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Stuij M, van Maarschalkerweerd PEA, Seidell JC, Halberstadt J, Dedding C. Youth perspectives on weight-related words used by healthcare professionals: A qualitative study. Child Care Health Dev 2020; 46:369-380. [PMID: 32037594 DOI: 10.1111/cch.12760] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although healthcare professionals often consider body weight a sensitive and difficult topic to discuss with children, a contextualized and comprehensive understanding of youth perspectives on weight-related words used in healthcare has yet to be established. This qualitative study aims to explore perspectives of Dutch children on the terminology healthcare professionals use when discussing weight. METHODS Fourteen interviews and one focus group discussion were held with children (age 8-16) who were in care because of their weight. A toolkit with customizable interview techniques was used in order to facilitate reflection and tailor the interview to each respondent. A narrative content analysis was conducted. RESULTS Respondents attached both clear and subtle differences in meanings to (certain) weight-related words. Their perspectives were not unanimous for any single word. Moreover, at times, respondents framed certain words in positive or negative ways or used a word they disliked to describe themselves. This illustrates that meanings of weight-related words are not fixed but context and situation specific. CONCLUSION This study revealed that meanings children assign to weight-related words are shaped by their experiences in the broader social context, especially at school, as well as with (previous) healthcare professionals. It pointed towards the importance of bedside manner, acquaintanceship, and support. Healthcare professionals treating children because of their body weight are advised to invest in a good patient-caregiver relationship, pay attention to children's previous (negative) social weight-related experiences, and reflect critically on their own preconceptions about body weight and the impact these preconceptions might have on their patient-caregiver relationships.
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Affiliation(s)
- Mirjam Stuij
- Department of Medical Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC (location VUmc), Amsterdam, The Netherlands.,Mulier Institute, Utrecht, The Netherlands
| | - Pomme E A van Maarschalkerweerd
- Faculty of Science, Department of Health Sciences, Section Youth and Lifestyle, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jaap C Seidell
- Faculty of Science, Department of Health Sciences, Section Youth and Lifestyle, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jutka Halberstadt
- Faculty of Science, Department of Health Sciences, Section Youth and Lifestyle, VU University Amsterdam, Amsterdam, The Netherlands
| | - Christine Dedding
- Department of Medical Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC (location VUmc), Amsterdam, The Netherlands
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102
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Sutin AR, Stephan Y, Robinson E, Daly M, Terracciano A. Body-related discrimination and dieting and substance use behaviors in adolescence. Appetite 2020; 151:104689. [PMID: 32247897 DOI: 10.1016/j.appet.2020.104689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/20/2020] [Accepted: 03/26/2020] [Indexed: 11/17/2022]
Abstract
Unfair treatment on the basis of a physical characteristic, such as body weight, is associated with unhealthy dieting behaviors in adolescence and adulthood and has also been implicated in substance use. Peer victimization is likewise associated with these health-risk behaviors. It is unclear, however, whether body discrimination is associated with these behaviors independent of peer victimization. The present research uses data from the Longitudinal Study of Australian Children (LSAC) to test the relation between body discrimination and dieting and substance use behaviors in adolescence and test whether the associations are independent of peer victimization, as well as depressive symptoms which are associated with both forms of victimization and health-risk behaviors. Participants (N = 2955) reported on body discrimination, dieting behaviors, and substance use at ages 14-15. Participants who experienced body discrimination were more likely to report fear of gaining weight, losing control over eating, going without eating, using medicine or vomiting to control their weight, engaging in restrained eating, and exercising to control their weight. They also had tried nicotine, alcohol, and marijuana. The associations with eating and alcohol use were independent of peer victimization, whereas the associations with smoking and marijuana were reduced when peer victimization was included in the model. All associations were also independent of depressive symptoms. Overall, the findings suggest that body discrimination is associated with harmful health behaviors at least as early as age 14.
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103
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Rubino F, Puhl RM, Cummings DE, Eckel RH, Ryan DH, Mechanick JI, Nadglowski J, Ramos Salas X, Schauer PR, Twenefour D, Apovian CM, Aronne LJ, Batterham RL, Berthoud HR, Boza C, Busetto L, Dicker D, De Groot M, Eisenberg D, Flint SW, Huang TT, Kaplan LM, Kirwan JP, Korner J, Kyle TK, Laferrère B, le Roux CW, McIver L, Mingrone G, Nece P, Reid TJ, Rogers AM, Rosenbaum M, Seeley RJ, Torres AJ, Dixon JB. Joint international consensus statement for ending stigma of obesity. Nat Med 2020; 26:485-497. [PMID: 32127716 PMCID: PMC7154011 DOI: 10.1038/s41591-020-0803-x] [Citation(s) in RCA: 393] [Impact Index Per Article: 98.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 02/14/2020] [Indexed: 12/11/2022]
Abstract
People with obesity commonly face a pervasive, resilient form of social stigma. They are often subject to discrimination in the workplace as well as in educational and healthcare settings. Research indicates that weight stigma can cause physical and psychological harm, and that affected individuals are less likely to receive adequate care. For these reasons, weight stigma damages health, undermines human and social rights, and is unacceptable in modern societies. To inform healthcare professionals, policymakers, and the public about this issue, a multidisciplinary group of international experts, including representatives of scientific organizations, reviewed available evidence on the causes and harms of weight stigma and, using a modified Delphi process, developed a joint consensus statement with recommendations to eliminate weight bias. Academic institutions, professional organizations, media, public-health authorities, and governments should encourage education about weight stigma to facilitate a new public narrative about obesity, coherent with modern scientific knowledge.
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Affiliation(s)
- Francesco Rubino
- King's College London, Department of Diabetes, School of Life Course Science, London, UK.
- King's College Hospital, Bariatric and Metabolic Surgery, London, UK.
| | - Rebecca M Puhl
- Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT, USA
| | - David E Cummings
- UW Medicine Diabetes Institute, University of Washington, Seattle, WA, USA
- Weight Management Program, Virginia Puget Sound Health Care System, University of Washington, Seattle, WA, USA
| | - Robert H Eckel
- Division of Endocrinology, Metabolism & Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Donna H Ryan
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Jeffrey I Mechanick
- The Marie-Josee and Henry R. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, New York, NY, USA
- Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Ximena Ramos Salas
- Obesity Canada, Edmonton, Canada
- European Association for the Study of Obesity, Teddington, UK
| | - Phillip R Schauer
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | | | - Caroline M Apovian
- Boston University School of Medicine, Boston, MA, USA
- Center for Nutrition and Weight Management, Boston Medical Center, Boston, MA, USA
| | - Louis J Aronne
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes and Metabolism, Weill Cornell Medicine, New York, NY, USA
| | - Rachel L Batterham
- National Institute of Health Research, University College London Hospitals Biomedical Research Centre, London, UK
- University College London Hospital Foundation Trust, London, UK
- Centre for Obesity Research, Department of Medicine, University College London, London, UK
| | - Hans-Rudolph Berthoud
- Neurobiology of Nutrition and Metabolism Department, Pennington Biomedical Research Centre, Louisiana State University System, Baton Rouge, LA, USA
| | - Camilo Boza
- Centro de Innovación Clinica Las Condes Universidad Adolfo Ibañez, Santiago, Chile
| | - Luca Busetto
- Department of Internal Medicine, University of Padova, Padua, Italy
| | - Dror Dicker
- Hasharon Hospital-Rabin Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obesity Management Task Force, European Association for the Study of Obesity, Teddington, UK
| | - Mary De Groot
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Daniel Eisenberg
- Department of Surgery, Stanford School of Medicine and Palo Alto Virginia Health Care System, Stanford, CA, USA
| | - Stuart W Flint
- School of Psychology, University of Leeds, Leeds, UK
- Scaled Insights, Nexus, University of Leeds, Leeds, UK
| | - Terry T Huang
- Department of Health Policy & Management, Center for Systems & Community Design, New York, NY, USA
- NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA
| | - Lee M Kaplan
- Obesity, Metabolism and Nutrition Institute, Massachusetts General Hospital, Boston, MA, USA
| | - John P Kirwan
- Integrated Physiology and Molecular Medicine, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Judith Korner
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - LaShawn McIver
- Government Affairs & Advocacy, American Diabetes Association, Arlington, VA, USA
| | - Geltrude Mingrone
- King's College London, Department of Diabetes, School of Life Course Science, London, UK
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Catholic University, Rome, Italy
| | | | - Tirissa J Reid
- Division of Endocrinology, Diabetes & Metabolism, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ann M Rogers
- Pennsylvania State Hershey Medical Center, Hershey, PA, USA
| | | | - Randy J Seeley
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Antonio J Torres
- Hospital Clinico San Carlos. Universidad Complutense de Madrid, Madrid, Spain
| | - John B Dixon
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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104
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Killedar A, Lung T, Petrou S, Teixeira-Pinto A, Hayes A. Estimating Age- and Sex-Specific Utility Values from the CHU9D Associated with Child and Adolescent BMI z-Score. PHARMACOECONOMICS 2020; 38:375-384. [PMID: 31814078 DOI: 10.1007/s40273-019-00866-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Our objective was to identify age- and sex-specific utilities for children and adolescents by body mass index (BMI) z-score. METHODS We used data from 6822 participants and 12,094 observations from two cohorts and two waves of interviews from the Longitudinal Study of Australian Children. We fit linear models using generalised estimating equations to investigate associations between Child Health Utility 9D and BMI z-score in girls and boys aged 10-17 years. We initially fit models for each sex, fully adjusted for known predictors of health-related quality of life, including socioeconomic position, long-term medical condition and maternal smoking status and also included an interaction between age and BMI z-score to examine age-specific effects. Finally, we derived a minimal model for each sex by eliminating interaction terms with P > 0.01 and predictors with P > 0.05. RESULTS Our adjusted results show different utility patterns in girls and boys. In girls, utility decrements for each unit increase in BMI z-score changed with age (P < 0.01 for interaction between age and BMI z-score). At age 10 years, the mean utility decrement for each unit increase in BMI z-score was 0.002 (95% confidence interval [CI] 0.011 decrement to 0.006 increment), but, by age 17 years, this utility decrement was 0.023 (95% CI 0.013 to 0.032). In boys, small non-significant decrements were found in utility for each unit increase in BMI z-score, with no observable change with age. CONCLUSION Our analyses demonstrated that age and sex should be considered when attributing utility values and decrements to BMI z-scores.
