1
|
Koob C, Stuenkel M, Gagnon RJ, Griffin SF, Sease K. Examining Patient- and Community-Level Factors Associated with Pediatric Mental Healthcare Access Within a Patient Navigation Program. Community Ment Health J 2024; 60:1055-1067. [PMID: 38507129 PMCID: PMC11199227 DOI: 10.1007/s10597-024-01258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
In 2021, national leaders in the United States declared a "national youth mental health crisis." Still, only 1-in-4 children receive adequate mental healthcare access. Patient Navigator Programs (PNPs) can improve children's referral-to-connection to mental health services. We examined patient- and community-level factors associated with pediatric mental healthcare access. Pediatric Support Services (PSS) is a PNP that triages mental and behavioral health referrals within a large health system in a southeastern state. This study analyzes PSS data from September 2017-March 2023 and Child Opportunity Index 2.0 state-normed zip-code level data to assess social drivers of health estimates. Structural equation modeling was conducted between patient- and community-level factors and connection to mental health services. Overall, 62.7% of children connected to mental health services since PSS' inception. Regardless of SDOH, as children get older, they are more likely to connect with mental health services (β = .053, SE = .010, p < .001). Children with greater number of referral needs are more likely to connect with mental health services (β = .034, SE = .011, p = .002). Further, children who live in communities with higher opportunity levels are more likely to connect with mental health services (β = .016, SE = .008, p = .040), suggesting that children who live in low-income communities experience more barriers to mental healthcare. Social drivers may inform referral practices and tiered navigation support for optimal mental healthcare access among children. Further research should demonstrate the effectiveness of PNPs integrated within healthcare and community-based settings.
Collapse
Affiliation(s)
- Caitlin Koob
- Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, 29634, USA.
- Prisma Health Children's Hospital-Upstate, Greenville, SC, USA.
| | | | - Ryan J Gagnon
- Department of Parks, Recreation, Tourism, and Management, Clemson University, Clemson, SC, USA
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, 29634, USA
| | - Kerry Sease
- Prisma Health Children's Hospital-Upstate, Greenville, SC, USA
- University of South Carolina School of Medicine Greenville, Greenville, SC, USA
| |
Collapse
|
2
|
Mahoney MR, Sommer EC, Popescu F, Adams LE, Barkin S. Comparing Family Health Before and After a Family-Focused Nutrition Program during the Pandemic. Matern Child Health J 2024; 28:1413-1421. [PMID: 38896148 PMCID: PMC11269479 DOI: 10.1007/s10995-024-03934-2] [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: 05/13/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION The COVID-19 pandemic affected child health behaviors, leading to worse physical health. Given the importance of good family health in improved child health outcomes, this secondary cohort analysis tested the hypothesis that family health would improve from baseline to 12-week follow-up after participation in a novel family nutrition program. METHODS Diverse parent-child dyads participated in a home-based virtual Teaching Kitchen Outreach (vTKO) program (11 weekly healthy, low-cost recipes, cooking videos, and associated groceries delivered). The primary outcome was the Family Healthy Lifestyle Subscale (FHLS). Secondary outcomes were parent and child nutrition, and food insecurity. Statistical testing and modeling were used to evaluate pre-post outcomes. RESULTS Of 123 enrolled dyads, 114 (93%) had sufficient data for analysis. Participants were 11% Hispanic, 54% Black, and 28% White; 31% completed high school or less; and 30% indicated food insecurity. Cohort mean pre-post FHLS scores significantly increased (25.5 vs. 27.3; p < 0.001). There were significant improvements in parent nutrition (p < 0.001) and child nutrition (p = 0.02 to < 0.001), but not in food security. After adjusting for baseline covariates, tobit regression found statistically significant pre-post FHLS differences (2.3; 95% CI=[1.4, 3.3]; p < 0.001). DISCUSSION Participants in the novel home-based vTKO program reported improved family health over 12 weeks.
Collapse
Affiliation(s)
- Margaret Rose Mahoney
- Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN, 37232, USA.
| | - Evan C Sommer
- Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, 37232, USA
| | - Filoteia Popescu
- Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, 37232, USA
- The University of Tennessee Health Science Center College of Medicine, 910 Madison Ave #1002, Memphis, TN, 38103, USA
| | - Laura E Adams
- Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, 37232, USA
| | - Shari Barkin
- Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, 37232, USA
- Children's Hospital of Richmond at VCU, 1000 E Broad St, Richmond, VA, 23219, USA
| |
Collapse
|
3
|
Bodepudi S, Hinds M, Northam K, Reilly-Harrington NA, Stanford FC. Barriers to Care for Pediatric Patients with Obesity. Life (Basel) 2024; 14:884. [PMID: 39063637 PMCID: PMC11277597 DOI: 10.3390/life14070884] [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: 05/11/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
This review article emphasizes the challenges pediatric patients face during obesity treatment. Prior research has been compartmentalized, acknowledging that stigma, the ability to implement lifestyle changes, social health determinants, and healthcare accessibility are considerable impediments for obese children. These issues emerge at various levels, including the individual or family, the community and school, and even national policy. This suggests the need for a more comprehensive, team-based approach to tackle pediatric obesity. Understanding these barriers is the first step toward creating effective strategies and solutions to overcome these challenges.
Collapse
Affiliation(s)
- Sreevidya Bodepudi
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
- Harvard Medical School, Boston, MA 02115, USA
| | | | - Kayla Northam
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
| | - Noreen A. Reilly-Harrington
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA 02115, USA
- MGH Weight Center, Massachusetts General Hospital, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Boston, MA 02114, USA
| |
Collapse
|
4
|
Dave JM, Chen TA, Castro AN, White MA, Onugha EA, Zimmerman S, Thompson D. Urban-Rural Disparities in Food Insecurity and Weight Status among Children in the United States. Nutrients 2024; 16:2132. [PMID: 38999879 PMCID: PMC11243017 DOI: 10.3390/nu16132132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Place of residence (urban versus rural) is a contextual determinant of health that has received less attention in the food insecurity literature. The purpose of this study was to assess the urban-rural disparity in the prevalence of food insecurity and weight status among US children. Using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 with three age groups of children (2-5, 6-11, and 12-17 years old), the associations of weight status and child and household food security status by urban-rural residence were examined using Rao-Scott Chi-square tests. Statistical significance was set at p < 0.05. Children living in urban areas were significantly more likely to experience household food insecurity (29.15%) compared to their rural counterparts (19.10%), among those aged 6-11 years. The associations between children's weight status and child and household food security status were significant for children living in urban areas overall and different age groups but not for children living in rural areas. These trends were more pronounced in older age groups. Given the link between food insecurity and higher obesity rates, particularly among urban children, this study highlights the importance of incorporating food security interventions into future obesity prevention programs.
Collapse
Affiliation(s)
- Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Tzuan A Chen
- Department of Psychological, Health, and Learning Sciences, University of Houston, 3657 Cullen Boulevard, Houston, TX 77204, USA
- HEALTH Research Institute, University of Houston, 4349 Martin Luther King Boulevard, Houston, TX 77204, USA
| | - Alexandra N Castro
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Mamie A White
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Elizabeth A Onugha
- Renal Services, Texas Children's Hospital, 1102 Bates Avenue, Houston, TX 77030, USA
- Department of Pediatrics-Nephrology, Baylor College of Medicine, 1102 Bates Avenue, Houston, TX 77030, USA
| | - Sloane Zimmerman
- Department of Pediatrics-Gastroenterology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| |
Collapse
|
5
|
McCabe CF, Wood GC, Franceschelli-Hosterman J, Bailey-Davis L. Childhood Obesity and Early Body Mass Index Gains Associated with COVID-19 in a Large Rural Health System. Acad Pediatr 2024; 24:832-836. [PMID: 38190886 DOI: 10.1016/j.acap.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To evaluate body mass index (BMI) change among a population of children with a high proportion residing in rural areas across two pandemic time periods. METHODS Electronic health records were evaluated in a rural health system. INCLUSION CRITERIA 2-17 years at initial BMI; >2 BMIs during pre-pandemic (January 1, 2018-February 29, 2020); >1 BMI in early pandemic (June 1, 2020-December 31, 2020); and >1 BMI in later pandemic (January 1, 2021-December 31, 2021). Mixed effects linear regression models were used to estimate average monthly rate of change in BMI slope (∆BMI) from pre-pandemic to pandemic and test for effect modification of sex, race/ethnicity, age, BMI, public insurance, and rural address. RESULTS Among the 40,627 participants, 50.2% were female, 84.6% were non-Hispanic white, 34.9% used public insurance, and 42.5% resided in rural areas. The pre-pandemic proportion of children with overweight, obesity, and severe obesity was 15.6%, 12.8%, and 6.3%, respectively. The ∆BMI nearly doubled during the early pandemic period compared with the pre-pandemic period (0.102 vs 0.055 kg/m2), however, ∆BMI in the later pandemic was lower (0.040 vs 0.055 kg/m2). ∆BMI remained higher in the later pandemic for all race categories compared to Non-Hispanic white. Children with public insurance had higher ∆BMI compared to those with private insurance that remained higher in the later pandemic (0.051 vs 0.035 kg/m2). There was no significant difference between ∆BMI for rural and urban children during pandemic periods. CONCLUSIONS Despite the decreased ∆BMI among children in the later pandemic, prevalence of obesity and severe obesity remain high. Efforts must continue to be made to limit excess weight gain during childhood and to assess the impact of forces like structural and social factors in both etiology and prevention.
Collapse
Affiliation(s)
- Carolyn F McCabe
- Department of Population Health Sciences (CF McCabe and L Bailey-Davis), Geisinger, Danville, Pa; Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa
| | - G Craig Wood
- Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa
| | - Jennifer Franceschelli-Hosterman
- Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa; Nutrition and Weight Management (J Franceschelli-Hosterman), Geisinger Medical Center, Danville, Pa
| | - Lisa Bailey-Davis
- Department of Population Health Sciences (CF McCabe and L Bailey-Davis), Geisinger, Danville, Pa; Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa.
| |
Collapse
|
6
|
Stackpole KMW, Kharofa RY, Tucker JM, Novick MB, Fals AM, Bernier AV, Tammi EM, Khoury PR, Siegel R, Paul S, Naramore SK, Moore JM. Telehealth Use in a National Pediatric Weight Management Sample During the COVID-19 Pandemic. Child Obes 2024; 20:309-320. [PMID: 37440173 DOI: 10.1089/chi.2023.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Background: This study aimed to assess the implementation and access to telehealth-delivered pediatric weight management (PWM) during the initial phase of the COVID-19 pandemic at six US PWM programs (PWMP) using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Methods: The COVID-19 period (COVID) was defined in this retrospective, multisite study as the time when each site closed in-person care during 2020. The Pre-COVID period (Pre-COVID) was an equivalent time frame in 2019. Patients were stratified by visit completion status. Patient characteristics for COVID and Pre-COVID were compared to examine potential changes/disparities in access to care. Results: There were 3297 unique patients included across the six sites. On average, telehealth was initiated 4 days after in-person clinic closure. Compared with Pre-COVID, COVID (mean duration: 9 weeks) yielded fewer total completed visits (1300 vs. 2157) and decreased revenue (mean proportion of nonreimbursed visits 33.30% vs. 16.67%). Among the completed visits, COVID included a lower proportion of new visits and fewer patients who were male, non-English speaking, Hispanic, or Asian and more patients who were Black or lived ≥20 miles from the program site (p < 0.05 for all). Among no-show/canceled visits, COVID included more patients who had private insurance, older age, or a longer time since the last follow-up. Conclusion: Rapid implementation of telehealth during COVID facilitated continuity of PWM care. Clinic volume and reimbursement were lower during COVID and differences in the patient population reached by telehealth emerged. Further characterization of barriers to telehealth for PWM is needed.
