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Knol LL, Myers HH, Black S, Robinson D, Awololo Y, Clark D, Parker CL, Douglas JW, Higginbotham JC. Development and Feasibility of a Childhood Obesity Prevention Program for Rural Families: Application of the Social Cognitive Theory. AMERICAN JOURNAL OF HEALTH EDUCATION 2016; 47:204-214. [PMID: 28392882 PMCID: PMC5383209 DOI: 10.1080/19325037.2016.1179607] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Effective childhood obesity prevention programs for preschool children are limited in number and focus on changes in the child care environment rather than the home environment. PURPOSE The purpose of this project was to develop and test the feasibility of a home environment obesity prevention program that incorporates mindful eating strategies and Social Cognitive Theory (SCT) constructs. Home Sweet Home is specifically designed for rural parents and grandparents of preschool-age children. METHODS HSH was developed using community-based participatory research practices and constructs from the SCT. Three community-based education sessions were delivered. Pre- and post-intervention data were collected from 47 grandparents and mothers.F. RESULTS Three of the four selected behavioral outcomes improved between pre- and post-intervention. The number of hours engaged in sedentary behaviors and intake of "red light" foods decreased while three of four mindful eating scores increased. Graduates of the program were able to decrease the number of "red light" foods available in their homes. DISCUSSION Improvements in mindful eating and several key behaviors were observed after a three week mindful eating/home environment intervention. TRANSLATION TO HEALTH EDUCATION PRACTICE Health educators should incorporate mindful eating strategies and use the SCT when designing childhood obesity prevention programs.
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Affiliation(s)
- Linda L Knol
- The University of Alabama, Department of Human Nutrition and Hospitality Management
| | | | - Sheila Black
- The University of Alabama, Department of Psychology
| | | | | | | | - Carson L Parker
- University of Alabama, Department of Human Nutrition and Hospitality Management
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Cull BJ, Rosenkranz SK, Dzewaltowski DA, Teeman CS, Knutson CK, Rosenkranz RR. Wildcat wellness coaching feasibility trial: protocol for home-based health behavior mentoring in girls. Pilot Feasibility Stud 2016; 2:26. [PMID: 27965845 PMCID: PMC5154020 DOI: 10.1186/s40814-016-0066-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 05/12/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Childhood obesity is a major public health problem, with one third of America's children classified as either overweight or obese. Obesity prevention and health promotion programs using components such as wellness coaching and home-based interventions have shown promise, but there is a lack of published research evaluating the impact of a combined home-based and wellness coaching intervention for obesity prevention and health promotion in young girls. The main objective of this study is to test the feasibility of such an intervention on metrics related to recruitment, intervention delivery, and health-related outcome assessments. The secondary outcome is to evaluate the possibility of change in health-related psychosocial, behavioral, and biomedical outcomes in our sample of participants. METHODS/DESIGN Forty girls who are overweight or obese (aged 8-13 years) will be recruited from a Midwestern college town. Participants will be recruited through posted flyers, newspaper advertisements, email, and social media. The volunteer convenience sample of girls will be randomized to one of two home-based wellness coaching interventions: a general health education condition or a healthy eating physical activity skills condition. Trained female wellness coaches will conduct weekly hour-long home visits for 12 consecutive weeks. Assessments will occur at baseline, post-intervention (3 months after baseline), and follow-up (6 months after baseline) and will include height, weight, waist circumference, body composition, pulmonary function, blood pressure, systemic inflammation, physical activity (Actical accelerometer), and self-reported survey measures (relevant to fruit and vegetable consumption, physical activity, and quality of life). DISCUSSION This study will evaluate the feasibility of home-based wellness coaching interventions for overweight and obese girls and secondarily assess the preliminary impact on health-related psychosocial, behavioral, and biomedical outcomes. Results will provide information regarding the feasibility of this new model for use in girls as an approach to reduce the burden of overweight and obesity toward the prevention of chronic disease. TRIAL REGISTRATION NCT01845480.
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Affiliation(s)
- Brooke J. Cull
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506 USA
| | - Sara K. Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506 USA
- Department of Kinesiology, Kansas State University, 1A Natatorium, 920 Denison Avenue, Manhattan, KS 66506 USA
| | - David A. Dzewaltowski
- Department of Kinesiology, Kansas State University, 1A Natatorium, 920 Denison Avenue, Manhattan, KS 66506 USA
| | - Colby S. Teeman
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506 USA
| | - Cassandra K. Knutson
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506 USA
| | - Richard R. Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506 USA
- Department of Kinesiology, Kansas State University, 1A Natatorium, 920 Denison Avenue, Manhattan, KS 66506 USA
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Positive influences of home food environment on primary-school children’s diet and weight status: a structural equation model approach. Public Health Nutr 2016; 19:2525-34. [DOI: 10.1017/s1368980016000999] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AbstractObjectivesThe mechanism by which the home food environment (HFE) influences childhood obesity is unclear. The present study aimed to investigate the relationship between HFE and childhood obesity as mediated by diet in primary-school children.DesignCross-sectional data collected from parents and primary-school children participating in the Obesity Prevention and Lifestyle Evaluation Project. Only children aged 9–11 years participated in the study. Matched parent/child data (n3323) were analysed. Exploratory factor analysis underlined components of twenty-one HFE items; these were linked to child diet (meeting guidelines for fruit, vegetable and non-core food intakes) and measured child BMI, in structural equation modelling, adjusting for confounders.SettingTwenty geographically bounded metropolitan and regional South Australian communities.SubjectsSchool children and their parents from primary schools in selected communities.ResultsIn the initial exploratory factor analysis, nineteen items remaining extracted eight factors with eigenvalues >1·0 (72·4 % of total variance). A five-factor structure incorporating ten items described HFE. After adjusting for age, gender, socio-economic status and physical activity all associations in the model were significant (P<0·05), explaining 9·3 % and 4·5 % of the variance in child diet and BMI, respectively. A more positive HFE was directly and indirectly associated with a lower BMI in children through child diet.ConclusionsThe robust statistical methodology used in the present study provides support for a model of direct and indirect dynamics between the HFE and childhood obesity. The model can be tested in future longitudinal and intervention studies to identify the most effective components of the HFE to target in childhood obesity prevention efforts.
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Kegler MC, Haardörfer R, Alcantara IC, Gazmararian JA, Veluswamy JK, Hodge TL, Addison AR, Hotz JA. Impact of Improving Home Environments on Energy Intake and Physical Activity: A Randomized Controlled Trial. Am J Public Health 2016; 106:143-52. [PMID: 26696290 DOI: 10.2105/ajph.2015.302942] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the effectiveness of an intervention targeting home food and activity environments to reduce energy intake and increase physical activity among overweight and obese patients from 3 community health centers in rural Georgia. METHODS We conducted a randomized controlled trial (n = 349) from 2011 to 2013, with follow-up at 6 and 12 months. Health coaches delivered the 16-week intervention by using tailored home environment profiles showing areas in need of improvement and positive aspects of the home environment, behavioral contracts for healthy actions, and mailed support materials. RESULTS Participants were mostly African American women (84.8%), with a mean age of 50.2 years and a mean body mass index (weight in kilograms divided by the square of height in meters) of 38.3. Daily energy intake decreased more for the intervention than control group at 6 (-274 vs -69 kcal) and 12 months (-195 vs -76 kcal). We observed no change for either objective or self-reported physical activity. At 12 months, 82.6% of intervention participants had not gained weight compared with 71.4% of control participants. CONCLUSIONS The intervention was effective in changing home environments and reducing energy intake.
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Affiliation(s)
- Michelle C Kegler
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Regine Haardörfer
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Iris C Alcantara
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Julie A Gazmararian
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - J K Veluswamy
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Tarccara L Hodge
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Ann R Addison
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - James A Hotz
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
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155
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Kranjac AW, Wagmiller RL. Association Between Age and Obesity Over Time. Pediatrics 2016; 137:peds.2015-2096. [PMID: 27244784 DOI: 10.1542/peds.2015-2096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A decline in the prevalence of obesity among 2- to 5-year-olds in the United States was recently reported. This decline may be due to changes in the population composition of children over time or may be a consequence of changes in how strongly individual- or family-level factors are linked to childhood obesity. We applied regression decomposition techniques to identify the sources of the decline. METHODS We used data from the 2003-2004 and 2011-2012 NHANES restricted to 2- to 5-year-old children and Blinder-Oaxaca regression decomposition techniques to partition the decline in early childhood obesity into 2 components: changes resulting from (1) how demographic, economic, and health characteristics of children have changed over this period (ie, changes in population composition) and (2) changes in how these demographic, economic, and health factors are associated with obesity (ie, changes in associations). RESULTS The obesity rate was lower in 2011-2012 than it was in 2003-2004 mainly because obesity was strongly and positively associated with age in 2003-2004 (ie, older children were more likely to be obese than younger children) but not in 2011-2012 (ie, older children were not more likely to be obese than younger children). CONCLUSIONS If the weaker association between age and obesity we observed for this cohort of 2- to 5-year-old children in 2011-2012 persists for subsequent cohorts of young children, the obesity rate for young children will remain at or near the lower rate seen in 2011-2012.
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Affiliation(s)
- Ashley Wendell Kranjac
- Department of Sociology and Kinder Institute for Urban Research, Rice University, Houston, Texas; and
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156
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Dalma A, Kastorini CM, Zota D, Veloudaki A, Petralias A, Yannakoulia M, Linos A. Perceptions of parents and children, participating in a school-based feeding programme in disadvantaged areas in Greece: a qualitative study. Child Care Health Dev 2016; 42:267-77. [PMID: 26757263 DOI: 10.1111/cch.12315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 11/09/2015] [Accepted: 11/22/2015] [Indexed: 10/22/2022]
Abstract
AIM The aim of this work was to explore parents' and children's attitudes towards healthy eating and the free provision of a daily school meal in underprivileged areas of Greece. METHODS Twenty focus groups were conducted in 14 schools. Eligible participants were children/adolescents and their parents, who were recipients of a food aid, healthy nutrition school-based programme. Their perceptions towards healthy eating and related barriers, experience of a school feeding programme, other nutrition intervention initiatives were qualitatively evaluated. RESULTS Most of the parents referred to the Mediterranean diet as a healthy dietary pattern. Nearly all parents were aware of their effect as role models and commented on the benefits of eating together as a family, as well as on the importance of improving their own dietary habits. Parents reported using various methods to promote a healthy diet, as part of their parenting role. They perceived their role as difficult, as they have to deal with children's resistance, financial constraints arising from the current economic crisis in Greece and busy work schedules. All students perceived the school feeding programme as health-promoting, reflecting their parents' perceptions. CONCLUSION The present findings indicate that although the traditional Mediterranean diet was perceived by the majority of the adults as a health and traditional dietary pattern, parents reported several barriers related to its adoption. In particular, the most common barriers included financial difficulties, limited time for food preparation and children's resistance to consume healthy foods.