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Affiliation(s)
- Anagha Killedar
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Thomas Lung
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Armando Teixeira-Pinto
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
| | - Alison Hayes
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
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105
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Murphy CM, Janssen T, Colby SM, Jackson KM. Low Self-Esteem for Physical Appearance Mediates the Effect of Body Mass Index on Smoking Initiation Among Adolescents. J Pediatr Psychol 2020; 44:197-207. [PMID: 30204918 DOI: 10.1093/jpepsy/jsy070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 08/13/2018] [Indexed: 01/08/2023] Open
Abstract
Objective Adolescence is a period during which youth may begin experimenting with substances. Youth with overweight or obesity may be at increased risk for substance use, including cigarette smoking. Understanding the associations between smoking and excess weight and the pathways associated with increased likelihood for smoking initiation is of particular importance given the increased risk for negative health outcomes associated with each. Methods Using longitudinal panel data from 1,023 middle school youth (baseline age M = 12.5, 52% female), we tested whether smoking initiation was concurrently and prospectively predicted by self-reported body mass index (BMI) and whether self-esteem for physical appearance (SEPA) mediated the effect of BMI on risk of early initiation. Results BMI predicted smoking initiation concurrently and prospectively in unadjusted models. In adjusted models, SEPA mediated the effects of BMI on smoking initiation. Bootstrapped mediation results indicated that the positive relationship between BMI and subsequent smoking initiation was significantly mediated by lower SEPA (B =.10, 95% confidence interval [0.01, 0.22]). Conclusions Adolescents who have overweight or obesity are more likely to feel negatively about their appearance and bodies, and this negative perception may result in experimentation with cigarettes. Cigarettes may be used by youth with overweight or obesity in an effort to manage weight, to cope with low self-esteem or for other reasons. Future research should explore the motives and psychosocial context of smoking initiation among adolescents with overweight/obesity further (e.g., with whom they first try smoking, perceived benefits of smoking).
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Affiliation(s)
- Cara M Murphy
- Center for Alcohol and Addiction Studies, Brown University
| | - Tim Janssen
- Center for Alcohol and Addiction Studies, Brown University
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106
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Stepanikova I, Acharya S, Abdalla S, Baker E, Klanova J, Darmstadt GL. Gender discrimination and depressive symptoms among child-bearing women: ELSPAC-CZ cohort study. EClinicalMedicine 2020; 20:100297. [PMID: 32300743 PMCID: PMC7152827 DOI: 10.1016/j.eclinm.2020.100297] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Depression is approximately two-fold more prevalent among women than men. Social theories suggest that discrimination is a pathway through which gender inequalities affect women's lives, but data are lacking. This cohort study evaluates whether perceived gender discrimination is linked to depressive symptoms among child-bearing women. METHODS Data were obtained from 4,688 participants enrolled in pregnancy in 1991-92 in the European Longitudinal Cohort Study of Pregnancy and Childhood, Czech Republic. Perceived gender discrimination was assessed in mid-pregnancy, year seven, and year eleven. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale at eight time-points between mid-pregnancy and year eleven post-delivery. Linear mixed error-component models of depressive symptoms were estimated. FINDINGS Perceived gender discrimination, reported by 10.7% of women, was related to higher depressive symptoms, both in the unadjusted analysis (b = 0.15 [95% confidence interval (CI): 0.12, 0.19], p < 0.001) and in the fully adjusted model (b = 0.12 [95% CI: 0.09, 0.16], p < 0.001). Covariates linked to higher depressive symptoms included financial hardship (b = 0.12 [95% CI: 0.10, 0.14], p < 0.001), childhood emotional/physical neglect (b = 0.18 [95% CI: 0.14, 0.22], p < 0.001), and childhood sexual abuse (b = 0.04 [95% CI: 0.03, 0.06], p < 0.001); an inverse relationship was evident for social support (-0.05 [95% CI: -0.07, -0.04], p < 0.001) and having a partner who performs female-stereotypical household tasks (b=-0.03 [95% CI: -0.05, -0.01], p = 0.001). INTERPRETATION The findings provide the first evidence that perceived gender discrimination is associated with depressive symptoms among child-bearing women. Social intervention programs aimed at reducing gender discrimination can potentially contribute to better mental health of women. FUNDING Bill and Melinda Gates Foundation.
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Affiliation(s)
- Irena Stepanikova
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
- Corresponding author at: Department of Sociology, University of Alabama at Birmingham, 1401 University Drive, Birmingham, Alabama, USA.
| | - Sanjeev Acharya
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Safa Abdalla
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Elizabeth Baker
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jana Klanova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Gary L. Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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107
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Lindberg L, Danielsson P, Persson M, Marcus C, Hagman E. Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study. PLoS Med 2020; 17:e1003078. [PMID: 32187177 PMCID: PMC7080224 DOI: 10.1371/journal.pmed.1003078] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 02/19/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Pediatric obesity is associated with increased risk of premature death from middle age onward, but whether the risk is already increased in young adulthood is unclear. The aim was to investigate whether individuals who had obesity in childhood have an increased mortality risk in young adulthood, compared with a population-based comparison group. METHODS AND FINDINGS In this prospective cohort study, we linked nationwide registers and collected data on 41,359 individuals. Individuals enrolled at age 3-17.9 years in the Swedish Childhood Obesity Treatment Register (BORIS) and living in Sweden on their 18th birthday (start of follow-up) were included. A comparison group was matched by year of birth, sex, and area of residence. We analyzed all-cause mortality and cause-specific mortality using Cox proportional hazards models, adjusted according to group, sex, Nordic origin, and parental socioeconomic status (SES). Over 190,752 person-years of follow-up (median follow-up time 3.6 years), 104 deaths were recorded. Median (IQR) age at death was 22.0 (20.0-24.5) years. In the childhood obesity cohort, 0.55% (n = 39) died during the follow-up period, compared to 0.19% (n = 65) in the comparison group (p < 0.001). More than a quarter of the deaths among individuals in the childhood obesity cohort had obesity recorded as a primary or contributing cause of death. Male sex and low parental SES were associated with premature all-cause mortality. Suicide and self-harm with undetermined intent were the main cause of death in both groups. The largest difference between the groups lay within endogenous causes of death, where children who had undergone obesity treatment had an adjusted mortality rate ratio of 4.04 (95% CI 2.00-8.17, p < 0.001) compared with the comparison group. The main study limitation was the lack of anthropometric data in the comparison group. CONCLUSIONS Our study shows that the risk of mortality in early adulthood may be higher for individuals who had obesity in childhood compared to a population-based comparison group.
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Affiliation(s)
- Louise Lindberg
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Pernilla Danielsson
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Martina Persson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Diabetes and Endocrinology, Sachsska Children’s Hospital, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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108
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Lindberg L, Hagman E, Danielsson P, Marcus C, Persson M. Anxiety and depression in children and adolescents with obesity: a nationwide study in Sweden. BMC Med 2020; 18:30. [PMID: 32079538 PMCID: PMC7033939 DOI: 10.1186/s12916-020-1498-z] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 01/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anxiety and depression are more common in children with obesity than in children of normal weight, but it is unclear whether this association is independent of other known risk factors. Interpretation of results from previous studies is hampered by methodological limitations, including self-reported assessment of anxiety, depression, and anthropometry. The aim of this study was to investigate whether obesity increases the risk of anxiety or depression independently of other risk factors in a large cohort of children and adolescents, using robust measures with regard to exposure and outcome. METHODS Children aged 6-17 years in the Swedish Childhood Obesity Treatment Register (BORIS, 2005-2015) were included (n = 12,507) and compared with a matched group (sex, year of birth, and area of residence) from the general population (n = 60,063). The main outcome was a diagnosis of anxiety or depression identified through ICD codes or dispensed prescribed medication within 3 years after the end of obesity treatment. Hazard ratios (HRs) with 95% confidence intervals (CIs) from Cox proportional models were adjusted for several known confounders. RESULTS Obesity remained a significant risk factor for anxiety and depression in children and adolescents after adjusting for Nordic background, neuropsychiatric disorders, family history of anxiety/depression, and socioeconomic status. Girls in the obesity cohort had a 43% higher risk of anxiety and depression compared to girls in the general population (adjusted HR 1.43, 95% CI 1.31-1.57; p < 0.0001). The risk in boys with obesity was similar (adjusted HR 1.33, 95% CI 1.20-1.48; p < 0.0001). In sensitivity analyses, excluding subjects with neuropsychiatric disorders and a family history of anxiety/depression, the estimated risks in individuals with obesity were even higher compared with results from the main analyses (adjusted HR [95% CI]: girls = 1.56 [1.31-1.87], boys = 2.04 [1.64-2.54]). CONCLUSIONS Results from this study support the hypothesis that obesity per se is associated with risk of both anxiety and depression in children and adolescents.
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Affiliation(s)
- Louise Lindberg
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A Novum, 141 57, Stockholm, Sweden.
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A Novum, 141 57, Stockholm, Sweden
| | - Pernilla Danielsson
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A Novum, 141 57, Stockholm, Sweden
| | - Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A Novum, 141 57, Stockholm, Sweden
| | - Martina Persson
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.,Department of Diabetes and Endocrinology, Sachsska Children's Hospital, Södersjukhuset, Stockholm, Sweden.,Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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109
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Werkhoven T. Designing, implementing and evaluating an educational intervention targeting weight bias and fat stereotyping. J Health Psychol 2020; 26:2084-2097. [PMID: 31960717 DOI: 10.1177/1359105319901310] [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: 11/16/2022] Open
Abstract
Weight bias directed at individuals at a higher weight leaves them feeling victimised and judged. When possessed by health professionals, stigmatising attitudes may compromise professionalism and quality of care or education provided. An intervention study was conducted in the higher education setting (n = 124), through tailored course design and delivery. The intervention was embedded into a health elective that pre-service health professionals were enrolled in. Attitudes to weight and knowledge of nutrition were targeted simultaneously. Surveys conducted pre- and post-intervention revealed moderate success in achieving study aims of improving nutrition knowledge and decreasing bias. Focus group analyses supported the quantitative findings.
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110
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Pearlman AT, Schvey NA, Higgins Neyland MK, Solomon S, Hennigan K, Schindler R, Leu W, Gillmore D, Shank LM, Lavender JM, Burke NL, Wilfley DE, Sbrocco T, Stephens M, Jorgensen S, Klein D, Quinlan J, Tanofsky-Kraff M. Associations between Family Weight-Based Teasing, Eating Pathology, and Psychosocial Functioning among Adolescent Military Dependents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010024. [PMID: 31861426 PMCID: PMC6982056 DOI: 10.3390/ijerph17010024] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/13/2019] [Accepted: 12/15/2019] [Indexed: 01/25/2023]
Abstract
Weight-based teasing (WBT) by family members is commonly reported among youth and is associated with eating and mood-related psychopathology. Military dependents may be particularly vulnerable to family WBT and its sequelae due to factors associated with their parents’ careers, such as weight and fitness standards and an emphasis on maintaining one’s military appearance; however, no studies to date have examined family WBT and its associations within this population. Therefore, adolescent military dependents at-risk for adult obesity and binge-eating disorder were studied prior to entry in a weight gain prevention trial. Youth completed items from the Weight-Based Victimization Scale (to assess WBT by parents and/or siblings) and measures of psychosocial functioning, including the Beck Depression Inventory-II, The Rosenberg Self-Esteem Scale, and the Social Adjustment Scale. Eating pathology was assessed via the Eating Disorder Examination interview, and height and fasting weight were measured to calculate BMIz. Analyses of covariance, adjusting for relevant covariates including BMIz, were conducted to assess relationships between family WBT, eating pathology, and psychosocial functioning. Participants were 128 adolescent military dependents (mean age: 14.35 years old, 54% female, 42% non-Hispanic White, mean BMIz: 1.95). Nearly half the sample (47.7%) reported family WBT. Adjusting for covariates, including BMIz, family WBT was associated with greater eating pathology, poorer social functioning and self-esteem, and more depressive symptoms (ps ≤ 0.02). Among military dependents with overweight and obesity, family WBT is prevalent and may be linked with eating pathology and impaired psychosocial functioning; prospective research is needed to elucidate the temporal nature of these associations.