Collapse
Affiliation(s)
- Kristin M W Stackpole
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Roohi Y Kharofa
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jared M Tucker
- Health Optimization Services, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Marsha B Novick
- Department of Pediatrics and Family and Community Medicine, Rush Medical College, Chicago, IL, USA
- Healthy Weight Program for Children and Teens, Penn State Hershey Children's Hospital, Hershey, PA, USA
| | - Angela M Fals
- AdventHealth for Children/AdventHealth Medical Group Pediatric Weight and Wellness, Orlando, FL, USA
| | - Angelina V Bernier
- Metabolic & Obesity Program, Pediatric Endocrinology, UF Health Shands Hospital, Gainesville, FL, USA
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Erin M Tammi
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Philip R Khoury
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Robert Siegel
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Suzanne Paul
- Department of Pediatrics, Section of Nutrition, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Children's Hospital Colorado, Aurora, CO, USA
| | - Sara K Naramore
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Indiana University School of Medicine, IN, USA
- Riley Hospital for Children at IU Health, Indianapolis, IN, USA
| | - Jaime M Moore
- Department of Pediatrics, Section of Nutrition, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Children's Hospital Colorado, Aurora, CO, USA
| |
Collapse
|
7
|
Stough CO, Rabin J, Gates T, Garr K, Combs A, Edwards ZT, Summer SS, Woo JG, Folger AT, Ammerman RT, Nuñez M, Berndsen J, Clark MJ, Frey JR, Vaughn LM. Infant Obesity Prevention Programs for Underrepresented Mothers in a Home Visiting Program: A Qualitative and Community-Engaged Needs Assessment. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:265-279. [PMID: 37202859 PMCID: PMC10983836 DOI: 10.1177/2752535x231176730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
A qualitative, community-engaged assessment was conducted to identify needs and priorities for infant obesity prevention programs among mothers participating in home visiting programs. Thirty-two stakeholders (i.e., community partners, mothers, home visitors) affiliated with a home visiting program serving low-income families during the prenatal to age three period participated in group level assessment sessions or individual qualitative interviews. Results indicated families face many challenges to obesity prevention particularly in terms of healthy eating. An obesity prevention program can address these challenges by offering realistic feeding options and non-judgmental peer support, improving access to resources, and tailoring program content to individual family needs and preferences. Informational needs, family factors in healthy eating outcomes, and the importance of access and awareness of programs were also noted. To ensure the cultural- and contextual-relevance of infant obesity prevention programs for underserved populations, needs and preferences among community stakeholders and the focal population should be used as a roadmap for intervention development.
Collapse
Affiliation(s)
| | - Julia Rabin
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Taylor Gates
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Katlyn Garr
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Angela Combs
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | | | - Suzanne S. Summer
- Schubert Research Clinic, Cincinnati Children’s Hospital Medical Center
| | - Jessica G. Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Alonzo T. Folger
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Robert T. Ammerman
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Miguel Nuñez
- Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Jennifer Berndsen
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Margaret J. Clark
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Jennifer R. Frey
- Every Child Succeeds, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Lisa M. Vaughn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Educational and Community-Based Action Research, University of Cincinnati College of Education, Criminal Justice & Human Services, Cincinnati, OH
| |
Collapse
|
8
|
Kawano B, Grisel B, Wischmeyer P, Holsman M, Agarwal S, Fernandez-Moure J, Haines KL. Racial and ethnic demographics in malnutrition related deaths. Clin Nutr ESPEN 2024; 60:135-138. [PMID: 38479901 DOI: 10.1016/j.clnesp.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND AND AIMS Currently, 40 million Americans are food insecure. They are forced to skip meals and buy non-nutritious food, leading to health disparities for those of low socioeconomic status. This study aims to investigate relationships between malnutrition deaths and sociodemographic groups. METHODS This cross-sectional study from 2009 to 2018 used aggregate data from the CDC Wide-ranging Online Data for Epidemiologic Research (CDC Wonder). Patients with known race, gender, and Hispanic origin age ≥18 who died from malnutrition (E40-E46) were included. Place of death was grouped into home, inpatient medical facility, hospice facility, nursing facility/long-term care, other (including outpatient, ED, and DOA), and unknown. Crude rates of malnutrition deaths per 100,000 persons for race, gender, and Hispanic origin were calculated using US census estimates. Gross proportions of total deaths were calculated for each place of death. RESULTS Between 2009 and 2018, there were 46,517 malnutrition deaths in the US. Death rates for Black (1.8) and White Americans (2) were twice as high compared to Native Americans (1.1) and Asians or Pacific Islanders (0.7). Death rates among females (2.3) were higher than males (1.5). Death rates among non-Hispanics (2.1) were twice as high compared to Hispanics (0.7). Most people who died of malnutrition died in hospitals (37 %). CONCLUSION Malnutrition deaths occur at greater rates among White, Black, non-Hispanic Americans, and females. Despite reported disparities in food access, Black and White Americans have similar malnutrition mortality rates, raising concerns that malnutrition is under-diagnosed among Black patients. Given the existing nutrition literature, this finding requires further investigation.
Collapse
Affiliation(s)
- Bradley Kawano
- Division of Trauma, Acute, and Critical Care Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
| | - Braylee Grisel
- Division of Trauma, Acute, and Critical Care Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
| | - Paul Wischmeyer
- Division of Critical Care Surgery, Department of Anesthesia, Duke University Medical Center, Durham, NC, USA.
| | - Maximilian Holsman
- Division of Trauma, Acute, and Critical Care Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
| | - Suresh Agarwal
- Division of Trauma, Acute, and Critical Care Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
| | - Joseph Fernandez-Moure
- Division of Trauma, Acute, and Critical Care Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
| | - Krista L Haines
- Division of Trauma, Acute, and Critical Care Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
| |
Collapse
|
9
|
Li Z, Zhang FF, Cash SB, Hager K, Trevino L, Folta SC. Caregiver perceptions of a pediatric produce prescription program during the COVID-19 pandemic. Front Nutr 2024; 11:1304519. [PMID: 38577157 PMCID: PMC10991727 DOI: 10.3389/fnut.2024.1304519] [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: 09/29/2023] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Produce prescription programs are rapidly expanding as a type of Food is Medicine intervention with prospects for mitigating food insecurity and reducing diet-related health disparities. Gaining insight into participant perspectives on program logistics and perceived impacts is crucial to program success and improvements. Methods Between May and June 2021, we conducted individual and small group interviews with 23 caregivers with children aged 1-5 years who participated in a produce prescription program from 2020 to 2021 in Texas, U.S. They were provided with a gift card to a major national grocery retailer to purchase fresh produce. The card was reloaded $60 monthly for 8 months with automatic roll-over of unused funds to the next month. Participants also received nutrition education in the form of two videos. A deductive analysis approach was employed, and NVivo qualitative data analysis software was used to perform coding and to assist with subsequent analyses. Results All 23 participants were female, with an average age of 37.5 years, and the majority identified as Hispanic/Latino (83%). About 43% of the families had three or more children. Six themes were generated from interviews. Three of these themes were related to program logistics: (1) ease of program use; (2) participant satisfaction with the incentive; and (3) desire for additional store options. The remaining main themes pertained to program impact: (1) the enhanced ability to purchase produce; (2) the usefulness of the nutrition education; and (3) persistent challenges encountered when preparing the produce for picky eaters and young children. Conclusion A pediatric produce prescription program was perceived as logistically easy and a helpful source of financial support for accessing fresh produce. Program features such as card-based incentive system and partnership with major grocery retailer were favored by participants. For future program design, it may be beneficial to consider collaborating with multiple grocery outlets and enhancing the intensity and targeting of nutrition education.
Collapse
Affiliation(s)
- Zhongyu Li
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Sean B. Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Kurt Hager
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Leo Trevino
- Amistad Community Health Center, Corpus Christi, TX, United States
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| |
Collapse
|
10
|
Devia C, Flórez K, Costa SA, Huang TTK. South-to-South parental migration patterns and excess weight among children: Insights from a national cross-sectional study in Colombia. Pediatr Obes 2024; 19:e13099. [PMID: 38286620 DOI: 10.1111/ijpo.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Evidence from Latin America suggests that children embedded in South-to-North migrant networks (i.e. relatives who live abroad, typically in the United States) are at increased risk of excess weight. It is unclear if the same findings apply to children embedded in Latin American intraregional migration or South-to-South migration networks. OBJECTIVE To compare excess weight among Colombian children embedded in South-to-South migration networks (n = 334) to children with non-migrant parents (n = 4272) using Colombia's 2015 National Survey of the Nutritional Situation. METHODS Prevalence ratios (PRs) for excess weight (BMI z-score ≥1) by parent migration history were estimated using weighted multivariable logistic regression adjusting for demographics, child behaviours, community and household indicators, including household food insecurity. RESULTS Most migrant parents returned to Colombia from Venezuela (84%) and reported higher household food insecurity rates than non-migrant parents (59% versus 32%). Models excluding household food insecurity showed that excess weight among children with migrant parents was 51% lower (PR = 0.49; 95% CI 0.25, 0.98) than among children with non-migrant parents. After adjustment for household food insecurity, no statistically significant differences were found. CONCLUSION Colombian children with return migrant parents from Venezuela experienced less excess weight than children with non-migrant parents, but higher rates of food insecurity in migrant households might partially explain this difference. This study calls attention to two serious public health concerns for Colombian children-those who have excess weight and those who lack sufficient food, particularly among migrant returnees (a situation that may have worsened since the COVID-19 pandemic).
Collapse
Affiliation(s)
- Carlos Devia
- Center for Systems & Community Design, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Karen Flórez
- Center for Systems & Community Design, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Sergio A Costa
- Center for Systems & Community Design, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Terry T-K Huang
- Center for Systems & Community Design, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| |
Collapse
|
11
|
Iacopetta D, Catalano A, Ceramella J, Pellegrino M, Marra M, Scali E, Sinicropi MS, Aquaro S. The Ongoing Impact of COVID-19 on Pediatric Obesity. Pediatr Rep 2024; 16:135-150. [PMID: 38391001 PMCID: PMC10885050 DOI: 10.3390/pediatric16010013] [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: 12/01/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
In the developed world, pediatric obesity (PO) has been a major health concern since the last century, and this condition may lead to detrimental life-long physical and mental comorbidities. Currently, its prevalence has increased in low- and middle-income countries and in many high-income countries. Thus, the provision of effective and tailored care for children and their families has become vital. The social consequences of the COVID-19 pandemic are known everywhere, and among these, it has been argued that the COVID-19 pandemic has had a major impact on PO. Overall, the growth of PO over the last decade has been enhanced by the pandemic. During the COVID-19 pandemic, children, adolescents and young adults gained weight as the pediatric population dealt with sedentary lifestyles and changes in food habits. In this review, we want to highlight the impact that the COVID-19 pandemic had on PO.
Collapse
Affiliation(s)
- Domenico Iacopetta
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Alessia Catalano
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", 70126 Bari, Italy
| | - Jessica Ceramella
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Michele Pellegrino
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Maria Marra
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Elisabetta Scali
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Maria Stefania Sinicropi
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| |
Collapse
|
12
|
Orkin S, Zhao X, Setchell KDR, Carr E, Arce-Clachar AC, Bramlage K, Huang R, Fei L, Beck AF, Fawaz R, Valentino PL, Xanthakos SA, Mouzaki M. Food Insecurity and Pediatric Nonalcoholic Fatty Liver Disease Severity. J Pediatr 2024; 265:113818. [PMID: 37931698 PMCID: PMC11108653 DOI: 10.1016/j.jpeds.2023.113818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/03/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE To determine the association between food insecurity and pediatric nonalcoholic fatty liver disease (NAFLD). METHODS Cross-sectional study of patients < 21 years of age with histologically confirmed NAFLD. The Household Food Security Survey Module was administered to determine food insecurity status. Skin lipidomics were performed to explore pathophysiologic mechanisms. RESULTS Seventy-three patients with histologically confirmed NAFLD completed the Household Food Security Survey Module. Of these, the majority were male (81%) and non-Hispanic (53%), with a mean age at biopsy of 13 ± 3 years. Food insecurity was seen in 42% (n = 31). Comparison of features between food insecure and food secure subgroups revealed no differences in sex, ethnicity, BMI z-score, aminotransferases, or histologic severity. However, children experiencing food insecurity presented on average 2 years before their food secure counterparts (12.3 ± 3.0 vs 14.4 ± 3.6 years, P = .015). A subset of 31 patients provided skin samples. Skin lipidomics revealed that food insecurity was associated with down-regulated features from the lipoamino acid class of lipids, previously linked to inflammation and adipocyte differentiation. CONCLUSIONS Food insecurity is highly prevalent in children with NAFLD and is associated with earlier presentation. Lipidomic analyses suggest a possible pathophysiologic link that warrants further exploration.