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Affiliation(s)
- A Dalma
- Institute of Preventive Medicine, Environmental and Occupational Health, Athens, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - C M Kastorini
- Institute of Preventive Medicine, Environmental and Occupational Health, Athens, Greece
| | - D Zota
- Institute of Preventive Medicine, Environmental and Occupational Health, Athens, Greece
| | - A Veloudaki
- Institute of Preventive Medicine, Environmental and Occupational Health, Athens, Greece
| | - A Petralias
- Institute of Preventive Medicine, Environmental and Occupational Health, Athens, Greece.,Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - M Yannakoulia
- Institute of Preventive Medicine, Environmental and Occupational Health, Athens, Greece.,Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - A Linos
- Institute of Preventive Medicine, Environmental and Occupational Health, Athens, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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157
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Using a mixed-methods approach to measure impact of a school-based nutrition and media education intervention study on fruit and vegetable intake of Italian children. Public Health Nutr 2016; 19:1952-63. [PMID: 26857624 DOI: 10.1017/s1368980015003729] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the impact of a school-based nutrition and media education intervention on the promotion of fruit and vegetable consumption to help prevent childhood obesity. DESIGN The 10-week-long intervention included sessions on nutrition education and media literacy. It also included a health communication media-based campaign workshop during which the children created posters, newsletters and video commercials related to fruits and vegetables targeted to their parents. For evaluation purposes, the study utilized a mixed-methods approach, including a quasi-experimental study (with one intervention group and one control group) and a focus group study. SETTING Four different elementary schools in Treviso (Veneto Region of Italy) agreed to participate in the research. SUBJECTS The target population for the study included 10-year-old Italian children and their parents. RESULTS Data indicate that this intervention was effective for children but not for parents. Evaluation results show that the intervention was effective in significantly increasing children's fruit and vegetable intake (P<0·05) and all psychosocial determinants (P<0·05). CONCLUSIONS The study results confirm the efficacy of a school-based health and media education intervention to address the children's obesity issue and, in particular, to increase children's fruit and vegetable intake. The study also opens a new perspective on the theoretical constructs investigated, because the development of 'ability of expression' could be considered one of the most important factors to determine the efficacy of the intervention.
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BESWA D, DLAMINI NR, SIWELA M, AMONSOU EO, KOLANISI U. Effect of Amaranth addition on the nutritional composition and consumer acceptability of extruded provitamin A-biofortified maize snacks. FOOD SCIENCE AND TECHNOLOGY 2016. [DOI: 10.1590/1678-457x.6813] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Daniso BESWA
- University of Venda, South Africa; University of KwaZulu-Natal, South Africa
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Spurrier NJ, Bell L, Wilson A, Lowe E, Golley R, Magarey AA. Minimal change in children's lifestyle behaviours and adiposity following a home-based obesity intervention: results from a pilot study. BMC Res Notes 2016; 9:26. [PMID: 26758057 PMCID: PMC4711013 DOI: 10.1186/s13104-015-1796-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 12/10/2015] [Indexed: 11/12/2022] Open
Abstract
Background/Methods Families of overweight and obese children require support to make sustainable lifestyle changes to improve their child’s diet and activity behaviours and in turn weight status. The aim of this pre-post intervention pilot study was to evaluate the feasibility of an individualised home-based intervention for treatment seeking overweight/obese 4–12 year olds and their caregivers. Baseline measures were used to develop a family-specific intervention to improve the quality of the home environment. The intervention was delivered as individualised written recommendations and resources plus phone call and home visit support. Baseline measures were repeated approximately 6 months later. Results Complete data for 24 children was available. Parents reported that 43 % of intervention recommendations were implemented ‘very much’. Some descriptive changes were observed in the home environment, most commonly including fruit and vegetables in their child’s lunchbox, not providing food treats, and restricting children’s access to chips/savoury snack biscuits. At the group level, minimal change was detected in children’s diet and activity behaviours or weight status (all p > 0.05). Conclusion The study findings did not support intervention feasibility in its current form. Future interventions should target the family food and activity environment, but also utilise an approach to address the complex social circumstances which limit parent’s ability to prioritise healthy family lifestyle behaviours. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) 3/12/2014. http://www.ANZCTR.org.au. ACTRN12614001264673
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Affiliation(s)
- Nicola J Spurrier
- Department of Public Health, University of Adelaide, Adelaide, 5000, Australia. .,Department of Paediatrics and Child Health, Flinders University, Bedford Park, 5042, Australia. .,Department for Health and Ageing, SA Health, Citi Centre Building, 11 Hindmarsh Square, Adelaide, SA, 5000, Australia.
| | - Lucinda Bell
- Nutrition and Dietetics, Flinders University, Bedford Park, 5042, Australia.
| | - Annabelle Wilson
- Department of Public Health, Flinders University, Bedford Park, 5042, Australia.
| | - Elizabeth Lowe
- Division of Health Sciences City East Campus, University of South Australia, Adelaide, 5001, Australia.
| | - Rebecca Golley
- Sansom Institute for Health Research, University of South Australia, Adelaide, 5001, Australia.
| | - Anthea A Magarey
- Nutrition and Dietetics, Flinders University, Bedford Park, 5042, Australia.
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160
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Loth KA, MacLehose RF, Larson N, Berge JM, Neumark-Sztainer D. Food availability, modeling and restriction: How are these different aspects of the family eating environment related to adolescent dietary intake? Appetite 2016; 96:80-86. [PMID: 26327222 PMCID: PMC4684786 DOI: 10.1016/j.appet.2015.08.026] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/18/2015] [Accepted: 08/20/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To examine individual associations between aspects of the family eating environment (home food availability, parental modeling, and food restriction) and adolescent dietary intake and explore the combined relationship (i.e., environment profiles) between these aspects of the family eating environment and adolescent dietary intake. METHODS Adolescents [14.4 years old (SD = 2.0)] and their parents (N = 2383 parent-adolescent pairs] participated in 2 coordinated, population-based studies. Adolescent surveys were completed at school and parent surveys were conducted via mail or phone. RESULTS Healthy home food availability was positively associated with fruit/vegetable intake and negatively associated with soda and snack food intake in adolescents. Healthy parental modeling was negatively associated with adolescent soda consumption. Food restriction was positively associated with fruit/vegetable consumption and snack food intake. Examination of family eating environment profiles revealed that it was the home food availability component of the profiles that was associated with observed differences in fruits/vegetable consumption, whereas the parental modeling and food restriction components contributed to differences in soda and snack foods consumption. CONCLUSIONS Findings indicate that among the three aspects of the family eating environment explored, making healthy food available at home was most consistently associated with healthy dietary intake in adolescents.
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Affiliation(s)
- Katie A Loth
- Division of Epidemiology and Community Health, School of Public Health and Department of Psychiatry, University of Minnesota, USA; Department of Family Medicine and Community Health, University of Minnesota, USA.
| | - Richard F MacLehose
- Division of Epidemiology and Community Health, School of Public Health, USA.
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, USA.
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161
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Campbell MK. Biological, environmental, and social influences on childhood obesity. Pediatr Res 2016; 79:205-11. [PMID: 26484623 DOI: 10.1038/pr.2015.208] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/30/2015] [Indexed: 01/04/2023]
Abstract
The prevalence of childhood obesity has increased globally over the past three decades, with evidence of recent leveling off in developed countries. Reduction in the, currently high, prevalence of obesity will require a full understanding of the biological and social pathways to obesity in order to develop appropriately targeted prevention strategies in early life. Determinants of childhood obesity include individual level factors, including biological, social, and behavioral risks, acting within the influence of the child's family environment, which is, in turn, imbedded in the context of the community environment. These influences act across childhood, with suggestions of early critical periods of biological and behavioral plasticity. There is evidence of sex and gender differences in the responses of boys and girls to their environments. The evidence that determinants of childhood obesity act at many levels and at different stages of childhood is of policy relevance to those planning early health promotion and primary prevention programs as it suggests the need to address the individual, the family, the physical environment, the social environment, and social policy. The purpose of this narrative review is to summarize current, and emerging, literature in a multilevel, life course framework.
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Affiliation(s)
- M Karen Campbell
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada.,Department of Pediatrics, The University of Western Ontario, London, Ontario, Canada.,Department of Obstetrics & Gynecology, The University of Western Ontario, London, Ontario, Canada.,Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
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Poelman MP, de Vet E, Velema E, de Boer MR, Seidell JC, Steenhuis IHM. PortionControl@HOME: results of a randomized controlled trial evaluating the effect of a multi-component portion size intervention on portion control behavior and body mass index. Ann Behav Med 2015; 49:18-28. [PMID: 25142041 PMCID: PMC4335123 DOI: 10.1007/s12160-014-9637-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Food portion sizes influence energy intake. Purpose The purpose of this paper is to determine effectiveness of the “PortionControl@HOME” intervention on body mass index and portion control behavior. Methods A randomized controlled trial among 278 overweight and obese participants was conducted. PortionControl@HOME aimed to increase: portion size awareness, portion control behavior, portion control cooking skills, and to create a home environment favoring portion control. Results Intention-to-treat multi-level regression analysis indicated statistically significant effects of the intervention on portion control behavior at 3, 6, and 12 months follow-up. The effect on body mass index was significant only at 3 months follow-up and when outliers (n = 3) were excluded (B = −0.45; 95 %CI = −0.88 to −0.04). The intervention effect on body mass index was mediated by portion control behavior. Conclusions The intervention improves portion control behavior, which in turn influence body mass index. Once the intervention ceased, sustained effects on body mass index were no longer evident. (Current-Controlled-Trials ISRCTN12363482). Electronic supplementary material The online version of this article (doi:10.1007/s12160-014-9637-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maartje P Poelman
- Department of Health Sciences and EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands,
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Virudachalam S, Chung PJ, Faerber JA, Pian TM, Thomas K, Feudtner C. Quantifying parental preferences for interventions designed to improve home food preparation and home food environments during early childhood. Appetite 2015; 98:115-24. [PMID: 26596704 DOI: 10.1016/j.appet.2015.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/13/2015] [Accepted: 11/08/2015] [Indexed: 12/13/2022]
Abstract
Though preparing healthy food at home is a critical health promotion habit, few interventions have aimed to improve parental cooking skills and behaviors. We sought to understand parents' preferences and priorities regarding interventions to improve home food preparation practices and home food environments during early childhood. We administered a discrete choice experiment using maximum difference scaling. Eighty English-speaking parents of healthy 1-4 year-old children rated the relative importance of potential attributes of interventions to improve home food preparation practices and home food environments. We performed latent class analysis to identify subgroups of parents with similar preferences and tested for differences between the subgroups. Participants were mostly white or black 21-45 year-old women whose prevalence of overweight/obesity mirrored the general population. Latent class analysis revealed three distinct groups of parental preferences for intervention content: a healthy cooking group, focused on nutrition and cooking healthier food; a child persuasion group, focused on convincing toddlers to eat home-cooked food; and a creative cooking group, focused on cooking without recipes, meal planning, and time-saving strategies. Younger, lower income, 1-parent households comprised the healthy cooking group, while older, higher income, 2-parent households comprised the creative cooking group (p < 0.05). The child persuasion group was more varied with regard to age, income, and household structure but cooked dinner regularly, unlike the other two groups (p < 0.05). Discrete choice experiments using maximum difference scaling can be employed to design and tailor interventions to change health behaviors. Segmenting a diverse target population by needs and preferences enables the tailoring and optimization of future interventions to improve parental home food preparation practices. Such interventions are important for creating healthier home food environments and preventing obesity starting from early childhood.
