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Natale R, Weerakoon S, Woody MT, Kolomeyer E, Pena K, Schladant M, Bulotsky-Shearer RJ, Messiah SE. Parent concerns regarding paediatric obesity in community-based programmes serving children with developmental disabilities. Child Care Health Dev 2020; 46:733-740. [PMID: 32803796 DOI: 10.1111/cch.12803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/18/2020] [Accepted: 08/07/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Previous studies show a higher prevalence of obesity among preschool-age children with developmental disabilities (DDs) versus children who are typically developing (TD). Little is known about parent concerns about obesity in young children with DD. The purpose of this study was to examine concerns regarding paediatric obesity among parents who had a preschool-age child with DD compared with parents with a child who is TD. METHODS A cross-sectional analysis occurred at baseline entry into one of three community-based programmes. Parents of a child with DD (n = 815) or TD (n = 563) were asked obesity-related questions about their child and in general. Multinomial and logistic regression unadjusted and adjusted models were run to generate the odds of obesity concerns based on disability status. RESULTS The average child age was 38 months. Parent concerns about paediatric obesity differed by disability status. Unadjusted odds of parents 'doing anything to control their child's weight' was 38% lower among parents of a child with DD versus TD (OR: 0.62, 95% CI: 0.48, 0.82). The adjusted odds of perceiving that their child was underweight was 83% higher among parents of a child with DD compared with parents of a child who is TD (aOR: 1.83, 95% CI: 1.27, 2.64). Parents of a child with DD were 179% more likely to believe that childhood obesity is a public health problem (aOR: 2.79, 95% CI: 1.88, 3.96). The models were adjusted for age, sex and race/ethnicity. CONCLUSIONS Findings indicate that parents of preschool-age children with DD are more likely to acknowledge that obesity is a public health concern. Because some parents of children with DD are concerned about their child's weight, families of preschool-age children with DD may be receptive to the delivery of healthy weight strategies in community-based programs.
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Affiliation(s)
- Ruby Natale
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sitara Weerakoon
- School of Public Health, University of Texas Health Science Center, Houston, Texas, USA
| | - Malaika T Woody
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ellen Kolomeyer
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Kristyna Pena
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | | | - Sarah E Messiah
- School of Public Health, University of Texas Health Science Center, Houston, Texas, USA
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Scott-Sheldon LAJ, Hedges LV, Cyr C, Young-Hyman D, Khan LK, Magnus M, King H, Arteaga S, Cawley J, Economos CD, Haire-Joshu D, Hunter CM, Lee BY, Kumanyika SK, Ritchie LD, Robinson TN, Schwartz MB. Childhood Obesity Evidence Base Project: A Systematic Review and Meta-Analysis of a New Taxonomy of Intervention Components to Improve Weight Status in Children 2-5 Years of Age, 2005-2019. Child Obes 2020; 16:S221-S248. [PMID: 32936038 PMCID: PMC7482126 DOI: 10.1089/chi.2020.0139] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: To evaluate the efficacy of childhood obesity interventions and conduct a taxonomy of intervention components that are most effective in changing obesity-related health outcomes in children 2-5 years of age. Methods: Comprehensive searches located 51 studies from 18,335 unique records. Eligible studies: (1) assessed children aged 2-5, living in the United States; (2) evaluated an intervention to improve weight status; (3) identified a same-aged comparison group; (4) measured BMI; and (5) were available between January 2005 and August 2019. Coders extracted study, sample, and intervention characteristics. Effect sizes [ESs; and 95% confidence intervals (CIs)] were calculated by using random-effects models. Meta-regression was used to determine which intervention components explain variability in ESs. Results: Included were 51 studies evaluating 58 interventions (N = 29,085; mean age = 4 years; 50% girls). Relative to controls, children receiving an intervention had a lower BMI at the end of the intervention (g = 0.10, 95% CI = 0.02-0.18; k = 55) and at the last follow-up (g = 0.17, 95% CI = 0.04-0.30; k = 14; range = 18-143 weeks). Three intervention components moderated efficacy: engage caregivers in praise/encouragement for positive health-related behavior; provide education about the importance of screen time reduction to caregivers; and engage pediatricians/health care providers. Conclusions: Early childhood obesity interventions are effective in reducing BMI in preschool children. Our findings suggest that facilitating caregiver education about the importance of screen time reduction may be an important strategy in reducing early childhood obesity.