Collapse
Affiliation(s)
- Sarah Orkin
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Xueheng Zhao
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Kenneth D R Setchell
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Emily Carr
- Division of Pediatric Gastroenterology and Hepatology, Yale New Haven Children's Hospital, New Haven, CT
| | - Ana Catalina Arce-Clachar
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Kristin Bramlage
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Rong Huang
- Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Lin Fei
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Andrew F Beck
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Rima Fawaz
- Division of Pediatric Gastroenterology and Hepatology, Yale New Haven Children's Hospital, New Haven, CT; Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Pamela L Valentino
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT; Division of Pediatric Gastroenterology and Hepatology, Seattle Children's Hospital, Seattle, WA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
| | - Stavra A Xanthakos
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Marialena Mouzaki
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
| |
Collapse
|
13
|
Yudkin JS, Koym K, Hamad Y, Malthaner LQ, Burgess RM, Ortiz LN, Dhurjati N, Mitha S, Calvi G, Hill K, Brownell M, Wei E, Swartz K, Atem FD, Galeener CA, Messiah SE, Barlow SE, Allicock MA. Family-based pediatric weight management interventions in US primary care settings targeting children ages 6-12 years old: A systematic review guided by the RE-AIM framework. Transl Behav Med 2024; 14:34-44. [PMID: 37632769 DOI: 10.1093/tbm/ibad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2023] Open
Abstract
Obesity is a pandemic that disproportionately affects children from vulnerable populations in the USA. Current treatment approaches in primary care settings in the USA have been reported to be insufficient at managing pediatric obesity, primarily due to implementation challenges for healthcare systems and barriers for families. While the literature has examined the efficacy of pediatric obesity interventions focused on internal validity, it lacks sufficient reporting and analysis of external validity necessary for successful translation to primary care settings. We conducted a systematic review of the primary-care-setting literature from January 2007 to March 2020 on family-based pediatric weight management interventions in both English and/or Spanish for children ages 6-12 years in the USA using the Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. A literature search, using PRISMA guidelines, was conducted in January 2022 using the following electronic databases: Medline Ovid, Embase, and Cochrane Library. 22 270 records were screened, and 376 articles were reviewed in full. 184 studies were included. The most commonly reported dimensions of the RE-AIM framework were Reach (65%), Efficacy/Effectiveness (64%), and Adoption (64%), while Implementation (47%) and Maintenance (42%) were less often reported. The prevalence of reporting RE-AIM construct indicators ranged greatly, from 1% to 100%. This systematic review underscores the need for more focus on external validity to guide the development, implementation, and dissemination of future pediatric obesity interventions based in primary care settings. It also suggests conducting additional research on sustainable financing for pediatric obesity interventions.
Collapse
Affiliation(s)
- Joshua S Yudkin
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Kelsey Koym
- Texas Medical Center Library, Houston, TX, USA
| | - Yasmin Hamad
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Lauren Q Malthaner
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Rebecca Meredith Burgess
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | | | - Nalini Dhurjati
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Sharmin Mitha
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Gabriela Calvi
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Kristina Hill
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
- Children's Health, Children's Medical Center Dallas, Dallas, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | | | - Elena Wei
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Kyle Swartz
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Folefac D Atem
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Carol A Galeener
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Sarah E Messiah
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Sarah E Barlow
- Children's Health, Children's Medical Center Dallas, Dallas, TX, USA
- Department of Pediatrics, Division of Pediatric Gastroenterology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Marlyn A Allicock
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| |
Collapse
|
14
|
Lloyd KM, Gabard-Durnam L, Beaudry K, De Lisio M, Raine LB, Bernard-Willis Y, Watrous JNH, Whitfield-Gabrieli S, Kramer AF, Hillman CH. Cross-sectional analysis reveals COVID-19 pandemic community lockdown was linked to dysregulated cortisol and salivary alpha amylase in children. Front Public Health 2023; 11:1210122. [PMID: 38169630 PMCID: PMC10758420 DOI: 10.3389/fpubh.2023.1210122] [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: 04/21/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
The COVID-19 pandemic altered everyday life starting in March 2020. These alterations extended to the lives of children as their normal routines were disrupted by community lockdowns, online learning, limited in-person social contact, increased screen time, and reduced physical activity. Considerable research has investigated the physical health impact of COVID-19 infection, but far fewer studies have investigated the physiological impact of stressful pandemic-related changes to daily life, especially in children. The purpose of this study was to leverage an ongoing clinical trial to investigate physiological consequences associated with chronic stress of pandemic community lockdown on children. As a part of the clinical trial, children provided saliva samples. Saliva samples were analyzed for cortisol and salivary alpha amylase (sAA) content. This secondary cross-sectional analysis included 94 preadolescent children located within the Greater Boston, Massachusetts community. Children participated in the study either before, during, or following the pandemic community lockdown to form three groups for comparison. In response to chronic stress caused by the pandemic community lockdown, participants demonstrated dysregulation of fast-acting catecholamine response of the locus-coeruleus-norepinephrine system and slower-acting glucocorticoid response, resulting in an asymmetrical relationship of hypocortisolism (M = 0.78 ± 0.19 μg/mL, p < 0.001) paired with higher sAA (M = 12.73 ± 4.06 U/mL, p = 0.01). Results suggest that the abrupt COVID-19 disruption to daily life, including the stressful experience of community lockdown, had physiological effects on typically developing children. Further research is required to investigate mental health outcomes of children following the chronic stress of the pandemic community lockdown.
Collapse
Affiliation(s)
- Katherine M. Lloyd
- Department of Psychology, Northeastern University, Boston, MA, United States
| | | | - Kayleigh Beaudry
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Michael De Lisio
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lauren B. Raine
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, United States
| | - Ysabeau Bernard-Willis
- Department of Psychology, Northeastern University, Boston, MA, United States
- Division of Cognitive and Behavioral Neurology at Brigham and Women’s Hospital, Boston, MA, United States
| | | | | | - Arthur F. Kramer
- Department of Psychology, Northeastern University, Boston, MA, United States
- University of Illinois Beckman Institute, Champaign-Urbana, IL, United States
| | - Charles H. Hillman
- Department of Psychology, Northeastern University, Boston, MA, United States
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, United States
| |
Collapse
|
15
|
Pike JM, Haberlin-Pittz KM, Alharbi BS, Perkins SM, Hannon TS. A co-designed, community-based intensive health behavior intervention promotes participation and engagement in youth with risk factors for type 2 diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1264312. [PMID: 38108040 PMCID: PMC10722280 DOI: 10.3389/fcdhc.2023.1264312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/31/2023] [Indexed: 12/19/2023]
Abstract
Background Obesity among youth (children and adolescents) is associated with increased risk for youth-onset type 2 diabetes. Lifestyle change can delay or prevent the development of type 2 diabetes, yet real-world implementation of health behavior recommendations is challenging. We previously engaged youth with risk factors for type 2 diabetes, their caregivers, and professionals in a human-centered design study to co-design a lifestyle change program. Here we report the outcomes for this 16-week co-designed lifestyle change program for youth at risk for T2D and their caregivers. Research design and methods This single-arm family-based cohort study included youth aged 7-18 years, with BMI ≥85th percentile (overweight or obese) and at least one additional risk factor for type 2 diabetes, and their caregivers. Clinical (BMI, HbA1c), self-reported physical activity, and quality of life outcomes were evaluated at baseline (B), post-intervention (M4), and 1 year (M12) following the intervention. Results Seventy-eight youth (mean age 12.4 ± 2.7y, 67% female, 37.8% white) and 65 caregivers were included in the data analysis. Youth baseline BMI z-scores (2.26 ± 0.47) and HbA1c (5.3 ± 0.3) were unchanged at follow up time points [BMI z-scores M4 (2.25 ± 0.52), M12 (2.16 ± 0.58), p-value 0.46], [HbA1c M4 (5.3 ± 0.3), M12 (5.2 ± 0.3), p-value (0.04)]. Youth reported increased physical activity at M4 (p = 0.004), but not at M12. Youth quality of life scores increased at M12 (p=0.01). Families who attended at least one session (n=41) attended an average of 9 out of 16 sessions, and 37 percent of families attended 13 or more sessions. Conclusion A co-designed, community-based lifestyle intervention promotes increased physical activity, improved quality of life, maintenance of BMI z-scores and HbA1c, and engagement in youth with risk factors for T2D.
Collapse
Affiliation(s)
- Julie M. Pike
- Department of Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Pediatric Endocrinology, Riley Children’s Health, Indiana University Health, Indianapolis, IN, United States
| | - Kathryn M. Haberlin-Pittz
- Department of Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Pediatric Endocrinology, Riley Children’s Health, Indiana University Health, Indianapolis, IN, United States
| | - Basmah S. Alharbi
- Department of Biostatistics and Health Data Science, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States
| | - Susan M. Perkins
- Department of Biostatistics and Health Data Science, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Tamara S. Hannon
- Department of Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Pediatric Endocrinology, Riley Children’s Health, Indiana University Health, Indianapolis, IN, United States
| |
Collapse
|
16
|
Hopkins L, Schier H, May L, Westrick M, O'Piela D, Mazurek Melnyk B, Smith L, Gunther C. Patterns of participation in summer programming among United States' elementary children from low-income urban households: Results from the project SWEAT study. Prev Med Rep 2023; 36:102475. [PMID: 37886725 PMCID: PMC10598049 DOI: 10.1016/j.pmedr.2023.102475] [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: 06/07/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
Food insecurity increases among marginalized children during the summer when school is out of session. Summer programming that offers access to healthy meals and snacks may reduce the risk. There is a national call in the US for more research to assure equitable access to summer programming. The objective of this prospective observational study was to characterize patterns of participation in summer programming among elementary children from low-income urban neighborhoods of metropolitan[Blinded]. Summer programming was broadly defined (e.g., church, school, recreation center, community center). Caregivers(n = 100) received weekly text messages via TextIt during the summer (Jun-Aug 2017). They were asked: "How many days this week did [ChildName] attend a summer program? Please respond with a number from 0 to 5, where 0 - no days, 2 - 2 days, etc." Weekly counts were summed. Stepwise logistic and linear regression models were conducted to examine differences in patterns of attendance according to key sociodemographic characteristics. Mean age was 7.03 ± 0.23. 52 % identified as female, 70 % were low-income, and 80.0 % identified as Black. 51 % attended summer programming at least once; 49 % never attended. Those who attended at least once vs. not at all were more likely to be male(p < 0.01); 62.75 % males vs. 37.25 % females attended summer programming at least once, whereas 67.35 % females compared to 32.65 % males never attended. Overall mean attendance was 10.40 ± 1.43 days(out of 50). Mean + SE attendance was lower for females (7.52 + 1.76) vs. males (13.52 + 2.21)(p < 0.05), and non-Black (4.30 + 1.97) vs. Black (11.93 + 1.67)(p = 0.01) children. Future research is needed to understand barriers to participation in summer programming.
