 PMCID: PMC5359977 DOI: 10.1016/j.ypmed.2016.07.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/03/2016] [Accepted: 07/25/2016] [Indexed: 11/17/2022]
Abstract
Childhood sedentary behavior has been linked to increased obesity risk. Prior work has identified associations between sedentary behavior, executive function (EF), and sleep. This study tested the hypothesis that reduced sleep duration may adversely impact EF and lead to increased childhood sedentary behavior. Southern California schoolchildren participating in the school-based health promotion program Pathways to Health (N=709) were assessed annually from 4th through 6th grades (2010-2013) on self-report measures of sedentary behavior, sleep duration, and executive function. A series of path models were specified treating average nightly sleep duration and weekend wake/bed-time shift at 4th grade as predictors of 6th grade sedentary behavior. Four EF subdomains were tested as potential mediators of longitudinal associations at 5th grade. Significant associations between average nightly sleep duration, EF and sedentary behavior were identified (p<0.05), adjusting for participant gender, physical activity, SES, ethnicity, program group assignment, and the presence/absence of parental screen time rules. Fifth grade overall EF (p<0.05)-and in particular the subdomains of inhibitory control (p<0.05) and organization of materials (p<0.01)-significantly mediated the relationship between 4th grade sleep duration and 6th grade sedentary behavior (p<0.05). Furthermore, delay of weekend bed- or wake-times relative to weekdays was prospectively associated with decreased overall EF (p<0.05), but not increased sedentary behavior (p=0.35 for bed-time delay; p=0.64 for wake-time delay), irrespective of average nightly sleep duration. Findings suggest that sleep promotion efforts may reduce children's sedentary behavior both directly and indirectly through changes in EF.
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Affiliation(s)
- Christopher Warren
- The Institute for Health Promotion & Disease Prevention Research (IPR), Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA 90032, USA.
| | - Nathaniel Riggs
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA
| | - Mary Ann Pentz
- The Institute for Health Promotion & Disease Prevention Research (IPR), Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA 90032, USA
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Appelhans BM, Moss OA, Cerwinske LA. Systematic review of paediatric weight management interventions delivered in the home setting. Obes Rev 2016; 17:977-88. [PMID: 27231126 DOI: 10.1111/obr.12427] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 04/08/2016] [Accepted: 04/19/2016] [Indexed: 12/30/2022]
Abstract
To increase their accessibility, paediatric weight management interventions are increasingly designed to be delivered in the home setting by trained staff. This systematic review summarizes the available evidence for interventions featuring home visitation and identifies key gaps in the literature. PubMed, CINAHL, Cochrane and PsycINFO were searched for intervention studies that reported change in objectively measured adiposity outcomes in youth ages 2-18 years. Studies published between 1 January 1995 and 12 February 2016 were analysed. Of 15 eligible studies, nine reported that interventions with home visitation were either superior to a control/comparison condition or achieved significant within-subjects reductions in adiposity. Interventions in which professional staff (e.g. dietitians and exercise trainers) conducted home visits tended to be more efficacious than those delivered by paraprofessional or community-based staff, as were interventions with more frequent contact. Most studies were judged to have low or unclear risk of bias across various domains. As most studies compared interventions with home visits with less intensive and qualitatively different approaches, it remains unclear whether home visitation per se enhances weight loss efficacy. Overall, paediatric weight management interventions that feature home visitation are promising, but the incremental benefit of the home visitation treatment modality remains to be rigorously evaluated. © 2016 World Obesity.
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Affiliation(s)
- B M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA. .,Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - O A Moss
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.,Department of Food and Nutrition, Rush University Medical Center, Chicago, IL, USA
| | - L A Cerwinske
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.,Department of Food and Nutrition, Rush University Medical Center, Chicago, IL, USA
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64
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Oberg C, Colianni S, King-Schultz L. Child Health Disparities in the 21st Century. Curr Probl Pediatr Adolesc Health Care 2016; 46:291-312. [PMID: 27712646 DOI: 10.1016/j.cppeds.2016.07.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The topic of persistent child health disparities remains a priority for policymakers and a concern for pediatric clinicians. Health disparities are defined as differences in adverse health outcomes for specific health indicators that exist across sub-groups of the population, frequently between minority and majority populations. This review will highlight the gains that have been made since the 1990s as well as describe disparities that have persisted or have worsened into the 21st century. It will also examine the most potent social determinants and their impact on the major disparities in mortality, preventive care, chronic disease, mental health, educational outcomes, and exposure to selected environmental toxins. Each section concludes with a description of interventions and innovations that have been successful in reducing child health disparities.