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Affiliation(s)
- Arielle T. Pearlman
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - Natasha A. Schvey
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Correspondence: ; Tel.: +1-301-295-9880
| | - M. K. Higgins Neyland
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Senait Solomon
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Kathrin Hennigan
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Rachel Schindler
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - William Leu
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - Dakota Gillmore
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - Lisa M. Shank
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Jason M. Lavender
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Natasha L. Burke
- Department of Psychology, Fordham University, Bronx, NY 10458, USA;
| | - Denise E. Wilfley
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63110, USA;
| | - Tracy Sbrocco
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - Mark Stephens
- Department of Family and Community Medicine, Pennsylvania State University, Old Main, State College, PA 16801, USA;
| | - Sarah Jorgensen
- Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA;
| | - David Klein
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, MD 20762, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
| | - Marian Tanofsky-Kraff
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
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Finn KE, Seymour CM, Phillips AE. Weight bias and grading among middle and high school teachers. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2019; 90:635-647. [PMID: 31654405 DOI: 10.1111/bjep.12322] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 07/23/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Weight bias is a pervasive problem for adolescents in school contexts. Despite evidence of negative attitudes towards students who are overweight, comparatively little research has examined whether teachers provide biased assessments of student work. AIMS The purpose of this study was to experimentally test whether middle and high school teachers unfairly assess students who are overweight and perceive them to be less competent. SAMPLE Participants included 133 teachers from first-ring suburban middle and high schools (Mteaching experience = 16 years; 38% male). METHODS Teachers evaluated the quality of a bogus student essay assignment accompanied by photographs that portrayed the student as either not overweight or overweight. Weight bias was assessed by having teachers grade the essay and provide perceptions of student sufficiency (perceived effort, need for tutoring, and overall success in school). Opinions about bias in grading for other teachers and self were also assessed. RESULTS Essays for students who were overweight were judged to be similar in structural quality, but were assigned lower grades compared to their healthy weight counterparts. Further, teachers estimated that students who were overweight put forth more effort, needed more remedial assistance, and had lower overall grades in school. Teachers' beliefs about grading bias showed low levels of supposed bias among other teachers and a significantly lesser degree for themselves. CONCLUSIONS This study confirms prior research on anti-fat attitudes and provides new evidence of biased attitudes in school settings.
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Ward P, McPhail D. Fat Shame and Blame in Reproductive Care: Implications for Ethical Health Care Interactions. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/23293691.2019.1653581] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Pamela Ward
- Centre for Nursing Studies, Memorial University, St. John’s, NL, Canada
- Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Deborah McPhail
- Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Grammer AC, Byrne ME, Pearlman AT, Klein DA, Schvey NA. Overweight and obesity in sexual and gender minority adolescents: A systematic review. Obes Rev 2019; 20:1350-1366. [PMID: 31334601 DOI: 10.1111/obr.12906] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/21/2022]
Abstract
Population data indicate that sexual and gender minority adolescents may be at increased risk for excess weight gain compared with cisgender, heterosexual youth. However, no studies, to our knowledge, have systematically reviewed the literature on weight disparities in this population nor explored risk for overweight and obesity by sexual and gender minority subgroup across studies. The current systematic review, therefore, identified 21 studies that assessed the relationship between sexual and gender minority status and weight among adolescents. Results indicated an overall greater prevalence of overweight and obesity among sexual and gender minority adolescents compared with cisgender, heterosexual youth. However, cisgender sexual minority males demonstrated lower or no added risk for overweight and obesity, whereas cisgender sexual minority females demonstrated greater risk for overweight and obesity. Findings were mixed among gender minority adolescents. This study highlights weight disparities in sexual and gender minority youth, although important subgroup differences exist. Additional research is needed to elucidate the mechanisms that may contribute to differential weight trajectories in this population and to develop tailored approaches for prevention and treatment.
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Affiliation(s)
- Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, 63110
| | - Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892
| | - Arielle T Pearlman
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814
| | - David A Klein
- Department of Family Medicine, Fort Belvoir Community Hospital (FBCH), Fort Belvoir, Virginia, 22032.,Department of Family Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Department of Pediatrics, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892
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[Body mass index among children and adolescents: prevalences and distribution considering underweight and extreme obesity : Results of KiGGS Wave 2 and trends]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1225-1234. [PMID: 31529189 DOI: 10.1007/s00103-019-03015-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The current results of the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS Wave 2, 2014-2017) indicate that the prevalence of overweight and obesity among children and adolescents in Germany has hardly changed during this period. OBJECTIVES What are the current prevalences for the other categories of the BMI distribution (severe underweight, underweight, and extreme obesity) and what changes have occurred between the KiGGS baseline survey (2003-2006) and KiGGS Wave 2 with regard to the BMI categories and the distribution of BMI values? MATERIALS AND METHODS KiGGS Wave 2 analyses are based on data from 1762 boys and 1799 girls aged 3 to 17 years with valid measurements of height and weight. The KiGGS baseline survey provides information on 7531 boys and 7215 girls for trend evaluations. RESULTS For underweight prevalence as well as for the prevalence of extreme obesity no change over time can be observed. The BMI percentiles also show only minor differences between the two survey periods with a marginal shift of the upper BMI percentiles downwards before puberty and a slight increase after puberty. There is no clear shift in the BMI distribution towards lower BMI values. DISCUSSION There are now many activities at the national, regional, and local level that focus on prevention and intervention to reduce overweight and obesity. The marginal shifts in the upper BMI percentiles in the upper BMI percentiles before puberty observed here suggest that some success may have been achieved in obesity prevention among children in Germany.
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Harriger JA, Schaefer LM, Thompson JK, Cao L. You can buy a child a curvy Barbie doll, but you can't make her like it: Young girls' beliefs about Barbie dolls with diverse shapes and sizes. Body Image 2019; 30:107-113. [PMID: 31238275 PMCID: PMC6857835 DOI: 10.1016/j.bodyim.2019.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 10/26/2022]
Abstract
This study utilized Mattel's new line of Fashionista Barbie dolls to examine attitudes about body shape and size in a sample of young girls. A total of 84 girls, 3-10 years of age, were asked to assign positive or negative traits to Barbie dolls which varied in size and shape (original, tall, petite, and curvy). Participants also answered questions about their preferences for the dolls and completed measures of body dissatisfaction. Results generally demonstrated greater negative attitudes towards the curvy Barbie doll and more positive attitudes towards dolls with a thinner body size/shape (i.e., original, tall, and petite dolls). Girls identified the curvy Barbie as the doll they least wanted to play with. Additionally, girls with higher levels of body dissatisfaction demonstrated less negative attitudes towards the original doll. Overall, findings demonstrate a preference for thin bodies and aversion towards larger bodies among young girls. Further, findings suggest that the simple availability of body-diverse dolls may not be a powerful enough intervention to overcome harmful weight attitudes, and highlight the importance of continued efforts to encourage exposure to and acceptance of diverse body shapes and sizes in young children.
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Affiliation(s)
- Jennifer A. Harriger
- Social Science Division, Pepperdine University, United States,Corresponding author. (J.A. Harriger)
| | | | - J. Kevin Thompson
- Department of Psychology, University of South Florida, United States
| | - Li Cao
- Sanford Center for Biobehavioral Research, United States
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Nabors L, Odar Stough C, Garr K, Merianos A. Predictors of victimization among youth who are overweight in a national sample. Pediatr Obes 2019; 14:e12516. [PMID: 30761770 DOI: 10.1111/ijpo.12516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 01/21/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The current cross-sectional study examined whether children who are overweight experience greater levels of parent-reported bullying behaviors and victimization using a national sample. Additionally, the relations among child (mental health), family (parent-child sharing of information), and contextual factors (neighborhood safety, school engagement) and risk of victimization in children who are overweight were assessed. METHODS Caregivers provided data via the 2016 National Survey of Children's Health. A series of multinomial logistic regressions were conducted with the subsample of children aged 10 to 17 years (N = 26 094). RESULTS Youth who were overweight were more likely to be victimized, but not more likely to bully. Being engaged in school and neighborhood safety were protective factors among youth who were overweight, while living in families where information is shared and difficulty making friends were risk factors. CONCLUSIONS Children who were overweight were more likely to be victims, rather than perpetrators, of bullying. Health professionals should assess family and contextual factors in relation to victimization status when developing interventions.
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Affiliation(s)
- Laura Nabors
- Health Promotion and Education Program, School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Cathy Odar Stough
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Katlyn Garr
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Ashley Merianos
- Health Promotion and Education Program, School of Human Services, University of Cincinnati, Cincinnati, OH, USA
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Cui Z, Truesdale KP, Robinson TN, Pemberton V, French SA, Escarfuller J, Casey TL, Hotop AM, Matheson D, Pratt CA, Lotas LJ, Po'e E, Andrisin S, Ward DS. Recruitment strategies for predominantly low-income, multi-racial/ethnic children and parents to 3-year community-based intervention trials: Childhood Obesity Prevention and Treatment Research (COPTR) Consortium. Trials 2019; 20:296. [PMID: 31138278 PMCID: PMC6540365 DOI: 10.1186/s13063-019-3418-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The recruitment of participants into community-based randomized controlled trials studying childhood obesity is often challenging, especially from low-income racial/ethnical minorities and when long-term participant commitments are required. This paper describes strategies used to recruit and enroll predominately low-income racial/ethnic minority parents and children into the Childhood Obesity Prevention and Treatment Research (COPTR) consortium. METHODS The COPTR consortium has run four independent 3-year, multi-level (individual, family, school, clinic, and community) community-based randomized controlled trials. Two were prevention trials in preschool children and the other two were treatment trials in pre-adolescents and adolescent youth. All trials reported monthly participant recruitment numbers using a standardized method over the projected 18-24 months of recruitment. After randomization of participants was completed, recruitment staff and investigators from each trial retrospectively completed a survey of recruitment strategies and their perceived top three recruitment strategies and barriers. RESULTS Recruitment was completed in 15-21 months across trials, enrolling a total of 1745 parent-child dyads- out of 6314 screened. The number of children screened per randomized child was 4.6 and 3.5 in the two prevention trials, and 3.1 and 2.5 in the two treatment trials. Recruitment strategies reported included: (1) careful planning, (2) working with trusting community partners, (3) hiring recruitment staff who were culturally sensitive, personality appropriate, and willing to work flexible hours, (4) contacting potential participants actively and repeatedly, (5) recruiting at times and locations convenient for participants, (6) providing incentives to participants to complete baseline measures, (7) using a tracking database, (8) evaluating whether participants understand the activities and expectations of the study, and (9) assessing participants' motivation for participating. Working with community partners, hiring culturally sensitive staff, and contacting potential participants repeatedly were cited by two trials among their top three strategies. The requirement of a 3-year commitment to the trial was cited by two trials to be among the top three recruitment barriers. CONCLUSIONS Comprehensive strategies that include community partnership support, culturally sensitive recruitment staff, and repeated contacts with potential participants can result in successful recruitment of low-income racial/ethnic minority families into obesity prevention and treatment trials. TRIAL REGISTRATION NET-Works trial: ClinicalTrials.gov, NCT01606891 . Registered on 28 May 2012. GROW trial: ClinicalTrials.gov, NCT01316653 . Registered on 16 March 2011. GOALS trial: ClinicalTrials.gov, NCT01642836 . Registered on 17 July 2012. IMPACT trial: ClinicalTrials.gov, NCT01514279 . Registered on 23 January 2012.