Collapse
Affiliation(s)
- Laura Hopkins
- Department of Public Health and Prevention Science, College of Education and Health Sciences, Baldwin Wallace University, USA
| | - Heather Schier
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Leah May
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Miranda Westrick
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Devin O'Piela
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Bernadette Mazurek Melnyk
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Laureen Smith
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Carolyn Gunther
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| |
Collapse
|
17
|
Siracusa C, Boat T. Additional considerations for CF nutritional guidelines. J Cyst Fibros 2023; 22:1133-1134. [PMID: 37788965 DOI: 10.1016/j.jcf.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Christopher Siracusa
- Division of Pulmonary Medicine, Cincinnati Children's Hospital, Cincinnati, OH, United States of America; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America.
| | - Thomas Boat
- Division of Pulmonary Medicine, Cincinnati Children's Hospital, Cincinnati, OH, United States of America; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
| |
Collapse
|
18
|
Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
Collapse
Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| |
Collapse
|
19
|
Gunther C, Banna J, Jones BL, Park C, Reicks M, Richards R, Schier H, Topham GL, Wong SS, Anderson AK, Ballejos M, Hopkins LC, Lora KR, Monroe-Lord L. Adolescent Independent Eating Occasions, Dietary Intake, and Parenting Practices During the COVID-19 Pandemic: A Qualitative Study of Parents and Adolescents From Households With Low Income. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:634-643. [PMID: 37422758 DOI: 10.1016/j.jneb.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE Examine how experiencing the coronavirus disease 2019 (COVID-19) pandemic influenced adolescent independent eating occasions (iEOs) and iEO-related parenting practices from the perspective of parents and adolescents METHODS: Cross-sectional remote interviews were conducted for this basic qualitative research study. Participants were a purposive sample of multiracial/ethnic adolescents aged 11-14 years and their parents from households with low income (n = 12 dyads) representing 9 US states. The main outcome measures were iEOs and iEO-related parenting practices. Data were analyzed using directed content analysis. RESULTS About half of the parents indicated that their adolescents had more iEOs during the COVID-19 pandemic and that there were changes in the types of foods consumed during iEOs. In contrast, most adolescents indicated their iEOs had not changed remarkably in frequency or foods consumed since the onset of the pandemic. Most parents reported no change in how they taught their adolescents about healthy food, the rules for foods/beverages permitted during iEOs, or how they monitored what their adolescents ate during iEOs; adolescent reports were in general agreement. Most parents indicated that family members were home together more often during the pandemic, which increased cooking frequency. CONCLUSIONS AND IMPLICATIONS The effect of the COVID-19 pandemic on adolescents' iEOs varied, and the parenting practices used to influence iEOs remained stable during the pandemic. Families experienced having more time together and cooking at home more often.
Collapse
Affiliation(s)
- Carolyn Gunther
- Martha S. Pitzer for Women, Children, and Youth, College of Nursing, The Ohio State University, Columbus, OH.
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI
| | - Blake L Jones
- Department of Psychology, Brigham Young University, Provo, UT
| | - Catherine Park
- Department of Biochemistry and Molecular Biology, Oregon State University, Corvallis, OR
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN
| | - Rickelle Richards
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - Heather Schier
- Department of Human Sciences, The Ohio State University, Columbus, OH
| | - Glade L Topham
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS
| | - Siew Sun Wong
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR
| | - Alex K Anderson
- Department of Nutritional Sciences, University of Georgia, Athens, GA
| | | | - Laura C Hopkins
- Department of Public Health and Prevention Science, Baldwin Wallace University, Berea, OH
| | - Karina R Lora
- Department of Exercise and Nutrition Sciences, The George Washington University, Washington, DC
| | - Lillie Monroe-Lord
- Center for Nutrition, Diet and Health, University of the District of Columbia, Washington, DC
| |
Collapse
|
20
|
Jung S, Shin J, Lee M. The Health and Nutritional Status of Children (10-18 years) Belonging to Food Insecure Households: The Korea National Health and Nutrition Examination Survey (2012-2019). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6695. [PMID: 37681835 PMCID: PMC10487755 DOI: 10.3390/ijerph20176695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/05/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
To research the health and nutritional status in Korean children and adolescents belonging to food insecure households (FI), the preregistered secondary data of 18 items from the Food Security Evaluation in the Korea National Health and Nutrition Examination Survey (KNHANES; 2012-2019) were used. Comparative analyses (food security group [FS], (n = 3150) vs. FI, (n = 405) of household characteristics, health status (anthropometrics, clinics, mentality), and nutritional status (nutrient intake, diet-quality, and pattern) were performed in children (boys: 1871, girls: 1684) aged 10-18 years. The FI comprised higher proportions of participants from low-income families, basic livelihood-security recipients, and vulnerability (characteristics: female household heads, aged ≥50, single, unemployed, with low education and unmet healthcare needs). Compared to FS, boys had higher abdominal obesity and alcohol use, whereas girls had lower high-density-lipoprotein cholesterol (HDLc) and mental vulnerability (self-perceived obesity despite FS-similar anthropometry) in FI. Inadequate protein intake among boys and girls, and high carbohydrate and inadequate fat intake among girls were especially found in the FI status. From the results of a nutrition quality test, Vit-A in boys, and protein, niacin, and iron intakes in girls were insufficient, respectively. Health-nutritional policies to improve children's lifestyles should reinforce FI-based intake of deficient nutrients.
Collapse
Affiliation(s)
- Sowon Jung
- Department of Food & Nutrition, Sungshin Women’s University, Seoul 01133, Republic of Korea;
| | - Jieun Shin
- Healthcare Data Science Center, Bio-Medical Informatics, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea;
| | - Myoungsook Lee
- Department of Food & Nutrition, Sungshin Women’s University, Seoul 01133, Republic of Korea;
- Research Institute of Obesity Science, Sungshin Women’s University, Seoul 01133, Republic of Korea
| |
Collapse
|
21
|
Butler LR, Abbott E, Mengsteab P, Dominy CL, Poeran J, Allen AK, Ranade SC. Epidemiology of pediatric trauma and fractures during and beyond the COVID-19 pandemic. J Child Orthop 2023; 17:322-331. [PMID: 37560351 PMCID: PMC10285363 DOI: 10.1177/18632521231180161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/01/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE Previous literature has shown decreases in pediatric trauma during the COVID-19 outbreak, but few have analyzed beyond the peak of the pandemic. This study assesses the epidemiology of pediatric trauma cases in a high-volume teaching hospital in New York City before, during, and after the height of the COVID-19 pandemic. METHODS Institutional data on pediatric trauma orthopedic cases from January 1, 2018 to November 30, 2021 were extracted. The following time frames were studied: (1) April 1-June 22 in 2018 and 2019 (pre-pandemic), (2) April 1-June 22, 2020 (peak pandemic), and (3) April 1-June 22, 2021 (post-peak pandemic). Inferential statistics were used to compare patient and trauma characteristics. RESULTS Compared to the pre-pandemic cohort (n = 6770), the peak pandemic cohort (n = 828) had a greater proportion of fractures (p < 0.01) and had a significantly decreased overall traumas per week rate (p < 0.01) and fractures per week rate (p < 0.01). These decreased trauma (p < 0.01) and fracture rates (p < 0.01) persisted for the post-peak pandemic cohort (n = 2509). Spatial analysis identified zip code clusters throughout New York City with higher rates of emergency department presentation during the peak pandemic compared to pre-pandemic, and these areas aligned with lower-income neighborhoods. CONCLUSION During the peak of the pandemic, overall trauma and fracture volumes decreased, the types of prevalent injuries changed, and neighborhoods of different economic resources were variably impacted. These trends have mostly persisted for 12 months post-peak pandemic. This longitudinal analysis helps inform and improve long-term critical care and public health resource allocation for the future. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Liam R Butler
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Erin Abbott
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Paulos Mengsteab
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Calista L Dominy
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Jashvant Poeran
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Abigail K Allen
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Sheena C Ranade
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| |
Collapse
|
22
|
Francis L, Spaulding EM, Bloom I, Patel A, Perrin N. A systematic appraisal of the information, engagement, aesthetic and functional quality of nutrition-related smartphone apps for children and adolescents. Public Health Nutr 2023; 26:1368-1379. [PMID: 36912110 PMCID: PMC10346071 DOI: 10.1017/s1368980023000526] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 01/09/2023] [Accepted: 02/24/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Nutrition-related smartphone applications (apps) could improve children's nutrition knowledge and skills. However, little is known about the quality of nutrition-related apps for children. This study aimed to identify and evaluate the quality of nutrition-related smartphone apps designed for children ages 4-17. DESIGN This systematic appraisal is guided by the Protocol for App Store Systematic Reviews. SETTING Using Google's Advanced Search, we identified 1814 apps/1184 additional apps in an updated search on iOS, of which twenty-four were eligible. The apps' objective and subjective quality were evaluated using the twenty-three-item, five-point Mobile App Rating Scale. The objective quality scale consists of four subscales: engagement, functionality, aesthetics and information. RESULTS Most of the apps (75 %) focussed solely on promoting nutrition skills, such as making food dishes, rather than nutrition knowledge. Of the twenty-four apps, 83 % targeted children 4-8 years old. The app objective quality mean score was 3·60 ± 0·41. The subscale mean scores were 3·20 ± 0·41 for engagement, 4·24 ± 0·47 for functionality, 4·03 ± 0·51 for aesthetics and 2·94 ± 0·62 for information. The app subjective quality mean score was 2·10 ± 0·90. CONCLUSIONS More robust approaches to app development leveraging co-design approaches, including involving a multidisciplinary team of experts to provide evidence-based nutrition information, are warranted.
Collapse
Affiliation(s)
- Lucine Francis
- Center for Community Programs, Innovation, and Scholarship, Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
| | - Erin M Spaulding
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
- Digital Health Innovation Laboratory, Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD21205, USA
| | - India Bloom
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
| | - Alisha Patel
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
| | - Nancy Perrin
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
| |
Collapse
|
23
|
Long X, Li XY, Jiang H, Shen LD, Zhang LF, Pu Z, Gao X, Li M. Impact of the COVID-19 kindergarten closure on overweight and obesity among 3- to 7-year-old children. World J Pediatr 2023; 19:469-477. [PMID: 36507980 PMCID: PMC9742663 DOI: 10.1007/s12519-022-00651-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/03/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Knowledge on the impact of the temporary kindergarten closure policy under COVID-19 in 2020 on childhood overweight and obesity is inadequate. We aimed to examine differences in rates of overweight and obesity from 2018 to 2021 among kindergarten children aged 3-7 years. METHODS Overweight was defined as body mass index (BMI) > 1 standard deviation (SD) for age and sex, and obesity was defined as BMI > 2 SD for age and sex. Generalized linear mixed modeling was used for analysis. RESULTS A total of 44,884 children and 71,216 growth data points from all 57 public kindergartens in Jiading District, Shanghai, China were analyzed. The rates of obesity from 2018 to 2021 were 6.9%, 6.6%, 9.5%, and 7.3% in boys and 2.8%, 2.8%, 4.5%, and 3.1% in girls, respectively. The rates of overweight from 2018 to 2021 were 14.3%, 14.3%, 18.2%, and 15.3% in boys and 10.6%, 10.9%, 13.9%, and 11.6% in girls. The rates of obesity and overweight among kindergarten children in 2020 were significantly higher than those in 2018, 2019, and 2021. Compared to 2020, the odds ratios of the obesity rate in 2018, 2019, and 2021 were 0.67 [95% confidence interval (CI) = 0.58-0.77, P < 0.001], 0.72 (95% CI = 0.64-0.80, P < 0.001) and 0.81 (95% CI = 0.72-0.92, P = 0.001), respectively. The odds ratios of the overweight rate in 2018, 2019, and 2021 were 0.75 (95% CI = 0.69-0.82, P < 0.001), 0.78 (95% CI = 0.72-0.84, P < 0.001), and 0.89 (95% CI = 0.81-0.97, P = 0.008), respectively, compared to 2020. CONCLUSIONS The rates of overweight and obesity significantly increased among kindergarten children in 2020 after the 5-month kindergarten closure. It was critical to provide guidance to caregivers on fostering a healthy lifestyle for children at home under public health emergencies.