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Affiliation(s)
- Senbagam Virudachalam
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Paul J Chung
- Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA; Department of Health Policy & Management, University of California Los Angeles, Los Angeles, CA, USA; RAND Corporation, Santa Monica, CA, USA; Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, USA.
| | | | - Timothy M Pian
- Warren Alpert Medical School, Brown University, Providence, RI, USA.
| | | | - Chris Feudtner
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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164
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Characteristics of the home food environment that mediate immediate and sustained increases in child fruit and vegetable consumption: mediation analysis from the Healthy Habits cluster randomised controlled trial. Int J Behav Nutr Phys Act 2015; 12:118. [PMID: 26381609 PMCID: PMC4574567 DOI: 10.1186/s12966-015-0281-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 09/12/2015] [Indexed: 11/30/2022] Open
Abstract
Background The home food environment can influence the development of dietary behaviours in children, and interventions that modify characteristics of the home food environment have been shown to increase children’s fruit and vegetable consumption. However to date, interventions to increase children’s fruit and vegetable consumption have generally produced only modest effects. Mediation analysis can help in the design of more efficient and effective interventions by identifying the mechanisms through which interventions have an effect. This study aimed to identify characteristics of the home food environment that mediated immediate and sustained increases in children’s fruit and vegetable consumption following the 4-week Healthy Habits telephone-based parent intervention. Method Analysis was conducted using 2-month (immediate) and 12-month (sustained) follow-up data from a cluster randomised control trial of a home food environment intervention to increase the fruit and vegetable consumption of preschool children. Using recursive path analysis, a series of mediation models were created to investigate the direct and indirect effects of immediate and sustained changes to characteristics of the home food environment (fruit and vegetable availability, accessibility, parent intake, parent providing behaviour, role-modelling, mealtime eating practices, child feeding strategies, and pressure to eat), on the change in children’s fruit and vegetable consumption. Results Of the 394 participants in the randomised trial, 357 and 329 completed the 2- and 12-month follow-up respectively. The final mediation model suggests that the effect of the intervention on the children’s fruit and vegetable consumption was mediated by parent fruit and vegetable intake and parent provision of these foods at both 2- and 12-month follow-up. Conclusion Analysis of data from the Healthy Habits trial suggests that two environmental variables (parental intake and parent providing) mediate the immediate and sustained effect of the intervention, and it is recommended these variables be targeted in subsequent home food environment interventions to bring about immediate and sustained changes in child fruit and vegetable intake. Trial registration ACTRN12609000820202.
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165
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Cameron AJ, Spence AC, Laws R, Hesketh KD, Lioret S, Campbell KJ. A Review of the Relationship Between Socioeconomic Position and the Early-Life Predictors of Obesity. Curr Obes Rep 2015; 4:350-62. [PMID: 26627493 DOI: 10.1007/s13679-015-0168-5] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A range of important early-life predictors of later obesity have been identified. Children of lower socioeconomic position (SEP) have a steeper weight gain trajectory from birth with a strong socioeconomic gradient in child and adult obesity prevalence. An assessment of the association between SEP and the early-life predictors of obesity has been lacking. The review involved a two-stage process: Part 1, using previously published systematic reviews, we developed a list of the potentially modifiable determinants of obesity observable in the pre-natal, peri-natal or post-natal (pre-school) periods; and part 2, conducting a literature review of evidence for socioeconomic patterning in the determinants identified in part 1. Strong evidence was found for an inverse relationship between SEP and (1) pre-natal risk factors (pre-pregnancy maternal body mass index (BMI), diabetes and pre-pregnancy diet), (2) antenatal/peri natal risk factors (smoking during pregnancy and low birth weight) and (3) early-life nutrition (including breastfeeding initiation and duration, early introduction of solids, maternal and infant diet quality, and some aspects of the home food environment), and television viewing in young children. Less strong evidence (because of a lack of studies for some factors) was found for paternal BMI, maternal weight gain during pregnancy, child sleep duration, high birth weight and lack of physical activity in young children. A strong socioeconomic gradient exists for the majority of the early-life predictors of obesity suggesting that the die is cast very early in life (even pre-conception). Lifestyle interventions targeting disadvantaged women at or before child-bearing age may therefore be particularly important in reducing inequality. Given the likely challenges of reaching this target population, it may be that during pregnancy and their child's early years are more feasible windows for engagement.
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Affiliation(s)
- Adrian J Cameron
- World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
| | - Alison C Spence
- School of Exercise and Nutrition Science, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
| | - Rachel Laws
- School of Exercise and Nutrition Science, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
- Centre for Obesity Prevention and Management Research Excellence in Primary Health Care, Sydney, Australia
| | - Kylie D Hesketh
- School of Exercise and Nutrition Science, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
| | - Sandrine Lioret
- INSERM, UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early Origins of Child Health and Development Team (ORCHAD), Villejuif, F-94807, France
- Paris-Descartes University, Paris, France
| | - Karen J Campbell
- School of Exercise and Nutrition Science, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
- Centre for Obesity Prevention and Management Research Excellence in Primary Health Care, Sydney, Australia
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166
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Emery CF, Olson KL, Lee VS, Habash DL, Nasar JL, Bodine A. Home environment and psychosocial predictors of obesity status among community-residing men and women. Int J Obes (Lond) 2015; 39:1401-7. [PMID: 25916909 PMCID: PMC4632497 DOI: 10.1038/ijo.2015.70] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 02/09/2015] [Accepted: 02/17/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Prior research indicates that features of the home environment (for example, televisions, exercise equipment) may be associated with obesity, but no prior study has examined objective features of the home food environment (for example, location of food) in combination with behavioral (for example, food purchasing), psychological (for example, self-efficacy) and social factors among obese adults. This study identified factors associated with obesity status from measures of home environment, food purchasing behavior, eating behavior and psychosocial functioning. SUBJECTS/METHODS One hundred community-residing obese (mean body mass index (BMI)=36.8, s.e.=0.60) and nonobese (mean BMI=23.7, s.e.=0.57) adults (mean age=42.7, s.e.=1.50; range=20-78 years) completed an observational study with 2-h home interview/assessment and 2-week follow-up evaluation of food purchases and physical activity. Data were analyzed with analysis of variance and logistic regression, controlling for sex. RESULTS Univariate analyses revealed that homes of obese individuals had less healthy food available than homes of nonobese (F(1,97)=6.49, P=0.012), with food distributed across a greater number of highly visible locations (F(1,96)=6.20, P=0.01). Although there was no group difference in household income or size, obese individuals reported greater food insecurity (F(1,97)=9.70, P<0.001), more reliance on fast food (F(1,97)=7.63, P=0.01) and more long-term food storage capacity in number of refrigerators (F(1,97)=3.79, P=0.05) and freezers (F(1,97)=5.11, P=0.03). Obese individuals also reported greater depressive symptoms (F(1,97)=10.41, P=0.002) and lower ability to control eating in various situations (F(1,97)=20.62, P<0.001). Multiple logistic regression revealed that obesity status was associated with lower self-esteem (odds ratio (OR) 0.58, P=0.011), less healthy food consumption (OR 0.94, P=0.048) and more food available in the home (OR 1.04, P=0.036). CONCLUSIONS The overall pattern of results reflected that home food environment and psychosocial functioning of obese individuals differed in meaningful ways from that of nonobese individuals. In particular, lower self-esteem may be an important psychosocial aspect of obesity, especially in the context of greater food consumption and food storage/availability.
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Affiliation(s)
- CF Emery
- Department of Psychology, Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Ohio State University, Columbus, OH, USA
- Institute for Behavioral Medicine Research, Ohio State University, Columbus, OH, USA
| | - KL Olson
- Department of Psychology, Ohio State University, Columbus, OH, USA
| | - VS Lee
- Department of Psychology, Ohio State University, Columbus, OH, USA
| | - DL Habash
- Department of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH, USA
| | - JL Nasar
- School of Architecture, Ohio State University, Columbus, OH, USA
| | - A Bodine
- Department of Psychology, Ohio State University, Columbus, OH, USA
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167
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Martin-Biggers J, Spaccarotella K, Delaney C, Koenings M, Alleman G, Hongu N, Worobey J, Byrd-Bredbenner C. Development of the Intervention Materials for the HomeStyles Obesity Prevention Program for Parents of Preschoolers. Nutrients 2015; 7:6628-69. [PMID: 26266419 PMCID: PMC4555140 DOI: 10.3390/nu7085301] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/20/2015] [Accepted: 07/30/2015] [Indexed: 12/12/2022] Open
Abstract
Home environment is key to the development of obesity-preventing behaviors during childhood, yet few resources help preschool parents address factors at home associated with obesity risk. This paper describes creation of materials for an in-home intervention (HomeStyles) with this population. An advisory group of stakeholders and target audience members determined salient factors affecting childhood obesity to address in-home and developed program materials. The Social Cognitive Theory, Faith's Core Behavior Change Strategies to Treat Childhood Obesity, Adult Learning Theory and motivational interviewing techniques guided development of 12 guides targeting strategies parents can use to shape the home environment. Interviews were conducted to determine effectiveness of the guides. Cognitive testing of guide design (n = 251) and content (n = 261) occurred in English and Spanish in New Jersey and Arizona with parents and home visitation staff who would present the guides. Interviews investigated perceptions of content usefulness and parent comprehension. Findings were also examined in light of theoretical underpinnings. Both home visitation staff and parents felt the guides were very readable and useful. Parents appreciated use of motivational interviewing techniques and Adult Learning Theory. Current research is testing these guides through an in-home, randomized control trial.