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Affiliation(s)
- Zhaohui Cui
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Kimberly P Truesdale
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas N Robinson
- Stanford Solutions Science Lab, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Victoria Pemberton
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Simone A French
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Juan Escarfuller
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Terri L Casey
- Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | - Anne M Hotop
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Donna Matheson
- Stanford Solutions Science Lab, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Charlotte A Pratt
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Lynn J Lotas
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Eli Po'e
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sharon Andrisin
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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van Vuuren CL, Wachter GG, Veenstra R, Rijnhart JJM, van der Wal MF, Chinapaw MJM, Busch V. Associations between overweight and mental health problems among adolescents, and the mediating role of victimization. BMC Public Health 2019; 19:612. [PMID: 31113424 PMCID: PMC6528281 DOI: 10.1186/s12889-019-6832-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 04/15/2019] [Indexed: 01/29/2023] Open
Abstract
Background Evidence has not been conclusive on whether adolescent overweight is associated with mental health, possibly caused by indirect, yet untested associations. Therefore, the purpose of this study was to examine the association between overweight or obesity and mental health problems among adolescents, and to determine whether victimization plays a mediating role in these associations. Methods Self-reported data on mental health and victimization and objectively measured Body Mass Index data were used, using three cohorts (2010–2011 until 2012–2013) and an interval between the measurement waves of two years later. We performed a multi-level mediation analysis with a two-level structure to incorporate the clustering of the measurements within individuals. The study population consisted of 13,740 secondary school students, 13–14 years old at the first measurement moment, in Amsterdam, the Netherlands. Results Compared to their normal-weight peers, adolescents with overweight or obesity reported psychosocial problems and suicidal thoughts more often. Victimization was a significant mediator in the relationship between having overweight, and psychosocial problems (indirect effect OR: 2.3; 95% CI 1.5, 3.7 and direct effect OR: 1.4; 95% CI 1.2, 1.7) or suicidal thoughts (indirect effect OR: 2.1; 95% CI 1.4, 3.2 and direct effect OR: 1.3; 95% CI 1.1, 1.5). The associations between obesity, and psychosocial problems (indirect OR: 6.2; 95% CI 2.8, 14.7 and direct effect OR: 1.4; 95% CI 1.0, 2.0), or suicidal thoughts (indirect OR: 4.5; 95% CI 2.3, 9.1 and direct effect OR: 1.5; 95% CI 1.1, 2.0) were even stronger. Conclusions Overweight and obesity were significantly associated with mental health problems in adolescents, and victimization played a mediating role in this association. Victimization and mental health should be integrated into prevention programs that address healthy weight development. Moreover, overweight should be given more attention in programs to prevent victimization and promote adolescent mental health. Electronic supplementary material The online version of this article (10.1186/s12889-019-6832-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cornelia Leontine van Vuuren
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, the Netherlands. .,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. BOX 7057, 1007 MB, Amsterdam, the Netherlands.
| | - Gusta G Wachter
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, the Netherlands
| | - René Veenstra
- Department of Sociology, Faculty of Behavioral and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands
| | - Judith J M Rijnhart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, P.O. BOX 7057, 1007 MB, Amsterdam, the Netherlands
| | - Marcel F van der Wal
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, the Netherlands
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. BOX 7057, 1007 MB, Amsterdam, the Netherlands
| | - Vincent Busch
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, the Netherlands
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Meadows A, Higgs S. Internalised Weight Stigma Moderates the Impact of a Stigmatising Prime on Eating in the Absence of Hunger in Higher- but Not Lower-Weight Individuals. Front Psychol 2019; 10:1022. [PMID: 31139111 PMCID: PMC6519002 DOI: 10.3389/fpsyg.2019.01022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/17/2019] [Indexed: 11/23/2022] Open
Abstract
A considerable body of evidence links internalised weight stigma with higher levels of disordered eating behaviour and cognitions in both normative- and higher-weight populations. However, to date, the impact of internalised weight stigma on objectively measured food intake has not been explored. In the present study, a weight-diverse sample of 158 non-smoking adults (BMI ≥ 25 kg/m2 n = 72, BMI < 25 kg/m2 n = 86) were recruited to a study on "The effects of hunger and satiety on information processing." Participants first completed a series of online questionnaires, then attended a lab visit in a fed state. Participants were randomised to read a sham news article on the negative consequences of either weight (stigma condition) or smoking (control condition) and answer some questions about the article. Then, under the pretence of a non-study-relevant break, participants were exposed to a pre-weighed selection of sweet and savoury snacks for 15 min. Mood and hunger levels were assessed prior to and after reading the vignette, and after the break. In contrast to the relationship with self-report eating behaviour, internalised weight stigma was not a significant independent predictor of total energy intake and did not moderate the relationship between exposure to the stigma prime and calories consumed. However, differences emerged on the basis of participants' weight status. Higher-weight participants with high levels of internalised weight stigma consumed fewer snack calories following exposure to a weight-stigma prime compared with a neutral prime (B = -137, SE = 58, t = -2.35, p = 0.020, 95% CI -252, -22) whereas those with low levels of internalised weight stigma tended to eat more in the weight stigma condition (B = 118, SE = 62, t = 1.91, p = 0.059, 95% CI -4, 241). In normative-weight participants, no differences in energy intake by levels of internalised weight stigma were observed. These findings suggest differences in the relationships between internalised weight stigma and self-reported disordered eating behaviour versus eating in the absence of hunger (EAH) measured under laboratory conditions. Additionally, internalised weight stigma appears to have differential effects on response to stigma in higher-weight and normative-weight individuals.
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Affiliation(s)
- Angela Meadows
- School of Psychology, University of Exeter, Exeter, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
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Employment Outcomes 2 Years After Bariatric Surgery: Relationship to Quality of Life and Psychosocial Predictors. Obes Surg 2019; 29:2854-2861. [DOI: 10.1007/s11695-019-03905-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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121
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Weight-Related Teasing of Adolescents Who Are Primarily Obese: Roles of Sociocultural Attitudes Towards Appearance and Physical Activity Self-Efficacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091540. [PMID: 31052342 PMCID: PMC6539393 DOI: 10.3390/ijerph16091540] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/25/2019] [Accepted: 04/27/2019] [Indexed: 11/16/2022]
Abstract
Adolescents who are obese are at risk for being teased about their appearance with the concomitant negative psychological sequelae. Identifying modifiable variables associated with teasing could inform pediatric weight-management interventions. Characterizing society's role in the victimization of these at-risk individuals could guide anti-bullying programs for schools and broader public health efforts. This study aims to examine novel societal and cognitive factors associated with weight-related teasing frequency. Participants were adolescents (N = 334) being evaluated for a hospital-affiliated weight-management program. The outcome was perceived weight-related teasing frequency. Predictors were sociocultural awareness and internalization of appearance-related attitudes, physical activity self-efficacy, and psychological functioning. Multivariate regressions controlled for demographics and body mass index (BMI) z-scores with separate regressions testing interactions of BMI z-scores with all predictors. In adjusted analyses, higher physical activity self-efficacy and fewer depressive symptoms related to lower teasing frequency. Interactions indicated that less awareness/internalization of sociocultural attitudes towards appearance, more positive body image, and higher self-esteem related to lower teasing frequency regardless of BMI. Targeted interventions and public health campaigns should be developed and tested for adolescents that improve body image with promotion of diverse views about attractiveness, bolster confidence in overcoming physical activity barriers, and identify and treat mood symptoms.
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Nasim M, Aldamry M, Omair A, AlBuhairan F. Identifying obesity/overweight status in children and adolescents; A cross-sectional medical record review of physicians' weight screening practice in outpatient clinics, Saudi Arabia. PLoS One 2019; 14:e0215697. [PMID: 31022236 PMCID: PMC6483234 DOI: 10.1371/journal.pone.0215697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/05/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND BMI is a feasible and recommended measure for overweight and obesity screening in children and adolescents. The study aimed to determine how often physicians correctly identified obesity/ overweight status in children and adolescents by using BMI percentile charts. METHODS This retrospective cross-sectional study reviewed the paper medical records of children and adolescents (6-14 years) who visited family medicine and pediatric outpatient clinics (Jan-June 2012) in a medical city in Riyadh. Investigators calculated BMI percentiles (using height, weight, age and gender data retrieved from the records) in order to identify patient weight status. Physician documentation of obesity/overweight diagnoses in patient problem lists were cross checked against their BMI percentile to assess the accuracy of physicians' identification of weight status. The recommended management plan for identified patients was also recorded. RESULTS A total of 481 charts were reviewed, 213 (44%) children were seen by family medicine physicians and 268 (56%) by pediatricians. The sample was equally distributed by gender. Height was undocumented for 13% (71) of visiting patients. Eighteen percent of patients (86) were classified as overweight (35)/obese (51) according to age and sex adjusted BMI percentile. Physicians' correctly identified and documented weight status in 20% of overweight/obese patients: 17 out of 86 subjects. Weight status identification was higher among pediatricians-25% as compared to family medicine physicians-10% [p = 0.08]. Dietary referral was the most common management plan for the identified children. Physicians were more likely to identify obese children {≥95th} compared to overweight {≥85th - 95th} children. Subjects whose BMI for age classified them into the highest BMI percentile category {≥95th} were more likely to be correctly identified (29%) compared to those classified within {≥85th - 95th} category-6% [p = 0.007]. CONCLUSION Physician identification of obesity/ overweight status for children and adolescents was low, irrespective of their specialty, and despite the condition being prevalent in the sample. Future research that concentrates on interventions that may improve documentation of obesity/overweight diagnoses and parameters needed for BMI indices would be beneficial.
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Affiliation(s)
- Maliha Nasim
- Department of Population Health, King Abdullah International Medical Research Center/ King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed Aldamry
- Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Aamir Omair
- Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fadia AlBuhairan
- Department of Pediatrics and Adolescent Medicine, Aldara Hospital and Medical Center, Riyadh, Saudi Arabia
- John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Psychometric properties and measurement invariance of the Weight Self-Stigma Questionnaire and Weight Bias Internalization Scale in children and adolescents. Int J Clin Health Psychol 2019; 19:150-159. [PMID: 31193103 PMCID: PMC6517648 DOI: 10.1016/j.ijchp.2019.03.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/13/2019] [Indexed: 02/05/2023] Open
Abstract
Given the negative consequences of weight bias, including internalized weight stigma, on health outcomes, two instruments—the Weight Self-Stigma Questionnaire (WSSQ) and Weight Bias Internalization Scale (WBIS)—have been developed. However, their psychometric properties are yet to be tested for Asian pediatric populations. Method:Participants aged 8 to 12 years (N = 287; 153 boys) completed the WSSQ and the WBIS, and they were classified into either a group with overweight or a group without overweight based on self-reported weight and height. Results:Both WSSQ and WBIS had their factor structures supported by confirmatory factor analyses (CFAs). The measurement invariance of two-factor structure was further supported for WSSQ across gender and weight status. The measurement invariance of single-factor structure was supported for WBIS across gender but not across weight status. Conclusions:WSSQ and WBIS were both valid to assess the internalization of weight bias. However, the two instruments demonstrated different properties and should be applied in different situations.
