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Johnson CM, Sharkey JR, Gómez L. Latino Fathers as Catalistas (Agents of Change): Strategies to Support Latino Fathers in Childhood Obesity Prevention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:540-545. [PMID: 33674235 DOI: 10.1016/j.jneb.2021.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
Latino children are disproportionately affected by childhood obesity. Prior research has encouraged father engagement to bolster prevention efforts and outlined general strategies for father recruitment, engagement, and retention. However, behavioral nutrition or education programs with a focus on Latino fathers are lacking, which means there is little guidance for working with Latino fathers in motivation and maintenance. This perspective highlights strategies for supporting dietary and activity behaviors with Latino fathers. Researchers can apply strategies to observational studies or program development and implementation, and practitioners can use strategies to tailor education and counseling with Latino fathers as part of obesity prevention.
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Affiliation(s)
- Cassandra M Johnson
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, San Marcos, TX.
| | - Joseph R Sharkey
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, Texas A&M University, College Station, TX
| | - Luis Gómez
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, Texas A&M University, College Station, TX
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Prochnow T, Umstattd Meyer MR, Johnson C, Delgado H, Gómez L, Sharkey J. The Development and Pilot Testing of the ¡Haz Espacio Para Papi! Program Physical Activity Curriculum for Mexican-heritage Fathers and Children. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1902888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Julius BR, O’Shea AM, Francis SL, Janz KF, Laroche H. Leading by Example: Association Between Mother and Child Objectively Measured Physical Activity and Sedentary Behavior. Pediatr Exerc Sci 2021; 33:49-60. [PMID: 33819915 PMCID: PMC8845373 DOI: 10.1123/pes.2020-0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/09/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE The authors examined the relationship between mother and child activity. METHODS The authors compared moderate-vigorous physical activity (MVPA) and sedentary time of low-income mothers with obesity and their 6- to 12-year-old children on week (WD) and weekend (WE) days. A total of 196 mother-child pairs wore accelerometers simultaneously for a week. Mothers completed questionnaires. Spearman correlation and multivariate regression were used. RESULTS WE MVPA (accelerometry) was significantly correlated between mothers with children aged 6-7 (rs = .35) and daughters (rs = .27). Self-reported maternal PA time spent with one of their children was significantly correlated with the WE MVPA of all children (rs = .21) and children aged 8-10 (rs = .22) and with the WD MVPA of all children (rs = .15), children aged 8-10 (rs = .23), aged 11-12 (rs = .52), and daughters (rs = .37), and inversely correlated to the WD sedentary time of all children (rs = -.21), children aged 8-10 (rs = -.30), aged 11-12 (rs = -.34), daughters (rs = -.26), and sons (rs = -.22). In multivariate regression, significant associations were identified between reported child-mother PA time together and child MVPA and sedentary time (accelerometry). CONCLUSIONS Mothers may influence the PA levels of their children with the strongest associations found in children aged 6-7 and daughters. Mother-child coparticipation in PA may lead to increased child MVPA and decreased sedentary behavior.
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Affiliation(s)
- Brad R. Julius
- University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, IA
- SSM Health Dean Medical Group, Endocrinology, Madison, WI
| | - Amy M.J. O’Shea
- University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, IA
- Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA
| | - Shelby L. Francis
- University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, IA
- University of Iowa, College of Liberal Arts & Sciences, Department of Health and Human Physiology, Iowa City, IA
| | - Kathleen F. Janz
- University of Iowa, College of Liberal Arts & Sciences, Department of Health and Human Physiology, Iowa City, IA
| | - Helena Laroche
- University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, IA
- Children’s Mercy Hospital, Center for Healthy Lifestyle’s & Nutrition, Kansas City, MO
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Guagliano JM, Morton KL, Hughes C, van Sluijs EMF. Effective and resource-efficient strategies for recruiting families in physical activity, sedentary behavior, nutrition, and obesity prevention research: A systematic review with expert opinion. Obes Rev 2021; 22:e13161. [PMID: 33331106 PMCID: PMC7613433 DOI: 10.1111/obr.13161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 01/13/2023]
Abstract
We systematically identified effective and resource-efficient strategies for recruiting families into health promoting intervention research. Four databases were searched for reviews. Interventions were extracted from included reviews. Additionally, a Delphi study was conducted with 35 experts in family-based research. We assessed extracted data from our review and Delphi participants' opinions by collating responses into overarching themes based on recruitment setting then recruitment strategies to identify effective and resource-efficient strategies for recruiting families into intervention research. A total of 64 articles (n = 49 studies) were included. Data regarding recruitment duration (33%), target sample size (32%), reach (18%), expressions of interest (33%), and enrollment rate (22%) were scarcely reported. Recruitment settings (84%) and strategies (73%) used were available for most studies. However, the details were vague, particularly regarding who was responsible for recruitment or how recruitment strategies were implemented. The Delphi showed recruitment settings, and strategies fell under six themes: school-based, print/electronic media, community settings-based, primary care-based, employer-based, and referral-based strategies. Underrecruitment in family-based trials is a major issue. Reporting on recruitment can be improved by better adherence to existing guidelines. Our findings suggest a multifaceted recruitment approach targeting adults and children with multiple exposures to study information.
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Affiliation(s)
- Justin M Guagliano
- MRC Epidemiology Unit & Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
| | - Katie L Morton
- MRC Epidemiology Unit & Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
| | - Claire Hughes
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Esther M F van Sluijs
- MRC Epidemiology Unit & Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
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DeCamp LR, Acosta J, Guerrero Vazquez M, Polk S. From Clinic to Community: Adapting Evidence-Based Weight Management for Overweight Latinx Children to Better Address Social Determinants. Health Promot Pract 2021; 23:518-529. [PMID: 33666103 DOI: 10.1177/1524839921993054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The U.S. Preventive Services Task Force recommends referral of all obese children to intensive weight management programs. When available, programs are limited to clinical settings and do not address social determinants of health barriers to healthy weight among Latinx immigrant families. Active and Healthy Families, a Spanish-language, culturally tailored group visit intervention has demonstrated effectiveness in decreasing child body mass index but does not address barriers to frequent engagement with the health care system nor social determinants other than immigration. Adapting the intervention for community-based delivery, and to address additional social determinants, may facilitate participation and increase acceptability and engagement among Latinx immigrant families. PURPOSE To engage a stakeholder network in planning adaptations of an evidence-based weight management intervention for community-based implementation. METHOD Guided by the intervention mapping-adapt process, we solicited feedback from a stakeholder network from August 2018 to March 2020. The stakeholder network assessed fit, planned adaptations and identified essential intervention components using photovoice, a Participatory Action Research method, and meetings incorporating user-centered design approaches. RESULTS The stakeholder network membership included Latinx immigrant families, community leaders, health care delivery experts, and researchers. Planned adaptations included curriculum changes to discuss social determinants barriers to behavior change and goal setting to mitigate them. CONCLUSIONS We successfully engaged a stakeholder network and, using a systematic process, identified adaptations of an evidence-based weight management intervention to allow for community-based implementation. Sustainably addressing obesity disparities for Latinx children also requires addressing structural factors to reduce social determinants of health barriers at the population level.
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Affiliation(s)
- Lisa Ross DeCamp
- University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.,Colorado School of Public Health, Aurora, CO, USA
| | | | | | - Sarah Polk
- Johns Hopkins University, Baltimore, MD, USA
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Perez O, Beltran A, Isbell T, Galdamez-Calderon E, Baranowski T, Morgan PJ, O'Connor TM. Papás Saludables, Niños Saludables: Perspectives From Hispanic Parents and Children in a Culturally Adapted Father-Focused Obesity Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:246-253. [PMID: 33358181 PMCID: PMC7954849 DOI: 10.1016/j.jneb.2020.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Qualitatively assess culturally adapted lifestyle intervention, Papás Saludables, Niños Saludables (PSNS; Healthy Dads, Healthy Kids), for Hispanic fathers and children. METHODS Semistructured interviews of parents and children after participation in 10-week PSNS program for Hispanic fathers and children. Qualitative data double-coded inductively and deductively until consensus reached. RESULTS Total of 26 fathers, 26 mothers, and 45 children interviewed. Parents and children had positive feedback about program content on culturally relevant nutrition and physical activity and reported improved father-child bonding. Mothers noted increased involvement among fathers in child's well-being. Participants suggested lengthening the program. CONCLUSIONS AND IMPLICATIONS Papás Saludables, Niños Saludables is an innovative approach with promise in engaging Hispanic fathers and children in a lifestyle program that emphasizes the role of fathers in children's lifestyle behaviors. Familism, respeto (respect), and promoting father-child relationships were important to engage fathers. Results from this study will inform future trials of PSNS and help identify ways to increase engagement of Hispanic men in other programs.
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Affiliation(s)
- Oriana Perez
- Department of Pediatrics, US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Alicia Beltran
- Department of Pediatrics, US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Tasia Isbell
- School of Public Health and McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Edgar Galdamez-Calderon
- Department of Pediatrics, US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Tom Baranowski
- Department of Pediatrics, US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Newcastle, New South Wales, Australia
| | - Teresia M O'Connor
- Department of Pediatrics, US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, and Academic General Pediatrics, Baylor College of Medicine, Houston, TX.
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A Family-Based Lifestyle Intervention Focusing on Fathers and Their Children Using Co-Creation: Study Protocol of the Run Daddy Run Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041830. [PMID: 33668562 PMCID: PMC7918485 DOI: 10.3390/ijerph18041830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/18/2022]
Abstract
Fathers play a unique and important role in shaping their children’s physical activity (PA), independent from the mother. Lifestyle interventions focusing simultaneously on PA of fathers and their children (“co-PA”) are therefore a novel and promising way to improve PA of both. A theory-based lifestyle intervention was co-created with fathers (i.e., the Run Daddy Run intervention), using the behavior change wheel as a theoretical framework. The aim of the present study is to describe the protocol of the Run Daddy Run intervention study, focusing on improving (co-)PA of fathers and children, and the prospected outcomes. The developed intervention consists of six (inter)active father-child sessions and an eHealth component, delivered over a 14-week intervention period. Baseline measurements will be conducted between November 2019–January 2020, post-test measurements in June 2020, and follow-up measurements in November 2020, with (co-)PA as the primary outcome variable. Outcomes will be measured using accelerometry and an online questionnaire. To evaluate the intervention, multilevel analyses will be conducted. This study will increase our understanding on whether a theory-based, co-created lifestyle intervention focusing exclusively on fathers and their children can improve their (co-)PA behavior and has important implications for future research and health policy, where targeting fathers might be a novel and effective approach to improve (co-)PA and associated health behaviors of both fathers and their children.
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Whooten RC, Kwete GM, Farrar-Muir H, Cournoyer RN, Barth EA, Kotelchuck M, Taveras EM. Engaging fathers in the first 1000 days to improve perinatal outcomes and prevent obesity: Rationale and design of the First Heroes randomized trial. Contemp Clin Trials 2021; 101:106253. [PMID: 33340750 PMCID: PMC10138076 DOI: 10.1016/j.cct.2020.106253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Early pregnancy through the first year of life represents an important period for family health promotion and obesity prevention. Overall, preventive interventions in pregnancy and infancy have insufficiently engaged fathers. We describe the rationale and design of First Heroes, an intervention to improve perinatal and obesity-related outcomes among mother-father-infant triads beginning in pregnancy. METHODS/DESIGN First Heroes is a hybrid type 1 effectiveness-implementation randomized trial of mother-father-infant triads recruited in the second trimester of pregnancy from a large Obstetric practice in eastern Massachusetts and continuing through 12 months of infant age. Triads are randomized to the intervention arm or to an enhanced safety education control group. Triads randomized to the intervention arm receive three virtual visits with a health educator, in the 3rd trimester of pregnancy, at 3-4 weeks, and 3-4 months postpartum, and receive continuous multimedia education through text messaging, print material, and videos. The educational curriculum addresses parent health behaviors, family relationships, social determinants of health, and infant feeding, sleep, and development. The primary outcome is prevalence of rapid infant weight gain from birth to 6 months of age. Secondary outcomes include parent anthropometrics, parent obesogenic behaviors, family functioning, and infant behaviors. DISCUSSION First Heroes will evaluate the extent to which intentional mother-father dyad engagement, coaching on adoption of early life health behaviors, and addressing social determinants of health, influence obesogenic behaviors and outcomes in the first year of life. Findings from this work will inform future obesity prevention efforts, especially those focused on whole family inclusion.