Collapse
Affiliation(s)
- Xiang Long
- Department of Woman and Child Health Care, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China
| | - Xing-Ying Li
- School of Public Health, Key Laboratory of Health Technology Assessment (National Health Commission of the People's Republic of China), Fudan University, Mailbox 175, 138 Yixueyuan Road, Xuhui District, Shanghai 200032, China
| | - Hong Jiang
- School of Public Health, Key Laboratory of Health Technology Assessment (National Health Commission of the People's Republic of China), Fudan University, Mailbox 175, 138 Yixueyuan Road, Xuhui District, Shanghai 200032, China.
| | - Lian-Di Shen
- Department of Administrative Office, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China.
| | - Li-Feng Zhang
- Department of Woman and Child Health Care, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China
| | - Zheng Pu
- Department of Woman and Child Health Care, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China
| | - Xia Gao
- Department of Woman and Child Health Care, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China
| | - Mu Li
- School of Public Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
24
|
Baxter SLK, Koob CE, Hossfeld CML, Griffin SF, Mobley C, Hossfeld LH. Food Insecurity, the Food Environment, and COVID-19 in Rural South Carolina. FAMILY & COMMUNITY HEALTH 2023; 46:128-135. [PMID: 36799946 PMCID: PMC9930688 DOI: 10.1097/fch.0000000000000355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In this study, we explored the relationship between the food environment and food security among rural adults during the COVID-19 pandemic. Researchers, with assistance from community partners, conducted a cross-sectional survey assessing the impact of COVID-19 on food access, food security, and physical activity in 9 rural South Carolina (SC) counties. This survey was administered to a purposive sample (N = 587) from August 2020 to March 2021. The dependent variable was a binary indicator of food insecurity (past 3 months), in accordance with the USDA Household Food Security Survey Module. Independent variables were sociodemographic characteristics, food environment factors (eg, shopping at grocery stores, partial markets, and farmers' markets), and shopping behaviors during the pandemic. Overall, 31% of respondents were food insecure. Food security status differed by income and household composition. Results indicate that the odds of food insecurity were higher for respondents who shopped frequently at partial markets (adjusted odds ratio [AOR] = 1.61, 95% confidence interval [CI]: 1.01-2.56) and shopped more for food before the pandemic than during the pandemic (AOR = 1.68, 95% CI: 1.07-2.64). Findings underscore the importance of examining the relationship between the food environment and food insecurity during COVID-19 in rural settings.
Collapse
Affiliation(s)
- Samuel L. K. Baxter
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Caitlin E. Koob
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Cassius M. L. Hossfeld
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Sarah F. Griffin
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Catherine Mobley
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Leslie H. Hossfeld
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| |
Collapse
|
25
|
Yamron E, Moon JY, Meissner P, Wylie-Rosett J, Shankar V, Rieder J. Trends in health behavior at an afterschool program: the impact of COVID-19 on students' behavior. RESEARCH SQUARE 2023:rs.3.rs-2679660. [PMID: 37034787 PMCID: PMC10081377 DOI: 10.21203/rs.3.rs-2679660/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Background A minority of American youth meet CDC physical activity (PA) recommendations; children in the Bronx face additional structural barriers to engaging in PA. The B'N Fit Power expansion draws on pilot programming to increase the proportion of middle school students who engage in one hour of daily PA. The COVID-19 pandemic presented additional obstacles, including increased food insecurity and suspension of organized PA programming. This research aimed to evaluate differences in baseline target behavior attainment before and after the start of the COVID-19 pandemic to inform future programming to help children reduce their risk of obesity. Methods Afterschool program leaders at three Bronx public schools collected demographic and target behavior data at baseline and attendance data throughout the school year. Results During the 2016-2017 and 2017-2018 school years, 76 students enrolled and completed one year of programming, which was administered at a single site (61 % Hispanic, 46% female). Of these, 76 (100%) completed a baseline target behaviors questionnaire. During the 2021-2022 school year, 417 students enrolled and completed one year of programming at one of the three sites (70% Hispanic, 48% female). 89 (21%) completed a baseline target behaviors questionnaire. Participants surveyed after the start of the COVID-19 pandemic reported drinking more sugar-sweetened beverages (Median=3 daily, IQR 2-5), sleeping less (Median=8 hours daily, IQR 6-9 hours), and consuming fast food more frequently (Median=1 time weekly, IQR 0 times weekly-2 to 3 times weekly) than those surveyed prior to the start of the pandemic. The number of PA hours completed each week trended toward significant decline (Median=3, IQR 2-5, p=0.09) in students tracked after the start of the pandemic. Conclusions The attainment of several target behaviors among school children linked to the reduction of childhood obesity declined during the COVID-19 pandemic. These findings can be applied to enhancing existing real-world afterschool PA programming.
Collapse
|
26
|
Natale RA, Cardenas EPV, Varanloo P, Ma R, Agosto Y, Palenzuela J, Hernandez J, Schladant M, Bloyer M, Messiah SE. Social Challenges as a Consequence of the COVID-19 Pandemic among South Florida Preschool Children with Disability and Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:619. [PMID: 37189868 PMCID: PMC10137173 DOI: 10.3390/children10040619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/07/2023] [Accepted: 03/11/2023] [Indexed: 03/29/2023]
Abstract
The COVID-19 pandemic has negatively impacted the childcare industry over the past two years. This study examined how pandemic-related challenges impacted preschool-aged children by disability and obesity status. Participants were 216 children (80% Hispanic, 14% non-Hispanic Black) aged 2 to 5 years in 10 South Florida childcare centers. In November/December 2021, parents completed a COVID-19 Risk and Resiliency Questionnaire, and body mass index percentile (BMI) was collected. Multivariable logistic regression models examined the association of COVID-19 pandemic-related social challenges (transportation, employment) and child BMI and disability status. As compared to normal-weight children, those families with a child who was obese were more likely to report pandemic-related transportation (OR: 2.51, 95% CI: 1.03-6.28) challenges and food insecurity (OR: 2.56, 95% CI: 1.05-6.43). Parents of children with disabilities were less likely to report that food did not last (OR: 0.19, 95% CI: 0.07-0.48) and that they could not afford balanced meals (OR: 0.33, 95% CI: 0.13-0.85). Spanish-speaking caregivers were more likely to have a child who was obese (OR: 3.04, 95% CI: 1.19-8.52). The results suggest that COVID-19 impacts obese preschool children from Hispanic backgrounds, while disability was a protective factor.
Collapse
Affiliation(s)
- Ruby A. Natale
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Erika Paola Viana Cardenas
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Parisa Varanloo
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Ruixuan Ma
- Division of Biostatistics, Department of Public Health Science, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Yaray Agosto
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Joanne Palenzuela
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Julieta Hernandez
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Michelle Schladant
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, Miami, FL 33130, USA
| | - Martha Bloyer
- Department of Physical Therapy, University of Miami, Coral Gables, FL 33146, USA
| | - Sarah E. Messiah
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX 75390, USA
- Center for Pediatric Population Health, Children’s Health System of Texas and UT Health School of Public Health, Dallas, TX 75390, USA
| |
Collapse
|
27
|
Fiechtner L, Woo Baidal J, Cheng ER. The Healthy, Hunger-Free Kids Act and Children's Body Mass Index Outcomes. JAMA Pediatr 2023; 177:335-336. [PMID: 36780154 DOI: 10.1001/jamapediatrics.2022.5834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- Lauren Fiechtner
- Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston, Massachusetts.,The Greater Boston Food Bank, Boston, Massachusetts
| | - Jennifer Woo Baidal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian Morgan Stanley Children's Hospital, New York
| | - Erika R Cheng
- Division of Children's Health Services Research, Indiana University School of Medicine, Indianapolis
| |
Collapse
|
28
|
Littlejohn E. Pediatric Obesity-A Looming Problem for the Pediatric Population. Pediatr Ann 2023; 52:e46-e47. [PMID: 36779878 DOI: 10.3928/19382359-20230102-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
29
|
Lin CA, Vosburgh KL, Roy D, Duffy VB. Usability Testing an mHealth Program with Tailored Motivational Messages for Early Adolescents. Nutrients 2023; 15:nu15030574. [PMID: 36771281 PMCID: PMC9921541 DOI: 10.3390/nu15030574] [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: 12/29/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Obesity among children is a rising concern throughout the world. In the U.S., rates of childhood obesity are the highest among children from diverse and economically disadvantaged households. Obesity in adolescence increases the risk of negative physical and psychological health consequences. Mobile-app-based health interventions have been found to be an effective tool to encourage children to adopt a healthier living style. A novel mobile app prototype was developed for early adolescents to communicate with and engage them interactively about healthy eating and active living. To test the app's usability, students from a U.S. middle school, with a majority of children from low-income families, were recruited to use the app and report their feedback. The usability testing results confirmed that the app was equally well received by participants of different genders, normal weight versus overweight/obesity, and amounts of screen time. Study participants also provided overwhelming positive feedback for the embedded and tailored motivational messages that encourage healthy eating and active living. The conceptualization of the app prototype was guided by the self-determination theory, social cognitive theory, and priming theory, in addition to incorporating evidence-based obesity prevention principles. This prototype, hence, provides a valid platform for building theory-based behavioral interventions.
Collapse
Affiliation(s)
- Carolyn A. Lin
- Department of Communication, University of CT, Storrs, CT 06269, USA
- Correspondence: ; Tel.: +1+860-486-3984
| | - Kayla L. Vosburgh
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269, USA
| | - Deya Roy
- Department of Communication, California State University San Marcos, 333 S. Twin Oaks Valley Rd, San Marcos, CA 92096, USA
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269, USA
| |
Collapse
|
30
|
Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition-Narrative Review. Nutrients 2023; 15:nu15020416. [PMID: 36678287 PMCID: PMC9865989 DOI: 10.3390/nu15020416] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition.
Collapse
|
31
|
Traore SS, Bo Y, Kou G, Lyu Q. Socioeconomic inequality in overweight/obesity among US children: NHANES 2001 to 2018. Front Pediatr 2023; 11:1082558. [PMID: 36873636 PMCID: PMC9978798 DOI: 10.3389/fped.2023.1082558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/23/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Previous research has found that the prevalence of childhood overweight/obesity varies depending on household income, ethnicity, and sex. The goal of our research is to examine changes over time in socioeconomic inequality and the prevalence of overweight/obesity among American children under five by sex and ethnicity. METHODS This cross-sectional analysis used data from the National Health and Nutrition Examination Surveys (NHANES) collected from 2001-02 to 2017-18. Overweight/obesity in children under five [Body Mass Index (BMI)-for-age z-score >2 standard deviations] was defined according to the World Health Organization (WHO) growth reference standard. The slope inequality index (SII) and the concentration index (CIX) were used to measure the socioeconomic inequality in overweight/obesity. RESULTS Between 2001-02 and 2011-12, childhood overweight/obesity in the United States decreased from 7.3% to 6.3%, and had increased to 8.1% by 2017-18. However, this pattern varied widely by ethnicity and sex. For both the 2015-16 and 2017-18 surveys, overweight/obesity was more concentrated in the poorest household quintile for overall Caucasian children ((SII = -11.83, IC 95% = -23.17, -0.49 and CIX = -7.368, IC 95% = -13.92, -0.82) and (SII = -11.52, IC 95% = -22.13, -0.91 and CIX = -7.24, IC 95% = -13.27, -1.21), respectively) and for males of other ethnicities [(SII = -13.93, IC 95% = -26.95, -0.92) and CIX = -8.55, IC 95% = -0.86, -16.25] and (SII = -21.19, IC 95% = -40.65, -1.74) and CIX = -13.11, IC 95% = -1.42, -24.80), respectively). In the last three surveys, overweight/obesity was also more concentrated in the poorest household quintile for the overall children of other ethnicities. With the exception of African American females in the 2013-14 survey, for whom overweight/obesity was significantly concentrated in a quintile of the richest households (SII = 12.60, 95% CI = 0.24, 24.97 and CIX = 7.86, 95% CI = 15.59, 0.12); overweight/obesity was found to be concentrated in the richest household quintile for overall African American children, but not significantly so. CONCLUSIONS Our findings give an update and reinforce the notion that overweight/obesity in children under the age of five has increased and that related wealth inequalities are a public health problem in the United States.