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Affiliation(s)
- Jennifer Martin-Biggers
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue New Brunswick, NJ 08901, USA; E-Mails: (J.M.-B.); (C.D.); (M.K.); (J.W.)
| | - Kim Spaccarotella
- Department of Biological Sciences, Kean University, 1000 Morris Avenue Union, NJ 07082, USA; E-Mail:
| | - Colleen Delaney
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue New Brunswick, NJ 08901, USA; E-Mails: (J.M.-B.); (C.D.); (M.K.); (J.W.)
| | - Mallory Koenings
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue New Brunswick, NJ 08901, USA; E-Mails: (J.M.-B.); (C.D.); (M.K.); (J.W.)
| | - Gayle Alleman
- Department of Nutritional Sciences, University of Arizona, 406 Shantz Building, 1177 E. 4th Street, Tucson, AZ 85721-0038, USA; E-Mails: (G.A.); (N.H.)
| | - Nobuko Hongu
- Department of Nutritional Sciences, University of Arizona, 406 Shantz Building, 1177 E. 4th Street, Tucson, AZ 85721-0038, USA; E-Mails: (G.A.); (N.H.)
| | - John Worobey
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue New Brunswick, NJ 08901, USA; E-Mails: (J.M.-B.); (C.D.); (M.K.); (J.W.)
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue New Brunswick, NJ 08901, USA; E-Mails: (J.M.-B.); (C.D.); (M.K.); (J.W.)
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168
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Conlon BA, McGinn AP, Lounsbury DW, Diamantis PM, Groisman-Perelstein AE, Wylie-Rosett J, Isasi C. The Role of Parenting Practices in the Home Environment among Underserved Youth. Child Obes 2015; 11:394-405. [PMID: 26258561 PMCID: PMC4528989 DOI: 10.1089/chi.2014.0093] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The home environment, which includes parenting practices, is an important setting in which children develop their health behaviors. We examined the role of parenting practices in the home environment among underserved youth. METHODS We examined baseline data of a family-focused pediatric obesity intervention. Parenting practices (monitoring, discipline, limit setting of soda/snacks [SS] and screen media [SM], pressure to eat, and reinforcement) and availability of fruits/vegetables (FV) and sugar-sweetened beverages (SSBs), family meals, television (TV) watching during meals, TVs in the home, owning active video games/sports equipment, and household food security were assessed in 301 parent/caregivers of overweight/obese children (ages 7-12 years; BMI≥85th percentile). Associations were evaluated using Spearman's rank correlation coefficients and logistic regression models adjusted for potential confounders. RESULTS Parents/caregivers (ages 22-67 years) were largely Hispanic/Latino (74.1%), female (92.4%), and reported high levels of limit setting SS and low levels of pressure to eat. Parent age, gender, country of birth, and years living in the United States accounted for differences among several parenting practices. Adjusted logistic regression models identified several statistically significant associations, including: Monitoring was positively associated with availability FV (odds ratio [OR]=2.19; 95% confidence interval [CI], 1.25, 3.82); limit setting SS was inversely associated with availability of SSBs (OR=0.40; 95% CI, 0.21, 0.75); and limit setting SM was inversely associated with TV viewing during family meals (OR=0.51; 95% CI, 0.31, 0.85). Nearly 40% of our population was food insecure, and food insecurity was positively associated with pressure to eat (OR=1.77; 95% CI, 1.01, 3.15). CONCLUSIONS Parenting practices play an important role in the home environment, and longitudinal studies are needed to examine these associations in the context of family-focused pediatric obesity interventions.
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Affiliation(s)
- Beth A. Conlon
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Aileen P. McGinn
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - David W. Lounsbury
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Pamela M. Diamantis
- Department of Pediatrics, Children's Health Services, Jacobi Medical Center, Bronx, NY
| | | | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Carmen Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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169
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Ranjit N, Wilkinson AV, Lytle LM, Evans AE, Saxton D, Hoelscher DM. Socioeconomic inequalities in children's diet: the role of the home food environment. Int J Behav Nutr Phys Act 2015. [PMID: 26222785 PMCID: PMC4518619 DOI: 10.1186/1479-5868-12-s1-s4] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background It is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy foods and that these differences in consumption patterns are influenced by neighborhood food environments. Less understood is the role that SES differences in physical and social aspects of the home food environment play in consumption patterns. Methods Using data on 4th grade children from the 2009–2011 Texas School Physical Activity and Nutrition (SPAN) study, we used mixed-effects regression models to test the magnitude of differences in the SPAN Health Eating Index (SHEI) by parental education as an indicator of SES, and the extent to which adjusting for measures of the home food environment, and measures of the neighborhood environment accounted for these SES differences. Results Small but significant differences in children’s SHEI by SES strata exist (-1.33 between highest and lowest SES categories, p<0.01). However, incorporating home food environment and neighborhood environment measures in this model eliminates these differences (-0.7, p=0.145). Home food environment explains a greater portion of the difference. Both social (mealtime structure) and physical aspects (food availability) of the home food environment are strongly associated with consumption of healthy and unhealthy foods. Conclusions Our findings suggest that modifiable parent behaviors at home can improve children’s eating habits and that the neighborhood may impact diet in ways other than through access to healthy food.
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170
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The influence of parental encouragement and caring about healthy eating on children’s diet quality and body weights. Public Health Nutr 2015; 19:822-9. [DOI: 10.1017/s1368980015002049] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractObjectiveIn order to mitigate childhood obesity, evidence on what influences children’s health behaviours is needed to inform new health promotion strategies. The present study investigated the association between parental practices and their child’s diet and body weight status.DesignGrade 5 students and their parents completed health surveys. Parents were asked how much they ‘encourage their child to eat healthy foods’ and how much they ‘personally care about healthy eating’. Children’s diet quality and vegetable and fruit intake were assessed using an FFQ. Children’s heights and weights were measured to determine body weight status. Mixed-effects regression models were used to determine the influence of parental responses on the outcomes of interest.SettingElementary schools across the province of Alberta, Canada.SubjectsGrade 5 students (aged 10 and 11 years;n8388) and their parent(s).ResultsMost parents reported caring about healthy eating and encouraging their child to eat healthy foods at least quite a lot. Children whose parents who cared or encouraged ‘very much’ compared with ‘quite a lot’ were more likely have better diet quality and were less likely to be overweight. Children whose parents both cared and encouraged ‘very much’ compared with ‘quite a lot’ scored an average of 2·06 points higher on the diet quality index (β=2·06; 95 % CI 1·45, 2·66).ConclusionsHealth promotion strategies that aim for a high level of parental interest and encouragement of their children to eat healthy foods may improve diet quality and prevent overweight among children.
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171
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Amuta AO, Jacobs W, Idoko EE, Barry AE, McKyer ELJ. Influence of the Home Food Environment on Children's Fruit and Vegetable Consumption: A Study of Rural Low-Income Families. Health Promot Pract 2015; 16:689-98. [PMID: 26055463 DOI: 10.1177/1524839915589733] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This investigation sought to identify micro-level built and sociocultural characteristics of a home food environment that have been theoretically linked with fruit and vegetable (F&V) consumption. METHOD We examined rural families (n = 298) from the southeastern United States. Hierarchical multiple regression analyses determined the association between the outcome variable (F&V consumption) and micro-level built and sociocultural characteristics of a home food environment. RESULTS Demographic characteristics were entered at Step 1, explaining 14% of variance in vegetable consumption and 9% in fruit consumption. After entry of sociocultural factors in the home food environment, such as parenting styles and so on, in Block 2, the total variance explained increased by 25% for vegetable consumption and 12% for fruit consumption. Micro-level built environmental factors such as the availability of F&V in the home was entered at Block 3, total variance explained by the model for vegetable consumption was 67%, F(17, 111) = 13.5, p < .001, and for fruit consumption was 57%, F(17, 160) = 12.5, p < .001. CONCLUSION F&V availability was the most important variable influencing a child's consumption of F&V. There are modifiable factors within the rural low-income home that could serve as priorities for intervention to improve F&V consumption.
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Affiliation(s)
- Ann O Amuta
- Texas A&M University, College Station, TX, USA
| | - Wura Jacobs
- Texas A&M University, College Station, TX, USA
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172
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Experiences of overweight/obese adolescents in navigating their home food environment. Public Health Nutr 2015; 18:3278-86. [DOI: 10.1017/s1368980015000786] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
AbstractObjectiveTo explore perceived factors that impede or facilitate healthful eating within the home environment among overweight/obese adolescents.DesignIn the present qualitative photovoice study, participants were instructed to take photographs of things that made it easier or harder to make healthful food choices at home. Digital photographs were reviewed and semi-structured interviews were conducted to promote discussion of the photographs. Data were analysed using constant comparative analysis.SettingVancouver, Canada, in 2012–2013.SubjectsTwenty-two overweight/obese adolescents who completed a family-based lifestyle modification intervention.ResultsThe mean age of participants was 14 (sd 1·9) years, 77 % were female and their mean BMI Z-score was 2·4 (sd 0·6). Adolescents talked about six aspects of the home environment that influenced their eating habits (in order of frequency): home cooking, availability and accessibility of foods/beverages, parenting practices, family modelling, celebrations and screen use/studying. In general, homes with availability of less healthful foods, where family members also liked to eat less healthful foods and where healthier foods were less abundant or inaccessible were described as barriers to healthful eating. Special occasions and time spent studying or in front of the screen were also conducive to less healthful food choices. Home cooked meals supported adolescents in making healthier food choices, while specific parenting strategies such as encouragement and restriction were helpful for some adolescents.ConclusionsAdolescents struggled to make healthful choices in their home environment, but highlighted parenting strategies that were supportive. Targeting the home food environment is important to enable healthier food choices among overweight/obese adolescents.
