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Obita G, Burns M, Nnyanzi LA, Kuo CH, Barengo NC, Alkhatib A. Childhood obesity and comorbidities-related perspective and experience of parents from Black and Asian minority ethnicities in England: a qualitative study. Front Public Health 2024; 12:1399276. [PMID: 39175897 PMCID: PMC11340680 DOI: 10.3389/fpubh.2024.1399276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/23/2024] [Indexed: 08/24/2024] Open
Abstract
Background Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualized factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority populations. Methods Following ethical approval, families (n = 180) from ethnic minority populations in the Northeast of England were contacted through flyers, community social groups and online forum. Of the 180 families contacted, 22 expressed interests, of whom 12 parents were eligible to participate in the study, and one family dropped out due to time constraints. Therefore 11 parents from ethnic minority communities living with at least one child with obesity were interviewed. Each family was separately visited at home and took part in a semi-structured interview based on the study's qualitative, descriptive phenomenological design. Nine of the families had one child who was diagnosed with an obesity-related comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems or respiratory disorder). Semi-structured interviews were standardized around parents' perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity impact on their lives. All interviews were analyzed using qualitative thematic analysis. Results Parents' perspectives revealed 11 themes centered around experience of living with a child with obesity, risks, and impact of obesity related Non-Communicable Diseases; and access to support, and barriers unique to minority ethnic groups. Parents revealed social disadvantages, fear of victimization by social services, perceptions on their cultural and religious traditions, and racial stigmatization related to their child's weight. Parents reported closer bonding with their children to protect them from the untoward consequences of overweight, and little awareness of healthcare obesity prevention programs. Work pressure, lack of time, absence of guidance from professionals were seen as barriers to healthy lifestyle, while support from friends and closer family bond in adopting healthy lifestyle behaviors were facilitators. However, there was little awareness or access to current healthcare obesity preventive offerings. Conclusion Minority ethnic communities' perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle interventions are needed beyond those administered by the primary healthcare system.
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Affiliation(s)
- George Obita
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Mark Burns
- James Cook University Hospital, South Tees Hospital Trusts, Middlesbrough, United Kingdom
| | | | - Chia-Hua Kuo
- Institute of Sport Science, University of Taipei, Taipei, Taiwan
| | - Noël C. Barengo
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | - Ahmad Alkhatib
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
- Institute of Sport Science, University of Taipei, Taipei, Taiwan
- College of Life Sciences, Birmingham City University, Birmingham, United Kingdom
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Ad G, Dc G, Nj J, Se W, Tr B, Slusser W, Pj C. A Hybrid Mobile Phone Feasibility Study Focusing on Latino Mothers, Fathers, and Grandmothers to Prevent Obesity in Preschoolers. Matern Child Health J 2023; 27:1621-1631. [PMID: 37347374 PMCID: PMC10359399 DOI: 10.1007/s10995-023-03700-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE To pilot the feasibility of a mobile phone childhood obesity intervention for family caregivers of Latino preschool-aged children. METHODS An evidence-based early childhood obesity intervention was adapted to have cultural relevance and a shorter-length curriculum for mothers, fathers, and grandmothers of 2- to 5-year-old Latino children. Traditional in-person group sessions (four weeks) were combined with eight weeks of mobile phone content to support parenting skills and evidence-based and age-appropriate nutritional practices in either English or Spanish. A convenience sample of Latino families were recruited from WIC and Early Education Centers in East Los Angeles. Feasibility measures were collected. Child and caregiver height and weight were measured, and caregiver surveys of child dietary intake were collected at baseline, 1- and 6-month post-baseline. Changes in child's dietary intake and BMI, as well as caregiver BMI, were examined using a mixed effects linear regression model with family random intercept and nested random slope for time period of measurement. RESULTS The program was delivered to 64 low-income Latino families (46 mothers, 34 fathers, 16 grandmothers, and 48 children). Children had a reduction in raw BMI, BMI percentile, and BMI z-scores at 6-months post-baseline compared to baseline measurements. The study also demonstrated stable BMI outcomes among all caregivers. CONCLUSION The pilot study shows promise in preventing childhood obesity, and having a multi-generational impact on weight outcomes. Leveraging the high-use of mobile phones has the potential to shorten in-person interventions, and engage fathers and grandmothers who play an important role in shaping healthy weight practices in young children.
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Affiliation(s)
- Guerrero Ad
- UCLA Department of Pediatrics and Children's Discovery and Innovation Institute, Los Angeles, CA, USA.
| | - Glik Dc
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Jackson Nj
- UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, CA, USA
| | - Whaley Se
- Division of Research and Evaluation, Public Health Foundation Enterprises WIC, Irwindale, CA, USA
| | - Belin Tr
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - W Slusser
- UCLA Department of Pediatrics and Children's Discovery and Innovation Institute, Los Angeles, CA, USA
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- UCLA Semel Healthy Campus Initiative Center, Los Angeles, CA, USA
| | - Chung Pj
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
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Blaychfeld Magnazi M, Gesser-Edelsburg A, Itzhaky Y, Endevelt R, Fliss Isakov N. Children in the Anthroposophical Education System Have Lower Rates of Obesity, and Higher Rates of Health Promoting Behaviors. Nutrients 2023; 15:3088. [PMID: 37513506 PMCID: PMC10386373 DOI: 10.3390/nu15143088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The anthroposophical philosophy is a holistic educational and lifestyle approach. Limited information exists on the health-promoting behavioral norms and obesity rates among children living anthroposophical vs. conventional lifestyles. AIMS This study aims to compare the prevalence of childhood obesity, and parents' perceptions of their children's food environment, between anthroposophical and conventional education systems. METHODS We performed a cross-sectional analysis of the National Anthropometric Measurement Survey for first grade students in Israel, comparing anthroposophical schools with matched conventional schools. Additionally, an online survey was distributed among parents of children in both school systems, assessing children's eating norms and dietary intake. RESULTS Overweight and obesity rates were higher among students in conventional schools (n = 205,500) compared to anthroposophical schools (n = 2247) (11.2% vs. 9.6%, and 7.8% vs. 4.8%, respectively; Pv < 0.001). Anthroposophical schools were perceived by more parents to have health-promoting curricula, health promoting teacher behavior, and health promoting social dietary norms, while their children's dietary intake was perceived as healthier both in school and in the after-school, social, and familial environment (Pv < 0.001). CONCLUSIONS Children in anthroposophical education exhibited lower overweight and obesity rates, and engaged in more health-promoting behaviors. Further research is needed to explore the relationship between the anthroposophical lifestyle and childhood obesity, and to identify effective anthroposophical strategies for health promotion among children.