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Affiliation(s)
- Rachel C Whooten
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States of America.
| | - Gracia M Kwete
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States of America
| | - Haley Farrar-Muir
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States of America
| | - Rachel N Cournoyer
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States of America
| | - Elizabeth A Barth
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States of America
| | - Milton Kotelchuck
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States of America
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States of America; Kraft Center for Community Health, Massachusetts General Hospital, 125 Nashua Street, Suite 860, Boston, MA 02114, United States of America; Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, United States of America
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Engaging Fathers to Improve Physical Activity and Nutrition in Themselves and in Their Preschool-Aged Children: The "Healthy Youngsters, Healthy Dads" Feasibility Trial. J Phys Act Health 2021; 18:175-184. [PMID: 33485269 DOI: 10.1123/jpah.2020-0506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/14/2020] [Accepted: 11/17/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Few lifestyle programs for young children have targeted fathers. This study examined the feasibility of a lifestyle intervention for fathers and their preschool-aged children. METHOD A total of 24 father/preschool child dyads were recruited from Newcastle, Australia, into a single-arm, feasibility trial (baseline and 3-mo postbaseline assessments). The 9-session program aimed to improve physical activity and dietary habits of fathers and children. A priori feasibility benchmarks targeted recruitment (15 dyads), eligibility rate (>60%), attendance (80%), retention (≥85%), and program acceptability (≥4 out of 5). Acceptability of data collection procedures, research team program/resource management, home-program compliance, and preliminary intervention outcomes were also assessed. RESULTS Feasibility benchmarks were surpassed for recruitment (24 dyads), eligibility rate (61.5%), attendance (89%), retention (100%), and program acceptability (4.6 out of 5). Data collection procedures were acceptable. Challenges included mothers reporting their own dietary intake rather than their child's, children moving during body composition measurement, and resetting pedometers. Resource and program management were excellent. Most families met home-program requirements (83%). Preliminary intervention outcomes were encouraging for fathers and children. CONCLUSION Program feasibility was demonstrated by excellent recruitment, attendance, acceptability, retention, program administration, and promising preliminary intervention outcomes. A few data collection difficulties were identified. A larger scale efficacy trial is warranted.
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Papás Activos: Associations between Physical Activity, Sedentary Behavior and Personal Networks among Fathers Living in Texas Colonias. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249243. [PMID: 33321902 PMCID: PMC7763635 DOI: 10.3390/ijerph17249243] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 12/24/2022]
Abstract
Despite growing health disparities in Latino populations related to lack of physical activity (PA), little is known regarding the impact of social networks on PA and sedentary behavior among a sample of Latino fathers residing in functionally rural colonias. Fathers wore accelerometers and responded to questions regarding their self-efficacy and characteristics of who they were active with most often. Fathers (n = 47) attained a mean of 73.3 min of moderate-to-vigorous PA (SD = 23.8) per day and were sedentary for a mean of 364.0 min (SD = 74.4) per day. In total, fathers reported 205 alters and significantly more family members (M = 3.60, SD = 1.64) than friends (M = 0.77, SD = 1.37). Sedentary time was positively associated with number of peers and inversely related to the number of children reported. Minutes of moderate-to-vigorous PA was significantly associated with greater self-efficacy and number of family members reported. This study contributes to the evidence by further examining PA correlates of Latino fathers from functionally rural colonia communities. Additionally, this study supported both family systems theory and the socio–ecological model as it details the interpersonal and familial influences of PA behavior. Thus, supports for family activity promotion and programs which impact familial norms and activity at the family level may be particularly useful.
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Bottorff JL, Huisken A, Hopkins M, Nesmith C. A RE-AIM evaluation of Healthy Together: a family-centred program to support children's healthy weights. BMC Public Health 2020; 20:1754. [PMID: 33225915 PMCID: PMC7681950 DOI: 10.1186/s12889-020-09737-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 10/21/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Healthy Together (HT) is family-centered program to support healthy eating and physical activity designed for implementation in community organizations serving families who may be experiencing vulnerabilities (e.g., related to low income, isolation, ethnicity, immigrant/refugee status, and/or Indigenous background). The purpose of this study was to conduct an evaluation of HT in a real-world, scale-up phase using the RE-AIM framework. METHODS Using a cross-sectional, non-comparative design, a community-based program evaluation was conducted in 29 organizations implementing HT as part of their core service programs. Data were collected using questionnaires with program participants and facilitators, and interviews with directors of participating organizations. Quantitative data were analyzed using descriptive statistics and qualitative data were content analyzed. RESULTS With regards to Reach, over 3400 caregivers, children and youth attended community programming that offered HT. Among those attending on the scheduled day for the evaluation, 663 completed the questionnaires. The majority of caregiver respondents (n = 431) were female (92%) and attended with children 0-6 years. Respondents also included children 4-6 years (n = 142) and 7-12 years (n = 65), and youth 13-18 years (n = 25). Effectiveness was demonstrated in reported improvements in physical activity, healthy eating, and strengthened social connections. HT was also widely supported by participants and facilitators. Adoption was influenced by the desire to enrich core service programs for families, HT's fit within existing programs, organizational commitment, and funding support. Implementation experiences indicated that fidelity to the HT program was generally maintained, with some setting specific adaptations. Maintenance of HT was influenced by financial and non-financial resources within community organizations. Most organizations also introduced new initiatives to extend support for healthy eating and physical activity. CONCLUSION Our findings indicate improvements in healthy eating and physical activity, and social connections among program participants, as well as efforts by community organizations to create environments to support healthy weights. HT was successfully delivered in "real-world" community settings across multiple contexts and with families with diverse backgrounds. This along with strategies to support program implementation and sustainability indicate that HT provides a model for other public health interventions to promote family health and wellbeing. TRIAL REGISTRATION ClincialTrials.gov NCT03550248. Registered May 25, 2018.
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Affiliation(s)
- Joan L. Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 1147 Research Road, Art 223, Kelowna, BC V1V 1V7 Canada
| | - Anne Huisken
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 1147 Research Road, Art 223, Kelowna, BC V1V 1V7 Canada
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Hobbs M, Schoeppe S, Duncan MJ, Vandelanotte C, Marek L, Wiki J, Tomintz M, Campbell M, Kingham S. Objectively measured waist circumference is most strongly associated in father-boy and mother-girl dyads in a large nationally representative sample of New Zealanders. Int J Obes (Lond) 2020; 45:438-448. [PMID: 33177613 DOI: 10.1038/s41366-020-00699-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 09/09/2020] [Accepted: 10/14/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The prevalence of children with elevated weight or obesity is concerning for public health due to associated comorbidities. This study investigates associations between parental adiposity, physical activity (PA), fruit and vegetable consumption, and child adiposity and moderation by both child and parent gender. METHODS Cross-sectional nationally representative data from the New Zealand Health Survey were pooled for the years 2013/14-2016/17. Parent and child surveys were matched resulting in 13,039 child (2-14 years) and parent (15-70 years) dyads. Parent and child, height (cm), weight (kg) and waist circumference (WC) were measured objectively. Height and weight were used to calculate BMI. Linear regression, accounting for clustered samples (b [95% CI]) investigated associations between parental characteristics and child BMI z-score and WC. Interactions and stratification were used to investigate effect moderation by parent gender, child gender, and parent adiposity. RESULTS Parental PA and fruit and vegetable consumption were unrelated to child adiposity. Overall, higher parent BMI was related to a higher child BMI z-score (b = 0.047 [0.042, 0.052]) and higher parental WC was related to a higher child WC (0.15 [0.12, 0.17]). A three-way interaction revealed no moderation by parent gender, child gender, and parent BMI for child BMI z-score ((b = 0.005 [-0.017, 0.027], p = 0.318). However, a three-way interaction revealed moderation by parent gender, child gender, and parent WC for child WC (b = 0.13 [0.05, 0.22]). The slightly stronger associations were seen between father-son WC (b = 0.20 [0.15, 0.24]) and mother-daughter WC (b = 0.19 [0.15, 0.22]). CONCLUSIONS The findings are highly relevant for those wishing to understand the complex relationships between child-parent obesity factors. Findings suggest that family environments should be a key target for obesity intervention efforts and show how future public health interventions should be differentiated to account for both maternal and paternal influences on child adiposity.
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Affiliation(s)
- M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Canterbury, New Zealand. .,Health Sciences, University of Canterbury, Christchurch, Canterbury, New Zealand.
| | - S Schoeppe
- Central Queensland University, School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Rockhampton, QLD, Australia
| | - M J Duncan
- School of Medicine & Public Health, Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - C Vandelanotte
- Central Queensland University, School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Rockhampton, QLD, Australia
| | - L Marek
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Canterbury, New Zealand
| | - J Wiki
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Canterbury, New Zealand
| | - M Tomintz
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Canterbury, New Zealand
| | - M Campbell
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Canterbury, New Zealand.,School of Earth and Environment, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - S Kingham
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Canterbury, New Zealand.,School of Earth and Environment, University of Canterbury, Christchurch, Canterbury, New Zealand
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Somaraki M, Eli K, Sorjonen K, Ek A, Sandvik P, Nowicka P. Changes in parental feeding practices and preschoolers’ food intake following a randomized controlled childhood obesity trial. Appetite 2020; 154:104746. [DOI: 10.1016/j.appet.2020.104746] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/03/2020] [Accepted: 05/16/2020] [Indexed: 12/14/2022]
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Schoeppe S, Salmon J, Williams SL, Power D, Alley S, Rebar AL, Hayman M, Duncan MJ, Vandelanotte C. Effects of an Activity Tracker and App Intervention to Increase Physical Activity in Whole Families-The Step It Up Family Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7655. [PMID: 33092219 PMCID: PMC7588994 DOI: 10.3390/ijerph17207655] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 12/24/2022]
Abstract
(1) Background: Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in whole families. Further, few family-centered interventions have actively involved both parents and assessed physical activity effects separately for children, mothers and fathers. Objective: To examine the feasibility and short-term effects of an activity tracker and app intervention to increase physical activity in the whole family (children, mothers and fathers). (2) Methods: This was a single-arm feasibility study with pre-post intervention measures. Between 2017-2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults; Garmin Australasia Pty Ltd., Sydney, Australia), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages and an introductory session. Parent surveys were used to assess physical activity effects measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers. Objective Garmin activity tracker data was recorded to assess physical activity levels (steps, active minutes) during the intervention. (3) Results: Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all p < 0.001). In mothers, MVPA increased by 27 min/day (p < 0.001) and in fathers, it increased by 31 min/day (p < 0.001). The percentage of children meeting Australia's physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (p < 0.001). The percentage of mothers and fathers meeting Australia's physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (p < 0.001) in mothers and from 21% to 68% (p < 0.001) in fathers. The percentage of families with 'at least one child and both parents' meeting the physical activity guidelines increased from 0% to 41% (p < 0.001). Objective activity tracker data recorded during the intervention showed that the mean (SD) number of active minutes per day in children was 82.1 (17.1). Further, the mean (SD) steps per day was 9590.7 (2425.3) in children, 7397.5 (1954.2) in mothers and 8161.7 (3370.3) in fathers. (4) Conclusions: Acknowledging the uncontrolled study design, the large pre-post changes in MVPA and rather high step counts recorded during the intervention suggest that an activity tracker and app intervention can increase physical activity in whole families. The Step it Up Family program warrants further efficacy testing in a larger, randomized controlled trial.
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Affiliation(s)
- Stephanie Schoeppe
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, Geelong, VIC 3125, Australia;
| | - Susan L. Williams
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Deborah Power
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Stephanie Alley
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Amanda L. Rebar
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Melanie Hayman
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
| | - Mitch J. Duncan
- Priority Research Centre for Physical Activity and Nutrition, School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
| | - Corneel Vandelanotte
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia; (S.L.W.); (D.P.); (S.A.); (A.L.R.); (M.H.); (C.V.)
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Davison KK, Haines J, Garcia EA, Douglas S, McBride B. Fathers' food parenting: A scoping review of the literature from 1990 to 2019. Pediatr Obes 2020; 15:e12654. [PMID: 32415676 PMCID: PMC8010159 DOI: 10.1111/ijpo.12654] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND While food parenting is a robust area of inquiry, studies have largely focused on mothers. Given the diversity of family structures today and increases in fathers' engagement in caregiving, fathers' food parenting warrants attention. OBJECTIVE We present a scoping review of research on fathers' food parenting (1990-2019). Eligible studies included peer-reviewed research published in English documenting fathers' food parenting and presenting results for fathers separate from mothers. RESULTS Seventy-seven eligible studies were identified. Most studies were based in the U.S (63.6%) and utilized a cross-sectional design (93.5%). Approximately half of studies used a validated measure of food parenting (54.5%) and slightly less than 30% utilized theory (28.6%). Many studies did not report information on fathers' residential status (37.7%) or their relationship to the target child (biological vs social) (63.6%). Content analysis of study findings showed that: fathers are involved in food parenting, but at lower levels than mothers; there are few consistent mother-father differences in food parenting practices; and fathers' controlling food parenting is linked with negative nutrition outcomes in children while responsive food parenting is linked with positive child outcomes. CONCLUSION To better inform family interventions to prevent childhood obesity, future food parenting research with fathers should recognize the diversity of family structures and utilize prospective, theory-based, designs.