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173
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Henry HK, Borzekowski DL. Well, that's what came with it. A qualitative study of U.S. mothers' perceptions of healthier default options for children's meals at fast-food restaurants. Appetite 2015; 87:108-15. [DOI: 10.1016/j.appet.2014.12.201] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 11/23/2014] [Accepted: 12/09/2014] [Indexed: 11/15/2022]
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174
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Bjelland M, Hausken SES, Bergh IH, Grydeland M, Klepp KI, Andersen LF, Totland TH, Lien N. Changes in adolescents' and parents' intakes of sugar-sweetened beverages, fruit and vegetables after 20 months: results from the HEIA study - a comprehensive, multi-component school-based randomized trial. Food Nutr Res 2015; 59:25932. [PMID: 25797051 PMCID: PMC4369556 DOI: 10.3402/fnr.v59.25932] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 02/09/2015] [Accepted: 03/02/2015] [Indexed: 11/24/2022] Open
Abstract
Background Interventions conducted in school-aged children often involve parents, but few studies have reported effects on parents’ own behaviour as a result of these interventions. Objective To determine if a multi-component, cluster randomized controlled trial targeting 11–13 year olds influenced their consumption of fruit, vegetables, sugar-sweetened soft drinks and fruit drinks, and to explore whether the results varied by gender, adolescent weight status or parental educational level. A final aim was to assess whether the parents’ intakes were affected by the intervention. Design Participants were 1,418 adolescents, 849 mothers and 680 fathers. Baseline and post-intervention data from the 20 months intervention study HEIA (HEalth In Adolescents) were included. Data were collected assessing frequency (and amounts; beverages only). Results No significant differences were found at baseline between the intervention and control groups, except for the parental groups (educational level and intakes). At post-intervention, the adolescents in the intervention group consumed fruit more frequently (P<0.001) and had a lower intake of sugar-sweetened fruit drinks compared to the control group (P=0.02). The parental educational level moderated the effect on intake of sugar-sweetened fruit drinks in adolescents. The intake was less frequent in the intervention groups compared to the control groups (P=0.02) for those who had parents with low and medium educational level. Furthermore, the intervention may have affected mothers’ fruit intake and the vegetable intake in higher educated fathers. Conclusion Favourable effects in favour of the intervention group were found for intake of fruit and sugar-sweetened fruit drinks among the adolescents in the HEIA study. Our results indicate that it is possible to reduce adolescents’ intake of sugar-sweetened fruit drinks across parental education, and potentially affect sub-groups of parents.
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Affiliation(s)
- Mona Bjelland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway;
| | - Solveig E S Hausken
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingunn H Bergh
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - May Grydeland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Knut-Inge Klepp
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lene F Andersen
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Torunn H Totland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
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175
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Abstract
This paper presents an overview to provide readers with an update on the literature about the relation between parental influences (general parenting and food parenting practices) and children's weight-related outcomes. It first summarizes the evidence regarding the role of food parenting practices in shaping and maintaining children's nutritional and weight status. It then describes empirical evidence on the relation between general parenting and children's weight status. This evidence is less convincing, possibly because general parenting has a different, more distal role in influencing child behavior than parenting practices. General parenting may moderate the impact of food parenting practices on children's nutrition behaviors. Finally, we discuss studies on interventions targeting childhood overweight and obesity. There is no consensus on the optimal intervention targets (i.e., general parenting and/or food parenting practices). Based on the overview, we offer suggestions for future research.
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Affiliation(s)
- S. M. P. L. Gerards
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - S. P. J. Kremers
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
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Wyse R, Campbell KJ, Brennan L, Wolfenden L. A cluster randomised controlled trial of a telephone-based intervention targeting the home food environment of preschoolers (The Healthy Habits Trial): the effect on parent fruit and vegetable consumption. Int J Behav Nutr Phys Act 2014; 11:144. [PMID: 25540041 PMCID: PMC4304182 DOI: 10.1186/s12966-014-0144-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 11/07/2014] [Indexed: 11/23/2022] Open
Abstract
Background The home food environment is an important setting for the development of dietary patterns in childhood. Interventions that support parents to modify the home food environment for their children, however, may also improve parent diet. The purpose of this study was to assess the impact of a telephone-based intervention targeting the home food environment of preschool children on the fruit and vegetable consumption of parents. Methods In 2010, 394 parents of 3–5 year–old children from 30 preschools in the Hunter region of Australia were recruited to this cluster randomised controlled trial and were randomly assigned to an intervention or control group. Intervention group parents received four weekly 30-minute telephone calls and written resources. The scripted calls focused on; fruit and vegetable availability and accessibility, parental role-modelling, and supportive home food routines. Two items from the Australian National Nutrition Survey were used to assess the average number of serves of fruit and vegetables consumed each day by parents at baseline, and 2-, 6-, 12-, and 18-months later, using generalised estimating equations (adjusted for baseline values and clustering by preschool) and an intention-to-treat-approach. Results At each follow-up, vegetable consumption among intervention parents significantly exceeded that of controls. At 2-months the difference was 0.71 serves (95% CI: 0.58-0.85, p < 0.0001), and at 18-months the difference was 0.36 serves (95% CI: 0.10-0.61, p = 0.0067). Fruit consumption among intervention parents was found to significantly exceed consumption of control parents at the 2-,12- and 18-month follow-up, with the difference at 2-months being 0.26 serves (95% CI: 0.12-0.40, p = 0.0003), and 0.26 serves maintained at 18-months, (95% CI: 0.10-0.43, p = 0.0015). Conclusions A four-contact telephone-based intervention that focuses on changing characteristics of preschoolers’ home food environment can increase parents’ fruit and vegetable consumption. (ANZCTR12609000820202)
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Affiliation(s)
- Rebecca Wyse
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia. .,Hunter Medical Research Institute (HMRI), Newcastle, NSW, Australia.
| | - Karen J Campbell
- Centre for Physical Activity & Nutrition Research, School of Exercise & Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.
| | - Leah Brennan
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia.
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia. .,Hunter Medical Research Institute (HMRI), Newcastle, NSW, Australia. .,Hunter New England Population Health, Locked Bag 10, Wallsend, 2287, NSW, Australia.
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177
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Alsharairi NA, Somerset SM. Associations between Parenting Styles and Children’s Fruit and Vegetable Intake. Ecol Food Nutr 2014; 54:93-113. [DOI: 10.1080/03670244.2014.953248] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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178
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Influences on the diet quality of pre-school children: importance of maternal psychological characteristics. Public Health Nutr 2014; 18:2001-10. [PMID: 25409750 DOI: 10.1017/s136898001400250x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To test the hypothesis that maternal psychological profiles relate to children's quality of diet. DESIGN Cross-sectional study. Mothers provided information on their health-related psychological factors and aspects of their child's mealtime environment. Children's diet quality was assessed using an FFQ from which weekly intakes of foods and a diet Z-score were calculated. A high score described children with a better quality diet. Cluster analysis was performed to assess grouping of mothers based on psychological factors. Mealtime characteristics, describing how often children ate while sitting at a table or in front of the television, their frequency of takeaway food consumption, maternal covert control and food security, and children's quality of diet were examined, according to mothers' cluster membership. SUBJECTS Mother-child pairs (n 324) in the Southampton Initiative for Health. Children were aged 2-5 years. SETTING Hampshire, UK. RESULTS Two main clusters were identified. Mothers in cluster 1 had significantly higher scores for all psychological factors than mothers in cluster 2 (all P < 0.001). Clusters were termed 'more resilient' and 'less resilient', respectively. Children of mothers in the less resilient cluster ate meals sitting at a table less often (P = 0.03) and watched more television (P = 0.01). These children had significantly poorer-quality diets (β = -0.61, 95% CI -0.82, -0.40, P ≤ 0.001). This association was attenuated, but remained significant after controlling for confounding factors that included maternal education and home/mealtime characteristics (P = 0.006). CONCLUSIONS The study suggests that mothers should be offered psychological support as part of interventions to improve children's quality of diet.
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179
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Abstract
OBJECTIVE The aim of the present study was to gain insight into (i) processed snack-food availability, (ii) processed snack-food salience and (iii) the size of dinnerware among households with overweight gatekeepers. Moreover, associations between gatekeepers' characteristics and in-home observations were determined. DESIGN A cross-sectional observation of home food environments was conducted as part of a baseline measurement of a larger study. SETTING Home food environments of overweight and obese gatekeepers in the Netherlands. SUBJECTS Household gatekeepers (n 278). Mean household size of the gatekeepers was 3.0 (SD 1.3) persons. Mean age of the gatekeepers was 45.7 (SD 9.2) years, 34.9% were overweight and 65.1% were obese. Of the gatekeepers, 20.9% had a low level of education and 42.7% had a high level of education. RESULTS In 70% of the households, eight or more packages of processed snack foods were present. In 54% of the households, processed snack foods were stored close to non-processed food items and in 78% of households close to non-food items. In 33% of the households, processed snack foods were visible in the kitchen and in 15% of the households processed snack foods were visible in the living room. Of the dinnerware items, 14% (plates), 57% (glasses), 78% (dessert bowls), 67% (soup bowls) and 58% (mugs) were larger than the reference norms of the Netherlands Nutrition Centre Foundation. Older gatekeepers used significantly smaller dinnerware than younger gatekeepers. CONCLUSIONS Environmental factors endorsing overconsumption are commonly present in the home environments of overweight people and could lead to unplanned eating or passive overconsumption.
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180
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Bjelland M, Hausken SES, Sleddens EFC, Andersen LF, Lie HC, Finset A, Maes L, Melbye EL, Glavin K, Hanssen-Bauer MW, Lien N. Development of family and dietary habits questionnaires: the assessment of family processes, dietary habits and adolescents' impulsiveness in Norwegian adolescents and their parents. Int J Behav Nutr Phys Act 2014; 11:130. [PMID: 25316270 PMCID: PMC4200224 DOI: 10.1186/s12966-014-0130-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 10/08/2014] [Indexed: 12/27/2022] Open
Abstract
Background There is a need for valid and comprehensive measures of parental influence on children’s energy balance-related behaviours (EBRB). Such measures should be based on a theoretical framework, acknowledging the dynamic and complex nature of interactions occurring within a family. The aim of the Family & Dietary habits (F&D) project was to develop a conceptual framework identifying important and changeable family processes influencing dietary behaviours of 13–15 year olds. A second aim was to develop valid and reliable questionnaires for adolescents and their parents (both mothers and fathers) measuring these processes. Methods A stepwise approach was used; (1) preparation of scope and structure, (2) development of the F&D questionnaires, (3) the conducting of pilot studies and (4) the conducting of validation studies (assessing internal reliability, test-retest reliability and confirmatory factor analysis) using data from a cross-sectional study. Results The conceptual framework includes psychosocial concepts such as family functioning, cohesion, conflicts, communication, work-family stress, parental practices and parental style. The physical characteristics of the home environment include accessibility and availability of different food items, while family meals are the sociocultural setting included. Individual characteristics measured are dietary intake (vegetables and sugar-sweetened beverages) and adolescents’ impulsivity. The F&D questionnaires developed were tested in a test-retest (54 adolescents and 44 of their parents) and in a cross-sectional survey including 440 adolescents (13–15 year olds), 242 mothers and 155 fathers. The samples appear to be relatively representative for Norwegian adolescents and parents. For adolescents, mothers and fathers, the test-retest reliability of the dietary intake, frequencies of (family) meals, work-family stress and communication variables was satisfactory (ICC: 0.53-0.99). Barratt Impulsiveness Scale-Brief (BIS-Brief) was included, assessing adolescent’s impulsivity. The internal reliability (Cronbach’s alphas: 0.77/0.82) and test-retest reliability values (ICC: 0.74/0.77) of BIS-Brief were good. Conclusions The conceptual framework developed may be a useful tool in guiding measurement and assessment of the home food environment and family processes related to adolescents’ dietary habits, in particular and for EBRBs more generally. The results support the use of the F&D questionnaires as psychometrically sound tools to assess family characteristics and adolescent’s impulsivity. Electronic supplementary material The online version of this article (doi:10.1186/s12966-014-0130-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mona Bjelland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Blindern, Oslo, NO-0316, Norway.