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Affiliation(s)
- Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Larry V Hedges
- Department of Statistics, Northwestern University, Evanston, IL, USA
| | - Chris Cyr
- Impact Genome Project, Mission Measurement, Chicago, IL, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Sciences, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Laura Kettel Khan
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Heather King
- Impact Genome Project, Mission Measurement, Chicago, IL, USA
| | - Sonia Arteaga
- Office of the Director, National Institutes of Health, National Institutes of Health, Bethesda, MD, USA
| | - John Cawley
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA
- Department of Economics, Cornell University, Ithaca, NY, USA
| | - Christina D Economos
- Division of Nutrition Interventions, Communication, and Behavior Change, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Debra Haire-Joshu
- Center for Obesity Prevention and Policy Research, Brown School, Washington University, Saint Louis, MO, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Bruce Y Lee
- CUNY Graduate School of Public Health and Policy, New York, NY, USA
| | - Shiriki K Kumanyika
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lorrene D Ritchie
- Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Berkeley, CA, USA
| | - Thomas N Robinson
- Departments of Pediatrics and Medicine, Stanford Solutions Science Lab, Stanford University, Stanford, CA, USA
| | - Marlene B Schwartz
- Department of Human Development and Family Studies, University of Connecticut, Hartford, CT, USA
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Messiah SE, Atem F, Lebron C, Ofori A, Mathew MS, Chang C, Natale RA. Comparison of Early Life Obesity-Related Risk and Protective Factors in Non-Hispanic Black Subgroups. Matern Child Health J 2020; 24:1130-1137. [PMID: 32632842 PMCID: PMC7423728 DOI: 10.1007/s10995-020-02979-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Previous obesity prevention studies in preschool-age children have included non-Hispanic Black (NHB) children, but few have investigated between-subgroup differences even though there may be cultural risk and protective practice differences, challenging the generalizability of findings. The purpose of this study was to examine differences in early childhood obesity-related factors in NHB subgroups (Haitian, other Caribbean Islander and African-American [AA]) children. METHODS Baseline data from two randomized controlled trials in 52 childcare centers of which 35 had data to test a preschool-based obesity prevention intervention was analyzed. The sub-sample included 370 caregiver-child dyads; 209 self-identified as AA, 120 as Haitian and 41 as Caribbean Islander/West Indian or mixed race. Multilevel regression models generated outcome estimates for group differences in body mass index (BMI) percentile, birthweight, breastfeeding initiation and duration, bottle feeding duration and age when solid foods were introduced. RESULTS Mean BMI percentile was similar for AA, Haitian and Caribbean Islander/West Indian/Multiracial (60.1th percentile, 60.8th percentile, 62.8th percentile, respectively) as was birthweight (6.3, 6.8, and 6.6 lb, respectively). Children of US-born caregivers had significantly lower BMI percentiles (9.13 percentile points) versus foreign-born caregivers. Haitian women were significantly more likely to initiate breastfeeding (64.9%) versus AA (47.6%) and Caribbean Islander/West Indian/Multiracial (62.2%) (p < .01). No significant group differences were found in breastfeeding or bottle feeding duration or age solid foods were introduced. CONCLUSIONS Findings here suggest that NHB race classification can identify important subgroup behavioral similarities which in turn may inform culturally sensitive strategies to promote early childhood healthy weight. Foreign-born caregivers may benefit from healthy weight promotion information, and as early as possible in their child's development.
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Affiliation(s)
- Sarah E Messiah
- University of Texas Health Science Center School of Public Health, Dallas, TX, USA.