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Affiliation(s)
- Kirsten K Davison
- Boston College School of Social Work, Chestnut Hill, Massachusetts, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Evelin A Garcia
- Boston College School of Social Work, Chestnut Hill, Massachusetts, USA
| | - Sabrina Douglas
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Brent McBride
- Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
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Karmali S, Battram DS, Burke SM, Cramp A, Johnson AM, Mantler T, Morrow D, Ng V, Pearson ES, Petrella RJ, Tucker P, Irwin JD. Perspectives and Impact of a Parent-Child Intervention on Dietary Intake and Physical Activity Behaviours, Parental Motivation, and Parental Body Composition: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6822. [PMID: 32962031 PMCID: PMC7560045 DOI: 10.3390/ijerph17186822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/04/2022]
Abstract
Adults and children in Canada are not meeting physical activity guidelines nor consuming sufficient nutrient-rich foods. High engagement in these unhealthy behaviours can lead to obesity and its associated diseases. Parent-child interventions aimed at obesity prevention/treatment have assisted families with making positive changes to their nutrition and physical activity behaviours. Given that the home environment shapes early health behaviours, it is important to target both parents and children when addressing diet and physical activity. One method that has been shown to improve health outcomes is co-active coaching. The current study explored the impact of a three-month co-active coaching and/or health education intervention on the dietary intake and physical activity behaviours of parents with overweight/obesity and their children (ages 2.5-10; of any weight). Body composition (i.e., body mass index [BMI] and waist circumference), changes in parental motivation with respect to physical activity and dietary behaviours, and parental perceptions of program improvements were collected. A concurrent mixed methods study comprised of a randomized controlled trial and a descriptive qualitative design was utilized. Fifty parent-child dyads were recruited and randomly assigned to the control (n = 25) or intervention (n = 25) group. Assessments were completed at baseline, mid-intervention (six weeks), post-intervention (three months), and six-month follow-up. A linear mixed effects model was utilized for quantitative analysis. Inductive content analysis was used to extract themes from parent interviews. No significant results were observed over time for the dependent measures. Parents in both control and intervention groups reported varied program experiences, including developing changes in perspective, increased awareness of habits, and heightened accountability for making positive changes in themselves, and consequently, their families. Parents also shared barriers they faced when implementing changes (e.g., time, weather, stress). Qualitatively, both groups reported benefitting from this program, with the intervention group describing salient benefits from engaging in coaching. This research expands on the utility of coaching as a method for behaviour change, when compared to education only, in parents with overweight/obesity and their children.
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Affiliation(s)
- Shazya Karmali
- Health & Rehabilitation Sciences, Western University, London, ON N6A 3K7, Canada; (S.K.); (A.M.J.); (D.M.)
| | - Danielle S. Battram
- Food and Nutritional Sciences, Western University, Brescia University College, London, ON N6G 1H2, Canada;
| | - Shauna M. Burke
- School of Health Studies, Western University, London, ON N6A 3K7, Canada; (S.M.B.); (T.M.)
| | - Anita Cramp
- Middlesex London Health Unit, London, ON N6A 3N7, Canada;
| | - Andrew M. Johnson
- Health & Rehabilitation Sciences, Western University, London, ON N6A 3K7, Canada; (S.K.); (A.M.J.); (D.M.)
- School of Health Studies, Western University, London, ON N6A 3K7, Canada; (S.M.B.); (T.M.)
| | - Tara Mantler
- School of Health Studies, Western University, London, ON N6A 3K7, Canada; (S.M.B.); (T.M.)
| | - Don Morrow
- Health & Rehabilitation Sciences, Western University, London, ON N6A 3K7, Canada; (S.K.); (A.M.J.); (D.M.)
| | - Victor Ng
- Department of Programs and Practice Support, College of Family Physicians of Canada, Mississauga, ON L4W 5A4, Canada;
| | - Erin S. Pearson
- School of Kinesiology, Faculty of Health and Behavioural Sciences, Lakehead University, Thunder Bay, ON P7B 5E1, Canada;
| | - Robert J. Petrella
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - Patricia Tucker
- School of Occupational Therapy, Western University, London, ON N6A 3K7, Canada;
| | - Jennifer D. Irwin
- Health & Rehabilitation Sciences, Western University, London, ON N6A 3K7, Canada; (S.K.); (A.M.J.); (D.M.)
- School of Health Studies, Western University, London, ON N6A 3K7, Canada; (S.M.B.); (T.M.)
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Persky S, Ferrer RA, Klein WMP, Goldring MR, Cohen RW, Kistler WD, Yaremych HE, Bouhlal S. Effects of Fruit and Vegetable Feeding Messages on Mothers and Fathers: Interactions Between Emotional State and Health Message Framing. Ann Behav Med 2020; 53:789-800. [PMID: 30395145 DOI: 10.1093/abm/kay088] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a pressing need to craft optimal public health messages promoting healthy feeding behaviors among parents. How these messages influence such feeding decisions are affected by multiple interactive factors including emotional states, message framing, and gender, but these factors have not been studied in the domain of parents' feeding of their children. PURPOSE To evaluate the role of message framing, emotional state, and parent gender on feeding choices that parents make for their children. METHODS In 2016-2017, 190 parents (126 mothers) of 4- to 7-year-old children were randomly assigned to an anger or fear emotion induction and read either a gain- or loss-framed message about the importance of children's fruit and vegetable (FV) consumption prior to choosing foods for their child from a virtual reality buffet. RESULTS Mothers in an angry state who received a gain-framed message chose relatively more FV for their child in the virtual buffet, F(3, 180) = 4.77, p = .027. However, fathers in this group did not feed more FV, but rather reported greater intention to improve future FV feeding, F(3, 180) = 4.91, p = .028. CONCLUSIONS Providing gain-framed messages to parents, particularly mothers, in an anger state may be most effective for motivating healthy dietary choices for children. CLINICAL TRIAL INFORMATION clinicaltrials.gov NCT02622035.
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Affiliation(s)
- Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA
| | - William M P Klein
- Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA
| | - Megan R Goldring
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rachel W Cohen
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - William D Kistler
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Haley E Yaremych
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sofia Bouhlal
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, Bethesda, MD, USA
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68
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Kang AW, Ash TR, Tovar A, Gans KM, Minkel J, Mena NZ, Risica PM. Exploring Parenting Contexts of Latinx 2-to-5-Year Old Children's Sleep: Qualitative Evidence Informing Intervention Development. J Pediatr Nurs 2020; 54:93-100. [PMID: 32801064 DOI: 10.1016/j.pedn.2020.07.006] [Citation(s) in RCA: 3] [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: 04/23/2020] [Revised: 07/12/2020] [Accepted: 07/16/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE Poor sleep quality is associated with childhood obesity, and Latinx children have the highest prevalence of obesity in the United States. Parents are key agents to ensuring good sleep quality among children, but limited research has examined sleep parenting among Latinx working parents who may have added responsibilities. DESIGN AND METHODS Working Latinx parents of 2-to-5-year old children participated in in-depth interviews exploring parenting and familial contexts of child sleep. Main topics in the interview guide included sleep-related parenting practices, social support, cultural influences, and intervention service delivery and content preferences. Thematic analysis was used to analyze data. RESULTS Twenty parents completed the interview. The following themes emerged: Sleep parenting, sleep knowledge, impact of familial structures, family commitments, child temperament, and broader contextual factors on sleep, and intervention content and design ideas. Across participants, employment was reported to be a barrier to effective sleep parenting. Parents also reported engaging in practices that may interfere with sleep quality such as using screen time as a distraction and reducing naptime during the weekends to increase the amount of family time. Family-level factors such as co-parenting and spousal support were reported to facilitate sleep parenting. Participants also indicated the need for more sleep parenting knowledge and a preference for mobile platforms and social media to deliver information. CONCLUSIONS Results not only fill critical gaps in the literature, but also highlight the variability in parents' approaches to sleep parenting and an urgent need for intervention/programming efforts to target Latinx parent's sleep knowledge and parenting.
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Affiliation(s)
- Augustine W Kang
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA.
| | - Tayla R Ash
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kim M Gans
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA
| | - Jared Minkel
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Noereem Z Mena
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Patricia M Risica
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Department of Epidemiology, Brown School of Public Health, Providence, RI, USA
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O'Connor TM, Beltran A, Musaad S, Perez O, Flores A, Galdamez-Calderon E, Isbell T, Arredondo EM, Parra Cardona R, Cabrera N, Marton SA, Baranowski T, Morgan PJ. Feasibility of Targeting Hispanic Fathers and Children in an Obesity Intervention: Papás Saludables Niños Saludables. Child Obes 2020; 16:379-392. [PMID: 32466678 PMCID: PMC7475092 DOI: 10.1089/chi.2020.0006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Hispanic children and men carry a high burden for obesity and associated medical conditions. Healthy Dads Healthy Kids was the first obesity prevention intervention targeting fathers and demonstrated weight loss among fathers and behavior change among fathers and children in Australia. The aim of this study was to assess the feasibility of a culturally adapted version of the program for Hispanic families, Papás Saludables Niños Saludables. Methods: A randomized waitlist controlled trial with a process evaluation was conducted to assess the feasibility of Papás Saludables Niños Saludables(NCT03532048). Fathers, their partner (mother), and one to three children were enrolled. A priori feasibility criteria were: (1) recruit 40 Hispanic fathers and their families in ≤4 months; (2) retain 80% of participants for pre- and postassessments; (3) maintain ≥70% attendance to the 10 sessions; (4) obtain 80% "excellent" or "good" satisfaction from participants; and (5) collect anthropometric and behavioral data on ≥75% of participants at baseline and follow-up. Results: The study enrolled 90% (n = 36) of the goal from one local pediatric clinic between May and August 2018; retained 75% of participants for postassessment; maintained 72% attendance among those who started the program; and achieved 100% "excellent/good" satisfaction ratings among the participating fathers and mothers. One hundred percent of participants had most anthropometric and behavioral data at baseline and 72% at follow-up. Conclusions: With oversampling and improvements in the recruitment strategies, Papás Saludables Niños Saludables is feasible for a randomized controlled clinical trial to address whether a father-targeted lifestyle program is efficacious among low-income Hispanic men and their children.
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Affiliation(s)
- Teresia M. O'Connor
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA.,Address correspondence to: Teresia M. O'Connor, MD, MPH, Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, 1100 Bates Street, Houston, TX 77030, USA
| | - Alicia Beltran
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Salma Musaad
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Oriana Perez
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Adriana Flores
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Edgar Galdamez-Calderon
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Tasia Isbell
- School of Public Health, University of Texas, Houston, TX, USA
| | - Elva M. Arredondo
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Ruben Parra Cardona
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Natasha Cabrera
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Stephanie A. Marton
- Texas Children's Health Plan, Houston, TX, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Tom Baranowski
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Philip J Morgan
- Faculty of Education and Arts, Priority Research Center for Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia
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Daniels LA, Mallan KM, Jansen E, Nicholson JM, Magarey AM, Thorpe K. Comparison of Early Feeding Practices in Mother-Father Dyads and Possible Generalization of an Efficacious Maternal Intervention to Fathers' Feeding Practices: A Secondary Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176075. [PMID: 32825517 PMCID: PMC7504426 DOI: 10.3390/ijerph17176075] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 08/17/2020] [Indexed: 01/26/2023]
Abstract
To compare feeding practices within mother-father dyads and explore whether outcomes of an efficacious intervention for mothers generalised to fathers' feeding practices. The NOURISH RCT evaluated an early feeding intervention that promoted positive feeding practices to support development of healthy eating habits and growth. The intervention was delivered to first-time mothers via 2 × 12 week modules commencing when children were 4 and 14 months. Mothers self-reported feeding practice outcomes at child age 2 years using validated scales (1 = low to 5 = high) from the Child Feeding Questionnaire (CFQ). Nine months later, an independent cross-sectional descriptive study to investigate fathers' feeding practices was initiated. Fathers were recruited by contacting (via letter) mothers participating in two pre-existing studies, including the NOURISH trial. Fathers completed a feeding practices questionnaire, similar to that used for NOURISH outcome assessments. Seventy-five fathers recruited via the NOURISH cohort (21% response) returned questionnaires. Response data from this subset of fathers were then linked to the corresponding NOURISH maternal data. Complete data were available from 70 dyads. Compared with mothers, fathers self-reported higher concern about child overweight (2.2 vs. 1.3), restriction (3.6 vs. 2.9) and pressure (2.6 vs. 2.1), all p < 0.001. Fathers whose partners were allocated to the intervention group used less pressure (mean difference 0.46, p = 0.045) and were more willing to let the child decide how much to eat (-0.51, p = 0.032). Fathers' higher concern about child weight and more frequent use of non-responsive feeding practices, when compared with mothers, identify them as potentially potent contributors to child feeding. This preliminary evidence for modest generalisation of an efficacious maternal intervention to apparent effects on some paternal feeding practices speaks to the importance and promise of including fathers in early feeding interventions.