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181
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Couch SC, Glanz K, Zhou C, Sallis JF, Saelens BE. Home food environment in relation to children's diet quality and weight status. J Acad Nutr Diet 2014; 114:1569-1579.e1. [PMID: 25066057 PMCID: PMC4177359 DOI: 10.1016/j.jand.2014.05.015] [Citation(s) in RCA: 191] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 05/14/2014] [Indexed: 12/11/2022]
Abstract
The objective of this cohort study was to explore relationships among the home food environment (HFE), child/parent characteristics, diet quality, and measured weight status among 699 child-parent pairs from King County, WA, and San Diego County, CA. HFE variables included parenting style/feeding practices, food rules, frequency of eating out, home food availability, and parents' perceptions of food costs. Child dietary intake was measured by 3-day recall and diet quality indicators included fruits and vegetables, sweet/savory snacks, high-calorie beverages, and Dietary Approaches to Stop Hypertension (DASH) score. Individual linear regression models were run in which child BMI z score and child diet quality indicators were dependent variables and HFE variables and child/parent characteristics were independent variables of interest. Fruit and vegetable consumption was associated with parental encouragement/modeling (β=.68, P<0.001) and unhealthful food availability (-0.27, P<0.05); DASH score with food availability (healthful: 1.3, P<0.01; unhealthful: -2.25, P<0.001), food rules (0.45, P<0.01), and permissive feeding style (-1.04, P<0.05); high-calorie beverages with permissive feeding style (0.14, P<0.01) and unhealthful food availability (0.21, P<0.001); and sweet/savory snacks with healthful food availability (0.26, P<0.05; unexpectedly positive). Children's BMI z score was positively associated with parent's use of food restriction (0.21, P<0.001), permissive feeding style (0.16, P<0.05), and concern for healthy food costs (0.10, P<0.01), but negatively with verbal encouragement/modeling (-0.17, P<0.05), and pressure to eat (-0.34, P<0.001). Various HFE factors associated with parenting around eating and food availability are related to child diet quality and weight status. These factors should be considered when designing interventions for improving child health.
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Affiliation(s)
- Sarah C. Couch
- Professor, Department of Nutritional Sciences, University of Cincinnati Medical Center, Cincinnati OH, 45267-0394, Telephone: 513-558-7504, Fax: 513-558-7500,
| | - Karen Glanz
- George A. Weiss Professor; Professor of Epidemiology, Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine and Nursing, Philadelphia PA 19104, Telephone: 215-898-0613, Fax: 215-573-5315,
| | - Chuan Zhou
- Research Associate Professor, Seattle Children’s Research Institute, Department of Pediatrics, University of Washington, Seattle, WA 98145, Telephone: 206-884-1028,
| | - James F Sallis
- Distinguished Professor of Family and Preventive Medicine, Chief Division of Behavioral Medicine, University of California, San Diego CA 92103, Telephone: 619-260-5535; Fax 619-260-1510,
| | - Brian E Saelens
- Professor of Pediatrics, Psychiatry and Behavioral Sciences, Seattle Children’s Research Institute, Department of Pediatrics, University of Washington, Seattle, WA 98145, telephone: 206-884-7800,
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182
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Masters MA, Stanek Krogstrand KL, Eskridge KM, Albrecht JA. Race/ethnicity and income in relation to the home food environment in US youth aged 6 to 19 years. J Acad Nutr Diet 2014; 114:1533-43. [PMID: 24935611 DOI: 10.1016/j.jand.2014.04.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 04/24/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The home food environment is complex and has the potential to influence dietary habit development in young people. Several factors may influence the home food environment, including income and race/ethnicity. OBJECTIVE To examine the relationship of income and race/ethnicity with three home food environment factors (ie, food availability frequency, family meal patterns [frequency of family and home cooked meals], and family food expenditures). DESIGN A cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES). PARTICIPANTS A total of 5,096 youth aged 6 to 19 years from a nationally representative sample of US individuals participating in NHANES 2007-10. STATISTICAL ANALYSES PERFORMED Prevalence of food availability frequency was assessed for the entire sample, race/ethnicity, poverty income ratio (PIR), and race/ethnicity stratified by PIR. Mean values of family meal patterns and food expenditures were calculated based on race/ethnicity, PIR, and race/ethnicity stratified by PIR using analysis of variance and least squares means. Tests of main effects were used to assess differences in food availability prevalence and mean values of family meal patterns and food expenditures. RESULTS Non-Hispanic whites had the highest prevalence of salty snacks (51.1%±1.5%) and fat-free/low-fat milk (39.2%±1.7%) always available. High-income homes had the highest prevalence of fruits (75.4%±2.4%) and fat-free/low-fat milk (38.4%±2.1%) always available. Differences were found for prevalence of food availability when race/ethnicity was stratified by PIR. Non-Hispanic blacks had the lowest prevalence of fat-free/low-fat milk always available across PIR groups. Differences in mean levels of family meal patterns and food expenditures were found for race/ethnicity, PIR, and race/ethnicity stratified by PIR. CONCLUSIONS Race/ethnicity and PIR appear to influence food availability, family meal patterns, and family food expenditures in homes of youth. Knowledge of factors that influence the home food environment could assist in developing effective strategies to improve food environments for young people.
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183
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Kegler MC, Alcantara I, Haardörfer R, Gazmararian JA, Ballard D, Sabbs D. The influence of home food environments on eating behaviors of overweight and obese women. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:188-196. [PMID: 24809866 DOI: 10.1016/j.jneb.2014.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 12/21/2013] [Accepted: 01/02/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To describe home food environments and examine which aspects are associated with fruit and vegetable intake and percent calories from fat among overweight and obese women. DESIGN Baseline data from a weight gain prevention trial collected through telephone interviews. SETTING Participants were recruited from 3 federally qualified health centers in rural Georgia. PARTICIPANTS Overweight and obese patients (n = 319) were referred by their providers if they had a body mass index (BMI) > 25 and lived with at least 1 other person. Participants were primarily African American (83.7%), with a mean BMI of 38.4. MAIN OUTCOME MEASURES Fruit and vegetable intake and percent calories from fat. ANALYSIS Descriptive statistics and multiple regression. RESULTS Participants reported a large variety of both fruits and vegetables and unhealthy foods in their homes, and an average of 2.6 family meals from non-home sources per week. Eating family meals with the television on was common. Availability of fruits and vegetables in the home (P < .001) and frequency of fruit shopping (P = .01) were associated with fruit and vegetable intake. The number of unhealthy foods in the home (P = .01) and food preparation methods (P = .01) were associated with percent calories from fat. CONCLUSIONS AND IMPLICATIONS Home food environments may be effective intervention targets for nutrition programs designed for overweight and obese women.
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Affiliation(s)
- Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Iris Alcantara
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, Emory University, Atlanta, GA
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Julie A Gazmararian
- Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Denise Ballard
- Cancer Prevention and Control, Cancer Coalition of South Georgia, Albany, GA
| | - Darrell Sabbs
- Community Benefits, Phoebe Putney Memorial Hospital, Albany, GA
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184
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Jones DJ, Gonzalez M, Ward DS, Vaughn A, Emunah J, Miller L, Anton M. Should child obesity be an issue for child protective services? A call for more research on this critical public health issue. TRAUMA, VIOLENCE & ABUSE 2014; 15:113-125. [PMID: 24231942 DOI: 10.1177/1524838013511544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Given the lasting effects on adolescent and adult health, childhood obesity is a major public health issue. The relatively slow progress toward the prevention and treatment of childhood obesity, however, has prompted leaders in both academic and practice sectors to advocate for what may be considered a radical intervention approach, to conceptualize extreme child obesity as an issue of child maltreatment. Advocates of this approach suggest that this conceptualization affords a new angle for intervention-the involvement of child protective services (CPS) in mandating family-focused lifestyle changes aimed at reducing child overweight and, in the most extreme cases, the removal of the obese child from the home. However, surprisingly little research has been conducted to inform policies or practices consistent with this recommendation, which is already being implemented in some states. This article aims to provide an overview of the challenges to the prevention and treatment of childhood obesity that have motivated the call for CPS involvement in extreme cases and to review the existing research related to this approach. Given that relatively little data are currently available to support or refute the merits of CPS involvement, recommendations for future research that would better inform public policy and decision making regarding this and other intervention strategies are also highlighted.
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Affiliation(s)
- Deborah J Jones
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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185
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Soares ALG, França GVAD, Gonçalves H. Household food availability in Pelotas, Brazil: An approach to assess the obesogenic environment. REV NUTR 2014. [DOI: 10.1590/1415-52732014000200006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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186
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Natale RA, Lopez-Mitnik G, Uhlhorn SB, Asfour L, Messiah SE. Effect of a child care center-based obesity prevention program on body mass index and nutrition practices among preschool-aged children. Health Promot Pract 2014; 15:695-705. [PMID: 24662896 DOI: 10.1177/1524839914523429] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the effect of an early childhood obesity prevention program on changes in Body Mass Index (BMI) z-score and nutrition practices. Eight child care centers were randomly assigned to an intervention or attention control arm. Participants were a multiethnic sample of children aged 2 to 5 years old (N = 307). Intervention centers received healthy menu changes and family-based education focused on increased physical activity and fresh produce intake, decreased intake of simple carbohydrate snacks, and decreased screen time. Control centers received an attention control program. Height, weight, and nutrition data were collected at baseline and at 3, 6, and 12 months. Analysis examined height, weight, and BMI z-score change by intervention condition (at baseline and at 3, 6, and 12 months). Pearson correlation analysis examined relationships among BMI z-scores and home activities and nutrition patterns in the intervention group. Child BMI z-score was significantly negatively correlated with the number of home activities completed at 6-month post intervention among intervention participants. Similarly, intervention children consumed less junk food, ate more fresh fruits and vegetables, drank less juice, and drank more 1% milk compared to children at control sites at 6 months post baseline. Ninety-seven percent of those children who were normal weight at baseline were still normal weight 12 months later. Findings support child care centers as a promising setting to implement childhood obesity prevention programs in this age group.