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Affiliation(s)
- Charles Oberg
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN; Department of Pediatrics, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN
| | - Sonja Colianni
- Department of Pediatrics, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN
| | - Leslie King-Schultz
- Department of Pediatrics, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN
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65
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Mosli RH, Kaciroti N, Corwyn RF, Bradley RH, Lumeng JC. Effect of Sibling Birth on BMI Trajectory in the First 6 Years of Life. Pediatrics 2016; 137:e20152456. [PMID: 26969271 PMCID: PMC4811309 DOI: 10.1542/peds.2015-2456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE This study examined the longitudinal association between birth of a sibling and changes in body mass index z-score (BMIz) trajectory during the first 6 years of life. METHODS Children (n = 697) were recruited across 10 sites in the United States at the time of birth. Sibship composition was assessed every 3 months. Anthropometry was completed when the child was age 15 months, 24 months, 36 months, 54 months, and in first grade. Children were classified based on the timing of their sibling's birth. A piecewise quadratic regression model adjusted for potential confounders examined the association of the birth of a sibling with subsequent BMIz trajectory. RESULTS Children whose sibling was born when they were 24 to 36 months or 36 to 54 months old, compared with children who did not experience the birth of a sibling by first grade, had a lower subsequent BMIz trajectory and a significantly lower BMIz at first grade (0.27 vs 0.51, P value = 0.04 and 0.26 vs 0.51, P value = 0.03, respectively). Children who did not experience the birth of a sibling by the time they were in first grade had 2.94 greater odds of obesity (P value = 0.046) at first grade compared with children who experienced the birth of a sibling when they were between 36 to 54 months old. CONCLUSIONS A birth of a sibling when the child is 24 to 54 months old is associated with a healthier BMIz trajectory. Identifying the underlying mechanism of association can help inform intervention programs.
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Affiliation(s)
- Rana H Mosli
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA; Department of Nutritional Sciences, School of Public Health,
| | | | - Robert F Corwyn
- Department of Psychology, University of Arkansas at Little Rock, Little Rock, Arkansas
| | - Robert H Bradley
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Julie C Lumeng
- Department of Nutritional Sciences, School of Public Health, Center for Human Growth and Development, and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
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66
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Brown CL. Helping Adolescents With Obesity Establish a Healthier Weight in Young Adulthood. J Adolesc Health 2016; 58:380-381. [PMID: 27013270 DOI: 10.1016/j.jadohealth.2016.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Callie L Brown
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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67
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Habitual Sleep Duration and Risk of Childhood Obesity: Systematic Review and Dose-response Meta-analysis of Prospective Cohort Studies. Sci Rep 2015; 5:16160. [PMID: 26537869 PMCID: PMC4633618 DOI: 10.1038/srep16160] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 10/08/2015] [Indexed: 12/15/2022] Open
Abstract
A meta-analysis of cross-sectional studies found that shorter-time sleep was correlated with increased risk of obesity in children. However, findings from prospective cohort studies were inconsistent. PubMed and other data resources were searched through May 2015. Twenty-five eligible studies were identified including 56,584 children and adolescents with an average 3.4-year follow-up. Compared with children having the longest sleep duration (~12.2 hours), kids with the shortest sleep duration (~10.0 hours) were 76% more likely to be overweight/obese (pooled odds ratio [OR]: 1.76; 95% confidence interval [CI]: 1.39, 2.23); and had relatively larger annual BMI gain (pooled β coefficient: 0.13; 95% CI: 0.01, 0.25 kg/m2). With every 1 hour/day increment in sleep duration, the risk of overweight/obesity was reduced by 21% (OR: 0.79; 95% CI: 0.70, 0.89); and the annual BMI gain declined by 0.05 kg/m2 (β = −0.05; 95% CI: −0.09, −0.01). The observed associations were not appreciably modified by region, baseline age or the length of follow-up. Accumulated literature indicates a modest inverse association between sleep duration and the risk of childhood overweight/obesity. Further research is needed to determine the age and gender specified optimal hours of sleep and ideal sleep pattern with respect to obesity prevention in children.