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Affiliation(s)
- Lynne A. Daniels
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD 4059, Australia;
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Correspondence: (L.A.D.); (E.J.); Tel.: +61-403-984-611 (L.A.D.)
| | - Kimberley M. Mallan
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD 4059, Australia;
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, 4014, Australia
| | - Elena Jansen
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD 4059, Australia;
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
- Correspondence: (L.A.D.); (E.J.); Tel.: +61-403-984-611 (L.A.D.)
| | - Jan M. Nicholson
- Judith Lumley Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Anthea M. Magarey
- Nutrition and Dietetics, School of Health Sciences, Flinders University, Adelaide, SA 5001, Australia;
| | - Karen Thorpe
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD 4059, Australia;
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD 4068, Australia
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Hennessy M, Byrne M, Laws R, Mc Sharry J, O'Malley G, Heary C. Childhood obesity prevention: priority areas for future research and barriers and facilitators to knowledge translation, coproduced using the nominal group technique. Transl Behav Med 2020; 9:759-767. [PMID: 30011024 DOI: 10.1093/tbm/iby074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Childhood obesity is a significant public health challenge, yet research priorities for childhood obesity prevention are not established. Coproduction of priorities leads to research which may be more translatable to the domains of policy and practice. The aim of the present study was to identify knowledge gaps and research priorities in addition to facilitators and barriers to knowledge translation in childhood obesity prevention. The nominal group technique involving consensus building with researchers, policymakers, and practitioners was employed during workshops at a national obesity conference held over 2 days in May 2017. Seventy-seven people participated in the first round of research prioritization on Day 1, while 14 stakeholders participated on Day 2. The top five research priorities identified were as follows: (i) Evaluate (including economic evaluation) current programs to inform practice and policy; (ii) How to change culture toward addressing the determinants of health; (iii) Implementation science: process; (iv) How to integrate obesity prevention into existing service structures; (v) How to enhance opportunities for habitual physical activity, including free play and active travel. Key themes emerging from this research prioritization exercise were the importance of funding and resources, coproduction of research, and a focus on both implementation research and social determinants within the field of childhood obesity prevention. The coproduced research priorities may help to shape the research agendas of funders and researchers, and aid in the conduct of policy-relevant research and the translation of research into practice in childhood obesity prevention.
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Affiliation(s)
- Marita Hennessy
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Rachel Laws
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jenny Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Grace O'Malley
- Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.,Association for the Study of Obesity on the Island of Ireland, Dublin, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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Neshteruk CD, Mazzucca S, Vaughn AE, Jones DJ, Ward DS. Identifying patterns of physical activity and screen time parenting practices and associations with preschool children's physical activity and adiposity. Prev Med Rep 2020; 18:101068. [PMID: 32154095 PMCID: PMC7058893 DOI: 10.1016/j.pmedr.2020.101068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/10/2020] [Accepted: 02/17/2020] [Indexed: 11/26/2022] Open
Abstract
Although physical activity and screen time parenting practices influence children's behaviors, little work has examined how these practices work in combination. The purpose of this study was to identify patterns of physical activity and screen time parenting practices, and examine differences in preschool children's physical activity, sedentary behavior, and adiposity among the identified patterns. Data were collected in 2009-2012 from 319 parent-child dyads enrolled in a randomized trial testing a parent-focused obesity prevention intervention. At baseline, physical activity and screen time parenting practices were assessed using a validated self-report survey. Children's physical activity and sedentary behavior were measured using accelerometers and child anthropometrics were objectively measured. Latent profile analyses identified patterns of physical activity and screen time parenting practices. Differences in child outcomes were tested among the identified classes. Three parent classes were identified: Rewarders (n = 165), Activity Supportive (n = 98), and Screen Time Permissive (n = 56). Rewarder parents were characterized by the highest scores on using physical activity and screen time to reward or control children's behavior. Activity Supportive parents generally had the highest scores on practices to promote physical activity, while Screen Time Permissive parents had the highest scores on practices facilitating screen time. There were no differences in the mean child physical activity, sedentary behavior or BMI z-score among the three classes. Findings revealed distinct classes of parents that could provide modifiable targets for family-based physical activity promotion, but more work is needed examining the influence of these patterns longitudinally and in different populations.
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Affiliation(s)
- Cody D. Neshteruk
- Department of Population Health Sciences, Duke University, Durham, NC, United States
| | - Stephanie Mazzucca
- Prevention Research Center in St. Louis, Washington University in St. Louis, St. Louis, MO, United States
| | - Amber E. Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Deborah J. Jones
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Dianne S. Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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73
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"They Just Need to Come Down a Little Bit to your Level": A Qualitative Study of Parents' Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103605. [PMID: 32455567 PMCID: PMC7277501 DOI: 10.3390/ijerph17103605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 12/28/2022]
Abstract
The first 1000 days is a critical window of opportunity to promote healthy growth and associated behaviours. Health professionals can play an important role, in part due to the large number of routine contacts they have with parents. There is an absence of research on the views of parents towards obesity prevention and the range of associated behaviours during this time period. This study aimed to elicit parents’ views on early life interventions to promote healthy growth/prevent childhood obesity, particularly those delivered by health professionals. Semi-structured interviews were conducted with 29 parents (24 mothers, 5 fathers) who were resident in Ireland and had at least one child aged under 30 months. Data were analysed using reflexive thematic analysis. Two central themes were generated: (1) navigating the uncertainty, stress, worries, and challenges of parenting whilst under scrutiny and (2) accessing support in the broader system. Parents would welcome support during this critical time period; particularly around feeding. Such support, however, needs to be practical, realistic, evidence-based, timely, accessible, multi-level, non-judgemental, and from trusted sources, including both health professionals and peers. Interventions to promote healthy growth and related behaviours need to be developed and implemented in a way that supports parents and their views and circumstances.
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74
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Understanding the Role of Fathers in Children's Physical Activity: A Qualitative Study. J Phys Act Health 2020; 17:540-547. [PMID: 32283541 DOI: 10.1123/jpah.2019-0386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/26/2019] [Accepted: 02/29/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Parents are influential in supporting children's physical activity, but relatively little is known about the role of fathers in children's physical activity. METHODS Semi-structured interviews (n = 24) were conducted with low-active and active fathers of children 3-11 years old. Deductive thematic analysis was used to identify fathers' physical activity practices and understand how fathers interact with their children around physical activity. RESULTS All fathers demonstrated coparticipation in physical activity with their children. Other physical activity practices commonly used by fathers included as follows: facilitation of active opportunities, modeling, involvement through coaching or teaching, and encouragement. In addition, fathers viewed physical activity as an opportunity to spend time with their children to bond and develop shared interests. Finally, fathers perceived their role in children's physical activity to be different compared with mothers. Regarding father activity level, active fathers discussed modeling more frequently and tended to engage in a variety of different activities compared with low-active fathers. CONCLUSIONS Fathers play an important role in their children's physical activity, suggesting that physical activity may be one context in which to prompt paternal involvement, foster father-child relationships, and strengthen paternal parenting.
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75
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O'Connor TM, Perez O, Beltran A, Colón García I, Arredondo E, Parra Cardona R, Cabrera N, Thompson D, Baranowski T, Morgan PJ. Cultural adaptation of 'Healthy Dads, Healthy Kids' for Hispanic families: applying the ecological validity model. Int J Behav Nutr Phys Act 2020; 17:52. [PMID: 32316983 PMCID: PMC7171778 DOI: 10.1186/s12966-020-00949-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 03/27/2020] [Indexed: 12/22/2022] Open
Abstract
Background Healthy Dads Healthy Kids (HDHK) is a unique lifestyle obesity intervention for fathers and children that demonstrated weight loss among the fathers and behavior change among fathers and children in Australia. The program is gender-tailored to specifically target fathers for weight loss and 5–12 year old children for obesity prevention. The aim of this formative study was to examine an Expert Panel’s and Hispanic Family Panel’s perceptions about the program and suggestions for the cultural adaptation of HDHK for Hispanic families in southwestern US. Methods Forty-four Hispanic participants (22 fathers, 13 mothers and 9 children) made up the Family Panel. They participated in 1–5 study contacts (focus groups, online survey, and/or interviews). The scripts and qualitative guides assessed participants’ perceptions of the HDHK content and material using the Ecological Validity Model. Studies were conducted in English or Spanish, depending on the preference of the participant. Focus groups and interviews were audio-recorded, transcribed, translated, and thematically coded. Findings were reviewed with the Expert Panel who helped inform the cultural adaptation. Results 80% of parents were foreign-born, 57% spoke only Spanish at home, and 60% did not graduate from high school. Several themes emerged to inform the cultural adaptation of the program. Parents agreed with the HDHK goals and recommended the program place greater emphasis on parenting and limiting children’s screen time. Some mothers and fathers wanted greater mother engagement. Weekly videos and a Facebook group emerged as favorite alternative options to engage mothers. Greater promotion of familism (inclusion and impact on whole family) was recommended for the program goals and activities. Gender roles for mothers and fathers, and differences in how fathers interact with male and female children, emerged and should be considered in program activities. Several barriers to father engagement surfaced, including lack of time due to work schedules, physically demanding jobs, concerns of caring for children without mother, fathers’ current fitness/weight, and lack of knowledge of how to eat more healthfully. The reading level of the HDHK materials was too high for some parents. Conclusion Findings from these formative qualitative studies informed the cultural adaptation of HDHK for Hispanic families, to account for literacy level, cultural values, and barriers to participation and engagement.
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Affiliation(s)
- Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA.
| | - Oriana Perez
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Alicia Beltran
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Isabel Colón García
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Elva Arredondo
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Ruben Parra Cardona
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Natasha Cabrera
- Dept of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Philip J Morgan
- Priority Research Centre for Physical Activity & Nutrition, Faculty of Education & Arts, University of Newcastle, Newcastle, Australia
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76
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Morgan PJ, Young MD, Barnes AT, Eather N, Pollock ER, Lubans DR. Engaging Fathers to Increase Physical Activity in Girls: The "Dads And Daughters Exercising and Empowered" (DADEE) Randomized Controlled Trial. Ann Behav Med 2020; 53:39-52. [PMID: 29648571 DOI: 10.1093/abm/kay015] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Existing strategies to increase girls' physical activity levels have seen limited success. Fathers may influence their children's physical activity, but often spend more time with their sons and rarely participate in family-based programs. Purpose To test a novel program designed to increase the physical activity levels of fathers and their daughters. Methods In a two-arm RCT, 115 fathers (29-53 years) and 153 daughters (4-12 years) were randomized to (i) the "Dads And Daughters Exercising and Empowered" (DADEE) program, or (ii) a wait-list control. The 8-week program included weekly educational and practical sessions plus home tasks. Assessments were at baseline, 2 months (postintervention), and 9 months. The primary outcomes were father-daughter physical activity levels (pedometry). Secondary outcomes included screen-time, daughters' fundamental movement skill proficiency (FMS: perceived and objective), and fathers' physical activity parenting practices. Results Primary outcome data were obtained from 88% of daughters and 90% of fathers at 9 months. Intention-to-treat analyses revealed favorable group-by-time effects for physical activity in daughters (p = .02, d = 0.4) and fathers (p < .001, d = 0.7) at postintervention, which were maintained at 9 months. At postintervention and follow-up, significant effects (p < .05) were also identified for daughters' FMS competence (objective: d = 1.1-1.2; perceived: d = 0.4-0.6), a range of fathers' physical activity parenting practices (d = 0.3-0.8), and screen-time for daughters (d = 0.5-0.8) and fathers (d = 0.4-0.6, postintervention only). Program satisfaction and attendance were very high. Conclusions This study provided the first experimental evidence that efforts to increase physical activity behavior in preadolescent girls would benefit from a meaningful engagement of fathers. Clinical Trial information: Australian New Zealand Clinical Trials Registry: ACTRN12615000022561.