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Affiliation(s)
- Ruby A Natale
- Division of Psychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gabriela Lopez-Mitnik
- Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susan B Uhlhorn
- Division of Psychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lila Asfour
- Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sarah E Messiah
- Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL, USA
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187
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An exploration and comparison of food and drink availability in homes in a sample of families of White and Pakistani origin within the UK. Public Health Nutr 2014; 18:1197-205. [PMID: 24607149 DOI: 10.1017/s1368980014000147] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Knowledge of the types and quantities of foods and drinks available in family homes supports the development of targeted intervention programmes for obesity prevention or management, or for overall diet improvement. In the UK, contemporary data on foods that are available within family homes are lacking. The present study aimed to explore home food and drink availability in UK homes. DESIGN An exploratory study using researcher-conducted home food availability inventories, measuring all foods and drinks within the categories of fruits, vegetables, snack foods and beverages. SETTING Bradford, a town in the north of the UK. SUBJECTS Opportunistic sample of mixed ethnicity families with infants approximately 18 months old from the Born in Bradford birth cohort. RESULTS All homes had at least one type of fruit, vegetable and snack available. Fresh fruits commonly available were oranges, bananas, apples, satsumas and grapes. Commonly available fresh vegetables included potatoes, cucumber, tomatoes and carrots. The single greatest non-fresh fruit available in homes was raisins. Non-fresh vegetables contributing the most were frozen mixed vegetables, tinned tomatoes and tinned peas. Ethnic differences were found for the availability of fresh fruits and sugar-sweetened beverages, which were both found in higher amounts in Pakistani homes compared with White homes. CONCLUSIONS These data contribute to international data on availability and provide an insight into food availability within family homes in the UK. They have also supported a needs assessment of the development of a culturally specific obesity prevention intervention in which fruits and vegetables and sugar-sweetened beverages are targeted.
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188
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Boutelle KN, Peterson CB, Crosby RD, Rydell SA, Zucker N, Harnack L. Overeating phenotypes in overweight and obese children. Appetite 2014; 76:95-100. [PMID: 24524975 DOI: 10.1016/j.appet.2014.01.076] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 12/11/2013] [Accepted: 01/30/2014] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to identify overeating phenotypes and their correlates in overweight and obese children. One hundred and seventeen treatment-seeking overweight and obese 8-12year-old children and their parents completed the study. Children completed an eating in the absence of hunger (EAH) paradigm, the Eating Disorder Examination interview, and measurements of height and weight. Parents and children completed questionnaires that evaluated satiety responsiveness, food responsiveness, negative affect eating, external eating and eating in the absence of hunger. Latent profile analysis was used to identify heterogeneity in overeating phenotypes in the child participants. Latent classes were then compared on measures of demographics, obesity status and nutritional intake. Three latent classes of overweight and obese children were identified: High Satiety Responsive, High Food Responsive, and Moderate Satiety and Food Responsive. Results indicated that the High Food Responsive group had higher BMI and BMI-Z scores compared to the High Satiety Responsive group. No differences were found among classes in demographics or nutritional intake. This study identified three overeating phenotypes, supporting the heterogeneity of eating patterns associated with overweight and obesity in treatment-seeking children. These finding suggest that these phenotypes can potentially be used to identify high risk groups, inform prevention and intervention targets, and develop specific treatments for these behavioral phenotypes.
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Affiliation(s)
- Kerri N Boutelle
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, MC 0874, La Jolla, CA 92037, United States; Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, MC 0874, La Jolla, CA 92037, United States.
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, ND, United States; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Sarah A Rydell
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Nancy Zucker
- Department of Psychiatry, Duke University, Durham, NC, United States
| | - Lisa Harnack
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
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189
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Abstract
Family-based interventions have been effective in managing childhood obesity, and pediatric nurse practitioners (PNPs) are positioned to provide obesity interventions in both patient and family primary care settings. The purpose of this article is to guide the PNP in implementing family-based childhood obesity interventions, including identification, diagnostic evaluation, and management.
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190
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Bundrick SC, Thearle MS, Venti CA, Krakoff J, Votruba SB. Soda consumption during ad libitum food intake predicts weight change. J Acad Nutr Diet 2013; 114:444-449. [PMID: 24321742 DOI: 10.1016/j.jand.2013.09.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 09/03/2013] [Indexed: 02/01/2023]
Abstract
Soda consumption may contribute to weight gain over time. Objective data were used to determine whether soda consumption predicts weight gain or changes in glucose regulation over time. Subjects without diabetes (128 men, 75 women; mean age 34.3±8.9 years; mean body mass index 32.5±7.4; mean percentage body fat 31.6%±8.6%) self-selected their food from an ad libitum vending machine system for 3 days. Mean daily energy intake was calculated from food weight. Energy consumed from soda was recorded as were food choices that were low in fat (<20% of calories from fat) or high in simple sugars (>30%). Food choices were expressed as percentage of daily energy intake. A subset of 85 subjects had measurement of follow-up weights and oral glucose tolerance (57 men, 28 women; mean follow-up time=2.5±2.1 years, range 6 months to 9.9 years). Energy consumed from soda was negatively related to age (r=-0.27, P=0.0001) and choosing low-fat foods (r=-0.35, P<0.0001), but positively associated with choosing solid foods high in simple sugars (r=0.45, P<0.0001) and overall average daily energy intake (r=0.46, P<0.0001). Energy intake from food alone did not differ between individuals who did and did not consume beverage calories (P=0.11). Total daily energy intake had no relationship with change in weight (P=0.29) or change in glucose regulation (P=0.38) over time. However, energy consumed from soda correlated with change in weight (r=0.21, P=0.04). This relationship was unchanged after adjusting for follow-up time and initial weight. Soda consumption is a marker for excess energy consumption and is associated with weight gain.
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Hales D, Vaughn AE, Mazzucca S, Bryant MJ, Tabak RG, McWilliams C, Stevens J, Ward DS. Development of HomeSTEAD's physical activity and screen time physical environment inventory. Int J Behav Nutr Phys Act 2013; 10:132. [PMID: 24313962 PMCID: PMC3906984 DOI: 10.1186/1479-5868-10-132] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 11/18/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The home environment has a significant influence on children's physical activity, sedentary behavior, dietary intake, and risk for obesity and chronic disease. Our understanding of the most influential factors and how they interact and impact child behavior is limited by current measurement tools, specifically the lack of a comprehensive instrument. HomeSTEAD (the Home Self-administered Tool for Environmental assessment of Activity and Diet) was designed to address this gap. This new tool contains four sections: home physical activity and media equipment inventory, family physical activity and screen time practices, home food inventory, and family food practices. This paper will describe HomeSTEAD's development and present reliability and validity evidence for the first section. METHODS The ANGELO framework guided instrument development, and systematic literature reviews helped identify existing items or scales for possible inclusion. Refinement of items was based on expert review and cognitive interviews. Parents of children ages 3-12 years (n = 125) completed the HomeSTEAD survey on three separate occasions over 12-18 days (Time 1, 2, and 3). The Time 1 survey also collected demographic information and parent report of child behaviors. Between Time 1 and 2, staff conducted an in-home observation and measured parent and child BMI. Kappa and intra-class correlations were used to examine reliability (test-retest) and validity (criterion and construct). RESULTS Reliability and validity was strong for most items (97% having ICC > 0.60 and 72% having r > 0.50, respectively). Items with lower reliability generally had low variation between people. Lower validity estimates (r < 0.30) were more common for items that assessed usability and accessibility, with observers generally rating usability and accessibility lower than parents. Small to moderate, but meaningful, correlations between physical environment factors and BMI, outside time, and screen time were observed (e.g., amount of child portable play equipment in good condition and easy to access was significantly associated with child BMI: r = -0.23), providing evidence of construct validity. CONCLUSIONS The HomeSTEAD instrument represents a clear advancement in the measurement of factors in the home environment related to child weight and weight-related behaviors. HomeSTEAD, in its entirety, represents a useful tool for researchers from which they can draw particular scales of greatest interest and highest relevance to their research questions.
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Affiliation(s)
| | | | | | | | | | | | | | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB 7461, Chapel Hill, NC 27599-7461, USA.
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192
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Van Lippevelde W, Te Velde SJ, Verloigne M, Van Stralen MM, De Bourdeaudhuij I, Manios Y, Bere E, Vik FN, Jan N, Fernández Alvira JM, Chinapaw MJM, Bringolf-Isler B, Kovacs E, Brug J, Maes L. Associations between family-related factors, breakfast consumption and BMI among 10- to 12-year-old European children: the cross-sectional ENERGY-study. PLoS One 2013; 8:e79550. [PMID: 24282508 PMCID: PMC3840060 DOI: 10.1371/journal.pone.0079550] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 09/24/2013] [Indexed: 12/16/2022] Open
Abstract
Objective To investigate associations of family-related factors with children’s breakfast consumption and BMI-z-score and to examine whether children’s breakfast consumption mediates associations between family-related factors and children’s BMI-z-score. Subjects Ten- to twelve-year-old children (n = 6374; mean age = 11.6±0.7 years, 53.2% girls, mean BMI-z-score = 0.4±1.2) and one of their parents (n = 6374; mean age = 41.4±5.3 years, 82.7% female, mean BMI = 24.5±4.2 kg/m2) were recruited from schools in eight European countries (Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, Spain, and Switzerland). The children self-reported their breakfast frequency per week. The body weight and height of the children were objectively measured. The parents responded to items on family factors related to breakfast (automaticity, availability, encouragement, paying attention, permissiveness, negotiating, communicating health beliefs, parental self-efficacy to address children’s nagging, praising, and family breakfast frequency). Mediation analyses were performed using multi-level regression analyses (child-school-country). Results Three of the eleven family-related variables were significantly associated with children’s BMI-z-score. The family breakfast frequency was negatively associated with the BMI-z-score; permissiveness concerning skipping breakfast and negotiating about breakfast were positively associated with the BMI-z-score. Children’s breakfast consumption was found to be a mediator of the two associations. All family-related variables except for negotiating, praising and communicating health beliefs, were significantly associated with children’s breakfast consumption. Conclusions Future breakfast promotion and obesity prevention interventions should focus on family-related factors including the physical home environment and parenting practices. Nevertheless, more longitudinal research and intervention studies to support these findings between family-related factors and both children’s breakfast consumption and BMI-z-score are needed.