Collapse
Affiliation(s)
- Stanislav Seydou Traore
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Guangning Kou
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China.,Centre of Sport Nutrition and Health, School of Physical Education, Zhengzhou University, Zhengzhou, China
| | - Quanjun Lyu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China.,Department of Nutrition, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
32
|
Chen S, Kracht CL, Beyl RA, Staiano AE. Temporal Changes in Energy-Balance Behaviors and Home Factors in Adolescents with Normal Weight and Those with Overweight or Obesity. INTERNATIONAL JOURNAL OF PHYSICAL ACTIVITY AND HEALTH 2023; 2:5. [PMID: 37675056 PMCID: PMC10481771 DOI: 10.18122/ijpah.020205.boisestate] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
This study aimed to examine the temporal changes in energy-balance behaviors and home factors in adolescents with normal weight and those with overweight or obesity (OWOB). Adolescents or parent proxies completed survey assessments two to four years before (T0; n = 82 ), ≤ six months before (T1; n = 68 ), and ≤ three months after the COVID-19 pandemic outbreak (T2; n = 82 ), to capture energy-balance behaviors (i.e., physical activity [PA], screen time, sleep) and home factors (i.e., food environment, food worry, parent support for PA). At T0 and T1 (before pandemic), participants visited our laboratory for anthropometric measurements. At T2, parent proxies also completed a survey to report the COVID-19 pandemic exposure and impact. The participating families experienced moderate levels of pandemic exposure and impact, although exposure was higher in the OWOB group F 1,78 = 5.50 , p < . 05 . Repeated-measure multivariate analyses of covariance (RM-MACOVAs) did not show significant time by weight status interaction effects (p > 0.05 ; adjusted for race and sex). However, the models detected significant time (T0 vs. T2) by race (White vs. non-White) interaction effect λ 7,66 = 0.81 , p < 0.05 , with greater increase in food worry F 1,72 = 4.36 , p < . 05 but less increase in screen time F 1,72 = 4.54 , p < . 05 among the non-White group. Graphical visualization depicted some favorable change patterns in adolescents with normal weight (vs. those with OWOB) for certain behaviors and home factors (e.g., number of days per week ≥ 60 mins PA, food worry). These findings suggest that the COVID-19 pandemic exerted greater adverse effects on adolescents with OWOB and specifically on screen time and food worry among non-White adolescents.
Collapse
|
33
|
Fabin-Czepiel K, Pieczyńska-Chapuła K, Deja G. "The obesity pandemic" in the COVID-19 pandemic - new treatment for an old problem. Pediatr Endocrinol Diabetes Metab 2023; 29:104-111. [PMID: 37728462 PMCID: PMC10411083 DOI: 10.5114/pedm.2023.129342] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/15/2023] [Indexed: 09/21/2023]
Abstract
Obesity is a worldwide problem, and the fact that it increasingly affects children and adolescents is worrying. The COVID-19 pandemic and the restrictions introduced affected the physical activity of children and adolescents, and changed their lifestyle and the amount of time spent in front of screens, which are significant factors correlated with weight gain. Due to the scale of the problem of obesity and overweight, much attention is currently paid to seeking effective forms of therapy in these different, difficult circumstances. Interventions promoting a healthy lifestyle among obese children after the COVID-19 pandemic are particularly important and necessary. This article provides a review of the literature on the recent worsening of obesity in the paediatric population, with particular emphasis on the importance of the COVID-19 pandemic. New methods of fighting obesity with the use of telemedicine and current methods of pharmacotherapy, including new drugs, are presented.
Collapse
Affiliation(s)
| | | | - Grażyna Deja
- Department of Paediatric Diabetology, Department of Paediatrics, Faculty of Medicine, Medical University of Silesia in Katowice, Poland
| |
Collapse
|
34
|
Alam MB, Shahid M, Alzghoul BI, Yang J, Zakar R, Malik NI, Bibi A, Tang K. The Effects of Financial Stress and Household Socio-Economic Deprivation on the Malnutrition Statuses of Children under Five during the COVID-19 Lockdown in a Marginalized Region of South Punjab, Pakistan. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010012. [PMID: 36670563 PMCID: PMC9857281 DOI: 10.3390/children10010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/28/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
The lockdown after the COVID-19 pandemic not only caused public health crises and income stress but also put millions at risk of food insecurity and malnutrition across the globe, especially in low and middle-income countries [LMICs]. This study evaluated the effects of financial stress and household socio-economic deprivation on the nutritional status of 1551 children under the age of five during COVID-19 in Pakistan. A self-administered questionnaire was used between November 2020 and April 2021 to collect information on age, height, children's weight, and socio-economic status from 1152 rural households from underdeveloped regions in Punjab, Pakistan. With the help of the proportionate simple random sampling method, this study employed a model (binary logistic regression) to calculate the likelihood of malnourishment. The findings showed that the stunting, underweight, and wasting prevalence rates during COVID-19 were 58.86%, 41.89%, and 8.11%, respectively, in the Bahawalpur region. According to the binary logistic regression analysis, among the household deprivation status (HDS) categories, the risks of childhood malnutrition were lesser in HDS-2 (OR = 0.05, 95% CI: 0. 005-0.879) and HDS-3 (OR = 0.04, 95% CI: 0.008-0.193). Similar to this, within the financial stress index (FSI) categories, the children in homes with medium financial stress had reduced odds of malnutrition (OR = 0.10, 95% CI: 0.018-0.567), and the children in households with low financial stress had reduced risks of malnutrition (OR = 0.006, 95% CI: 0.005-0.061). The proposed research found that stunting and underweight increased by 17.26% and 12.29% during the COVID-19 lockdown in the Bahawalpur region. Additionally, financial stress and socio-economic deprivation strongly affected children's nutritional statuses during the COVID-19 lockdown in the Bahawalpur region of Southern Punjab.
Collapse
Affiliation(s)
- Muhammad Babar Alam
- Department of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore 54000, Pakistan
- World Health Organization, Peshawar 25000, Pakistan
| | - Muhammad Shahid
- World Health Organization, Peshawar 25000, Pakistan
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing 100029, China
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Bashar Isam Alzghoul
- Respiratory Care Department, College of Applied Medical Sciences in Jubail, Imam Abdulrahman Bin Faisal University-Dammam, Jubail 35816, Saudi Arabia
| | - Juan Yang
- Chinese Academy of Sciences and Technology for Development, Beijing 100038, China
- Correspondence: (J.Y.); (K.T.); Tel.: +86-13671129425 (K.T.)
| | - Rubeena Zakar
- Department of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore 54000, Pakistan
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha 40100, Pakistan
| | - Asma Bibi
- Independent Researcher, Lahore 54000, Pakistan
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
- Correspondence: (J.Y.); (K.T.); Tel.: +86-13671129425 (K.T.)
| |
Collapse
|
35
|
Parzen-Johnson S, Sun S, Patel AB, Scardina TL, Shah SK, Patel SJ. Sociodemographic Comparison of Children With High-risk Medical Conditions Referred vs Identified Through Screening Plus Outreach for COVID-19 Therapeutics. JAMA Netw Open 2022; 5:e2248671. [PMID: 36576739 PMCID: PMC9857346 DOI: 10.1001/jamanetworkopen.2022.48671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IMPORTANCE Minoritized groups are less likely to receive COVID-19 therapeutics, but few studies have identified potential methods to reduce disparities. OBJECTIVE To determine whether screening plus outreach, when compared with referral alone, increases identification of vulnerable pediatric patients at high risk for severe disease eligible for COVID-19 therapeutics from low-resourced communities. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study of COVID-19 medication allocation between January 1, 2022, and February 15, 2022, at Lurie Children's Hospital, a quaternary care children's hospital, in Chicago, Illinois. The cohorts were pediatric patients referred for COVID-19 therapeutics or with a positive SARS-CoV-2 polymerase chain reaction within the hospital system followed by outreach. Screening involved daily review of positive cases of SARS-CoV-2, followed by medical record review for high-risk conditions, and communication with clinicians and/or patients and families to offer therapy. EXPOSURES Diagnosis of COVID-19. MAIN OUTCOMES AND MEASURES The primary measure was difference in child opportunity index (COI) scores between the 2 cohorts. Secondary measures included presence and duration of symptoms at diagnosis, medication uptake, race and ethnicity, insurance type, qualifying medical condition, sex, primary language, and age. RESULTS Of 145 total patients, the median (IQR) age was 15 (13-17) years, and most were male (87 participants [60.0%]), enrolled in public insurance (83 participants [57.2%]), and members of minoritized racial and ethnic groups (103 participants [71.0%]). The most common qualifying conditions were asthma and/or obesity (71 participants [49.0%]). From 9869 SARS-CoV-2 tests performed, 94 eligible patients were identified via screening for COVID-19 therapeutics. Fifty-one patients were identified via referral. Thirty-two patients received medication, of whom 8 (25%) were identified by screening plus outreach alone. Compared with referred patients, patients in the screening plus outreach group were more likely to have moderate, low, or very low COI composite scores (70 patients [74.5%] vs 27 patients [52.9%]); public insurance (65 patients [69.1%] vs 18 patients [35.3%]); and asthma or obesity (60 patients [63.8%] vs 11 patients [21.6%]). Patients in the referral group were more likely to be non-Hispanic White (23 patients [45.1%] vs 19 patients [20.2%]) and receive medication (24 patients [47.1%] vs 8 patients [8.5%]). CONCLUSIONS AND RELEVANCE Compared with referral patients, screening plus outreach patients for COVID-19 medications were more socially vulnerable, with lower COI scores, and more likely to have asthma or obesity. Future studies should investigate communication strategies to improve uptake of these medications after outreach.
Collapse
Affiliation(s)
- Simon Parzen-Johnson
- Division of Infectious Diseases, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Shan Sun
- Division of Infectious Diseases, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Ami B Patel
- Division of Infectious Diseases, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Tonya L Scardina
- Department of Pharmacy, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Seema K Shah
- Division of Advanced General Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Sameer J Patel
- Division of Infectious Diseases, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|
36
|
Gomes CS, Santi NMM, da Silva DRP, Werneck AO, Szwarcwald CL, de Azevedo Barros MB, Malta DC. The COVID-19 pandemic and changes in eating habits of Brazilian adolescents. DIALOGUES IN HEALTH 2022; 1:100070. [PMID: 36785626 PMCID: PMC9632237 DOI: 10.1016/j.dialog.2022.100070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/10/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
Introduction The social distancing imposed by the COVID-19 pandemic influenced lifestyle and modified dietary patterns. Our objective was to evaluate the consumption of fruits and vegetables (FV), and ultra-processed foods (UPF), before and after the COVID-19 pandemic, as well as to identify the sociodemographic factors associated. Methods This study used data from the "Convid Adolescents", a survey on health behaviors that were collected through an online questionnaire self-completed by 9.470 adolescents between 12 and 17 years of age during the pandemic in Brazil in 2020. Individuals were invited to participate through a chain-sampling procedure called "virtual snowballing". Information about FV, and UPF consumption before and during the pandemic period were reported. The independent variables used were sex, age group, race/color of skin, kind of school, education level of the mother, region of Brazil, financial difficulties during the pandemic, food insecurity, and social restrictions. Logistic regression models were used. Results There was a reduction in the low consumption of FV (83.5% to 80.3%) and there was no significant difference in the high consumption of UPF (38.9% to 38.1%) before and during the pandemic. The incidence of low consumption of FV and high consumption of UPF during the pandemic was 20% and 13.8%, respectively. Girls, private school adolescents, who reported having food insecurity and financial difficulties during the pandemic were the most affected subgroups. Conclusions Despite little change in the prevalence of FV and UPF consumption before and during the pandemic, the incidence of high consumption of UPF and low FV consumption was high, and it identified in specific population subgroups.
Collapse
Affiliation(s)
- Crizian Saar Gomes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós Graduação em Saúde Pública, Belo Horizonte, Minas Gerais, Brazil
| | - Nathália Mota Mattos Santi
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós Graduação em Saúde Pública, Belo Horizonte, Minas Gerais, Brazil
| | | | - André Oliveira Werneck
- Universidade de São Paulo (USP), Escola de Saúde Pública, Departamento de Nutrição, São Paulo, Brazil
| | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde da Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
37
|
Costa AL, Pereira JL, Franco L, Guinot F. COVID-19 Lockdown: Impact on Oral Health-Related Behaviors and Practices of Portuguese and Spanish Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16004. [PMID: 36498079 PMCID: PMC9739203 DOI: 10.3390/ijerph192316004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to assess and compare the impact of COVID-19 pandemic lockdowns on the oral health attitudes, dietary habits and access to dental care of Portuguese and Spanish children. A cross-sectional observational study involving caregivers of 3−17-year-old children who had cohabited during a COVID-19 pandemic lockdown in Spain and Portugal was conducted. Caregivers completed an online anonymous questionnaire. Aiming groups comparison, chi-square test was used for qualitative variables. 770 surveys were obtained. Significant changes in the children’s routine were higher in Portugal (p < 0.001). Both countries showed a large percentage of children who had between 2−3 snacks between meals (p < 0.001) and a higher consumption of snacks was particularly noticed among Spanish children with untreated dental caries during the lockdown (p = 0.003). Most caregivers reported children’s oral hygiene habits did not suffer noteworthy alterations (p = 0.417), although parental supervision of toothbrushing was associated with dental attendance during the lockdown. The majority of the sample had no dental attendance during confinement. Confinement appears to have not markedly affected the oral health status and habits of the majority of these children, although an important impact of some demographic and behavioral factors upon dietary and oral care/habits was detected.