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Affiliation(s)
- Philip J Morgan
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - Myles D Young
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - Alyce T Barnes
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - Narelle Eather
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - Emma R Pollock
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - David R Lubans
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
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77
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Searle BRE, Harris HA, Thorpe K, Jansen E. What children bring to the table: The association of temperament and child fussy eating with maternal and paternal mealtime structure. Appetite 2020; 151:104680. [PMID: 32222402 DOI: 10.1016/j.appet.2020.104680] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 01/10/2023]
Abstract
Fussy eating is a nuanced, mealtime-specific behaviour associated with difficult temperament but has been rarely examined within the context of mealtime structure. The aim of this study was to a) examine associations between child temperament, and mothers' and fathers' structure-related feeding practices and b) explore whether these associations were mediated by child fussy eating. Cohabiting mother-father pairs (N = 205) of children aged between 2- to 5-years residing in a socioeconomically disadvantaged Australian city completed self-reported, validated measures of child temperament, food fussiness and structure-related feeding practices (structured meal timing, structured meal setting and family meal setting). Child temperament was associated with maternal and paternal structure-related feeding practices, such that more difficult temperament was associated with less mealtime structure. Mothers' perception of child food fussiness mediated the relationship between difficult temperament and increased provision of alternative meals to the child from the rest of the family. Additionally, mothers' and fathers' perception of child food fussiness mediated the relationship between difficult child temperament and lower frequency of sitting at a table together for family meals. Therefore, perceptions of child food fussiness may explain why mothers and fathers use less structure at mealtimes with children who have more difficult temperaments. These results suggests that similar intervention approaches can be used for both mothers and fathers from socioeconomically disadvantaged families to target fussy eating and structure the mealtime environment. Promoting mealtime structure to facilitate parents' appropriate responses to food refusal or difficult behaviour at mealtimes is indicated.
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Affiliation(s)
- Bonnie-Ria E Searle
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Holly A Harris
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Karen Thorpe
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Elena Jansen
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
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78
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Kortsmit K, Garfield C, Smith RA, Boulet S, Simon C, Pazol K, Kapaya M, Harrison L, Barfield W, Warner L. Paternal Involvement and Maternal Perinatal Behaviors: Pregnancy Risk Assessment Monitoring System, 2012-2015. Public Health Rep 2020; 135:253-261. [PMID: 32017658 PMCID: PMC7036615 DOI: 10.1177/0033354920904066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Paternal involvement is associated with improved infant and maternal outcomes. We compared maternal behaviors associated with infant morbidity and mortality among married women, unmarried women with an acknowledgment of paternity (AOP; a proxy for paternal involvement) signed in the hospital, and unmarried women without an AOP in a representative sample of mothers in the United States from 32 sites. METHODS We analyzed 2012-2015 data from the Pregnancy Risk Assessment Monitoring System, which collects site-specific, population-based data on preconception, prenatal and postpartum behaviors, and experiences from women with a recent live birth. We calculated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) to examine associations between level of paternal involvement and maternal perinatal behaviors. RESULTS Of 113 020 respondents (weighted N = 6 159 027), 61.5% were married, 27.4% were unmarried with an AOP, and 11.1% were unmarried without an AOP. Compared with married women and unmarried women with an AOP, unmarried women without an AOP were less likely to initiate prenatal care during the first trimester (married, aPR [95% CI], 0.94 [0.92-0.95]; unmarried with AOP, 0.97 [0.95-0.98]), ever breastfeed (married, 0.89 [0.87-0.90]; unmarried with AOP, 0.95 [0.94-0.97]), and breastfeed at least 8 weeks (married, 0.76 [0.74-0.79]; unmarried with AOP, 0.93 [0.90-0.96]) and were more likely to use alcohol during pregnancy (married, 1.20 [1.05-1.37]; unmarried with AOP, 1.21 [1.06-1.39]) and smoke during pregnancy (married, 3.18 [2.90-3.49]; unmarried with AOP, 1.23 [1.15-1.32]) and after pregnancy (married, 2.93 [2.72-3.15]; unmarried with AOP, 1.17 [1.10-1.23]). CONCLUSIONS Use of information on the AOP in addition to marital status provides a better understanding of factors that affect maternal behaviors.
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Affiliation(s)
- Katherine Kortsmit
- Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA,
USA
- ORISE Fellow, Research Participation Program, Centers for Disease Control
and Prevention, Administered by the Oak Ridge Institute for Science and Education, Oak
Ridge, TN, USA
| | - Craig Garfield
- Departments of Pediatrics and Medical Social Sciences, Northwestern
University Feinberg School of Medicine, Chicago, IL, USA
| | - Ruben A. Smith
- Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA,
USA
| | - Sheree Boulet
- Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA,
USA
| | - Clarissa Simon
- Departments of Pediatrics and Medical Social Sciences, Northwestern
University Feinberg School of Medicine, Chicago, IL, USA
| | - Karen Pazol
- Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA,
USA
| | - Martha Kapaya
- Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA,
USA
| | - Leslie Harrison
- Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA,
USA
| | - Wanda Barfield
- Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA,
USA
| | - Lee Warner
- Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA,
USA
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79
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Morgan PJ, Collins CE, Lubans DR, Callister R, Lloyd AB, Plotnikoff RC, Burrows TL, Barnes AT, Pollock ER, Fletcher R, Okely AD, Miller A, Handley S, Young MD. Twelve-month outcomes of a father-child lifestyle intervention delivered by trained local facilitators in underserved communities: The Healthy Dads Healthy Kids dissemination trial. Transl Behav Med 2020; 9:560-569. [PMID: 31094438 DOI: 10.1093/tbm/ibz031] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Healthy Dads Healthy Kids (HDHK) was the first program internationally to specifically target overweight and obese fathers to improve their children's health. In previous randomized controlled trials, HDHK generated meaningful short-term improvements in the adiposity, physical activity, and eating behaviors of both fathers and children. The aim of this dissemination trial was to evaluate the 12-month impact of HDHK when delivered by trained facilitators across four low socioeconomic and regional communities in the Hunter Region, Australia. The study was a nonrandomized, prospective trial with minimal eligibility criteria (i.e., father body mass index [BMI] ≥ 25 kg/m2 and children aged 4-12 years). HDHK included eight weekly practical and theoretical sessions. Assessments were baseline, 3 months (post-intervention), 6-months, and 12-months. The primary outcome was fathers' weight. Secondary outcomes included child BMI z-score and validated lifestyle behavior measures (e.g., physical activity, diet). Overall, 189 fathers (mean age: 40.2 years, BMI: 32.6 kg/m2) and 306 children (mean age: 8.1 years) participated in one of 10 HDHK programs in four areas. Intention-to-treat linear mixed models revealed a significant mean reduction in fathers' weight at post-intervention (-3.6 kg, 95% confidence interval: -4.3, -2.9), which was maintained at 12 months (71% retention). Corresponding improvements were also detected in children's BMI z-score and a range of lifestyle behaviors for both fathers and children. Attendance and satisfaction levels were high. Positive intervention effects observed in previous randomized controlled trials were largely replicated and sustained for 12 months when HDHK was delivered by trained local facilitators in underserved communities. Further investigation into the key systems, processes, and contextual factors required to deliver HDHK at scale appears warranted.
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Affiliation(s)
- Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Education, Faculty of Education and Arts, University of Newcastle, NSW, Australia
| | - Clare E Collins
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, NSW, Australia
| | - David R Lubans
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Education, Faculty of Education and Arts, University of Newcastle, NSW, Australia
| | - Robin Callister
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, NSW, Australia
| | - Adam B Lloyd
- School of Education, Faculty of Education and Arts, University of Newcastle, NSW, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Education, Faculty of Education and Arts, University of Newcastle, NSW, Australia
| | - Tracy L Burrows
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, NSW, Australia
| | - Alyce T Barnes
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Education, Faculty of Education and Arts, University of Newcastle, NSW, Australia
| | - Emma R Pollock
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Education, Faculty of Education and Arts, University of Newcastle, NSW, Australia
| | | | - Anthony D Okely
- Early Start Research Institute, University of Wollongong, NSW, Australia
| | - Andrew Miller
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Education, Faculty of Education and Arts, University of Newcastle, NSW, Australia
| | - Siobhan Handley
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, NSW, Australia
| | - Myles D Young
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia.,School of Education, Faculty of Education and Arts, University of Newcastle, NSW, Australia
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80
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Davis AM, Canter KS, Pina K. The importance of fathers in pediatric research: These authors are on to something important. Transl Behav Med 2020; 9:570-572. [PMID: 31094429 DOI: 10.1093/tbm/ibz053] [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] [Indexed: 01/13/2023] Open
Abstract
Pediatric obesity remains a prevalent health issue in the United States and around the world. Treatments are challenged by a lack of meaningful improvements in child healthy weight. The current commentary describes an intervention study with a unique approach: engaging fathers. The commentary describes why this approach is unique and promising in terms of future directions for the field to consider.
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Affiliation(s)
- Ann M Davis
- Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA.,Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kimberly S Canter
- Department of Pediatrics, Nemours Children's Health System, Wilmington Delaware, USA
| | - Kimberly Pina
- Division of Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, Missouri, USA
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81
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Griffin T, Sun Y, Sidhu M, Adab P, Burgess A, Collins C, Daley A, Entwistle A, Frew E, Hardy P, Hurley K, Jones L, McGee E, Pallan M, Young M, Morgan P, Jolly K. Healthy Dads, Healthy Kids UK, a weight management programme for fathers: feasibility RCT. BMJ Open 2019; 9:e033534. [PMID: 31826896 PMCID: PMC6924741 DOI: 10.1136/bmjopen-2019-033534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/03/2019] [Accepted: 11/01/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To assess (1) the feasibility of delivering a culturally adapted weight management programme, Healthy Dads, Healthy Kids United Kingdom (HDHK-UK), for fathers with overweight or obesity and their primary school-aged children, and (2) the feasibility of conducting a definitive randomised controlled trial (RCT). DESIGN A two-arm, randomised feasibility trial with a mixed-methods process evaluation. SETTING Socioeconomically disadvantaged, ethnically diverse localities in West Midlands, UK. PARTICIPANTS Fathers with overweight or obesity and their children aged 4-11 years. INTERVENTION Participants were randomised in a 1:2 ratio to control (family voucher for a leisure centre) or intervention comprising 9 weekly healthy lifestyle group sessions. OUTCOMES Feasibility of the intervention and RCT was assessed according to prespecified progression criteria: study recruitment, consent and follow-up, ability to deliver intervention, intervention fidelity, adherence and acceptability, weight loss, using questionnaires and measurements at baseline, 3 and 6 months, and through qualitative interviews. RESULTS The study recruited 43 men, 48% of the target sample size; the mean body mass index was 30.2 kg/m2 (SD 5.1); 61% were from a minority ethnic group; and 54% were from communities in the most disadvantaged quintile for socioeconomic deprivation. Recruitment was challenging. Retention at follow-up of 3 and 6 months was 63%. Identifying delivery sites and appropriately skilled and trained programme facilitators proved difficult. Four programmes were delivered in leisure centres and community venues. Of the 29 intervention participants, 20 (69%) attended the intervention at least once, of whom 75% attended ≥5 sessions. Sessions were delivered with high fidelity. Participants rated sessions as 'good/very good' and reported lifestyle behavioural change. Weight loss at 6 months in the intervention group (n=17) was 2.9 kg (95% CI -5.1 to -0.6). CONCLUSIONS The intervention was well received, but there were significant challenges in recruitment, programme delivery and follow-up. The HDHK-UK study was not considered feasible for progression to a full RCT based on prespecified stop-go criteria. TRIAL REGISTRATION NUMBER ISRCTN16724454.
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Affiliation(s)
- Tania Griffin
- Department of Health, University of Bath, Bath, Somerset, UK
| | - Yongzhong Sun
- Birmingham Clinical Trials Unit (BCTU), University of Birmingham, Birmingham, UK
| | - Manbinder Sidhu
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Clare Collins
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Amanda Daley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Emma Frew
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Pollyanna Hardy
- Birmingham Clinical Trials Unit (BCTU), University of Birmingham, Birmingham, UK
| | - Kiya Hurley
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Laura Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Eleanor McGee
- Birmingham Community Healthcare NHS Trust, Aston, Birmingham, UK
| | - Miranda Pallan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Myles Young
- School of Education, University of Newcastle, Callaghan, New South Wales, Australia
| | - Philip Morgan
- School of Education, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Jang M, Owen B, Lauver DR. Different types of parental stress and childhood obesity: A systematic review of observational studies. Obes Rev 2019; 20:1740-1758. [PMID: 31475448 DOI: 10.1111/obr.12930] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/23/2019] [Accepted: 07/10/2019] [Indexed: 12/11/2022]
Abstract
Different types of parental stress may influence children's health behaviors and weight. The aim of this review was to systematically examine the relationships between parental stress and child obesity. We reviewed 27 studies published through December 2018 and classified parental stress as parents' general stress, parenting role stress, and life event stress. There were positive relationships of parents' general stress and parenting role stress with child obesity among families with younger children and in longitudinal studies. The relationship between life event stress and child obesity differed by measures. We found that parenting role stress may be associated with unhealthy parenting practices. Contextual factors such as children's and parents' sex, race or ethnicity, socioeconomic status, and family structure appeared to play a moderating role in the relationship between parents' stress and child obesity, which warrant cautious interpretation. Our recommendations for future research include clarifying further the types of parental stress that influence child obesity, evaluating long-term relationship between parental stress and child obesity, and identifying possible mediating factors to support the relationship between parents' stress and child obesity. Researchers may also consider developing stress management programs for parents to address child obesity.