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Affiliation(s)
| | - Saskia J. Te Velde
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Maïté Verloigne
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Maartje M. Van Stralen
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Elling Bere
- Faculty of Health and Sport, University of Agder, Kristiansand, Norway
| | - Froydis N. Vik
- Faculty of Health and Sport, University of Agder, Kristiansand, Norway
| | - Nataša Jan
- Slovenian Heart Foundation, Ljubljana, Slovenia
| | | | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Bettina Bringolf-Isler
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health
- University of Basel, Basel, Switzerland
| | - Eva Kovacs
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Lea Maes
- Department of Public Health, Ghent University, Ghent, Belgium
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193
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Schneiderman JU, Smith C, Arnold-Clark JS, Fuentes J, Duan L. Weight changes in children in foster care for 1 year. CHILD ABUSE & NEGLECT 2013; 37:832-40. [PMID: 23499524 PMCID: PMC3713178 DOI: 10.1016/j.chiabu.2013.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 02/05/2013] [Accepted: 02/18/2013] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The aims of this study of predominately racial/ethnic minority children in foster care (N=360, birth to 19 years old) in Los Angeles, CA were to examine the (1) prevalence of obesity (≥ 95 percentile) and overweight/obese (≥ 85 percentile) upon entrance to foster care (T1) and after 1 year in foster care (T2); (2) comparison of high weight categories to national statistics; (3) relationship of changes in weight status to age, reason for entry into foster care, and placement. METHODS Chi-square test and McNemar test comparing paired proportions were used to determine whether there were significant changes in the proportion of high weight categories between T1 and T2. Chi-square test or Fisher's exact test were used to evaluate the association between age, placement, and reason for foster care with the change in weight category. Changes in weight were categorized as (1) decreased in weight, (2) remained at overweight or obese, (3) increased in weight, or (4) remained normal. RESULTS The proportion of obese and obese/overweight children between ages 2 and 5 were significantly lower at T2 than T1. There were no significant changes in the prevalence of obesity for the total population at T2. Children age 6 or older had a higher prevalence of obesity and overweight/obesity compared to national statistics. Of children at all ages, 64.7% of children of all ages entered foster care with a normal weight and stayed in the normal range during their first year in foster care, 12.2% decreased their weight, 15.4% remained overweight or obese, and 7.7% increased their weight. Age and parental substance use was related to change in weight category from T1 to T2. CONCLUSION Children did not become more overweight or obese in foster care; however 28% of the children were obese or overweight upon entry into foster care. Children who are 6 years or older and obese upon entering foster care should be targeted for weight reduction. The pediatric community and child welfare system need to work together by including weight percentiles in the foster care file and training/monitoring child welfare caregivers in weight reduction interventions.
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Affiliation(s)
- Janet U Schneiderman
- School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA 90089-0411, USA.
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194
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Kallem S, Carroll-Scott A, Rosenthal L, Chen E, Peters SM, McCaslin C, Ickovics JR. Shift-and-persist: a protective factor for elevated BMI among low-socioeconomic-status children. Obesity (Silver Spring) 2013; 21:1759-63. [PMID: 23671041 PMCID: PMC4325991 DOI: 10.1002/oby.20195] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 06/18/2012] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Low socioeconomic status (SES) is associated with many adverse health outcomes, including childhood overweight and obesity. However, little is understood about why some children defy this trend by maintaining a healthy weight despite living in obesogenic environments. The objective of this study is to test the hypothesis that the psychological strategy of "shift-and-persist" protects low-SES children from overweight and obesity. Shift-and-persist involves dealing with stressors by reframing them more positively while at the same time persisting in optimistic thoughts about the future. DESIGN AND METHODS Middle school children (N = 1,523, ages 9-15) enrolled in a school-based obesity prevention trial completed health surveys and physical assessments. Multiple linear regression analysis was used to examine the role of SES, shift-and-persist strategies, and their interaction on BMI z-scores, while controlling for student race/ethnicity, gender, and reported diet and physical activity. RESULTS Among children reporting engaging in less frequent shift-and-persist strategies, lower SES was associated with significantly higher BMI z-scores (P < 0.05). However, among children reporting engaging in more frequent shift-and-persist strategies, there was no association of SES with BMI z-score (P = 0.16), suggesting that shift-and-persist strategies may be protective against the association between SES and BMI. CONCLUSIONS Interventions aimed at improving psychological resilience among children of low SES may provide a complementary approach to prevent childhood overweight and obesity among at-risk populations.
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Affiliation(s)
- Stacey Kallem
- Yale University School of Medicine, New Haven, Connecticut, USA
- CARE: Community Alliance for Research and Engagement, New Haven, Connecticut, USA
| | - Amy Carroll-Scott
- CARE: Community Alliance for Research and Engagement, New Haven, Connecticut, USA
- Yale School of Public Health, New Haven, Connecticut, USA
| | - Lisa Rosenthal
- CARE: Community Alliance for Research and Engagement, New Haven, Connecticut, USA
- Yale School of Public Health, New Haven, Connecticut, USA
| | - Edith Chen
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
| | - Susan M. Peters
- CARE: Community Alliance for Research and Engagement, New Haven, Connecticut, USA
- Yale School of Public Health, New Haven, Connecticut, USA
| | | | - Jeannette R. Ickovics
- CARE: Community Alliance for Research and Engagement, New Haven, Connecticut, USA
- Yale School of Public Health, New Haven, Connecticut, USA
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195
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A Call for Culinary Skills Education in Childhood Obesity-Prevention Interventions: Current Status and Peer Influences. J Acad Nutr Diet 2013; 113:1031-6. [DOI: 10.1016/j.jand.2013.05.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 04/29/2013] [Indexed: 11/21/2022]
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Vaughn AE, Tabak RG, Bryant MJ, Ward DS. Measuring parent food practices: a systematic review of existing measures and examination of instruments. Int J Behav Nutr Phys Act 2013; 10:61. [PMID: 23688157 PMCID: PMC3681578 DOI: 10.1186/1479-5868-10-61] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 05/08/2013] [Indexed: 11/10/2022] Open
Abstract
During the last decade, there has been a rapid increase in development of instruments to measure parent food practices. Because these instruments often measure different constructs, or define common constructs differently, an evaluation of these instruments is needed. A systematic review of the literature was conducted to identify existing measures of parent food practices and to assess the quality of their development. The initial search used terms capturing home environment, parenting behaviors, feeding practices and eating behaviors, and was performed in October of 2009 using PubMed/Medline, PsychInfo, Web of knowledge (ISI), and ERIC, and updated in July of 2012. A review of titles and abstracts was used to narrow results, after which full articles were retrieved and reviewed. Only articles describing development of measures of parenting food practices designed for families with children 2-12 years old were retained for the current review. For each article, two reviewers extracted data and appraised the quality of processes used for instrument development and evaluation. The initial search yielded 28,378 unique titles; review of titles and abstracts narrowed the pool to 1,352 articles; from which 57 unique instruments were identified. The review update yielded 1,772 new titles from which14 additional instruments were identified. The extraction and appraisal process found that 49% of instruments clearly identified and defined concepts to be measured, and 46% used theory to guide instrument development. Most instruments (80%) had some reliability testing, with internal consistency being the most common (79%). Test-retest or inter-rater reliability was reported for less than half the instruments. Some form of validity evidence was reported for 84% of instruments. Construct validity was most commonly presented (86%), usually with analysis of associations with child diet or weight/BMI. While many measures of food parenting practices have emerged, particularly in recent years, few have demonstrated solid development methods. Substantial variation in items across different scales/constructs makes comparison between instruments extremely difficult. Future efforts should be directed toward consensus development of food parenting practices constructs and measures.
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Affiliation(s)
- Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L, King Jr, Blvd,, CB 7426, Chapel Hill, NC 27599-7426, USA.
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198
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Smith S, Wleklinski D, Roth SL, Tragoudas U. Does school size affect interest for purchasing local foods in the midwest? Child Obes 2013; 9:150-6. [PMID: 23531086 DOI: 10.1089/chi.2012.0055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Due to the recent surge in environmental consciousness and the need to address childhood obesity, Farm to School programs have gained momentum. Even though Farm to School programs have increased in popularity, many schools still fail to take advantage of the benefits from such programs. School food service employees' lack of familiarity with the benefits of Farm to School programs or the means to overcome obstacles to implement such programs, along with school size, may represent key variables that serve to explain why more schools do not purchase more local foods for their schools. METHODS This study used a convenience sampling methodology to gather information regarding food service employees' perceptions of the benefits and obstacles and their attitudes to purchasing and serving local foods in their schools. A self-administered questionnaire was used to collect data from school food service employees in southern Illinois. Data (n=151) were collected from 60 schools, representing 16 counties during the month of December, 2009. RESULTS Purchasers from large- and medium-size schools perceived the "ability to know product sources" as a greater benefit to purchasing local food and perceived "cost of food," "adequate volume," "reliable supply of food quantity," "payment arrangement," and "packing material" as greater obstacles (p<0.05) compared to small schools. In addition, results indicated that food service employees were interested in receiving training to prepare and serve more local foods. CONCLUSIONS Findings from this study indicate a need for continued education, development, and training to better prepare school food service purchasers in southern Illinois for how to buy more local foods to meet the 2020 legislation requiring schools to purchase at least 10% locally.
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Affiliation(s)
- Sylvia Smith
- Department of Animal Science, Food and Nutrition, Southern Illinois University Carbondale, Carbondale, IL 62901, USA.
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The relationship between parental education and adolescents' soft drink intake from the age of 11-13 years, and possible mediating effects of availability and accessibility. Br J Nutr 2013; 110:926-33. [PMID: 23375110 DOI: 10.1017/s0007114512005946] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The present study examined the prospective relationship between parental education and adolescents' soft drink intake over 20 months, and possible mediating effects of adolescents' availability and accessibility of soft drinks at home. A total of 866 adolescents, with data on two time points in the Norwegian HEalth In Adolescents (HEIA) cohort study (2007-9), were included in the analyses. Data on intake and determinants of soft drinks were collected from adolescents and both parents by questionnaires. Mediation analyses using linear regression investigated the total and direct effects of parental education on adolescents' soft drink intake from the age of 11-13 years. In order to investigate prospective relationships, two models were set up to measure the (1) prediction and (2) change in consumption over 20 months. Possible mediation effects of availability and perceived accessibility at home were further examined in both models. The results showed that a lower level of parental education predicted a higher intake of soft drinks among adolescents after 20 months, and that higher perceived accessibility of soft drinks reported by adolescents and mothers explained 39 % of the total effect. No relationship was observed between parental education and the change in adolescents' intake of soft drinks over 20 months. Interventions aimed at families with low parental education should target the perceived accessibility of soft drinks at home in order to diminish social differences in adolescents' soft drink consumption.
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Cultural differences in parental feeding practices and children’s eating behaviours and their relationships with child BMI: a comparison of Black Afro-Caribbean, White British and White German samples. Eur J Clin Nutr 2012; 67:180-4. [DOI: 10.1038/ejcn.2012.198] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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