Collapse
Affiliation(s)
- Ana L. Costa
- Paediatric and Preventive Dentistry Institute, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Joana L. Pereira
- Paediatric and Preventive Dentistry Institute, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Lara Franco
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, 080195 Sant Cugat del Vallès, Spain
| | - Francisco Guinot
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, 080195 Sant Cugat del Vallès, Spain
| |
Collapse
|
38
|
John B, Etsitty SO, Greenfeld A, Alsburg R, Egge M, Sandman S, George C, Curley C, Curley C, De Heer HD, Begay G, Ashley ME, Yazzie D, Antone-Nez R, Shin SS, Bancroft C. Navajo Nation Stores Show Resilience During COVID-19 Pandemic. Health Promot Pract 2022; 23:86S-95S. [PMID: 36374592 PMCID: PMC10726380 DOI: 10.1177/15248399221118393] [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] [Indexed: 10/13/2023]
Abstract
On April 8, 2020, the Navajo Nation issued an administrative order limiting business operations. Facing high coronavirus disease 2019 (COVID-19) rates and limited food infrastructure, a survey was conducted among Navajo Nation store managers to assess: (1) COVID-19 adaptations; (2) challenges; (3) changes in customer volume and purchasing; and (4) suggestions for additional support. Purposive sampling identified 29 stores in Navajo communities. Representatives from 20 stores (19 store managers/owners, 1 other; 7 grocery, and 13 convenience/other stores) were interviewed by phone or in-person to reach saturation (new information threshold < 5%). Responses were coded using frequencies and inductive thematic analysis. All 20 stores implemented COVID-19 guidelines (Centers for Disease Control and Prevention [CDC]/Navajo Nation) and most received orientation/support from local chapters, community organizations, or health centers. Stores implemented staff policies (50%, handwashing, vaccinations, protective personal equipment (PPE), sick leave, temperature checks), environmental changes (50%, hand sanitizer, checkout dividers), customer protocols (40%, limit customers, mask requirements, closed restrooms), and deep cleaning (40%). Most stores (65%) reported challenges including stress/anxiety, changing guidelines, supply chain and customer compliance; 30% reported infection or loss of staff. Weekday customer volume was slightly higher vs. pre-COVID, but weekend lower. Stores reported consistent or more healthy food purchases (50%), more nonfood essentials (20%), or shelf-stable foods (10%). Desired support included further orientation (30%), leadership support (20%), overtime/time to learn guidelines (20%), and signage/handouts (15%). Despite a high COVID-19 burden and limited food store infrastructure, Navajo Nation stores adapted by implementing staff, environmental and customer policies. Local support, staffing, and small store offerings were key factors in healthy food access.
Collapse
Affiliation(s)
- Brianna John
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Brigham and Women’s Hospital, Boston, MA, USA
- Northern Arizona University, Flagstaff, AZ, USA
| | - Sean O. Etsitty
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Alex Greenfeld
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Robert Alsburg
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Malyssa Egge
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Northern Arizona University, Flagstaff, AZ, USA
| | - Sharon Sandman
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Northern Arizona University, Flagstaff, AZ, USA
| | - Carmen George
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Caleigh Curley
- Northern Arizona University, Flagstaff, AZ, USA
- The University of Arizona, Mel & Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Cameron Curley
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | | | | | | | - Del Yazzie
- Navajo Epidemiology Center, Window Rock, AZ, USA
| | | | - Sonya Sunhi Shin
- Community Outreach & Patient Empowerment, Gallup, NM, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | | |
Collapse
|
39
|
Gedeon R, Hallit S, Wakim LH. Food insecurity and eating habits of Lebanese children aged 5–11 years during the COVID-19 pandemic and the socioeconomic crisis: a national study. BMC Public Health 2022; 22:1982. [PMID: 36307806 PMCID: PMC9616611 DOI: 10.1186/s12889-022-14387-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Food insecurity is the lack of access to nutritious healthy food due to economic and financial insufficiencies. Food insecurity is expected to be higher during these difficult times in Lebanon, which is facing many financial, political, economic and health debates. The present study aims to find the prevalence of food insecurity among Lebanese children during the COVID-19 pandemic and its correlates.
Methods
This cross-sectional study enrolled 4001 participants from all Lebanese governorates (March–April 2022). The Ministry of Education and Higher Education randomly disseminated the link to parents of children aged between 5 and 11 years from public and private schools.
Results
The results showed that 1505 (37.6%) and 1497 (37.4%) had moderate and severe food insecurity. A significantly higher percentage of families with severe food insecurity was reported by fathers compared to mothers. In addition, participants who reported a bad overall health status of their children had a severe food insecurity. Moreover, those with a severe food insecurity had their children’s daily snacking habit between meals decreased, with a decreased quantity of meals, intake of vegetables/fruits, the intake of balanced diet, junk food, sugar-sweetened beverages, consumption of sweets/candies/chocolate, consumption of unhealthy food, intake of immunity-boosting food, intake of nutrition supplements, participation in the house chores, number of sleeping hours and sleep quality, as well as stress/anxiety decreased. Finally, a higher mean financial burden was seen in families with severe food insecurity compared to the other groups.
Conclusion
The current study found a high prevalence of moderate to severe food insecurity among Lebanese children during the COVID-19 pandemic. Food insecurity should be seriously discussed in Lebanon due to its rapid development in the middle of all the crises facing the country in order to avoid short and long term consequences on human’s health.
Collapse
|
40
|
McKay FH, Zinga J, van der Pligt P. Consensus from an expert panel on how to identify and support food insecurity during pregnancy: A modified Delphi study. BMC Health Serv Res 2022; 22:1231. [PMID: 36199090 PMCID: PMC9533284 DOI: 10.1186/s12913-022-08587-x] [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: 07/20/2022] [Revised: 08/29/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background Food insecurity and hunger during pregnancy have significant implications for the health of the mother and baby. Assisting clinicians when they encounter women who are experiencing hunger or food insecurity during their pregnancy will increase the opportunity for better birth and pregnancy outcomes. At present there are no guidelines for Australian clinicians on how to do this. Methods This study uses a modified Delphi technique, allowing diverse participation in the process, to create consensus on the ways to address and respond to food insecurity during pregnancy. This modified Delphi collected data via two rounds of consensus. The opinions collected from the first round were thematically categorised and grouped. The topics were integrated into the survey for the second round and circulated to participants. During the second round, priorities were scored by giving five points to the topic considered most important, and one point to the least important. Results Through two rounds of consultation, the panel achieved consensus on how to identify food insecurity during pregnancy, with some clear items of consensus related to interventions that could be implemented to address food insecurity during pregnancy. Experts achieved consensus on items that have importance at the institution and policy level, as well as services that exist in the community. The consensus across the spectrum of opportunities for assistance, from the clinical, to community-provided assistance, and on to government policy and practice demonstrate the complexity of this issue, and the multipronged approach that will be required to address it. Conclusion This is the first time such a consultation with experts on hunger and food insecurity during pregnancy has been conducted in Australia. Items that achieved consensus and the importance of the issue suggest several ways forward when working with pregnant women who are hungry and/or food insecure. Supplementary information The online version contains supplementary material available at 10.1186/s12913-022-08587-x.
Collapse
Affiliation(s)
- Fiona H McKay
- School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Deakin University, 3220, Geelong, VIC, Australia.
| | - Julia Zinga
- School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Deakin University, 3220, Geelong, VIC, Australia.,Department of Nutrition and Dietetics, Royal Women's Hospital, Parkville, VIC, Australia
| | - Paige van der Pligt
- The Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 3220, Geelong, VIC, Australia.,Department of Nutrition Western Health, Footscray, Australia
| |
Collapse
|
41
|
Hernández-Vásquez A, Vargas-Fernández R. Changes in the Prevalence of Overweight and Obesity among Peruvian Children under Five Years before and during the COVID-19 Pandemic: Findings from a Nationwide Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12390. [PMID: 36231690 PMCID: PMC9565992 DOI: 10.3390/ijerph191912390] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to identify changes in the prevalence of childhood (children under five years of age) overweight and obesity in Peru as a whole and at the departmental level, before and during the coronavirus disease (COVID-19) pandemic. We performed a secondary data analysis of two Demographic and Family Health Surveys (2019 and 2021) in Peru. The outcome was childhood overweight and obesity, defined as a weight-for-height score greater than 2 standard deviations. Poisson log generalized linear regression models adjusted for sex and/or age in months of the child were fitted to obtain the prevalence ratios of the changes in childhood overweight and obesity from 2019 to 2021. The analysis included 41,533 (2019: 20,414; 2021: 21,119) participants. The prevalence of childhood overweight and obesity was 6.4% in 2019 and 7.8% in 2021. Female children, aged 2, 3 and 4 years, and mothers who self-identified as non-native, had secondary and higher education, belonged to the middle and richer wealth quintile and resided in an urban area, in a village, in a small city and in the coastal region showed the largest increases in the prevalence of childhood overweight and obesity in 2021 compared to 2019. The departments of Pasco, Apurímac, Junín, Cusco, Lambayeque and La Libertad presented the largest increases in the prevalence of these nutritional disorders. During the pandemic, an increase in the prevalence of childhood overweight and obesity was observed, with demographic and socioeconomic factors accounting for the largest increases in the prevalence rates. A restructuring of overweight and obesity control strategies is required to curb this steady increase.
Collapse
Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15024, Peru
| | | |
Collapse
|
42
|
Vážná A, Vignerová J, Brabec M, Novák J, Procházka B, Gabera A, Sedlak P. Influence of COVID-19-Related Restrictions on the Prevalence of Overweight and Obese Czech Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911902. [PMID: 36231219 PMCID: PMC9565202 DOI: 10.3390/ijerph191911902] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 06/02/2023]
Abstract
Apart from influencing the health of the worldwide population, the COVID-19 pandemic changed the day-to-day life of all, including children. A sedentary lifestyle along with the transformation of eating and sleep habits took place in the child population. These changes created a highly obesogenic environment. Our aim was to evaluate the current weight in the child population and identify the real effects of the pandemic. Height and weight data were collected by pediatricians from the pre-COVID-19 and post-COVID-19 periods from 3517 children (1759 boys and 1758 girls) aged 4.71 to 17.33 years. We found a significant rise in the z-score BMI between pediatric visits in the years 2019 and 2021 in both sexes aged 7, 9, 11, and 13 years. Especially alarming were the percentages of (severely) obese boys at the ages of 9 and 11 years, which exceed even the percentages of overweight boys. With the use of statistical modeling, we registered the most dramatic increment at around 12 years of age in both sexes. Based on our research in the Czech Republic, we can confirm the predictions that were given at the beginning of the pandemic that COVID-19-related restrictions worsened the already present problem of obesity and excess weight in children.
Collapse
Affiliation(s)
- Anna Vážná
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Albertov 6, 128 00 Prague, Czech Republic
| | - Jana Vignerová
- Institute of Endocrinology, Národní 8, 110 00 Prague, Czech Republic
| | - Marek Brabec
- Institute of Computer Science, Czech Academy of Sciences, Pod Vodárenskou Věží 271/2, 182 00 Prague, Czech Republic
- National Institute of Public Health, Srobarova 48, 100 00 Prague, Czech Republic
| | - Jan Novák
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Albertov 6, 128 00 Prague, Czech Republic
| | - Bohuslav Procházka
- MUDr Bohuslav Procházka s.r.o., Radnická 635, 284 01 Kutná Hora, Czech Republic
| | - Antonín Gabera
- Zdravotní Středisko Krásné Březno, U Pivovarské Zahrady 5, 400 07 Ústí nad Labem, Czech Republic
| | - Petr Sedlak
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Albertov 6, 128 00 Prague, Czech Republic
| |
Collapse
|
43
|
Obesity, Pregnancy and the Social Contract with Today’s Adolescents. Nutrients 2022; 14:nu14173550. [PMID: 36079808 PMCID: PMC9459961 DOI: 10.3390/nu14173550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 12/16/2022] Open
Abstract
Adolescent health and well-being are of great concern worldwide, and adolescents encounter particular challenges, vulnerabilities and constraints. The dual challenges of adolescent parenthood and obesity are of public health relevance because of the life-altering health and socioeconomic effects on both the parents and the offspring. Prevention and treatment strategies at the individual and population levels have not been successful in the long term, suggesting that adolescent pregnancy and obesity cannot be managed by more of the same. Here, we view adolescent obese pregnancy through the lens of the social contract with youth. The disruption of this contract is faced by today’s adolescents, with work, social and economic dilemmas which perpetuate socioeconomic and health inequities across generations. The lack of employment, education and social opportunities, together with obesogenic settings, increase vulnerability and exposure to lifelong health risks, affecting their offspring’s life chances too. To break such vicious circles of disadvantage and achieve sustainable solutions in real-world settings, strong efforts on the part of policymakers, healthcare providers and the community must be oriented towards guaranteeing equity and healthy nutrition and environments for today’s adolescents. The involvement of adolescents themselves in developing such programs is paramount, not only so that they feel a sense of agency but also to better meet their real life needs.