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68
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Asplund KM, Kair LR, Arain YH, Cervantes M, Oreskovic NM, Zuckerman KE. Early Childhood Screen Time and Parental Attitudes Toward Child Television Viewing in a Low-Income Latino Population Attending the Special Supplemental Nutrition Program for Women, Infants, and Children. Child Obes 2015; 11:590-9. [PMID: 26390321 PMCID: PMC4628228 DOI: 10.1089/chi.2015.0001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Early childhood media exposure is associated with obesity and multiple adverse health conditions. The aims of this study were to assess parental attitudes toward childhood television (TV) viewing in a low-income population and examine the extent to which child BMI, child/parent demographics, and household media environment are associated with adherence to American Academy of Pediatrics (AAP) guidelines for screen time. METHODS This was a cross-sectional survey study of 314 parents of children ages 0-5 years surveyed in English or Spanish by self-administered questionnaire at a Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinic in Oregon. RESULTS In this majority Latino sample (73%), half (53%) of the children met AAP guidelines on screen time limits, 56% met AAP guidelines for no TV in the child's bedroom, and 29% met both. Children were more likely to meet AAP guidelines when there were <2 TVs in the home, there was no TV during dinner, or their parents spent less time viewing electronic media. Parents who spent less time viewing electronic media were more likely to report believing that TV provides little value or usefulness. CONCLUSIONS In this low-income, predominantly Latino population attending WIC, parent media-viewing and household media environment are strongly associated with child screen time. Programs aimed at reducing child screen time may benefit from interventions that address parental viewing habits.
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Affiliation(s)
- Karin M. Asplund
- School of Medicine, Oregon Health & Science University, Portland, OR
| | - Laura R. Kair
- Stead Family Department of Pediatrics, University of Iowa, Carver College of Medicine, Iowa City, IA
| | - Yassar H. Arain
- Department of Pediatrics, Lucile Packard Children's Hospital at Stanford, Palo Alto, CA
| | - Marlene Cervantes
- Division of General Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR
| | - Nicolas M. Oreskovic
- Departments of Pediatrics and Internal Medicine, Massachusetts General Hospital, Boston, MA.,Department of Pediatrics, Harvard Medical School, Boston MA
| | - Katharine E. Zuckerman
- Division of General Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR
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69
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Brown CL, Halvorson EE, Cohen GM, Lazorick S, Skelton JA. Addressing Childhood Obesity: Opportunities for Prevention. Pediatr Clin North Am 2015; 62:1241-61. [PMID: 26318950 PMCID: PMC4555982 DOI: 10.1016/j.pcl.2015.05.013] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The overweight and obesity epidemic among children and adolescents in the United States continues to worsen, with notable racial, ethnic, and socioeconomic disparities. Risk factors for pediatric obesity include genetics; environmental and neighborhood factors; increased intake of sugar-sweetened beverages (SSBs), fast-food, and processed snacks; decreased physical activity; shorter sleep duration; and increased personal, prenatal, or family stress. Pediatricians can help prevent obesity by measuring body mass index at least yearly and providing age- and development-appropriate anticipatory guidance to families. Public policies and environmental interventions aim to make it easier for children to make healthy nutrition and physical activity choices. Interventions focused on family habits and parenting strategies have also been successful at preventing or treating childhood obesity.
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Affiliation(s)
- Callie L Brown
- Department of Pediatrics, University of North Carolina at Chapel Hill, 301B, S. Columbia Street, Chapel Hill, NC 27599, USA
| | - Elizabeth E Halvorson
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Gail M Cohen
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Brenner FIT (Families in Training) Program, Brenner Children's Hospital, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Suzanne Lazorick
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; Department of Public Health, East Carolina University, Greenville, NC 27834, USA
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Brenner FIT (Families in Training) Program, Brenner Children's Hospital, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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70
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Hakim F, Kheirandish-Gozal L, Gozal D. Obesity and Altered Sleep: A Pathway to Metabolic Derangements in Children? Semin Pediatr Neurol 2015; 22:77-85. [PMID: 26072337 PMCID: PMC4466552 DOI: 10.1016/j.spen.2015.04.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Obstructive sleep apnea (OSA) is a frequent disorder in children and is primarily associated with adenotonsillar hypertrophy. The prominent increases in childhood overweight and obesity rates in the world even among youngest of children have translated into parallel increases in the prevalence of OSA, and such trends are undoubtedly associated with deleterious global health outcomes and life expectancy. Even an obesity phenotype in childhood OSA, more close to the adult type, has been recently proposed. Reciprocal interactions between sleep in general, OSA, obesity, and disruptions of metabolic homeostasis have emerged in recent years. These associations have suggested the a priori involvement of complex sets of metabolic and inflammatory pathways, all of which may underlie an increased risk for increased orexigenic behaviors and dysfunctional satiety, hyperlipidemia, and insulin resistance that ultimately favor the emergence of metabolic syndrome. Here, we review some of the critical evidence supporting the proposed associations between sleep disruption and the metabolism-obesity complex. In addition, we describe the more recent evidence linking the potential interactive roles of OSA and obesity on metabolic phenotype.
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Affiliation(s)
- Fahed Hakim
- Pediatric Pulmonary Institute, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Leila Kheirandish-Gozal
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
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