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Affiliation(s)
- Moran Blaychfeld Magnazi
- Nutrition Division, Public Health Services, Ministry of Health, Jerusalem 9101002, Israel
- School of Public Health, the Health and Risk Communication Laboratory, University of Haifa, Haifa 3498838, Israel
| | - Anat Gesser-Edelsburg
- School of Public Health, the Health and Risk Communication Laboratory, University of Haifa, Haifa 3498838, Israel
| | - Yafit Itzhaky
- Department of Public Health Nursing, Public Health Services, Ministry of Health, Jerusalem 9101002, Israel
| | - Ronit Endevelt
- Nutrition Division, Public Health Services, Ministry of Health, Jerusalem 9101002, Israel
- School of Public Health, the Health and Risk Communication Laboratory, University of Haifa, Haifa 3498838, Israel
| | - Naomi Fliss Isakov
- Nutrition Division, Public Health Services, Ministry of Health, Jerusalem 9101002, Israel
- School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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4
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Ayala GX, Monge-Rojas R, King AC, Hunter R, Berge JM. [Entorno social y obesidad infantil: implicaciones para la investigación y la práctica en Estados Unidos y en los países latinoamericanos]. Obes Rev 2021; 22 Suppl 5:e13350. [PMID: 34708540 PMCID: PMC9138052 DOI: 10.1111/obr.13350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/02/2022]
Abstract
The environments of children influence their risk for childhood obesity through, among other factors, a child's weight-related behaviors (i.e., diet and physical activity). In this article, we present evidence on social environmental factors associated with a child's diet and physical activity, and more generally, the prevention and control of childhood obesity among Hispanic/Latinx children in the United States and children from countries in Latin America. Using a socio-ecologic lens, we present evidence from cross-sectional and longitudinal studies conducted in the United States involving Hispanic/Latinx children, and evidence from studies involving children in Latin America. Studies examining parenting factors in the home environment (e.g., parenting strategies) are especially emphasized, with more limited evidence on social environmental factors in other lived contexts (e.g., school). The influence of acculturation on social relationships cuts across levels of the socio-ecological framework. Intervention research identified strategies and research gaps for intervening on social factors to promote healthy behaviors and reduce risk for childhood obesity. Community health workers and others forms of peer support were identified as relevant approaches at multiple levels of the socio-ecological framework. This article concludes with directions for future research to further understand the environment using newer information and communication technologies.
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Affiliation(s)
- Guadalupe X Ayala
- School of Public Health, San Diego State University, the Institute for Behavioral and Community Health, and the SDSU HealthLINK Center, San Diego, California, EE. UU
| | - Rafael Monge-Rojas
- Unidad de Salud y Nutrición, Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Cartago, Costa Rica
| | - Abby C King
- Departments of Epidemiology & Population Health and Medicine (Stanford Prevention Research Center), Stanford University School of Medicine, Stanford, California, EE. UU
| | - Ruth Hunter
- Centre for Public Health, Queen's University Belfast, Irlanda del Norte, Belfast, Reino Unido
| | - Jerica M Berge
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Mineápolis, Minesota, EE. UU
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Ayala GX, Monge‐Rojas R, King AC, Hunter R, Berge JM. The social environment and childhood obesity: Implications for research and practice in the United States and countries in Latin America. Obes Rev 2021; 22 Suppl 3:e13246. [PMID: 33951272 PMCID: PMC8365653 DOI: 10.1111/obr.13246] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/17/2022]
Abstract
The environments of children influence their risk for childhood obesity through, among other factors, a child's weight-related behaviors (i.e., diet and physical activity). In this article, we present evidence on social environmental factors associated with a child's diet and physical activity, and more generally, the prevention and control of childhood obesity among Hispanic/Latinx children in the United States and children from countries in Latin America. Using a socio-ecologic lens, we present evidence from cross-sectional and longitudinal studies conducted in the United States involving Hispanic/Latinx children, and evidence from studies involving children in Latin America. Studies examining parenting factors in the home environment (e.g., parenting strategies) are especially emphasized, with more limited evidence on social environmental factors in other lived contexts (e.g., school). The influence of acculturation on social relationships cuts across levels of the socio-ecological framework. Intervention research identified strategies and research gaps for intervening on social factors to promote healthy behaviors and reduce risk for childhood obesity. Community health workers and others forms of peer support were identified as relevant approaches at multiple levels of the socio-ecological framework. This article concludes with directions for future research to further understand the environment using newer information and communication technologies.
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Affiliation(s)
- Guadalupe X. Ayala
- School of Public HealthSan Diego State University, the Institute for Behavioral and Community Health, and the SDSU HealthLINK CenterSan DiegoCaliforniaUSA
| | - Rafael Monge‐Rojas
- Health and Nutrition UnitCosta Rican Institute for Research and Education on Nutrition and Health (INCIENSA)CartagoCosta Rica
| | - Abby C. King
- Departments of Epidemiology & Population Health and Medicine (Stanford Prevention Research Center)Stanford University School of MedicineStanfordCaliforniaUSA
| | - Ruth Hunter
- Centre for Public HealthQueen's University Belfast, North IrelandBelfastUK
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, Medical SchoolUniversity of MinnesotaMinneapolisMinnesotaUSA
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Tamayo MC, Dobbs PD, Pincu Y. Family-Centered Interventions for Treatment and Prevention of Childhood Obesity in Hispanic Families: A Systematic Review. J Community Health 2020; 46:635-643. [DOI: 10.1007/s10900-020-00897-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Ames H, Mosdøl A, Blaasvær N, Nøkleby H, Berg RC, Langøien LJ. Communication of children's weight status: what is effective and what are the children's and parents' experiences and preferences? A mixed methods systematic review. BMC Public Health 2020; 20:574. [PMID: 32345274 PMCID: PMC7189728 DOI: 10.1186/s12889-020-08682-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/08/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Early intervention and conversation about a child's weight may offer an important chance of success in reducing weight and implementing a healthier lifestyle. This review explores the most effective ways to notify parents and children about the child's weight as well as their preferences and experiences around weight notification. METHODS We systematically searched nine databases for relevant primary research. Records were independently screened by two authors. We extracted data into a form designed for this review. Effect data was analysed using narrative synthesis and qualitative data using a best-fit framework synthesis. We assessed our confidence in the evidence using GRADE and GRADE-CERQual. RESULTS Studies of effect found that the format of feedback made little or no difference in parents attending further treatment, recognising their child as overweight or obese, reactions to the way the weight notification is given, motivation for lifestyle change, understanding how to reduce the risk of overweight, or taking any action. However, parents receiving feedback with motivational interviewing have somewhat greater satisfaction with the way the healthcare provider supports them. Qualitative studies found that parents had clear preferences for the format, timing, content and amount of information they wanted to receive in relation to both the weighing process and weight notification. They also had clear preferences for how they wanted health care providers to interact and communicate with them and their children. Both parents and children often felt that they were not receiving enough information and worried about how their results would be kept private. Many parents experienced an emotional response when told about their child's weight ranging from positive, disbelief and negative feelings. Those who reacted with disbelief or negatively were less likely to accept their child's weight status and/or act upon the notification letter. No studies reported results for children who were underweight. CONCLUSIONS Based on these qualitative results people working with weight assessment and notification programs should consider parents' preferences when developing feedback formats, considering the mode of feedback they are going to use and provide parents and children with tailored feedback and personalized follow up once a child is identified as overweight or obese.