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Affiliation(s)
- Myoungock Jang
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin
| | - Brenda Owen
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin
| | - Diane R Lauver
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin
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83
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Keys EM, Norris JM, Cameron EE, Bright KS, Tomfohr-Madsen LM, Benzies KM. Recruitment and retention of fathers with young children in early childhood health intervention research: a systematic review and meta-analysis protocol. Syst Rev 2019; 8:300. [PMID: 31787109 PMCID: PMC6886200 DOI: 10.1186/s13643-019-1215-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fathers are under-represented in research and programs addressing early childhood health and development. Recruiting fathers into these interventions can be hampered for multiple reasons, including recruitment and retention strategies that are not tailored for fathers. The primary aim of this systematic review and meta-analysis is to determine the effectiveness of recruitment and retention strategies used to include fathers of children (from conception to age 36 months) in intervention studies. The secondary aim is to investigate study-level factors that may influence recruitment and retention. METHODS We will conduct searches for scholarly peer-reviewed randomized controlled trials, quasi-experimental studies, and pre-post studies that recruited fathers using the following databases: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), and CINAHL. English-language articles will be eligible if they recruited self-identified fathers of children from conception to age 36 months for health-promoting interventions that target healthy parents and children. Two reviewers will independently screen titles/abstracts and full texts for inclusion, as well as grading methodological quality. Recruitment and retention proportions will be calculated for each study. Where possible, we will calculate pooled proportional effects with 95% confidence intervals using random-effects models and conduct a meta-regression to examine the impact of potential modifiers of recruitment and retention. DISCUSSION Findings from this review will help inform future intervention research with fathers to optimally recruit and retain participants. Identifying key factors should enable health researchers and program managers design and adapt interventions to increase the likelihood of increasing father engagement in early childhood health interventions. Researchers will be able to use this review to inform future research that addresses current evidence gaps for the recruitment and retention of fathers. This review will make recommendations for addressing key target areas to improve recruitment and retention of fathers in early childhood health research, ultimately leading to a body of evidence that captures the full potential of fathers for maximizing the health and wellbeing of their children. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018081332.
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Affiliation(s)
- Elizabeth M. Keys
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Jill M. Norris
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Emily E. Cameron
- Department of Psychology, University of Calgary, Calgary, Alberta Canada
| | - Katherine S. Bright
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Lianne M. Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta Canada
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | - Karen M. Benzies
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
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84
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Latomme J, Huys N, Cardon G, Morgan PJ, Lateva M, Chakarova N, Kivelä J, Lindström J, Androutsos O, González-Gil EM, De Miguel-Etayo P, Nánási A, Kolozsvári LR, Manios Y, De Craemer M. Do physical activity and screen time mediate the association between European fathers' and their children's weight status? Cross-sectional data from the Feel4Diabetes-study. Int J Behav Nutr Phys Act 2019; 16:100. [PMID: 31685028 PMCID: PMC6829912 DOI: 10.1186/s12966-019-0864-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/18/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Most research on parenting and childhood obesity and obesity-related behaviours has focused on mothers while fathers have been underrepresented. Yet, recent literature has suggested that fathers uniquely influence their children's lifestyle behaviours, and hence could also affect their weight status, but this has not yet been scientifically proven. Therefore, the present study aimed to determine whether the association between fathers' weight status and their children's weight status is mediated by fathers' and children's movement behaviours (i.e. physical activity (PA) and screen time (ST)). METHODS Cross-sectional data of 899 European fathers and their children were analyzed. Fathers/male caregivers (mean age = 43.79 ± 5.92 years, mean BMI = 27.08 ± 3.95) completed a questionnaire assessing their own and their children's (mean age = 8.19 ± 0.99 years, 50.90% boys, mean BMIzscore = 0.44 ± 1.07) movement behaviours. Body Mass Index (BMI, in kg/m2) was calculated based on self-reported (fathers) and objectively measured (children) height and weight. For children, BMI z-scores (SD scores) were calculated to obtain an optimal measure for their weight status. Serial mediation analyses were performed using IBM SPSS 25.0 Statistics for Windows to test whether the association between fathers' BMI and children's BMI is mediated by fathers' PA and children's PA (model 1) and fathers' ST and children's ST (model 2), respectively. RESULTS The present study showed a (partial) mediation effect of fathers' PA and children's PA (but not father's ST and children's ST) on the association between fathers' BMI and children's BMI (model for PA; coefficient: 0.001, 95% CI: [0.0001, 0.002]; model for ST; coefficient: 0.001, 95% CI: [0.000, 0.002]). Furthermore, fathers' movement behaviours (PA and ST) were positively associated with their children's movement behaviours (PA and ST) (model for PA, coefficient: 0.281, SE: 0.023, p < 0.001; model for ST, coefficient: 0.345, SE: 0.025, p < 0.001). CONCLUSIONS These findings indicate that the influence of fathers on their children's weight status partially occurs through the association between fathers' PA and children's PA (but not their ST). As such, intervening by focusing on PA of fathers but preferably of both members of the father-child dyad (e.g. engaging fathers and their children in co-PA) might be a novel and potentially effective strategy for interventions aiming to prevent childhood overweight and obesity. Longitudinal studies or intervention studies confirming these findings are however warranted to make meaningful recommendations for health intervention and policy. TRIAL REGISTRATION The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov , ID: 643708 .
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Affiliation(s)
- Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Nele Huys
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Philip J. Morgan
- School of Education, PRCPAN (Priority Research Centre for Physical Activity and Nutrition), University of Newcastle, Newcastle, Australia
| | - Mina Lateva
- Clinic of Paediatric Endocrinology, Medical University Varna, Varna, Bulgaria
| | - Nevena Chakarova
- Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Jemina Kivelä
- National Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- National Institute for Health and Welfare, Helsinki, Finland
| | - Odysseas Androutsos
- School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Esther M. González-Gil
- GENUD (Growth, Exercise, Nutrition and Development), University of Zaragoza, Zaragoza, Spain
| | - Pilar De Miguel-Etayo
- GENUD (Growth, Exercise, Nutrition and Development), University of Zaragoza, Zaragoza, Spain
| | - Anna Nánási
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - László R. Kolozsvári
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Yannis Manios
- School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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85
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Reisz S, Aviles AI, Messina S, Duschinsky R, Jacobvitz D, Hazen N. Fathers' attachment representations and infant feeding practices. Appetite 2019; 142:104374. [PMID: 31344420 PMCID: PMC6706278 DOI: 10.1016/j.appet.2019.104374] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 12/21/2022]
Abstract
This study examined how fathers' adult attachment representations, assessed before the birth of their first child, predict feeding practices with their 8-month-old infants. Fathers have been underrepresented in child feeding research, particularly in longitudinal and observational studies. Feeding is a key parenting task of infancy and a growing number of studies have begun to explore the connection between attachment and parental feeding practices and behavior, revealing a clear link between mothers' adult attachment and how they feed their children. This is the first longitudinal examination of attachment as a prenatal predictor of fathers' infant feeding behavior. Participants were 118 first-time fathers and their infants. Adult Attachment Interviews were conducted in the third trimester of pregnancy, and father-infant feeding interactions were observed at home when the infant was 8-months-old. Videotaped feedings were coded using Chatoor's Feeding Scale (1997). Compared to other fathers, (1) those with secure attachment representations were more attuned to their infants during feeding, (2) those with dismissing representations were less attuned, and (3) those with unresolved trauma displayed more controlling behaviors. Fathers were more controlling with their sons than their daughters across all attachment representations. Study results suggest that father's infant feeding behaviors may influence by their own attachment representations. The links to fathers' controlling feeding practices are noteworthy because of the negative implications controlling parental feeding practices can have on child outcomes. The prediction of paternal feeding behaviors from assessments conducted prenatally has important intervention implications.
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Affiliation(s)
- Samantha Reisz
- University of Cambridge, Public Health & Primary Care, UK.
| | - Ashleigh I Aviles
- University of Texas at Austin, Human Development & Family Sciences, USA
| | - Serena Messina
- University of Texas at Austin, Human Development & Family Sciences, USA
| | | | - Deborah Jacobvitz
- University of Texas at Austin, Human Development & Family Sciences, USA
| | - Nancy Hazen
- University of Texas at Austin, Human Development & Family Sciences, USA
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86
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Morales Camacho WJ, Molina Díaz JM, Plata Ortiz S, Plata Ortiz JE, Morales Camacho MA, Calderón BP. Childhood obesity: Aetiology, comorbidities, and treatment. Diabetes Metab Res Rev 2019; 35:e3203. [PMID: 31299135 DOI: 10.1002/dmrr.3203] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/04/2019] [Accepted: 07/06/2019] [Indexed: 12/24/2022]
Abstract
Obesity is currently considered a global epidemic, and its implications in mortality and morbidity in a paediatric patient and in adulthood are increasingly important. The objective of this article is to review in detail the definition of obesity according to age group, and, in turn, the epidemiology of this entity worldwide and in South America. Available evidence about pathophysiology and, additionally, associated comorbidities are reported in some of the most important and clinically relevant body systems. The recommendations on pharmacological and nonpharmacological management through changes in lifestyle and relevant aspects of bariatric surgery in the paediatric population are also described.
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Affiliation(s)
- William Javier Morales Camacho
- Pediatrics, El Bosque University (UEB), Bogotá D.C., Colombia
- Investigation Group of Pediatrics, El Bosque University (UEB), Bogotá D.C., Colombia
| | - Jorge Mario Molina Díaz
- Department of Child Endocrinology, Federico Gómez Children's Hospital of Mexico (HIMFG), Mexico City, Mexico
- Faculty of Medicine, Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Sandra Plata Ortiz
- Faculty of Medicine, University of Santander (UDES), Bucaramanga, Colombia
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87
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Tully LA, Piotrowska PJ, Collins DAJ, Frick PJ, Anderson V, Moul C, Lenroot RK, Kimonis ER, Hawes D, Dadds MR. Evaluation of 'The Father Effect' Media Campaign to Increase Awareness of, and Participation in, an Online Father-Inclusive Parenting Program. HEALTH COMMUNICATION 2019; 34:1423-1432. [PMID: 29985642 DOI: 10.1080/10410236.2018.1495160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is substantial evidence that parenting programs are effective in improving parenting and child mental health outcomes. While there is increasing focus on delivering parenting interventions online to increase their reach and dissemination, fathers are underrepresented in all formats of parenting programs. However, research suggests that father participation is important for intervention effectiveness. This study evaluated the effectiveness of a media campaign for increasing awareness of, and participation in, an online father-inclusive parenting program called 'ParentWorks'. An 8-week campaign was conducted in Australia via social media channels, digital display advertising, digital television, and radio. To assess the impact of the campaign, data were obtained from caregivers registering for ParentWorks during the campaign period (n = 848) and an 8-week comparison period that occurred 3 months later (n = 254). Additionally, a nationally representative sample of 2021 caregivers of children aged 2-16 years completed an online survey. Survey questions asked about exposure to the campaign, registration for participation in ParentWorks, and knowledge of the importance of father participation in parenting programs. Three times as many caregivers registered during the 8-week media campaign compared to the comparison period, and a significantly greater proportion of male caregivers registered in the campaign versus the comparison period. The online survey found that 11% of caregivers reported exposure to the campaign, and significantly more fathers than mothers reported exposure. Results showed that those who were exposed to the campaign were significantly more likely to endorse the importance of father participation in parenting programs, than those not exposed to the campaign. The findings indicate that media campaigns appear to be an effective method of increasing awareness of online parenting programs and enhancing rates of father involvement.
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Affiliation(s)
| | | | | | - Paul J Frick
- Learning Sciences Institute of Australia, Australian Catholic University & Department of Psychology, Louisiana State University
| | - Vicki Anderson
- Royal Children's Hospital, Murdoch Children's Research Institute, & Departments of Psychology & Paediatrics, University of Melbourne
| | | | - Rhoshel K Lenroot
- School of Psychiatry, Faculty of Medicine, University of New South Wales
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88
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Rhodes RE, Spence JC, Berry T, Faulkner G, Latimer-Cheung AE, O’Reilly N, Tremblay MS, Vanderloo L. Parental support of the Canadian 24-hour movement guidelines for children and youth: prevalence and correlates. BMC Public Health 2019; 19:1385. [PMID: 31660925 PMCID: PMC6816147 DOI: 10.1186/s12889-019-7744-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 10/03/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To explore the prevalence of parental support for meeting the Canadian 24-Hour Movement Guidelines for Children and Youth, identify key interactive support profiles among the four movement behaviors, and investigate subsequent sociodemographic and social cognitive correlates of these profiles. METHODS A sample of Canadian parents (N = 1208) with children aged 5 to 17 years completed measures of the theory of planned behavior (TPB), and support of the four child movement behaviors via questionnaire. Differences in the proportion of parents supporting these four health behaviors were explored and demographic and social cognitive (attitude and perceived control) correlates of combinations of parental support for the four health behaviors were evaluated. RESULTS Child and youth sleep behavior had the highest parental support (73%) and moderate to vigorous physical activity support had the lowest prevalence (23%). Interactive profiles of the four movement behaviors yielded six primary clusters and comprised wide variation from parents who supported none of these behaviors (19%), to parents who supported all four behaviors (14%). These profiles could be distinguished by the age of the child (younger children had higher support) and the gender of the parent (mothers provided more support), as well as constructs of the TPB, but TPB cognitions were more specific predictors of each health behavior rather than general predictors of aggregate health behavior clusters. CONCLUSIONS Teenagers and fathers may represent key targets for parental support intervention of the 24-Hour Movement Guidelines. Intervention content may need to comprise the underlying foundations of attitude and perceived behavioral control to change parental support while considering the unique features of each health behavior to maximize related intervention effectiveness.