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Meadows A, Higgs S. The Multifaceted Nature of Weight-Related Self-Stigma: Validation of the Two-Factor Weight Bias Internalization Scale (WBIS-2F). Front Psychol 2019; 10:808. [PMID: 31040808 PMCID: PMC6477068 DOI: 10.3389/fpsyg.2019.00808] [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: 11/02/2018] [Accepted: 03/26/2019] [Indexed: 11/13/2022] Open
Abstract
Background Internalized weight stigma (IWS) is generally operationalized as self-devaluation due to weight in higher-weight individuals. The most commonly used measure of IWS, the Weight Bias Internalization Scale (WBIS), was developed from an original pool of 19 items. Item selection was guided by statistical techniques based upon an a priori hypothesized unidimensional factor structure. The resulting 11-item scale mostly assesses appearance-related attitudes, fear of stigma, affect, and desire for change, all of which may be a natural response to societal weight stigma, even in the absence of self-devaluation. Items pertaining to self-blame, stigma awareness, perceived legitimacy of weight stigma, and most items pertaining to self-worth, were excluded from the final scale. It is unclear whether an a priori assumption of multi-dimensionality would have produced different results. Methods Exploratory and confirmatory factor analysis of the original 19-item questionnaire was conducted in 931 higher-weight individuals. Results A 13-item two-factor structure was identified. Factor 1 comprised seven items that could be loosely conceived as weight-related distress. Factor 2 comprised six items, all of which pertained to weight-related self-worth. Tested individually, the six items making up the self-devaluation factor were an excellent fit for the data on all fit indices. Conclusion IWS is a multi-dimensional construct. The two-factor WBIS (WBIS-2F) provides options to explore the relationships between different aspects of IWS and upstream and downstream variables. The Self-Devaluation subscale is suitable for standalone use when weight-related self-devaluation per se is the construct of interest.
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Affiliation(s)
- Angela Meadows
- School of Psychology, University of Exeter, Exeter, United Kingdom
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
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Forsell C, Gronowitz E, Larsson Y, Kjellberg BM, Friberg P, Mårild S. Four-year outcome of randomly assigned lifestyle treatments in primary care of children with obesity. Acta Paediatr 2019; 108:718-724. [PMID: 30230026 DOI: 10.1111/apa.14583] [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: 04/17/2018] [Revised: 08/28/2018] [Accepted: 09/14/2018] [Indexed: 12/12/2022]
Abstract
AIM To assess the four-year outcome in children with obesity randomised to one of two 12-month lifestyle treatment programmes in primary care. METHODS At baseline, 64 children with obesity aged 8.0-13.0 years were randomised to a treatment programme managed either by a nurse, dietician and physiotherapist (n = 32) or by a nurse and dietician (n = 32). RESULTS From baseline to follow-up, the mean body mass standard deviation score (BMISDS) had decreased by -0.50 [standard deviation (SD) 0.73], p = 0.002, in the nurse, dietician and physiotherapist group (n = 27), by -0.26 (SD 0.73), p = 0.057 in the other group (n = 29); adjusted mean difference was -0.22, 95% confidence interval -0.59; 0.16, p = 0.25. Changes in weight categories did not differ between the groups: both had a change from obesity to normal weight in 1 and to overweight in 6; in the physiotherapist group 1 case of severe obesity changed to obesity. The combined treatment groups (n = 56) had a mean reduction in BMISDS of -0.37 (SD 0.73) and an improved distribution in weight categories, p = 0.015. CONCLUSION After four years, there was no difference in outcome between the treatment options. In the treatment groups combined the number of children with obesity and their adiposity measures were significantly lower.
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Affiliation(s)
- Christer Forsell
- Paediatric Department; Alingsås Hospital; Västra Götaland Region Sweden
| | - Eva Gronowitz
- Department of Paediatrics; Sahlgrenska Academy at Gothenburg University; Gothenburg Sweden
| | - Yvonne Larsson
- Paediatric Department; Alingsås Hospital; Västra Götaland Region Sweden
| | | | - Peter Friberg
- Department of Physiology; Sahlgrenska Academy at Gothenburg University; Gothenburg Sweden
| | - Staffan Mårild
- Department of Paediatrics; Sahlgrenska Academy at Gothenburg University; Gothenburg Sweden
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Longo C, Bartlett G, Schuster T, Ducharme FM, MacGibbon B, Barnett TA. Weight status and nonadherence to asthma maintenance therapy among children enrolled in a public drug insurance plan. J Asthma 2019; 57:627-637. [PMID: 30912698 DOI: 10.1080/02770903.2019.1590593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Objective: The pediatric obese-asthma phenotype is associated with poor control, perhaps because of medication nonadherence. This study aimed to assess whether weight status is associated with nonadherence in children prescribed new asthma maintenance therapies.Methods: A historical cohort was constructed from a clinical database linking individual patient and prescription data to Quebec's prescription claims registry. Children aged 2-18 years with specialist-diagnosed asthma who were newly prescribed one of the following maintenance controllers: leukotriene receptor antagonists (LTRA); low-dose inhaled corticosteroids (ICS); medium/high-dose ICS; or combination therapy (ICS with long-acting beta-2 agonists and/or LTRA), at the Asthma Center of the Montreal Children's Hospital from 2000-2007 were included. Primary nonadherence was defined as not claiming any prescriptions, whereas secondary nonadherence was measured with the proportion of prescribed days covered (PPDC ≤ 50%) among primary adherers over a 6-month follow-up period. A modified Poisson regression model served to estimate the effect of excess weight (BMI > 85th percentile) on primary and secondary nonadherence.Results: Approximately one third of patients were primary nonadherers and 60% took less than 50% of prescribed therapy. Excess weight was associated with a trend toward increased risk of primary nonadherence in children newly prescribed low-dose ICS (RR 1.53, 95%CI 0.94-2.49), and of secondary nonadherence in children initiating medium/high-dose ICS (RR 1.24; 95%CI 0.98-1.59).Conclusions: Excess weight status is a possible determinant of primary nonadherence in children initiating low-dose ICS and secondary nonadherence to higher-dose ICS regimens. This hypothesis-generating study suggests that nonadherence may be a potential contributor to higher morbidity in children with obese-asthma.
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Affiliation(s)
- Cristina Longo
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Gillian Bartlett
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Francine M Ducharme
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada.,Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Brenda MacGibbon
- Département de Mathématiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada.,Unité d'Épidémiologie et Biostatistiques, INRS-Institut Armand-Frappier, Laval, Québec, Canada
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Abstract
Background: While considerable attention has been given to explanations for youth suicide, less is known about the reasons that young people themselves give for suicidality. Research on online communications gives an opportunity to investigate the real-time reasons young people give for feeling suicidal. Aims: This study aimed to identify the reasons that young people provide for feeling suicidal in posts published on a suicide prevention forum, hosted on the social media platform Tumblr. Method: We filtered 2 months' worth of posts to identify those that related specifically to suicide. In total, 210 posts were thematically analyzed to identify the reasons given for suicidality and the meanings associated with these. Results: Six main reasons for suicidality were identified in the analysis: feeling lonely and socially disconnected, experiencing identity stigma, failing to meet expectations, being helpless, feeling worthless, and experiences of mental ill-health. Limitations: There are advantages as well as limitations associated with relying on Internet-based data. Limitations include the inability to establish participant demographics and the lack of context for posts. Conclusion: Suicide prevention efforts should target the reasons that young people give for feeling suicidal in the moment of crisis in order to engage this population more effectively.
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Affiliation(s)
- Aamina Ali
- School of Psychology, University of Auckland, New Zealand
| | - Kerry Gibson
- School of Psychology, University of Auckland, New Zealand
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Baranowski T, Motil KJ, Moreno JP. Multi-etiological Perspective on Child Obesity Prevention. Curr Nutr Rep 2019; 8:10.1007/s13668-019-0256-3. [PMID: 30649714 PMCID: PMC6635107 DOI: 10.1007/s13668-019-0256-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW The simple energy balance model of obesity is inconsistent with the available findings on obesity etiology, prevention, and treatment. Yet, the most commonly stated causes of pediatric obesity are predicated on this model. A more comprehensive biological model is needed upon which to base behavioral interventions aimed at obesity prevention. In this light, alternative etiologies are little investigated and thereby poorly understood. RECENT FINDINGS Three candidate alternate etiologies are briefly presented: infectobesity, the gut microbiome, and circadian rhythms. Behavioral child obesity preventive investigators need to collaborate with biological colleagues to more intensively analyze the behavioral aspects of these etiologies and to generate innovative procedures for preventing a multi-etiological problem, e.g., group risk analysis, triaging for likely causes of obesity.
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Affiliation(s)
- Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA.
| | - Kathleen J Motil
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Jennette P Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
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Spinelli A, Buoncristiano M, Kovacs VA, Yngve A, Spiroski I, Obreja G, Starc G, Pérez N, Rito AI, Kunešová M, Sant'Angelo VF, Meisfjord J, Bergh IH, Kelleher C, Yardim N, Pudule I, Petrauskiene A, Duleva V, Sjöberg A, Gualtieri A, Hassapidou M, Hyska J, Burazeri G, Petrescu CH, Heinen M, Takacs H, Zamrazilová H, Bosi TB, Sacchini E, Pagkalos I, Cucu A, Nardone P, Gately P, Williams J, Breda J. Prevalence of Severe Obesity among Primary School Children in 21 European Countries. Obes Facts 2019; 12:244-258. [PMID: 31030201 PMCID: PMC6547273 DOI: 10.1159/000500436] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/17/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6-9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published. OBJECTIVES The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI. METHOD The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child's age and mother's educational level, were performed in a select group of countries. RESULTS A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7-1.3 and 0.7-1.5, respectively) to 5.5% (95% CI 4.9-6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6-9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child's age did not show a clear pattern. Severe obesity was more common among children whose mother's educational level was lower. CONCLUSIONS Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.