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Affiliation(s)
- H Ames
- The Norwegian Institute of Public Health, Oslo, Norway.
| | - A Mosdøl
- The Norwegian Institute of Public Health, Oslo, Norway
| | - N Blaasvær
- The Norwegian Institute of Public Health, Oslo, Norway
| | - H Nøkleby
- The Norwegian Institute of Public Health, Oslo, Norway
| | - R C Berg
- The Norwegian Institute of Public Health, Oslo, Norway
| | - L J Langøien
- The Norwegian Institute of Public Health, Oslo, Norway
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Garcia ML, Crespo NC, Behar AI, Talavera GA, Campbell N, Shadron LM, Elder JP. Examining Mexican-Heritage Mothers' Perceptions of Their Children's Weight: Comparison of Silhouette and Categorical Survey Methods. Child Obes 2020; 16:44-52. [PMID: 31556701 PMCID: PMC6931916 DOI: 10.1089/chi.2019.0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: Failure to recognize children's overweight status by parents may contribute to children's risk for obesity. We examined two methods of measuring mothers' perceptions of children's weight and factors associated with weight perception inaccuracy. Methods: Cross-sectional analyses of clinical and self-report data from 287 Mexican-heritage mother-child dyads. Mothers identified their child's weight category using a scale (e.g., "normal/overweight/obese") and a visual silhouette scale (11 child gender-specific weight-varying images). Children's height and weight were measured to calculate body mass index (BMI). Chi-square tests examined associations between categorical, silhouette, and BMI percentile categories of children's weight. Bivariate logistic regression analyses examined factors associated with mothers' inaccuracy of their children's weight. Results: Only 13% of mothers accurately classified their child as obese using the categorical scale, while 78% accurately classified their child as obese using the silhouette scale. Mothers were more likely to underestimate their child's weight using BMI categories (62%) compared to using the silhouette scale (23%). Predictors of mothers' underestimation using the categorical method were child sex [female] (adjusted odds ratio [AOR] = 1.99; 95% CI: 1.02-3.86), child age [younger age] (AOR = 10.39; 95% CI: 4.16-25.92 for ages 5-6 years), and mother's weight status (overweight AOR = 2.99; 95% CI: 1.05-8.51; obese AOR = 5.19; 95% CI: 1.89-14.18). Child BMI was the only predictor of mothers' overestimation (AOR = 0.89; 95% CI: 0.85-0.94) using the silhouette method. Conclusions: Using silhouette scales to identify children's body weight may be a more accurate tool for clinicians and interventionists to activate parents' awareness of unhealthy weight in children compared to using traditional categorical weight-labeling methods.
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Affiliation(s)
- Melawhy L. Garcia
- Department of Health Science, Center for Latino Community Health, Evaluation, and Leadership Training, California State University Long Beach, Long Beach, CA.,Address correspondence to: Melawhy L. Garcia, MPH, PhD, Department of Health Science, California State University Long Beach, 1250 Bellflower Boulevard, HHS2-115, Long Beach, CA 90840
| | - Noe C. Crespo
- School of Public Health, Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
| | - Alma I. Behar
- School of Public Health, Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
| | - Gregory A. Talavera
- Department of Psychology, South Bay Latino Research Center, San Diego State University, Chula Vista, CA
| | - Nadia Campbell
- Sponsored Research Administration, San Diego State University Research Foundation, San Diego, CA
| | - Lisa M. Shadron
- Sponsored Research Administration, San Diego State University Research Foundation, San Diego, CA
| | - John P. Elder
- School of Public Health, Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
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Confiac N, Turk MT, Zoucha R, McFarland M. Mexican American Parental Knowledge and Perceptions of Childhood Obesity: An Integrative Review. HISPANIC HEALTH CARE INTERNATIONAL 2019; 18:105-116. [PMID: 31537084 DOI: 10.1177/1540415319873400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION For the past two decades, childhood obesity has remained a national public health concern, particularly among Hispanic populations. Multiple cross-sectoral obesity prevention strategies have been implemented yet remain unsuccessful in generating sustainable lifestyle changes. METHOD The purpose of this integrative review, using the Whittemore and Knafl method, was to examine the literature from 2009 to 2018 regarding Mexican American parental knowledge and perceptions of childhood obesity. The CINAHL, PubMed, PsycINFO, and ERIC databases were used to search the literature, and 13 peer-reviewed articles met the inclusion criteria. RESULTS Three main themes emerged from the literature synthesis: (1) parental misperception of child body weight and size, (2) influence of cultural health and growth beliefs on parental perception of child weight, and (3) parental perspectives of causes and consequences of childhood obesity and how to address it. However, cultural variations in parental perceptions were found; therefore, attempts to generalize Mexican Americans' cultural practices should be avoided. CONCLUSION Studies using qualitative approaches are needed to gain deeper insights about Mexican American culture regarding children's health as it relates to body weight, the roles of different family members in the Mexican American childrearing tradition, and the impact of their associated health beliefs.