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Affiliation(s)
- Ryan E. Rhodes
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2 Canada
| | | | | | - Guy Faulkner
- University of British Columbia, Vancouver, BC Canada
| | | | | | - Mark S. Tremblay
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
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89
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Vollmer RL, Adamsons K, Mobley AR. Recruitment, Engagement, and Retention of Fathers in Nutrition Education and Obesity Research. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1121-1125. [PMID: 31378688 PMCID: PMC6788966 DOI: 10.1016/j.jneb.2019.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 06/20/2019] [Accepted: 07/10/2019] [Indexed: 06/10/2023]
Abstract
This article provides a perspective about recruiting, engaging, and retaining fathers in research and programming related to nutrition education and childhood obesity prevention. Recent research emphasizes the importance of fathers in childhood obesity prevention, and although father-friendly approaches can emulate other underserved populations, some researchers have acknowledged that differences may exist. Family sciences- related and nutritional sciences-related literature is summarized to provide guidance for nutrition and obesity scholars. Best practices may vary by the type of study and father characteristics; and the venues, content, structure, timing, and approach of research and interventions may need to be tailored for fathers.
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Affiliation(s)
- Rachel L Vollmer
- Department of Family and Consumer Sciences, Bradley University, Ave, Peoria, IL
| | - Kari Adamsons
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT
| | - Amy R Mobley
- Department of Health Education and Behavior, University of Florida, Gainesville, FL.
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90
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Sandvik P, Ek A, Eli K, Somaraki M, Bottai M, Nowicka P. Picky eating in an obesity intervention for preschool-aged children - what role does it play, and does the measurement instrument matter? Int J Behav Nutr Phys Act 2019; 16:76. [PMID: 31481062 PMCID: PMC6724280 DOI: 10.1186/s12966-019-0845-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/27/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Research on picky eating in childhood obesity treatment is limited and inconsistent, with various instruments and questions used. This study examines the role of picky eating in a randomized controlled obesity intervention for preschoolers using subscales from two instruments: The Child Eating Behavior Questionnaire (CEBQ) and the Lifestyle Behavior Checklist (LBC). METHOD The study includes 130 children (mean age 5.2 years (SD 0.7), 54% girls, mean Body Mass Index (BMI) z-score 2.9 (SD 0.6)) and their parents (nearly 60% of non-Swedish background, 40% with university degree). Families were randomized to a parent-group treatment focusing on evidence-based parenting practices or to standard treatment focusing on lifestyle changes. The children's heights and weights (BMI z-score) were measured at baseline, and at 3, 6 and 12 months post baseline. At these time-points, picky eating was reported by parents using the CEBQ (Food Fussiness scale, 6 items) and 5 items from the LBC. Child food intake was reported with a Food Frequency Questionnaire (FFQ). Pearson correlation was used to study associations between baseline picky eating and baseline BMI z-scores and food intake. Mixed effects models were used to study associations between the two measurements of picky eating and changes in picky eating, to assess the effects of changes in picky eating on BMI z-scores, and to evaluate baseline picky eating as a predictor of changes in BMI z-scores. RESULTS Neither the standard treatment nor the parent-group treatment reduced the degree of picky eating (measured with CEBQ or LBC). Baseline picky eating measured with the CEBQ was associated with a lower BMI z-score and lower intake of vegetables. Children with a higher degree of picky eating at baseline (measured with the CEBQ) displayed a lower degree of weight loss. When degree of picky eating was examined, for 25% of the children, the CEBQ and the LBC yielded diverging results. CONCLUSIONS Baseline picky eating may weaken the effectiveness of obesity treatment, and assessments should be conducted before treatment to adjust the treatment approach. Different measurements of picky eating may lead to different results. The CEBQ seems more robust than the LBC in measuring picky eating. TRIAL REGISTRATION Clinicaltrials.gov , NCT01792531. Registered 15 February 2013 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01792531.
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Affiliation(s)
- Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden.
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Karin Eli
- Social Science and Systems in Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, England.,Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, England
| | - Maria Somaraki
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden.,Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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91
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Sherwood NE, Levy RL, Seburg EM, Crain AL, Langer SL, JaKa MM, Kunin‐Batson A, Jeffery RW. The Healthy Homes/Healthy Kids 5-10 Obesity Prevention Trial: 12 and 24-month outcomes. Pediatr Obes 2019; 14:e12523. [PMID: 30873752 PMCID: PMC8853652 DOI: 10.1111/ijpo.12523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/22/2019] [Accepted: 02/17/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Pediatric primary care is an important setting for addressing obesity prevention. OBJECTIVE The Healthy Homes/Healthy Kids 5-10 randomized controlled trial evaluated the efficacy of an obesity prevention intervention integrating pediatric primary care provider counseling and parent-targeted phone coaching. METHODS Children aged 5 to 10 years with a BMI between the 70th and 95th percentile and their parents were recruited from pediatric primary care clinics. Participants received well-child visit provider counseling about obesity and safety/injury prevention and were then randomized to a 14-session phone-based obesity prevention (OP; n = 212) or safety and injury prevention contact control (CC; n = 209) intervention. The primary outcome was 12 and 24-month child BMI percentile. RESULTS There was no overall significant treatment effect on child BMI percentile. Caloric intake was significantly lower among OP compared with CC participants at 12 months (P < .005). In planned subgroup analyses, OP condition girls had significantly lower BMI percentile (P < .05) and BMI z-score (P < .02) at 12 and 24 months relative to CC girls and were less likely to be overweight (38.0% vs 53.0%, P < .01) or (obese 3.4% vs 8.8%, P < .10) at follow-up. CONCLUSIONS AND RELEVANCE An obesity prevention intervention integrating brief provider counseling and parent-targeted phone counseling did not impact 12 and 24-month BMI status overall but did have a significant impact on BMI in girls.
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Affiliation(s)
- Nancy E. Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rona L. Levy
- UW School of Social Work (SSW), Seattle, WA, USA
| | | | | | - Shelby L. Langer
- UW School of Social Work (SSW), Seattle, WA, USA,Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Meghan M. JaKa
- DC Department of Behavioral Health, Applied Research and Evaluation, Washington, DC, USA
| | | | - Robert W. Jeffery
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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92
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Abstract
PURPOSE OF REVIEW There is a growing evidence of the important role that fathers play in influencing their children's eating and other weight-related behaviors. Latino children are at high risk for obesity and associated medical conditions. Engaging Latino fathers is a potentially important and unique way to help promote healthy lifestyles for Latino children, but doing so requires a culturally sensitive understanding both of fathers' current role and the family perceptions of this role. RECENT FINDINGS Here, we review recent data and argue that there are subtle but important differences between the qualitative and quantitative research conducted regarding the role Latino fathers may play in promoting healthy eating and physical activity for their children. We suggest how to synthesize these findings and also present qualitative results for ways to best engage Latino fathers in research studies with a focus on physical activity. Results from the review support that Latino fathers are important potential targets for child obesity prevention, but our findings stress the importance of considering cultural values when trying to recruit, engage and retain Latino fathers for such research.
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93
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Persky S, Goldring MR, El-Toukhy S, Ferrer RA, Hollister B. Parental Defensiveness about Multifactorial Genomic and Environmental Causes of Children's Obesity Risk. Child Obes 2019; 15:289-297. [PMID: 30946599 PMCID: PMC6590722 DOI: 10.1089/chi.2018.0315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Future integration of genomics into weight management may target children with overweight given prospects for prevention. Meanwhile, parents learn about weight-related genomics primarily through the media, and little is known about parental reactions to complex genomic and environmental causes underlying children's obesity risk. Methods: Three hundred twenty-four parents with overweight who have a child 3-13 years of age were recruited through Amazon Mechanical Turk. Parents were randomized to read an article highlighting one of three causes of obesity risk: genetics only, family environment only, gene-family environment interactions (G × FE), or read a control article. Results: Parents who perceived their child to be overweight exhibited increased risk perception and guilt over parents of lean children overall, but exhibited decreased worry in response to the G × FE message. Furthermore, parents of children with overweight who received the G × FE message did not exhibit heightened risk perception or guilt, reported that the message was less relevant, and that they paid less attention to it. Conclusions: Multifactorial causal information about children's obesity risk elicits unintended consequences among parents whose children are most at-risk for obesity in adulthood. As these messages are most accurate, it is crucial to investigate effective ways to communicate the holistic nature of obesity risk to parents.
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Affiliation(s)
- Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD.,Address correspondence to: Susan Persky, PhD, Social and Behavioral Research Branch, National Human Genome Research Institute, 31 Center Drive B1B36, Bethesda, MD 20892
| | | | - Sherine El-Toukhy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD
| | - Rebecca A. Ferrer
- Behavioral Research Program, National Cancer Institute, Bethesda, MD
| | - Brittany Hollister
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD
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94
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Walsh AD, Hesketh KD, Hnatiuk JA, Campbell KJ. Paternal self-efficacy for promoting children's obesity protective diets and associations with children's dietary intakes. Int J Behav Nutr Phys Act 2019; 16:53. [PMID: 31253143 PMCID: PMC6599370 DOI: 10.1186/s12966-019-0814-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 06/18/2019] [Indexed: 11/10/2022] Open
Abstract
Objective Fathers’ parenting behaviours contribute to the development of children’s dietary behaviours and subsequent weight outcomes, yet the majority of research focusses on maternal influences. Understanding fathers’ perceptions of their effectiveness to influence children’s dietary behaviours will allow the development of whole-of-family interventions promoting obesity protective behaviours. This unique study is the first to investigate 1) tracking of paternal self-efficacy for promoting obesity protective dietary intakes in young children; 2) demographic characteristics of fathers and their self-efficacy category; and 3) associations between paternal self-efficacy and young children’s dietary intakes. Methods Paternal self-efficacy for promoting children’s obesity protective dietary intakes was assessed longitudinally from fathers (n = 195) in the Extended Infant Feeding Activity and Nutrition Trial Program at child age 4 and 36 months. Multinomial logistic regression examined self-efficacy tracking categories (persistently high; persistently low; increasing; decreasing) by paternal age, education and BMI. Linear regression examined associations between paternal self-efficacy tracking categories and child dietary intakes at 36 months. Results Paternal self-efficacy for promoting children’s obesity protective dietary intakes reduced over time. Fathers with trade/certificate or university qualifications had lower odds of having persistently low/decreasing self-efficacy (97 and 87% lower respectively) compared to high-school educated fathers. Positive associations (β (95% CI)) were observed between paternal self-efficacy category and children’s dietary intakes at 36 months: increasing self-efficacy and fruit (β89.8 (6.8; 172.7)), and vegetables (β39.2 (12.2; 66.2)); persistently high self-efficacy and water (β69.1 (2.9; 135.1)); decreasing self-efficacy and non-core drinks ((β30.1 (10.1; 50.1)). Persistently high self-efficacy was negatively associated with non-core drinks (β-20.2 (− 34.8; − 5.5)), with negative associations observed between decreasing self-efficacy and children’s intakes of fruit (β − 49.9 (− 87.5; − 12.3)), vegetables (β-19.9 (− 31.7; − 8.2)) and water (β-92.4 (− 172.6; − 12.3)). Conclusions Higher and/or sustained paternal self-efficacy is associated with fathers’ education and is important in promoting children’s obesity protective dietary intakes. Associations between paternal self-efficacy and children’s dietary intakes are present at a young age. This investigation was unique in its focus on paternal self-efficacy for promoting children’s obesity protective dietary intakes and associations with children’s dietary intakes. Future family interventions should consider how to maintain and/or improve paternal self-efficacy to promote obesity protective intakes from early childhood.