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Affiliation(s)
- Angela Spinelli
- Istituto Superiore di Sanità (National Institute of Health), National Centre for Disease Prevention and Health Promotion, Rome, Italy,
| | - Marta Buoncristiano
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
| | - Viktoria Anna Kovacs
- National Institute of Pharmacy and Nutrition, DG of Food and Nutrition Science, Budapest, Hungary
| | - Agneta Yngve
- Department of food studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Igor Spiroski
- Institute of Public Health of the Republic of Macedonia, Skopje, North Macedonia
| | - Galina Obreja
- State University of Medicine and Pharmacy, Chișinău, Moldova
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Napoleón Pérez
- Spanish Observatory of Nutrition and Study of Obesity, Madrid, Spain
| | - Ana Isabel Rito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | - Jørgen Meisfjord
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingunn Holden Bergh
- Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Iveta Pudule
- Centre for Disease Prevention and Control, Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vesselka Duleva
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Agneta Sjöberg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | | | - Maria Hassapidou
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | - Hajnalka Takacs
- Semmelweis University, Karoly Racz School of PhD Studies, Budapest, Hungary
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | | | - Ioannis Pagkalos
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | - Paola Nardone
- Istituto Superiore di Sanità (National Institute of Health), National Centre for Disease Prevention and Health Promotion, Rome, Italy
| | - Paul Gately
- Centre for Applied Obesity Research, Leeds Beckett University, Leeds, United Kingdom
| | - Julianne Williams
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
| | - João Breda
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
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Calogero RM, Tylka TL, Mensinger JL, Meadows A, Daníelsdóttir S. Recognizing the Fundamental Right to be Fat: A Weight-Inclusive Approach to Size Acceptance and Healing From Sizeism. WOMEN & THERAPY 2018. [DOI: 10.1080/02703149.2018.1524067] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
| | - Tracy L. Tylka
- Department of Psychology, The Ohio State University, Columbus, Ohio
| | - Janell L. Mensinger
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Lebacq T, Dujeu M, Méroc E, Moreau N, Pedroni C, Godin I, Castetbon K. Perceived social support from teachers and classmates does not moderate the inverse association between body mass index and health-related quality of life in adolescents. Qual Life Res 2018; 28:895-905. [DOI: 10.1007/s11136-018-2079-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 11/29/2022]
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Sutin AR, Robinson E, Daly M, Terracciano A. Perceived Body Discrimination and Intentional Self-Harm and Suicidal Behavior in Adolescence. Child Obes 2018; 14:528-536. [PMID: 30226995 PMCID: PMC6249665 DOI: 10.1089/chi.2018.0096] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study examines whether discrimination based on the body is associated with intentional self-harm and suicidal behavior in adolescence. METHODS Participants were from the Longitudinal Study of Australian Children (N = 2948; 48% female). Discrimination and items on self-harm and suicidal behavior were measured in the Wave 6 assessment, when study participants were 14-15 years old. BMI, depressive symptoms, peer victimization, and weight self-perception were also assessed. RESULTS Discrimination was associated with increased risk of thoughts of self-harm (OR = 2.41, 95% CI = 1.88-3.10), hurting the self on purpose (OR = 2.27, 95% CI = 1.67-3.08), considering suicide (OR = 2.17, 95% CI = 1.59-2.96), having a suicide plan (OR = 2.50, 95% CI = 1.81-2.47), attempting suicide (OR = 1.96, 95% CI = 1.30-2.96), controlling for sociodemographic factors, BMI, and depressive symptoms. These associations generally held adjusting for peer victimization or weight self-perception. CONCLUSIONS Weight discrimination has been associated consistently with poor outcomes in adulthood. The present research indicates these associations extend to adolescence and an extremely consequential outcome: the social experience of weight increases risk of intentional self-harm and suicidal behavior.
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Affiliation(s)
- Angelina R. Sutin
- Florida State University College of Medicine, Tallahassee, FL.,Address correspondence to: Angelina R. Sutin, PhD, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 1115 W. Call Street, Tallahassee, FL 32306
| | - Eric Robinson
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Michael Daly
- Behavioural Science Centre, University of Stirling, Stirling, United Kingdom.,UCD Geary Institute, University College Dublin, Dublin, Ireland.,Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
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Golaszewski NM, Pasch KE, Fernandez A, Poulos NS, Batanova M, Loukas A. Perceived Weight Discrimination and School Connectedness Among Youth: Does Teacher Support Play a Protective Role? THE JOURNAL OF SCHOOL HEALTH 2018; 88:754-761. [PMID: 30203480 DOI: 10.1111/josh.12682] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 11/20/2017] [Accepted: 04/11/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Weight discrimination has been associated with poor academic performance and decreased school attendance. Little is known about weight discrimination and students' feelings of belonging to their school. This study examined the association between weight discrimination and school connectedness among adolescents. Teacher support was examined as a protective factor. METHODS Middle school students (N = 639; 57% white; Mean age = 12.16 years) completed a health behaviors survey. Weight discrimination from peers and/or good friends was dichotomized into never versus experienced weight discrimination. The mean of 5 school connectedness items assessed level of school connectedness. Teacher support was measured by taking the mean of 4 teacher support items. Hierarchical linear regression was used to examine the association between weight discrimination and school connectedness. Teacher support was tested as a moderator. RESULTS Weight discrimination was associated with lower levels of school connectedness (p < .05). Teacher support was associated with higher levels of school connectedness (p < .001) but did not moderate the association between weight discrimination and school connectedness. CONCLUSION The association between weight discrimination and low levels of school connectedness is important as students spend most of their time at school and should benefit from the positive effects of feeling connected to school.
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Affiliation(s)
- Natalie M Golaszewski
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, TX 78712-1415
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, TX 78712-1415
| | - Alejandra Fernandez
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, TX 78712-1415
| | - Natalie S Poulos
- Department of Nutritional Sciences, The University of Texas at Austin, 103 W 24TH ST A2703, Austin, TX, 78712-1415
| | - Milena Batanova
- Making Caring Common, Harvard Graduate School of Education, Appian Way, Cambridge, MA 02138
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, TX 78712-1415
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135
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Ritchie K, Bora S, Woodward LJ. Peer Relationship Outcomes of School-Age Children Born Very Preterm. J Pediatr 2018; 201:238-244. [PMID: 29958672 DOI: 10.1016/j.jpeds.2018.05.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/10/2018] [Accepted: 05/17/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To characterize the friendship networks, peer relationships, and bullying experiences of 12-year-old children born extremely preterm (EPT; 23-27 weeks of gestation), very preterm (VPT; 28-32 weeks of gestation), and full term (FT; 38-41 weeks of gestation), and to identify child characteristics placing children at risk of peer problems. STUDY DESIGN A regional cohort of 44 EPT, 60 VPT, and 109 FT born children were followed prospectively to 12 years of age. The nature of children's close friendships, peer relations, and bullying experiences were assessed using a multimethod approach, including parent, teacher, and child report. RESULTS Across all measures, children born EPT had more peer social difficulties than children born VPT and FT. They were more likely to report no close friendships (5%-14% EPT vs 0%-3% VPT/FT), dissatisfaction with their peer network (16% vs 1%-2%), and less time interacting face-to-face with friends (16%-23% vs 5%-8%). They were also 3 times more likely to be rated by their parents and teachers as experiencing problems relating to peers (P ≤ .001). In contrast, rates of chronic bullying (≥2 times/week) were similar for EPT and VPT children (12%-14% vs 4% FT). Emotional problems, inattention/hyperactivity, and motor deficits were associated with an increased risk of peer relationship problems, whereas higher body mass index, delayed pubertal development, vision problems, and inattention/hyperactivity problems were associated with frequent bullying. CONCLUSIONS With the exception of bullying, risks of peer social difficulties were greatest among children born EPT. Peer social relationships should be monitored as part of longer term developmental surveillance and support.
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Affiliation(s)
- Kirsten Ritchie
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Samudragupta Bora
- Mothers, Babies and Women's Health Program, Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia
| | - Lianne J Woodward
- Department of Psychology, University of Canterbury, Christchurch, New Zealand; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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136
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Schroeder K, McCormick R, Perez A, Lipman TH. The role and impact of community health workers in childhood obesity interventions: a systematic review and meta-analysis. Obes Rev 2018; 19:1371-1384. [PMID: 30160002 PMCID: PMC6329372 DOI: 10.1111/obr.12714] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 04/05/2018] [Accepted: 04/27/2018] [Indexed: 12/12/2022]
Abstract
Childhood obesity increases the risk for poor health during childhood, as well as for adult obesity and its associated comorbidities. Children from racial/ethnic minority groups or who live in poverty experience elevated rates of obesity. One potential method for reducing childhood obesity disparities is to involve community health workers (frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served). The purpose of this systematic review and meta-analysis was to explore the role and effectiveness of community health workers in childhood obesity interventions. Eleven studies met inclusion criteria, of which nine were eligible for inclusion in the meta-analysis. Results demonstrated that community health workers played various roles in childhood obesity interventions in the home, clinic, school, and community setting. Interventions focused primarily on children from underserved populations. Meta-analytic findings demonstrated a small but significant impact on BMIz and BMI percentile (BMIz [7 studies]: -0.08, 95% CI: -0.15, -0.01, p = 0.03, I2 = 39.4%; BMI percentile [2 studies]: -0.25, 95% CI: -0.38, -0.11, p < 0.01, I2 = 0%). Findings from this review demonstrate that partnering with community health workers may be an important strategy for reducing childhood obesity disparities and advancing health equity.
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Affiliation(s)
- K Schroeder
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, USA
| | - R McCormick
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, USA
| | - A Perez
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, USA
| | - T H Lipman
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, USA
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137
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Arias Ramos N, Calvo Sánchez MD, Fernández-Villa T, Ovalle Perandones MA, Fernández García D, Marqués-Sánchez P. Social exclusion of the adolescent with overweight: study of sociocentric social networks in the classroom. Pediatr Obes 2018; 13:614-620. [PMID: 30110716 DOI: 10.1111/ijpo.12396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 03/09/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple studies have shown the social consequences of suffering overweight, with social exclusion or isolation as some of the most important. In order to study the social patterns among adolescents, we have set as objectives to analyse the position of the individual within their network from a sociocentric perspective, comparing the relational pattern of the adolescents suffering from overweight with those who are normal weight. METHOD This was a cross-sectional descriptive study using logistic regression and social network analysis. We analysed the contact patterns of 235 adolescents in 11 social networks, classifying contact into three levels of intensity: minimum, intermediate and maximum (friendship). The WHO reference was used for the variable of overweight. RESULTS The prevalence of overweight was 30.2% (25.5% overweight and 4.7% obesity). An analysis of the relational patterns of individuals with overweight showed that at the minimum contact level, they established fewer relationships and less closeness (odds ratio [OR]: 2.32; confidence interval [CI] 95%: 1.17-4.66; p-value: 0.016). This effect was more marked in female adolescents. At intermediate contact level, they had few relationships and low prestige (OR: 3.29; CI: 95%; 1.03-10.51; p-value: 0.045, OR: 3.18; CI: 95%; 1.00-10.04; p-value: 0.049, respectively). At maximum contact level (friendship), female adolescents related little with other adolescents (OR: 3.78; CI: 95%; 1.07-13.32; p-value: 0.038). CONCLUSIONS Adolescents with overweight take up peripheral positions within their social network, choosing by themselves not to establish contact with others. Social network analysis is crucial to detect adolescents with overweight at risk of exclusion and help alleviate psychological and social deficits.