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Foster BA, Weinstein K, Shannon J. Growing Healthy Together: protocol for a randomized clinical trial using parent mentors for early childhood obesity intervention in a Latino community. Trials 2019; 20:235. [PMID: 31023345 PMCID: PMC6485154 DOI: 10.1186/s13063-019-3342-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 04/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Latino children in the US experience high rates of obesity, increasing their risk of subsequent diabetes. There are few clinical trials among low-income, Latino families to test interventions that account for and address their unique situation. METHODS/DESIGN This trial, conducted in a Head Start (early childhood education) setting, randomly assigns children 2-5 years of age who have obesity by CDC (Centers for Disease Control and Prevention) guidelines (at least 95th percentile body mass index) and their parents to one of three conditions: (1) control, (2) parent mentor with an experimental curriculum, or (3) parent mentor with a standard curriculum (active control). We designed the experimental arm (2) using data from positive deviants: low-income, Latino families who had been successful in moving their child toward a healthy weight. Parent mentors are recruited and trained from the Head Start centers. Parent mentors then facilitate the teaching and coaching of parent-child dyads with weekly interactions over the course of a 6-month period. The primary outcome is change in adjusted body mass index z-score at the end of intervention and at 6 months post-intervention. Secondary outcomes include generalized self-efficacy, dietary intake, the home food environment, and reported physical activity. DISCUSSION This clinical trial contributes to the field by evaluating parent mentoring interventions that are potentially scalable for a population at high risk for continued obesity and subsequent morbidity and mortality. TRIAL REGISTRATION This trial was registered on October 31, 2017 (ClinicalTrials.gov identifier: NCT03330743 ).
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Affiliation(s)
- Byron A. Foster
- School of Medicine, Oregon Health and Science University, 3303 SW Bond Avenue CH16D, Portland, OR 97239 USA
| | - Kelsey Weinstein
- School of Medicine, Oregon Health and Science University, 3303 SW Bond Avenue CH16D, Portland, OR 97239 USA
| | - Jackilen Shannon
- School of Public Health, Oregon Health and Science University and Portland State University, 3181 SW Sam Jackson Park Road GH230, Portland, OR 97239 USA
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Kim LP, Mallo N. Maternal Perceptions of Self-Weight and Child Weight May Influence Milk Choice of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). J Obes 2019; 2019:3654728. [PMID: 30719345 PMCID: PMC6335787 DOI: 10.1155/2019/3654728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 12/11/2018] [Indexed: 11/17/2022] Open
Abstract
Objective To examine the association between maternal perceptions of self-weight and child weight status and milk consumption behavior of Hispanic WIC participants. Methods Mixed methods design with phone survey (n=529) and one-on-one interviews (n=35). Demographic characteristics, Chi-square, and thematic analyses were conducted. Results More than half of overweight mothers misperceived their own weight status as well as those of their children. Mothers who perceived their child to be overweight were more likely to make a healthier food choice for their family, namely, choosing reduced-fat milk instead of whole milk. Qualitative interviews revealed a cultural preference for larger size children, and mothers defined healthy weight for their child as a function of (1) the child's ability to be as active as other children their age, regardless of child's BMI, and (2) the pediatrician's opinion of the child's weight status. Conclusions Maternal perception of self-weight and child weight status seems to guide milk choices. Mothers may have some level of recognition of overweight in themselves and their child, thus adopting healthier milk choices. Culturally related perceptions should be considered when designing obesity prevention strategies, and the role of a pediatrician cannot be understated when developing obesity prevention programs for Hispanic families.
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Innella N, McNaughton D, Schoeny M, Tangney C, Breitenstein S, Reed M, Wilbur J. Child Temperament, Maternal Feeding Practices, and Parenting Styles and Their Influence on Obesogenic Behaviors in Hispanic Preschool Children. J Sch Nurs 2018; 35:287-298. [PMID: 29699450 DOI: 10.1177/1059840518771485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Although obesogenic behaviors (physical activity and/or sedentary behavior and dietary intake) are known predictors of childhood weight status, little is known about mother and child behaviors contributing to obesogenic behaviors and obesity in Hispanic preschool children, whose obesity rate is higher than in non-Hispanic Whites and non-Hispanic Blacks. The purpose of this cross-sectional, descriptive study was to examine relationships among child temperament, maternal behaviors (feeding practices and parenting style), child obesogenic behaviors, and child weight status in 100 Hispanic preschool children. Results showed that higher scores on the negative affectivity dimension of child temperament were associated with higher scores on the dimension of permissive parenting, and permissive parenting was associated with less time spent in sedentary behaviors (B = -3.53, confidence interval [-7.52, -0.90]). Findings can guide school nurses in developing interventions that consider child temperament and parenting style to promote nonobesogenic behavior in Hispanic preschoolers.
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Affiliation(s)
| | | | | | | | | | - Monique Reed
- 1 Rush University Medical Center, Chicago, IL, USA
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13
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Broilo MC, Vitolo MR, Stenzel LM, Levandowski DC. Mothers' perceptions of their own diets and the diets of their children at 2-3 years of age. PSICOLOGIA-REFLEXAO E CRITICA 2017; 30:13. [PMID: 32025955 PMCID: PMC6964162 DOI: 10.1186/s41155-017-0067-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 05/26/2017] [Indexed: 11/10/2022] Open
Abstract
This is a cross-sectional analysis of a follow-up study to examine the perceptions of mothers treated at public health centers, regarding their own diets and the diets of their children aged 2–3. Among the 464 participants, 57% (n = 267) reported perceiving their own diets as unhealthy while 72% (n = 334) perceiving their children’s diets as healthy. The mothers’ perceptions of their own diets as healthy were associated with less maternal schooling and having received health care from professionals who had received special training (p < 0.05). The mothers’ perceptions of their children’s diets as healthy were associated with more maternal schooling (p < 0.05). This difference between the mothers’ perceptions of their own diets and those of their children reinforce the importance of considering maternal beliefs and attitudes in infant nutritional intervention programs.
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Affiliation(s)
- Mônica Cristina Broilo
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre-UFCSPA, Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil.
| | - Márcia Regina Vitolo
- Department of Nutrition, Federal University of Health Sciences of Porto Alegre-UFCSPA, Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
| | - Lucia Marques Stenzel
- Department of Psychology, Federal University of Health Sciences of Porto Alegre-UFCSPA, Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
| | - Daniela Centenaro Levandowski
- Department of Psychology, Federal University of Health Sciences of Porto Alegre-UFCSPA, Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
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Ochoa A, Berge JM. Home Environmental Influences on Childhood Obesity in the Latino Population: A Decade Review of Literature. J Immigr Minor Health 2017; 19:430-447. [PMID: 28005241 PMCID: PMC5334210 DOI: 10.1007/s10903-016-0539-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Latinos are the largest and fastest-growing ethnically diverse group in the United States. Latino children are also among the most overweight and obese ethnic groups of children in the United States. Research over the last decade has identified the home environment as a key influence on the diet and physical activity of children. To summarize cross-sectional and longitudinal research that has identified factors within the home environment of Latino families that are associated with childhood obesity and to provide recommendations for future research and intervention development with Latino families. A decade review from 2005 to 2015 was conducted. Studies identifying factors within the home environments of Latino families that were associated with childhood obesity were examined. Five main factors were identified across the literature as home environment factors that are associated with childhood obesity in Latino children. These factors included: parental influences (e.g., parent feeding practices, modeling), screen time, physical activity/sedentary behavior, socioeconomic status/food security and sleep duration. The current review identified several home environment factors that may contribute to the disparities in childhood obesity for Latino children. Results from this review such as, focusing on decreasing controlling parent feeding practices, and increasing parent modeling of healthy behaviors and child sleep duration, can be used in developing culturally-specific interventions for Latino children.