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA.
| | - Folefac Atem
- University of Texas Health Science Center School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA
| | - Cynthia Lebron
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
| | - Ashley Ofori
- University of Texas Health Science Center School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA
| | - M Sunil Mathew
- University of Texas Health Science Center School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA
| | | | - Ruby A Natale
- Department of Pediatrics, University of Miami, Miami, FL, USA
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Palau MA, Meier MR, Brinton JT, Hwang SS, Roosevelt GE, Parker TA. The impact of parental primary language on communication in the neonatal intensive care unit. J Perinatol 2019; 39:307-313. [PMID: 30531932 DOI: 10.1038/s41372-018-0295-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 11/07/2018] [Accepted: 11/26/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Language barriers contribute to suboptimal healthcare delivery. We sought to explore disparities in communication between English and Spanish-speaking parents and their neonatal intensive care unit (NICU) providers. STUDY DESIGN We compared English-speaking versus Spanish-speaking parents' understanding of their infant's diagnosis through a structured interview. RESULTS Spanish-speaking parents were four times (RR 4.0, 95% CI: 1.5, 11.0; p = 0.004) more likely to incorrectly identify their child's diagnosis than English-speaking parents. Spanish speakers also self-reported lower understanding of NICU interventions. Physicians provided updates to Spanish-speaking parents in their native language only 39% of the time. CONCLUSIONS Spanish-speaking NICU parents more commonly misunderstood aspects of their child's care than did English-speaking parents. Providers' failed to communicate with Spanish-speaking families in their native language the majority of the time. Additional research is needed to assess the barriers to effective communication between NICU providers and Spanish-speaking parents.
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Affiliation(s)
- Mauricio A Palau
- Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - Maxene R Meier
- Department of Biostatistics and Informatics, School of Public Health, University of Colorado Denver, Aurora, CO, 80045, USA
| | - John T Brinton
- Department of Biostatistics and Informatics, School of Public Health, University of Colorado Denver, Aurora, CO, 80045, USA
| | - Sunah S Hwang
- Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Genie E Roosevelt
- Department of Emergency Medicine, University of Colorado School of Medicine, Denver Health Medical Center, Denver, CO, 80204, USA
| | - Thomas A Parker
- Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
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Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. HEALTH EDUCATION & BEHAVIOR 2015; 43:94-106. [DOI: 10.1177/1090198115596737] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. The purpose of this study was to evaluate the efficacy of the Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention at 1-year, postintervention follow-up. Method. A mixed between–within subjects design was used to evaluate the trial. Independent variables included a two-level, group assignment: EMPOWER (experimental intervention) based on social cognitive theory (SCT) as well as a knowledge-based intervention Healthy Lifestyles (active control intervention). Dependent variables were evaluated across four levels of time: baseline (Week 0), posttest (Week 4), 1-month follow-up (Week 8), and 1-year follow-up (Week 60). Dependent variables included five maternal-facilitated SCT constructs (environment, emotional coping, expectations, self-control, and self-efficacy) as well as four child behaviors (minutes of child physical activity, cups of fruits and vegetables consumed, 8-ounce glasses of sugar-sweetened beverages consumed, and minutes of screen time). Null hypotheses implied no significant group-by-time interactions for the dependent variables under investigation. Results. A significant group-by-time interaction for child fruit and vegetable consumption was found in the experimental group ( p = .012) relative to the control group. At 1 year, results suggested an overall increase of 1.847 cups of fruits and vegetables (95% confidence interval = 1.207-2.498) in the experimental group ( p < .001). Analysis suggested changes in the maternal-facilitated home environment accounted for 13.3% of the variance in the change in child fruit and vegetable consumption. Improvements in child physical activity, sugar-free beverage intake, and screen time first detected at 1-month follow-up in both groups were no longer significant at 1-year follow-up. Conclusions. An online family-and-home-based intervention was efficacious for improving child fruit and vegetable consumption. Follow-up booster sessions may assist in maintaining treatment effects.
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