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Affiliation(s)
- N Arias Ramos
- SALBIS Research Group. Health Science School. Department of Nursing and Physiotherapy, University of Leon, León, Spain
| | - M D Calvo Sánchez
- Administrative Law, Law Faculty, Universty of Salamanca, Salamanca, Spain
| | - T Fernández-Villa
- The Research Group in Gene-Environment and Health Interactions, Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, University of León, León, Spain
| | - M A Ovalle Perandones
- Department of Library and Information Science, School of Humanities, Communication and Library, University Carlos III of Madrid, Madrid, Spain
| | - D Fernández García
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, University of León, León, Spain
| | - P Marqués-Sánchez
- Head of SALBIS Research Group. Health Science School. Department of Nursing and Physiotherapy, University of Leon, León, Spain
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138
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Lee Y, Lee KS. Associations between History of Hospitalization for Violence Victimization and Substance-Use Patterns among Adolescents: A 2017 Korean National Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1543. [PMID: 30037050 PMCID: PMC6068931 DOI: 10.3390/ijerph15071543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/11/2018] [Accepted: 07/19/2018] [Indexed: 11/17/2022]
Abstract
Violence victimization can adversely affect adolescents' long-term health. Existing research has mainly focused on the link between victimization and substance use; however, the evidence obtained to date has been inconsistent. This study, using a Korean national representative sample, examined the association between violence victimization and substance-use patterns (including tobacco, alcohol, and drug use) in terms of sex and number of violence victimization experiences. We analyzed secondary data from the 2017 Korean Youth Risk Behavior Web-based Survey. Chi-squared test analyses and logistic regression analysis were used to examine substance use in terms of violence victimization; additionally, p-values for trends were calculated to reveal the dose-response relationship per number of violence victimization experiences. We consequently found that participants' rates of tobacco, alcohol, and drug use were higher among those who experienced violence victimization than among those who did not. For each substance-use-related variable, the greater the violence victimization experience, the higher the odds of substance use (p for trend < 0.001). Early intervention may help prevent the development of substance use, especially among adolescents who have experienced violence victimization. Prevention efforts regarding substance abuse and violence prevention should be included in school curricula to effectively prevent adverse health consequences among adolescents.
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Affiliation(s)
- Yeji Lee
- Department of Public Health, Graduate School, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
| | - Kang-Sook Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
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139
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Tzani-Pepelasi C, Ioannou M, Synnott J, Ashton SA. Comparing factors related to school-bullying and cyber-bullying. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23744006.2018.1474029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Calli Tzani-Pepelasi
- Department of Psychology, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Maria Ioannou
- Department of Psychology, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - John Synnott
- Department of Psychology, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Sally-Ann Ashton
- Department of Applied Health and Social Care, Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
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140
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Schroeder K, Malone SK, McCabe E, Lipman T. Addressing the Social Determinants of Health: A Call to Action for School Nurses. J Sch Nurs 2018; 34:182-191. [PMID: 29343161 PMCID: PMC6083826 DOI: 10.1177/1059840517750733] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Social determinants of health (SDOH), the conditions in which children are born, grow, live, work or attend school, and age, impact child health and contribute to health disparities. School nurses must consider these factors as part of their clinical practice because they significantly and directly influence child well-being. We provide clinical guidance for addressing the SDOH when caring for children with three common health problems (obesity, insufficient sleep, and asthma). Given their unique role as school-based clinical experts, care coordinators, and student advocates, school nurses are well suited to serve as leaders in addressing SDOH.
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Affiliation(s)
- Krista Schroeder
- University of Pennsylvania School of Nursing, Philadelphia,
PA, USA
| | - Susan Kohl Malone
- Center for Sleep and Circadian Neurobiology, University of
Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Rory Meyers College of Nursing, New York University, New
York, NY, USA
| | - Ellen McCabe
- University of Pennsylvania School of Nursing, Philadelphia,
PA, USA
| | - Terri Lipman
- University of Pennsylvania School of Nursing, Philadelphia,
PA, USA
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141
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Zuba A, Warschburger P. Weight bias internalization across weight categories among school-aged children. Validation of the Weight Bias Internalization Scale for Children. Body Image 2018; 25:56-65. [PMID: 29477970 DOI: 10.1016/j.bodyim.2018.02.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 02/16/2018] [Accepted: 02/16/2018] [Indexed: 11/20/2022]
Abstract
Anti-fat bias is widespread and is linked to the internalization of weight bias and psychosocial problems. The purpose of this study was to examine the internalization of weight bias among children across weight categories and to evaluate the psychometric properties of the Weight Bias Internalization Scale for Children (WBIS-C). Data were collected from 1484 primary school children and their parents. WBIS-C demonstrated good internal consistency (α = .86) after exclusion of Item 1. The unitary factor structure was supported using exploratory and confirmatory factor analyses (factorial validity). Girls and overweight children reported higher WBIS-C scores in comparison to boys and non-overweight peers (known-groups validity). Convergent validity was shown by significant correlations with psychosocial problems. Internalization of weight bias explained additional variance in different indicators of psychosocial well-being. The results suggest that the WBIS-C is a psychometrically sound and informative tool to assess weight bias internalization among children.
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Affiliation(s)
- Anna Zuba
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476 Potsdam, Germany
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476 Potsdam, Germany.
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142
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Lee B, Jeong S, Roh M. Association between body mass index and health outcomes among adolescents: the mediating role of traditional and cyber bullying victimization. BMC Public Health 2018; 18:674. [PMID: 29848300 PMCID: PMC5977749 DOI: 10.1186/s12889-018-5390-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 03/28/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND It is well-documented that obese children and adolescents tend to experience a variety of negative physical and psychological health consequences. Despite the association between obesity and physical and psychological well-being, few studies have examined the role of off-line and on-line forms of bullying victimization in this link. The main objective of the current study is to investigate the direct and mediating effects of traditional and cyber bullying victimization in explaining the relationship between the body mass index (BMI) and physical/psychological distress. METHODS A nationally representative sample of 10,160 school children (mean age = 12.95 ± 1.75) were collected from the 2009 Health Behavior in School-aged Children (HBSC) study. Data were collected on body mass index, physical and psychological health, bullying victimization experience, and demographic information. A seemingly unrelated regression (SUR) was employed to assess and compare the indirect effects in multiple mediation models. RESULTS While a significant direct association was found between BMI and both physical and psychological health, the indirect effect of BMI on physical distress was significant only via traditional bullying victimization. Both forms of bullying victimization had a mediating impact between BMI and psychological distress. However, the indirect effect on psychological distress was manifested through a negative mediating role of cyberbullying victimization. The negative relation between cyberbullying victimization and psychological distress warrants further exploration. CONCLUSIONS Obesity represents a serious risk to adolescent health and well-being, both physically and psychologically. If becoming a victim of traditional bullying mediates (specifically exacerbates) the level of physical and psychological distress among obese and overweight adolescents, health professionals need to focus on raising awareness of the importance of weight-based victimization for children and adolescents with obesity. School administrators and teachers could increase the efforts to identify school-age children who are stigmatized for their weight and recommend coping strategies for distressed victims of traditional and cyberbullying.
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Affiliation(s)
- Byung Lee
- Central Connecticut State University, 1615 Stanley Street, New Britain, CT, USA
| | - Seokjin Jeong
- University of Texas at Arlington, 701 S. Nedderman Drive, Arlington, TX 76019 USA
| | - Myunghoon Roh
- Texas A&M University - San Antonio, One University way, San Antonio, TX 78224 USA
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143
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Moores CJ, Bell LK, Miller J, Damarell RA, Matwiejczyk L, Miller MD. A systematic review of community-based interventions for the treatment of adolescents with overweight and obesity. Obes Rev 2018; 19:698-715. [PMID: 29345042 DOI: 10.1111/obr.12660] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/09/2017] [Accepted: 11/29/2017] [Indexed: 12/20/2022]
Abstract
Adolescent obesity is a risk factor for obesity and other chronic disease in adulthood. Evidence for the effectiveness of community-based obesity treatment programs for adolescents is required to inform policy and clinical decisions. This systematic review aims to evaluate recent effective and scalable community-based weight management programs for adolescents (13-17 years) who are overweight or obese. Eight databases (Medline, Embase, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Informit, and Scopus) were searched for studies published between January 2011-2 March 2017 which are scalable in a community setting and reported primary outcome measures relating to weight. Following deduplication, 10,074 records were screened by title/abstract with 31 publications describing 21 programs included in this review. Programs were heterogeneous in nature (including length, number and frequency of sessions, parent-involvement and technology involvement). Reduction in adolescent BMIz ranged from 2 to 9% post-program and from 2 to 11% after varied lengths of follow-up. Study quality varied (n = 5 weak; n = 8 moderate; n = 8 high), and findings are limited by the risk of selection and retention bias in the included studies. Factors including the effectiveness and acceptability to the target population must be considered when selecting such community programs.
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Affiliation(s)
- C J Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - L K Bell
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - J Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - R A Damarell
- Gus Fraenkel Medical Library, Flinders University, Adelaide, South Australia, Australia
| | - L Matwiejczyk
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - M D Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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144
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Bucher Della Torre S, Courvoisier DS, Saldarriaga A, Martin XE, Farpour-Lambert NJ. Knowledge, attitudes, representations and declared practices of nurses and physicians about obesity in a university hospital: training is essential. Clin Obes 2018; 8:122-130. [PMID: 29327430 DOI: 10.1111/cob.12238] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/08/2017] [Accepted: 11/23/2017] [Indexed: 11/26/2022]
Abstract
In the context of a worldwide obesity epidemic, healthcare providers play a key role in obesity management. Knowledge of current guidelines and attitudes to prevent stigmatization are especially important. This study aimed to assess knowledge, attitudes, beliefs, perception of opportunity for intervention, declared practices and need for training and material of nurses and physicians about obesity in a Swiss University Hospital. A total of 834 physicians and nurses filled an online survey. The questionnaire was based on literature, exploratory interviews and expert committee review. It was pre-tested with 15 physicians and nurses. Participants declared a low level of negative attitudes towards individuals living with obesity. However, the results highlighted a lack of knowledge to diagnose obesity in adults and children, as well as confidence and training to care of patients with obesity. One-third of providers did not know how to calculate body mass index. Half of providers felt it was part of their role to take care of patients with obesity, even if 55% of them had the feeling that they did not have adequate training. Nurses and physicians working in a university hospital showed a low level of negative attitudes but a lack of knowledge and skills on obesity management. Training should be improved in this population to insure adequate and coherent messages and equal access to evidence-based treatment for patients living with obesity.
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Affiliation(s)
- S Bucher Della Torre
- Department of Nutrition and Dietetics, School of Health Sciences - Geneva, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - D S Courvoisier
- Quality of Care Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - A Saldarriaga
- Department of Public Education, Geneva Child and Youth Health Service, Geneva, Switzerland
| | - X E Martin
- Health and Movement Consultation, Unit of Pediatric Cardiology, Service of Pediatric Specialties, Department of Child and Adolescent, University Hospitals of Geneva, Switzerland
| | - N J Farpour-Lambert
- Obesity Prevention and Care Program, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva, Geneva, Switzerland
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145
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Jung FU, Luck-Sikorski C, Stroh C, Riedel-Heller SG. [Referral behavior of general physicians for patients with obesity]. Chirurg 2018; 89:577-582. [PMID: 29500694 DOI: 10.1007/s00104-018-0616-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The prevalence of obesity and overweight is constantly rising. Thus, obesity is increasingly considered as one of the most important healthcare problems in Germany. Surgical interventions have been proven to be the only treatment option to achieve sustained weight loss along with a reduction of obesity-related comorbidities in the vast majority of morbidly obese patients. With respect to the small numbers of weight loss surgeries conducted in Germany, several reasons are currently discussed. General practitioners play a very important role in gatekeeping when it comes to decisions about treatment. Research has shown that knowledge and stigma play a role when treatment pathways for patients with obesity are defined. Interventions are required to make treatment decisions by physicians or patients independent of social pressure due to stigma or gaps in expertise.