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Affiliation(s)
- Alejandra Ochoa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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15
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CAMPOS MLB, MACHADO MMT, AZEVEDO DVD, SILVA KA. Dietary patterns of obese children: Maternal perceptions and experiences. REV NUTR 2017. [DOI: 10.1590/1678-98652017000200005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective: To understand maternal perceptions and experiences regarding the eating habits of obese children aged five to nine years. Methods: This is a qualitative research, and semi-structured interviews and discourse analysis were used to interpret narratives of 13 women from the city of Fortaleza, Ceará state, Brazil. Results: These women described the eating habits of their obese children in terms of how they eat and mentioned: eating fast, eating in front of the television, secret eating, eating large amounts of food, and the consumption of processed foods that are high in fat, sugars, and sodium. Conclusion: Seeing the mother and her obese child as a unit that needs support and guidance is a big step to plant the seeds to reap the rewards, i.e., exerting important impacts on the lives of these families and on the current scenario of childhood obesity.
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16
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Gonzalez G. Primary Care Interventions to Reduce Childhood Obesity in Latino Families. J Pediatr Health Care 2016; 30:471-9. [PMID: 26677979 DOI: 10.1016/j.pedhc.2015.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/30/2015] [Accepted: 11/06/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Increasing rates of obesity in Latino children call for culturally sensitive primary care interventions. Despite recent efforts to address this growing disparity, little is known about cultural variables that influence obesity management programs in Latino children. METHODS A literature search was conducted using CINHAL, Scopus, PubMed, and PsycINFO to review the state of the science regarding primary care interventions to decrease obesity in Latino children. The author analyzed the effects of several cultural practices on obesity and made recommendations based on their clinical implications for weight reduction management programs. RESULTS Obesity in Latino children is a multifactorial problem influenced by family behaviors, cultural perceptions of weight and health, traditional dietary norms, and socioeconomic status. Current practice lags behind national obesity management recommendations and is further hindered by a lack of consideration of the roles of key cultural differences in Latino families. DISCUSSION It is imperative to recognize the importance of family preferences and culture when developing weight reduction programs so as to foster long-term behavior changes. More research assessing the efficacy of culturally competent interventions is necessary to guide national efforts to address this increasing disparity.
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White C, Murphy T, Hodges EA, Berry DC. Barriers for Hispanic Caregivers With Obese Preschool Children. HISPANIC HEALTH CARE INTERNATIONAL 2016; 14:141-55. [PMID: 27553227 DOI: 10.1177/1540415316665355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Childhood obesity is a growing epidemic, and the rates are disproportionately higher in minorities. Clinical guidelines have contributed to decreased prevalence overall, but the rates in Hispanic preschoolers have increased. METHOD This review of the literature summarizes the perceptions and beliefs of caregivers of Hispanic preschool children regarding weight status and feeding behaviors, as well as the perceived cultural barriers to guideline adherence. A search of the CINAHL, PubMed, Joanna Briggs, and Global Health databases identified studies performed between January 1, 2008, and April 1, 2016. Search terms included Hispanics, guideline adherence, gap, barriers, obesity, overweight, and attitude to obesity. RESULTS Fifteen studies met the inclusion criteria, including some about Hispanic caregivers of preschool-aged children. Several cultural perceptions and beliefs were identified. CONCLUSION Further study is needed to develop more culturally relevant and sensitive guidelines and to design specific and effective interventions for this population.
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Affiliation(s)
| | | | - Eric A Hodges
- The University of North Carolina at Chapel Hill, NC, USA
| | - Diane C Berry
- The University of North Carolina at Chapel Hill, NC, USA
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18
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Gauthier KI, Gance-Cleveland B. Hispanic parents' perceptions of their preschool children's weight status. J SPEC PEDIATR NURS 2016; 21:84-93. [PMID: 27079822 DOI: 10.1111/jspn.12143] [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: 10/05/2015] [Revised: 02/18/2016] [Accepted: 03/04/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to examine the accuracy of Hispanic parents' perceptions of their preschool children's weight status. DESIGN AND METHODS A cross-sectional descriptive design with Hispanic parent-child dyads (n = 83) from a Head Start setting was used to compare parents' perceptions of their children's weight status with their 2- to 5-year-old children's body mass index (BMI) and weight categories. Methods included a word choice from five response options, and varying body size silhouettes presented in a linear fashion and a random circular pattern. Parents' perceptions were compared with the children's BMI, and in relationship to parents' demographic characteristics and BMI. RESULTS Approximately half of parents underestimated their child's weight status, and overweight/obese parents tended to underestimate their overweight/obese children's weight status. PRACTICE IMPLICATIONS Eliciting parent perception of their child's weight is one way providers can engage in obesity prevention dialogue.