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Affiliation(s)
- Adam D Walsh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Jill A Hnatiuk
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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95
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Davison KK, Gavarkovs A, McBride B, Kotelchuck M, Levy R, Taveras EM. Engaging Fathers in Early Obesity Prevention During the First 1,000 Days: Policy, Systems, and Environmental Change Strategies. Obesity (Silver Spring) 2019; 27:525-533. [PMID: 30900405 DOI: 10.1002/oby.22395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 12/03/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Fathers are critical stakeholders in childhood obesity prevention but are difficult to engage. This review presents a new approach to engaging fathers in obesity prevention during the first 1,000 days. METHODS The review focuses on five existing health and social service programs, including prenatal care, pediatric care, the Special Supplemental Nutrition Program for Women, Infants, and Children, home visiting, and Early Head Start. For each program, the obesity prevention services provided, evidence of father engagement, and barriers thereto are outlined. Subsequently, policy, systems, and environmental strategies are outlined to address the noted barriers and promote father engagement. RESULTS Although the programs hold great promise in bringing obesity prevention services to fathers, barriers to their engagement are present in the inner (e.g., limited hours of operation, lack of father-specific materials and programming) and outer (e.g., lack of model programs, best practice models, and consistent funding) settings of programs. Policy, systems, and environmental strategies to increase father engagement focus on earmarked funding, changes to national practice guidelines and practitioner training requirements, and the establishment of father-engagement performance metrics. CONCLUSIONS Increasing father involvement in the specified programs will likely increase their engagement in early obesity prevention in an efficient and sustainable manner.
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Affiliation(s)
- Kirsten K Davison
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Adam Gavarkovs
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Brent McBride
- Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Milton Kotelchuck
- Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Raymond Levy
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Elsie M Taveras
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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96
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Peeters M, Davison K, Ma D, Haines J. Meeting Report on the Conference on Fathers' Role in Children's Weight-Related Behaviors and Outcomes. Obesity (Silver Spring) 2019; 27:523-524. [PMID: 30900414 DOI: 10.1002/oby.22396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/14/2018] [Indexed: 11/05/2022]
Abstract
On September 22, 2017, "Engaging the Forgotten Parent: Conference of Experts on Fathers' Role in Children's Weight-Related Behaviours and Outcomes" brought researchers, students, health professionals, community stakeholders, and knowledge users from Canada, Australia, and the United States together to Toronto, Ontario, for a 1-day gathering focused on furthering scientific understanding of effective strategies to recruit, engage, and retain fathers in family-based obesity research. Furthermore this conference focused on identifying key knowledge gaps and opportunities for collaborative research to further our understanding of fathers' roles in the development of their children's behaviors and weight outcomes. The following four themes emerged from the conference: (1) underrepresentation of fathers in family-based obesity research, (2) fathers' engagement in children's weight-related behaviors and desire to participate in research, (3) best practices in recruiting, engaging, and retaining fathers in research, and (4) key lessons learned from fatherhood research in developmental science.
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Affiliation(s)
- Mwalu Peeters
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Kirsten Davison
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - David Ma
- Department of Human Health and Nutritional Sciences, 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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97
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Karmali S, Ng V, Battram D, Burke S, Morrow D, Pearson ES, Tucker P, Mantler T, Cramp A, Petrella R, Irwin JD. Coaching and/or education intervention for parents with overweight/obesity and their children: study protocol of a single-centre randomized controlled trial. BMC Public Health 2019; 19:345. [PMID: 30922282 PMCID: PMC6437993 DOI: 10.1186/s12889-019-6640-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 03/10/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND In Canada, a majority of children and adults are insufficiently active for health gains, and about one in seven children and over 20% of adults are overweight or obese. Overweight and obesity are risk factors for many chronic diseases in both adults and children and can result in lower quality and quantity of life. Children whose parents are overweight or obese are more likely to become overweight themselves. Thus, parent/child interventions are important for reducing obesity and promoting long-term healthy weights among members of the family unit. Programs using Co-Active coaching have resulted in positive behaviour changes among adults with overweight/obesity; however, little research has explored the effects of Co-Active coaching on parents, and the consequent impact on the family unit (i.e. all parents and children in the same household). This protocol paper provides a detailed methodological account of a coaching-based program targeting parent and child dyads, in hopes of enhancing health behaviours within the family unit. METHODS Using a randomized controlled trial design, the researchers aim to identify the impact of coaching plus education (intervention) compared to education only (control) on parents with overweight/obesity and their children (ages 2.5-10, of any weight). A total of 50 dyads are being recruited and randomly assigned using a 1:1 ratio into the control or intervention group. The control group receive 6 webinar-based education sessions focused on physical activity and nutrition. The intervention group receive the same education sessions and nine, 20-min telephone-based sessions with a certified coach. Coaching and health education sessions are conducted with the parent/guardian of the dyad. This paper provides a detailed methodological account of this program. DISCUSSION The expected findings from this research will advance coaching literature, research, and practice on this topic by determining whether coaching and education are more effective than education alone at producing behaviour changes among a family unit. If proven effective, this approach may be applied more broadly through public health interventionists to parent and child populations in hopes of affecting change with both individuals and their families. TRIAL REGISTRATION ISRCTN ISRCTN69091372 . Retrospectively registered 24 September 2018.
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Affiliation(s)
- Shazya Karmali
- Western University, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- Health & Rehabilitation Sciences, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
| | - Victor Ng
- Department of Emergency Medicine, Scarborough Health Network - Centenary Campus, 2867 Ellesmere Road, Scarborough, ON Canada
| | - Danielle Battram
- Western University, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- Food and Nutritional Sciences, Brescia University College, 1285 Western Road, London, ON Canada
| | - Shauna Burke
- Western University, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- Health & Rehabilitation Sciences, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- School of Health Studies, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
| | - Don Morrow
- Western University, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- Health & Rehabilitation Sciences, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- School of Kinesiology, London, ON Canada
| | - Erin S. Pearson
- School of Kinesiology, Faculty of Health and Behavioural Sciences Sanders Fieldhouse, Lakehead University, Thunder Bay, Canada
| | - Patricia Tucker
- Western University, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- Health & Rehabilitation Sciences, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- School of Occupational Therapy, Elborn College, 1201 Western Road (Elborn College), London, ON Canada
| | - Tara Mantler
- Western University, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- School of Health Studies, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
| | - Anita Cramp
- Middlesex London Health Unit, Healthy Living Department, 50 King St, London, ON Canada
| | - Robert Petrella
- Western University, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- School of Kinesiology, London, ON Canada
- Schulich School of Medicine and Dentistry, 1151 Richmond St, London, ON Canada
| | - Jennifer D. Irwin
- Western University, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- Health & Rehabilitation Sciences, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
- School of Health Studies, 1151 Richmond St. (Arthur & Sonia Labatt Health Sciences Building), London, ON Canada
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98
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Blanchette S, Lemoyne J, Trudeau F. Tackling Childhood Overweight: Parental Perceptions of Stakeholders' Roles in a Community-Based Intervention. Glob Pediatr Health 2019; 6:2333794X19833733. [PMID: 30911590 PMCID: PMC6425524 DOI: 10.1177/2333794x19833733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction. Collaborative efforts among communities, schools, parents, and health professionals are needed to prevent childhood obesity, which touches one third of Canadian youth. The purpose of this case study was to obtain parents’ experience and perceptions about stakeholder roles in a multidisciplinary community-based intervention aiming to tackle childhood overweight. Methods. Data were collected from semistructured interviews with 10 parents following their participation in a community-based program designed to help families with overweight children adopt a healthier lifestyle. Results and Discussion. All parents preferred a multidisciplinary health team to monitor their children’s health. They expect that a physician or a pediatrician could diagnose overweight, explain results to parents, and refer families to resources. The team could also include professionals from health and education such as nutritionists/dietitians, nurses, physical education teachers, psychologists, kinesiologists, and social workers. Parents’ own perceived role would consist of instructing and reinforcing their children about healthy behaviors, role modeling for a healthy lifestyle, and seeking for professional help when needed. Conclusion. Parents involved in a support group with overweight child consider their own role as crucial to help changing their family lifestyle. They also prefer a multidisciplinary team that can address different aspects of overweight/obesity. However, the physician was perceived as having the central role in mobilizing a group of stakeholders around youth with overweight/obese, including the parents. A further step would be to understand barriers and facilitators to collaboration among health professionals in childhood overweight prevention and treatment.
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Affiliation(s)
| | - Jean Lemoyne
- Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada
| | - Francois Trudeau
- Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada
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99
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Guagliano JM, Brown HE, Coombes E, Hughes C, Jones AP, Morton KL, Wilson ECF, van Sluijs EMF. The development and feasibility of a randomised family-based physical activity promotion intervention: the Families Reporting Every Step to Health (FRESH) study. Pilot Feasibility Stud 2019; 5:21. [PMID: 30788135 PMCID: PMC6368737 DOI: 10.1186/s40814-019-0408-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/25/2019] [Indexed: 01/06/2023] Open
Abstract
Background There is a need for high-quality research aiming to increase physical activity in families. This study assessed the feasibility and acceptability of FRESH (Families Reporting Every Step to Health), a child-led family-based physical activity intervention delivered online. Methods In a two-armed randomised feasibility study, 12 families (with an 8–10-year-old index child) were allocated to a ‘child-only’ (CO) or ‘family’ arm (FAM) of the theory-based FRESH intervention. Both received access to the FRESH website, allowing participants to select step challenges to ‘travel’ to target cities around the world, log their steps, and track their progress as they virtually globetrot. Only index children wore pedometers in CO; in FAM, all family members wore pedometers and worked towards collective goals. All family members were eligible to participate in the evaluation. Mixed-methods process evaluation (questionnaires and family focus groups) at 6-week follow-up consisted of completing questionnaires assessing acceptability of the intervention and accompanying effectiveness evaluation, focussed on physical (e.g. fitness, blood pressure), psychosocial (e.g. social support), and behavioural (e.g. objectively-measured family physical activity) measures. Results All families were retained (32 participants). Parents enjoyed FRESH and all children found it fun. More FAM children wanted to continue with FRESH, found the website easy to use, and enjoyed wearing pedometers. FAM children also found it easier to reach goals. Most CO families would have preferred whole family participation. Compared to CO, FAM exhibited greater website engagement as they travelled to more cities (36 ± 11 vs. 13 ± 8) and failed fewer challenges (1.5 ± 1 vs. 3 ± 1). Focus groups also revealed that most families wanted elements of competition. All children enjoyed being part of the evaluation, and adults disagreed that there were too many intervention measures (overall, 2.4 ± 1.3) or that data collection took too long (overall, 2.2 ± 1.1). Conclusion FRESH was feasible and acceptable to participating families; however, findings favoured the FAM group. Recruitment, intervention fidelity and delivery and some measurement procedures are particular areas that require further attention for optimisation. Testing the preliminary effectiveness of FRESH on family physical activity is a necessary next step. Trial registration This study was registered and given an International Standard Randomised Controlled Trials Number (ISRCTN12789422). Registered 16 March 2016. http://www.isrctn.com/ISRCTN12789422
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Affiliation(s)
- Justin M Guagliano
- 1MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
| | - Helen Elizabeth Brown
- 1MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
| | - Emma Coombes
- 2Norwich Medical School and UKCRC Centre for Diet and Activity Research, University of East Anglia, Norwich, UK
| | - Claire Hughes
- 3Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Andy P Jones
- 2Norwich Medical School and UKCRC Centre for Diet and Activity Research, University of East Anglia, Norwich, UK
| | - Katie L Morton
- 1MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
| | - Edward C F Wilson
- 4Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Esther M F van Sluijs
- 1MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
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100
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Maternal Depressive Symptoms Mediate the Association between Socio-economic Status and Adolescent Weight Outcomes: A Longitudinal Analysis. Matern Child Health J 2018; 22:1462-1469. [PMID: 29948764 DOI: 10.1007/s10995-018-2541-y] [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] [Indexed: 10/14/2022]
Abstract
Introduction The prevalence of pediatric obesity is an issue in the United States, in which approximately one-third of children and adolescents are overweight or obese. Youth living in low socioeconomic (SES) households are at an increased risk for developing obesity; yet, research is needed to understand the mechanisms that might better explain the relationship between SES and obesity risk. Maternal depression presents a potential mechanism by which SES might predict a later risk for obesity in pediatric populations. Methods The present study used a national dataset from the National Institute of Child Health and Human Development-Study of Early Child Care and Youth Development (NICHD-SECCYD) to examine whether maternal depressive symptoms (at an age of 9 years) mediated the association between early SES (the income-to-needs ratio measured at an age of 1 month) and adolescent weight outcomes [Body Mass Index z-scores (zBMI) for age and sex, at an age of 15 years]. Results The results suggested that greater maternal depressive symptoms helped to explain a significant amount of the variance of lower SES predicting poorer weight outcomes in adolescents. Discussion These findings illustrate the role of maternal depressive symptoms in explaining how SES predicts adolescent weight outcomes. Implications are discussed, and future research is needed to identify women from lower SES households who are experiencing depressive symptoms to provide support and initiate points of early intervention to address relevant health outcomes in youths.
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