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Affiliation(s)
- F U Jung
- Integriertes Forschungs- und Behandlungszentrum (IFB) Adipositas Erkrankungen, Universität Leipzig, Leipzig, Deutschland. .,SRH Hochschule für Gesundheit Gera, Neue Straße 28-30, 07548, Gera, Deutschland.
| | - C Luck-Sikorski
- Integriertes Forschungs- und Behandlungszentrum (IFB) Adipositas Erkrankungen, Universität Leipzig, Leipzig, Deutschland.,SRH Hochschule für Gesundheit Gera, Neue Straße 28-30, 07548, Gera, Deutschland
| | - C Stroh
- Allgemein‑, Visceral- und Kinderchirurgie, SRH Wald-Klinikum Gera, Gera, Deutschland
| | - S G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig, Deutschland
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146
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Bass B, Lake E, Elvy C, Fodemesi S, Iacoe M, Mazik E, Brooks D, Lee A. Smoking-Related Stigma Expressed by Physiotherapists toward Individuals with Lung Disease. Physiother Can 2018; 70:65-71. [PMID: 29434420 DOI: 10.3138/ptc.2016-98] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: We determined the extent and nature of stigma exhibited by a sample of Canadian cardiorespiratory physiotherapists toward people with lung disease who had a smoking history. Method: A quantitative online survey was distributed to Canadian cardiorespiratory physiotherapists, and an anti-smoking attitudes questionnaire was used to measure explicit stigma. We used two case studies with questions to measure implicit stigma. The first involved a patient with chronic obstructive pulmonary disease (COPD) and a smoking history, and the second described a patient with COPD with no smoking history. Results: Of the respondents (n=50), 56% demonstrated mild explicit stigma and 44% demonstrated moderate to severe explicit stigma. The extent of explicit stigma was not associated with respondents' age, area of practice, personal smoking history, or family history of lung disease resulting from smoking. The results indicated no evidence of implicit stigma, and no significant differences were found between the participants' prospective treatments and their professional attitudes toward patient cases. Conclusions: Canadian cardiorespiratory physiotherapists demonstrated explicit stigma toward people with lung disease with a significant smoking history, but there was no evidence of implicit stigma. These findings suggest that further research is needed to investigate how stigma held by cardiorespiratory physiotherapists may affect the quality of care provided for patients with a smoking history.
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Affiliation(s)
- Bethany Bass
- Department of Physical Therapy, University of Toronto
| | | | - Chelsea Elvy
- Department of Physical Therapy, University of Toronto
| | | | - Mara Iacoe
- Department of Physical Therapy, University of Toronto
| | - Emilie Mazik
- Department of Physical Therapy, University of Toronto
| | - Dina Brooks
- Department of Physical Therapy, University of Toronto.,Department of Respiratory Medicine, West Park Healthcare Centre, Toronto
| | - Annemarie Lee
- Department of Physical Therapy, University of Toronto.,Department of Respiratory Medicine, West Park Healthcare Centre, Toronto
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147
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Lian Q, Su Q, Li R, Elgar FJ, Liu Z, Zheng D. The association between chronic bullying victimization with weight status and body self-image: a cross-national study in 39 countries. PeerJ 2018; 6:e4330. [PMID: 29404221 PMCID: PMC5794335 DOI: 10.7717/peerj.4330] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/16/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Childhood obesity and school bullying are pervasive public health issues and known to co-occur in adolescents. However, the association between underweight or thinness and chronic bullying victimization is unclear. The current study examined whether chronic bullying victimization is associated with weight status and body self-image. METHODS A school-based, cross-sectional study in 39 North American and European countries and regions was conducted. A total of 213,595 adolescents aged 11, 13, and 15 years were surveyed in 2009/10. Chronic bullying victimization was identified using the Revised Olweus Bully/Victim Questionnaire. Weight status was determined using self-reported height and weight and the body mass index (BMI), and body self-image was based on perceived weight. We tested associations between underweight and bullying victimization using three-level logistic regression models. RESULTS Of the 213,595 adolescents investigated, 11.28% adolescents reported chronic bullying victimization, 14.80% were classified as overweight/obese according to age- and sex-specific BMI criteria, 12.97% were underweight, and 28.36% considered themselves a little bit fat or too fat, 14.57% were too thin. Bullying victimization was less common in older adolescent boys and girls. Weight status was associated with chronic bullying victimization (adjusted ORunderweight = 1.10, 95% CI = 1.05-1.16, p = 0.002; adjusted ORoverweight = 1.40, 95% CI = 1.32-1.49, p < 0.0001; adjusted ORobese = 1.91, 95% CI = 1.71-2.14, p < 0.0001). Body self-image also related to chronic bullying victimization (adjusted ORtoo thin = 1.42, 95% CI = 1.36-1.49, p < 0.0001; adjusted ORa little bit fat = 1.54, 95% CI = 1.48-1.61, p < 0.0001; adjusted ORtoo fat = 3.30, 95% CI = 2.96-3.68, p < 0.0001). CONCLUSION Both perceived weight and self-rated overweight are associated with chronic bullying victimization. Both overweight and underweight children are at risk of being chronically bullied.
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Affiliation(s)
- Qiguo Lian
- Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
- School of Public Health, Fudan University, Shanghai, China
| | - Qiru Su
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ruili Li
- Children Health and Development Department, Capital Institute of Pediatrics, Beijing, China
| | - Frank J. Elgar
- Institute for Health and Social Policy, McGill University, Montreal, QC, Canada
| | - Zhihao Liu
- Institute for Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, China
| | - Dongpeng Zheng
- Huajing Community Health Service Center, Shanghai, China
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Cross-lagged structural equation models for the relationship between health-related state and behaviours and body bullying in adolescence: findings from longitudinal study ELANA. PLoS One 2018; 13:e0191253. [PMID: 29342218 PMCID: PMC5771614 DOI: 10.1371/journal.pone.0191253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/02/2018] [Indexed: 11/19/2022] Open
Abstract
We investigated the stability and the directionality of being body bullied and a set of four variables– 1) Body Mass Index (BMI), 2) moderate and vigorous physical activity (MVPA), 3) television time (TV) and 4) video game/computer time (VG)-, termed in the present study as ‘health-related state and behaviours (HRSB)’–across adolescence. The Adolescent Nutritional Assessment Longitudinal Study (ELANA) is a cohort study conducted among middle school students from two public and four private schools in Rio de Janeiro-Brazil. We analysed data from 2010 (T1) and 2012 (T2) among 810 adolescents (aged 9–15 at T1). Gender-specific structural equation models (SEM) were estimated, including autoregressive paths for the HRSB and being body bullied over time, correlations at T1 and T2, respectively, and cross-lagged effects. The results presented significant stability coefficients for almost all variables over time in both genders (except for MVPA in boys and girls and TV time among girls). There were positive correlations between BMI and being body bullied, as well as between TV and VG for boys (0.32, p<0.001 and 0.24, p<0.001, respectively) and girls (0.30, p<0.001 and 0.30, p<0.001, respectively) at T1. It remained significant at T2 (boys: 0.18, p<0.05 and 0.16, p<0.01; girls: 0.21, p<0.01 and 0.22, p<0.01, respectively). Examining the cross-lagged paths between being body bullied and HRSB, we observed that the reciprocal model provided the best fit for boys, indicating that BMI at T1 had a significant effect in being body bullied at T2 (0.12, p<0.05) and being body bullied at T1 had an effect on VG at T2 (0.14, p<0.01). Among girls the forward causation model showed the best fit, demonstrating a significant effect of being body bullied at T1 on VG at T2 (0.16, p<0.01). Apart from MVPA, both being body bullying and HRSB were largely stable across adolescence. For boys and girls alike, exposure to being body bullied seemed to increase their time spent on VG, while for boys BMI also predicted being body bullied. This study highlighted the complex interplay between being body bullied and HRSB and the importance of acknowledging gender differences in this context.
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Finn KE, Faith MS, Seo YS. School Engagement in Relation to Body Mass Index and School Achievement in a High-School Age Sample. J Obes 2018; 2018:3729318. [PMID: 30402282 PMCID: PMC6191957 DOI: 10.1155/2018/3729318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 06/15/2018] [Accepted: 08/02/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Research has documented an inverse relationship between body mass index (BMI) and school achievement but has failed to empirically explain it. We tested whether this association among adolescents can be explained in part by student engagement. METHODS A self-report survey about health and school behaviors was completed by 196 high school students; BMI and achievement data were obtained from school records. Three forms of engagement were assessed: behavioral, presenteeism, and affective. Associations of engagement with BMI and achievement were examined, and mediation analyses were conducted. RESULTS The simple relationship between BMI and achievement was confirmed and demonstrated that BMI was negatively related to academic achievement. Higher BMI was also significantly correlated with lower classroom participation. Mediation tests showed the significant relationship between BMI and achievement was reduced after accounting for behavioral engagement but not affective engagement. CONCLUSIONS These novel findings shed light on why heavier students often experience lower academic achievement. Intervention studies targeting barriers to classroom engagement among overweight and obese youth are needed so that their academic potential is not compromised.
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Affiliation(s)
- Kristin E. Finn
- School of Education and Human Services, Canisius College, 2001 Main Street, Buffalo, NY 14208, USA
| | - Myles S. Faith
- Department of Counseling, School, and Educational Psychology, University at Buffalo–State University of New York, 420 Baldy Hall, Buffalo, NY 14260-1000, USA
| | - Young S. Seo
- Department of Counseling, School, and Educational Psychology, University at Buffalo–State University of New York, 420 Baldy Hall, Buffalo, NY 14260-1000, USA
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150
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Waite F, Freeman D. Body image and paranoia. Psychiatry Res 2017; 258:136-140. [PMID: 29020647 DOI: 10.1016/j.psychres.2017.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/27/2017] [Accepted: 10/02/2017] [Indexed: 11/25/2022]
Abstract
Paranoia builds upon feelings of vulnerability. Our clinical experience indicates that negative body image, including concerns regarding weight, may be one source of feeling vulnerable and hence raise the risk of paranoia. There has been no empirical test of an association between body image and paranoia. Our aim was to provide the first test of this issue by examining in epidemiologically representative cohorts the cross-sectional associations between paranoia and a proxy measure of body image. This was an initial exploration of a potentially important but overlooked issue. Data were used from 5515 participants in the US National Comorbidity Survey-Replication (NCS-R). To validate the findings, the analyses were replicated with 10,113 participants in the US National Comorbidity Survey-Adolescents (NCS-A). Concerns about weight were associated with paranoia in the NCS-R (OR = 1.48, p = 0.006, CI = 1.123, 1.955) and NCS-A (OR = 1.67, p < 0.001, CI = 1.490, 1.873). The associations remained significant after controlling for gender and body mass index. The results show that negative body image and paranoia are associated in the general population, consistent with the idea that paranoia may build upon feelings of vulnerability arising from body image concerns. Studies are needed to examine whether there is a causal relationship.
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Affiliation(s)
- Felicity Waite
- Department of Psychiatry, University of Oxford, Warneford Hospital, UK.
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Warneford Hospital, UK
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