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Affiliation(s)
- Kristine I Gauthier
- Assistant Professor, University of Colorado, Anschutz Medical Campus, College of Nursing
| | - Bonnie Gance-Cleveland
- Professor, University of Colorado, Anschutz Medical Campus, College of Nursing, Aurora, Colorado, USA
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19
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Guerrero AD, Chung PJ. Racial and Ethnic Disparities in Dietary Intake among California Children. J Acad Nutr Diet 2016; 116:439-448. [PMID: 26433453 PMCID: PMC4769954 DOI: 10.1016/j.jand.2015.08.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The prevalence of childhood obesity among racial and ethnic minority groups is high. Multiple factors affect the development of childhood obesity, including dietary practices. OBJECTIVE To examine the racial and ethnic differences in reported dietary practices among the largest minority groups of California children. METHODS Data from the 2007 and 2009 California Health Interview Survey were analyzed using multivariate regression with survey weights to examine how race, ethnicity, sociodemographic characteristics, and child factors were associated with specific dietary practices. RESULTS The sample included 15,902 children aged 2 to 11 years. In multivariate regressions, substantial differences in fruit juice, fruit, vegetable, sugar-sweetened beverages, sweets, and fast-food consumption were found among the major racial and ethnic groups of children. Asians regardless of interview language were more likely than whites to have low vegetable intake consumption (Asians English interview odds ratio [OR] 1.20, 95% CI 1.01 to 1.43; Asians non-English-interview OR 2.09, 95% CI 1.23 to 3.57) and low fruit consumption (Asians English interview OR 1.69, 95% CI 1.41 to 2.03; Asians non-English interview OR 3.04, 95% CI 2.00 to 4.6). Latinos regardless of interview language were also more likely than whites to have high fruit juice (Latinos English interview OR 1.54, 95% CI 1.28 to 1.84 and Latinos non-English interview OR 1.29, 95% CI 1.02 to 1.62) and fast-food consumption (Latinos English interview OR 1.74, 95% CI 1.46 to 2.08 and Latinos non-English interview OR 1.48, 95% CI 1.16 to 1.91); but Latinos were less likely than whites to consume sweets (Latinos English interview OR 0.81, 95% CI 0.66 to 0.99 and Latinos non-English interview OR 0.56, 95% CI 1.16 to 1.91). CONCLUSIONS Significant racial and ethnic differences exist in the dietary practices of California children. Increased fruit and vegetable consumption appears to be associated with parent education but not income. Our findings suggest that anticipatory guidance and dietary counseling might benefit from tailoring to specific ethnic groups to potentially address disparities in overweight and obesity.
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20
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Slusser W, Whitley M, Izadpanah N, Kim SL, Ponturo D. Multidisciplinary Pediatric Obesity Clinic via Telemedicine Within the Los Angeles Metropolitan Area: Lessons Learned. Clin Pediatr (Phila) 2016; 55:251-9. [PMID: 26187610 DOI: 10.1177/0009922815594359] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Telemedicine has been shown to be effective for rural populations, but little is reported on pediatric obesity care via telemedicine in urban settings. This study aims to assess feasibility and acceptability of multidisciplinary pediatric obesity care via telemedicine within the same metropolitan area in terms of information technology, coordination, patient care, and clinical outcomes. All project notes and communications were reviewed to extract key lessons from implementation. Patient and Provider Satisfaction Questionnaires were conducted to assess overall satisfaction; baseline and follow-up information were collected from chart reviews to evaluate clinical outcomes. Based on the questionnaires, 93% of responding patients (n = 28) and 88.3% of referring providers (n = 17) felt satisfied with the appointment. Chart review indicated a trend for decreased or stabilized body mass index and blood pressure (n = 32). Implementation of telemedicine for tertiary multidisciplinary pediatric obesity care in urban settings is both feasible and acceptable to patients and health care providers.
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Affiliation(s)
- Wendy Slusser
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA UCLA Fielding School Public Health, Los Angeles, CA, USA
| | | | | | - Sion L Kim
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Don Ponturo
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
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21
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Gauthier KI, Gance-Cleveland B. Hispanic Parental Perceptions of Child Weight in Preschool-Aged Children: An Integrated Review. Child Obes 2015. [PMID: 26218438 DOI: 10.1089/chi.2014.0152] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Obesity continues to disproportionately affect ethnic minorities. Parents play an integral role in early childhood, and parental perceptions regarding their child's weight are key to obesity prevention. Cultural differences contribute to parental perceptions, and increased understandings of these characteristics provide a basis to address obesity in high-risk populations at an earlier age. The aim of this integrative review was to analyze extant literature to identify Hispanic parental perceptions of their preschool-aged child's weight status. METHODS An integrative review of studies measuring Hispanic parental perception was conducted. Computerized searches were completed using MEDLINE, PubMed, CINHAL, Eric, and PsychINFO. Articles were included if they were English, included children 2-5 years of age, included a Hispanic population, and evaluated parental perception of their child's weight status. A total of 14 articles (n=8 qualitative; n=6 quantitative) met criteria and were included in the review. Cooper's integrative review methodology was used, and articles were evaluated for quality using Polit and Beck's evidence hierarchy leveling system. RESULTS The results revealed six themes of Hispanic parental perceptions relative to their preschool-aged child's weight: parental perception of body weight; relationship between child weight and health; causes and consequences of overweight; familial roles and influences on child weight; prevention of overweight; and cultural influences within the United States. CONCLUSIONS This review highlights the importance of developing sociocultural approaches to addressing childhood obesity within the Hispanic population. Additional research is needed to incorporate what is known about Hispanic parental perceptions to positively influence behavior change during early childhood.
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Affiliation(s)
- Kristine I Gauthier
- College of Nursing, University of Colorado Anschutz Medical Campus , Aurora, CO
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22
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Perceptions of Weight and Health Practices in Hispanic Children: A Mixed-Methods Study. Int J Pediatr 2015; 2015:761515. [PMID: 26379715 PMCID: PMC4561986 DOI: 10.1155/2015/761515] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/15/2015] [Accepted: 07/28/2015] [Indexed: 11/29/2022] Open
Abstract
Background. Perception of weight by parents of obese children may be associated with willingness to engage in behavior change. The relationship between parents' perception of their child's weight and their health beliefs and practices is poorly understood, especially among the Hispanic population which experiences disparities in childhood obesity. This study sought to explore the relationship between perceptions of weight and health beliefs and practices in a Hispanic population. Methods. A cross-sectional, mixed-methods approach was used with semistructured interviews conducted with parent-child (2–5 years old) dyads in a primarily Hispanic, low-income population. Parents were queried on their perceptions of their child's health, health practices, activities, behaviors, and beliefs. A grounded theory approach was used to analyze participants' discussion of health practices and behaviors. Results. Forty parent-child dyads completed the interview. Most (58%) of the parents of overweight and obese children misclassified their child's weight status. The qualitative analysis showed that accurate perception of weight was associated with internal motivation and more concrete ideas of what healthy meant for their child. Conclusions. The qualitative data suggest there may be populations at different stages of readiness for change among parents of overweight and obese children, incorporating this understanding should be considered for interventions.
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Innella N, Breitenstein S, Hamilton R, Reed M, McNaughton DB. Determinants of Obesity in the Hispanic Preschool Population: An Integrative Review. Public Health Nurs 2015; 33:189-99. [DOI: 10.1111/phn.12215] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy Innella
- College of Nursing; Rush University; Chicago Illinois
| | | | | | - Monique Reed
- College of Nursing; Rush University; Chicago Illinois
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24
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Maternal Attitudes and Behaviors Regarding Feeding Practices in Elementary School-Aged Latino Children: A Pilot Qualitative Study on the Impact of the Cultural Role of Mothers in the US-Mexican Border Region of San Diego, California. J Acad Nutr Diet 2015; 115:S34-41. [PMID: 25911519 DOI: 10.1016/j.jand.2015.02.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2013] [Indexed: 01/19/2023]
Abstract
This study aimed to explore the attitudes and behaviors of Latino mothers around feeding their children. Using qualitative methods, we conducted four focus groups in Spanish with 41 Latino mothers of elementary school-age children in San Diego County, CA. Latino mothers' mean age was 41 years; 90% were foreign-born; and 74% had a high school education or less. We explored cultural viewpoints around feeding and cooking and feeding strategies used. Focus groups were analyzed based on a priori and emergent themes. The following themes around feeding emerged: feeding attitudes central to the maternal responsibility of having well-fed children and feeding behaviors that centered on cooking methods, supportive behaviors, and reinforcement strategies for "eating well." These findings increase our understanding of the Latino maternal role to feed children and can help to inform more culturally appropriate research to effectively address nutritional issues and obesity prevention in Latino children.
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25
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Morgan PL, Farkas G, Hillemeier MM, Mattison R, Maczuga S, Li H, Cook M. Minorities are Disproportionately Underrepresented in Special Education: Longitudinal Evidence Across Five Disability Conditions. EDUCATIONAL RESEARCHER (WASHINGTON, D.C. : 1972) 2015; 44:278-292. [PMID: 27445414 PMCID: PMC4950880 DOI: 10.3102/0013189x15591157] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We investigated whether and to what extent minority children attending elementary and middle schools in the U.S. are over- or under-identified as disabled and so disproportionately represented in special education. To address existing limitations in the field's knowledge base, we (a) analyzed multi-year longitudinal data, (b) used hazard modeling to estimate over-time dynamics of disability identification across five specific conditions, and (c) extensively corrected for child-, family-, and school-level potential confounding variables (e.g., child-level academic achievement and behavior, family-level socioeconomic status, school-level state location). Despite long-standing and on-going federal legislative and policy efforts to reduce minority over-representation in special education, our analyses indicated that this has not been occurring in the U.S. Instead, minority children are less likely than otherwise similar White, English-speaking children to be identified as disabled and so receive special education services. From kindergarten entry to at least the end of middle school, racial and ethnic minority children are less likely than otherwise similar White children to be identified as having (a) learning disabilities, (b) speech or language impairments, (c) intellectual disabilities, (d) health impairments, or (d) emotional disturbances. Language minority children are less likely to be identified as having (a) specific learning disabilities or (b) speech or language impairments.
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Affiliation(s)
| | | | | | | | | | - Hui Li
- Pennsylvania State University, University Park, PA
| | - Michael Cook
- Pennsylvania State University, University Park, PA
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26
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Foster BA, Farragher J, Parker P, Hale DE. A positive deviance approach to early childhood obesity: cross-sectional characterization of positive outliers. Child Obes 2015; 11:281-8. [PMID: 25885174 PMCID: PMC4484711 DOI: 10.1089/chi.2014.0098] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Positive deviance methodology has been applied in the developing world to address childhood malnutrition and has potential for application to childhood obesity in the United States. We hypothesized that among children at high-risk for obesity, evaluating normal weight children will enable identification of positive outlier behaviors and practices. METHODS In a community at high-risk for obesity, a cross-sectional mixed-methods analysis was done of normal weight, overweight, and obese children, classified by BMI percentile. Parents were interviewed using a semistructured format in regard to their children's general health, feeding and activity practices, and perceptions of weight. RESULTS Interviews were conducted in 40 homes in the lower Rio Grande Valley in Texas with a largely Hispanic (87.5%) population. Demographics, including income, education, and food assistance use, did not vary between groups. Nearly all (93.8%) parents of normal weight children perceived their child to be lower than the median weight. Group differences were observed for reported juice and yogurt consumption. Differences in both emotional feeding behaviors and parents' internalization of reasons for healthy habits were identified as different between groups. CONCLUSIONS We found subtle variations in reported feeding and activity practices by weight status among healthy children in a population at high risk for obesity. The behaviors and attitudes described were consistent with previous literature; however, the local strategies associated with a healthy weight are novel, potentially providing a basis for a specific intervention in this population.
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Affiliation(s)
- Byron Alexander Foster
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Jill Farragher
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Paige Parker
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Daniel E. Hale
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX
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27
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Martinez SM, Rhee K, Blanco E, Boutelle K. Maternal attitudes and behaviors regarding feeding practices in elementary school-aged Latino children: a pilot qualitative study on the impact of the cultural role of mothers in the US-Mexican border region of San Diego, California. J Acad Nutr Diet 2013; 114:230-237. [PMID: 24315129 DOI: 10.1016/j.jand.2013.09.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 09/26/2013] [Indexed: 01/19/2023]
Abstract
This study aimed to explore the attitudes and behaviors of Latino mothers around feeding their children. Using qualitative methods, we conducted four focus groups in Spanish with 41 Latino mothers of elementary school-age children in San Diego County, CA. Latino mothers' mean age was 41 years; 90% were foreign-born; and 74% had a high school education or less. We explored cultural viewpoints around feeding and cooking and feeding strategies used. Focus groups were analyzed based on a priori and emergent themes. The following themes around feeding emerged: feeding attitudes central to the maternal responsibility of having well-fed children and feeding behaviors that centered on cooking methods, supportive behaviors, and reinforcement strategies for "eating well." These findings increase our understanding of the Latino maternal role to feed children and can help to inform more culturally appropriate research to effectively address nutritional issues and obesity prevention in Latino children.
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28
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Lowenstein LM, Perrin EM, Berry D, Vu MB, Pullen Davis L, Cai J, Tzeng JP, Ammerman AS. Childhood obesity prevention: fathers' reflections with healthcare providers. Child Obes 2013; 9:137-43. [PMID: 23472966 PMCID: PMC3621357 DOI: 10.1089/chi.2012.0111] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND To prevent childhood obesity, parents and their children's healthcare providers need to engage in effective dialogue. We know much about mothers' experiences, but very little about fathers' experiences. METHODS We explored African-American, Caucasian, and Latino fathers' perceptions and experiences communicating with their children's provider during clinic visits regarding weight, diet, and physical activity. Focus groups (n=3), grouped by race/ethnicity, including a total of 24 fathers, were conducted. The men were asked open-ended questions; responses were recorded and transcribed, and analyzed using ATLAS.ti. RESULTS Findings revealed that these fathers were involved in their children's healthcare and found providers to be helpful partners in keeping their children healthy, yet they generally felt "left out" during clinic appointments. The quality of the relationship with their children's provider influenced how receptive fathers were to discussing their children's weight, diet, and physical activity behaviors. Fathers made suggestions to help improve communication between providers and fathers, such as personalizing the discussion. CONCLUSIONS These fathers expressed strong feelings about the provider-parent relationship when discussing weight, diet, and physical activity.
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Affiliation(s)
- Lisa M. Lowenstein
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Present address: Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Eliana M. Perrin
- Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC.,Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
| | - Diane Berry
- School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Maihan B. Vu
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
| | - Lisa Pullen Davis
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC.,Present address: Duke Translational Medicine Institute, Duke University, Durham, NC
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Janice P. Tzeng
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Present address: RTI International, Raleigh, NC
| | - Alice S. Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
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29
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Rosado JI, Johnson SB, McGinnity KA, Cuevas JP. Obesity among Latino children within a migrant farmworker community. Am J Prev Med 2013; 44:S274-81. [PMID: 23415193 DOI: 10.1016/j.amepre.2012.11.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 11/15/2012] [Accepted: 11/21/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Childhood obesity has increased substantially among Latino children, placing them at risk for its related health consequences. Limited attention has been given to childhood obesity among Latino migrant farm-working communities. PURPOSE To examine, within a migrant farm-working community, (1) the prevalence of obesity among Latino children and parents and (2) parent perceptions of children's weight status and intentions to take corrective action. METHODS Structured interviews were completed with the parents of 495 children seen for well-child office visits in the pediatric department of a community health center during a 15-month period between 2010 and 2011. Medical chart reviews were completed for each child participant. RESULTS Forty-seven percent of the children were overweight (20%) or obese (27%). In comparison to preschool-aged children, those in elementary and middle school were more likely to be obese. In elementary school, girls were more likely than boys to be overweight or obese. Child obesity was associated with parent obesity. Parental concern about their child's weight was associated with child obesity but not with child overweight. Parental concern was associated with parent intention to address the child's weight, particularly in older children. Analysis was completed in 2012. CONCLUSIONS Interventions are needed that address both childhood obesity and parent weight status among Latino migrant farmworkers. Prevention programs that address the weight status of Latino children who are overweight, but not necessarily obese, are also needed, as their parents tend to be no more concerned about a child who is overweight than one who is normal weight.
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Affiliation(s)
- Javier I Rosado
- College of Medicine, Florida State University, Immokalee, Florida, USA.
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30
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Cespedes E, Andrade GOM, Rodríguez-Oliveros G, Perez-Cuevas R, González-Unzaga MA, Trejo AB, Haines J, Gillman MW, Taveras EM. Opportunities to Strengthen Childhood Obesity Prevention in Two Mexican Health Care Settings. INTERNATIONAL JOURNAL OF PERSON CENTERED MEDICINE 2012; 2:496-504. [PMID: 25530836 PMCID: PMC4269346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The purpose of this study was to examine Mexican caregivers' perceptions of the role of primary care in childhood obesity management, understand the barriers and facilitators of behavior change, and identify opportunities to strengthen obesity prevention and treatment in clinical settings. METHODS We conducted 52 in-depth interviews with parents and caregivers of overweight and obese children age 2-5 years in 4 Ministry of Health (public, low SES) and 4 Social Security Institute (insured, higher SES) primary care clinics in Mexico City and did systematic thematic analysis. RESULTS In both health systems, caregivers acknowledged childhood overweight but not its adverse health consequences. Although the majority of parents had not received nutrition or physical activity recommendations from health providers, many were open to clinician guidance. Despite knowledge of healthful nutrition and physical activity, parents identified several barriers to change including child feeding occurring in the context of competing priorities (work schedules, spouses' food preferences), and cultural norms (heavy as healthy, food as nurturance) that take precedence over adherence to dietary guidelines. Physical activity, while viewed favorably, is not a structured part of most preschooler's routines as reported by parents. CONCLUSIONS The likelihood of success for clinic-based obesity prevention among Mexican preschoolers will be higher by addressing contextual barriers such as cultural norms regarding children's weight and support of family members for behavior change. Similarities in caregivers' perceptions across 2 health systems highlight the possibility of developing comprehensive interventions for the population as a whole.
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Affiliation(s)
- Elizabeth Cespedes
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, 133 Brookline Avenue, 6th Floor, Boston, MA 02215 US, Phone: 617-509-9900 - Fax: 617-859-8112
| | - Gloria Oliva Martínez Andrade
- Epidemiology and Health Services Research Unit, Mexican Institute of Social Security, Edificio anexo a la farmacia 3er Piso. Cuauhtémoc 330, Col. Doctores. Del. Cuauhtémoc. CP 06720, México D.F., 525-5627-6900
| | - Guadalupe Rodríguez-Oliveros
- Centre for Health Systems Research, National Institute of Public Health; Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, México CP 62100, Phone: 52-777-329-3000
| | - Ricardo Perez-Cuevas
- Division of Social Protection and Health. Inter-American Development Bank. Ave. Paseo de la Reforma 222, Juárez. Mexico DF 10200 Mexico. Phone +52 55 51412496
| | - Marco A. González-Unzaga
- Epidemiology and Health Services Research Unit, Mexican Institute of Social Security, Edificio anexo a la farmacia 3er Piso. Cuauhtémoc 330, Col. Doctores. Del. Cuauhtémoc. CP 06720, México D.F., 525-5627-6900
| | - Amalia Benitez Trejo
- Community Health Department. Hospital Infantil de México Federico Gómez; Doctor Márquez 162 Doctores, Cuauhtémoc, 06720 Mexico, D.F.; Phone: 55-5228-9917
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, Room 226, Macdonald Stewart Hall, University of Guelph, 50 Stone Road East, Guelph, Ontario, Canada N1G 2W1, Phone: 519-824-4120, ext 53780, Fax: 519-766-0691
| | - Matthew W. Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, 133 Brookline Avenue, 6th Floor, Boston, MA 02215 US, Phone: 617-509-9900 - Fax: 617-859-8112
| | - Elsie M. Taveras
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, 133 Brookline Avenue, 6th Floor, Boston, MA 02215 US, Phone: 617-509-9900 - Fax: 617-859-8112
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