Collapse
|
44
|
Lyons ER, Nekkanti AK, Funderburk BW, Skowron EA. Parent-Child Interaction Therapy Supports Healthy Eating Behavior in Child Welfare-Involved Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10535. [PMID: 36078247 PMCID: PMC9518458 DOI: 10.3390/ijerph191710535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We tested the efficacy of standard Parent-Child Interaction Therapy (PCIT), a live-coached, behavioral parent-training program, for modifying problematic eating behaviors in a larger effectiveness trial of PCIT for children involved in the child welfare system. METHOD Children ages 3-7 years and their parents were randomly assigned to PCIT intervention (n = 120) or services as the usual control (SAU; n = 84) groups in a randomized clinical trial. Children's eating behaviors were assessed pre- and post-intervention via the Child Eating Behaviors Questionnaire (CEBQ). Intention-to-treat analyses were conducted, followed by per-protocol analyses, on treatment-engaging families only. RESULTS PCIT led to reductions in child welfare-involved children's food responsiveness, speed of food consumption, and tendency to engage in emotional overeating relative to children in the services-as-usual control condition. Standard PCIT may be an effective intervention to promote healthy child eating behaviors in families involved with child welfare, even when food-related behaviors are not directly targeted by the intervention. Public Health Significance: This clinical trial provides evidence that child welfare-involved children who received PCIT experienced significant reductions in maladaptive eating-related behaviors, namely food responsiveness, emotional overeating, and speed of eating. These findings were observed in relation to children in a comparison control group who had access to child welfare services-as-usual.
Collapse
Affiliation(s)
- Emma R. Lyons
- Pediatric Mental Health Institute, Children’s Hospital Colorado, Aurora, CO 80045, USA
| | - Akhila K. Nekkanti
- Center for Innovation and Research on Choice-Filled Lives, Choice-Filled Lives, Inc., Atlanta, GA 30305, USA
| | - Beverly W. Funderburk
- Department of Developmental and Behavioral Pediatrics, Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | | |
Collapse
|
45
|
Freizinger M, Jhe GB, Dahlberg SE, Pluhar E, Raffoul A, Slater W, Shrier LA. Binge-eating behaviors in adolescents and young adults during the COVID-19 pandemic. J Eat Disord 2022; 10:125. [PMID: 36002838 PMCID: PMC9399990 DOI: 10.1186/s40337-022-00650-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and subsequent public health measures have resulted in a worsening of eating disorder symptoms and an increase in psychological distress. The present study examined symptoms and behaviors in adolescents and young adults with emotional eating, bingeing behaviors and binge eating disorder during the pandemic. Additionally, the study explored if individuals who experienced pandemic-related food availability and food affordability issues experienced increased binge-eating symptoms and negative feelings. METHOD Participants (n = 39) were a convenience sample who participated between November 2020 and January 2021 in a weight and lifestyle management program at an urban New England pediatric hospital. Participants completed online surveys that assessed (1) participant's exposure to COVID-19 related stress and binge-eating behaviors using the COVID-19 Exposure and Family Impact Survey-Adolescent and Young Adult Version (CEFIS-AYA) and the Binge Eating Scale (BES) respectively, (2) participants' and their families' ability to attain and afford food and its association with bingeing behaviors, and (3) the relationship between food availability and affordability and negative emotions. RESULTS Nearly half of all participants (48.7%) reported moderate to severe bingeing during the COVID-19 pandemic; those who experienced greater COVID-related stress reported more binge-eating behaviors (p = 0.03). There were no associations between indicators of food availability and affordability and binge eating or between food availability and affordability and negative feelings. CONCLUSIONS Higher pandemic-related stress was associated with more binge-eating behaviors among adolescents and young adults. These results underscore the need to monitor symptoms and provide treatment for these patients despite barriers to care imposed by the COVID-19 pandemic. Research and clinical care for adolescents and young adults with EDs must recognize and respond to pandemic effects across the weight and disordered eating spectrum.
Collapse
Affiliation(s)
- Melissa Freizinger
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA. .,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, 5th Floor, Boston, MA, USA.
| | - Grace B Jhe
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Suzanne E Dahlberg
- Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.,Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Emily Pluhar
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Amanda Raffoul
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Wallis Slater
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Lydia A Shrier
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| |
Collapse
|
46
|
Cyrenne-Dussault M, Sirois M, St-Pierre J, Drouin-Chartier JP. Food insecurity in households of children receiving care at a paediatric obesity management clinic in Montreal: Overall prevalence and changes associated with the COVID-19 pandemic. Paediatr Child Health 2022; 27:396-402. [PMCID: PMC9384639 DOI: 10.1093/pch/pxac072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/16/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Food insecurity and paediatric obesity are two major public health issues in Canada that may have been exacerbated by the COVID-19 pandemic. We assessed food insecurity and its correlates among households of children receiving care at a paediatric obesity management clinic in Montreal. We also assessed whether the prevalence of food insecurity among households of children who received care during the COVID-19 pandemic differed from those who received care before it. Methods This is a retrospective, cross-sectional analysis of medical records of children (2 to 17 years) who received care at a paediatric obesity management clinic in Montreal (Maison de santé prévention – Approche 180 [MSP-180]). Children’s household food security status was assessed using Health Canada’s Household Food Security Survey Module. Results Among the 253 children included in the study, 102 (40.3%) lived in households with moderate (n=89; 35.2%) or severe food insecurity (n=13; 5.1%). Food insecurity was more prevalent in households of children who were first- or second-generation immigrants compared with those who were third generation or more (48.3% versus 30.1%; P=0.03). Prevalence of food insecurity among households of children who received care during the COVID-19 pandemic was 5.5% higher than among those who received care before the pandemic, but the difference was not statistically significant (39.6% versus 45.1%; P=0.65). Conclusions Forty per cent of children treated at this paediatric obesity clinic lived in a food insecure household. This prevalence may have increased during the first year of the COVID-19 pandemic, but statistical power was insufficient to confirm it.
Collapse
Affiliation(s)
- Marie Cyrenne-Dussault
- NUTRISS (Nutrition, Health and Society) Research Center, Institute on Nutrition and Functional Foods (INAF), Laval University , Quebec City, Quebec , Canada
- Faculty of Pharmacy, Laval University , Quebec City, Quebec , Canada
| | - Maude Sirois
- Maison de Santé Prévention - Approche 180 de Montréal, Quebec , Canada
| | - Julie St-Pierre
- Maison de Santé Prévention - Approche 180 de Montréal, Quebec , Canada
- Department of Paediatrics, McGill University , Montreal, Quebec , Canada
| | - Jean-Philippe Drouin-Chartier
- NUTRISS (Nutrition, Health and Society) Research Center, Institute on Nutrition and Functional Foods (INAF), Laval University , Quebec City, Quebec , Canada
- Faculty of Pharmacy, Laval University , Quebec City, Quebec , Canada
| |
Collapse
|
47
|
Abstract
Pediatric obesity is a significant public health concern, and the COVID-19 pandemic altered many of its risk factors. Understanding this impact can help pediatricians and public health officials prioritize initiatives and identify high-risk subgroups. We performed a retrospective longitudinal cohort study of 596 children and adolescents in a primary care clinic to determine changes in weight gain during the pandemic. A significant rise in normalized BMI was found during the prepandemic period across all age groups and initial BMI classification groups. This rate of change increased during the pandemic for those with pre-existing overweight or obesity status who were ≥10 years of age. Children with regular clinic visits in the prepandemic study period, but without a clinic visit during the pandemic, had significantly higher baseline normalized BMI and were older. These changes in the rate of weight gain during the COVID-19 pandemic period raise the possibility that pandemic influences may have exacerbated the rate of weight gain in children and adolescents with pre-existing obese or overweight range BMI. The difference in composition of the cohort without a pandemic time-period visit highlights the need for future studies in this area, especially those focused on adolescents.
Collapse
Affiliation(s)
- Andrew J Loza
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Isabella Child
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Benjamin R Doolittle
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
48
|
Andrade GND, Matoso LF, Silva TMRD, Beinner MA, Romano MCC, Vieira EWR. Covid-19 pandemic impacts on follow-up of child growth and development. Rev Saude Publica 2022; 56:56. [PMID: 35766785 PMCID: PMC9239421 DOI: 10.11606/s1518-8787.2022056004279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/26/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To analyze the impact of the covid-19 pandemic on the use of primary health care services to follow-up the child growth and development in Brazil. METHOD A total of 7.9 million consultations of children (0–2 years old) across Brazil between March 2017 and May 2020 were studied. Differences between medians were analyzed using non-parametric tests, the Global Moran Index (IGM) and the Local Indicators of Spatial Association. RESULTS During the initial period of the pandemic, the median number of consultations was significantly lower than the same period in previous years, reducing more than 50%. The drop in 2020, compared to 2019, ranged from 49% to 62.2% across all regions of the country, except the South. The percentage reduction registered in 2019–2020 showed significant spatial autocorrelation (IGM = 0.20; p = 0.04), with the presence of low-low (states with reduction between 29% and 51%) and high-high (states with reduction between 55% and 69%) spatial clusters. CONCLUSION The covid-19 pandemic impacted the follow-up of child growth and development in primary health care services in Brazil, with a geographically uneven reduction.
Collapse
Affiliation(s)
- Gisele Nepomuceno de Andrade
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Programa de Pós-Graduação em Enfermagem. Belo Horizonte, MG, Brasil
| | - Leonardo Ferreira Matoso
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Programa de Pós-Graduação em Enfermagem. Belo Horizonte, MG, Brasil
| | - Tércia Moreira Ribeiro da Silva
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública.Belo Horizonte, MG, Brasil
| | - Mark Anthony Beinner
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública.Belo Horizonte, MG, Brasil
| | | | - Ed Wilson Rodrigues Vieira
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública.Belo Horizonte, MG, Brasil
| |
Collapse
|
49
|
Thomas LN, Donadio A, Carnevale T, Neal P. Improved management of pediatric obesity in the primary care setting through implementation of the healthy care for healthy kids obesity toolkit. J Pediatr Nurs 2022; 65:e115-e125. [PMID: 35484005 DOI: 10.1016/j.pedn.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/14/2022] [Accepted: 04/07/2022] [Indexed: 12/11/2022]
Abstract
Pediatric obesity has become a major health care concern over the last several decades. This condition can lead to detrimental life-long physical and mental comorbidities. Pediatric primary care providers have a unique opportunity to both prevent and treat pediatric obesity in their clinics. However, discussing this topic with families can be uncomfortable and time consuming. Time efficient resources to educate and increase confidence are needed to improve the management of pediatric obesity. This quality improvement project integrated the Healthy Care for Healthy Kids by the National Institute for Children's Healthcare Quality (2014) into the electronic medical record at a pediatric primary care office in rural East Tennessee. This toolkit included handouts, management algorithms, and provider education for pediatric obesity. After an 8-week implementation period, improvements in lab draws and evaluation of a family''s readiness to change were noted. Overall, providers reported the toolkit was helpful and improved patient interaction. Currently, the clinic is still utilizing the integrated resources and handouts.
Collapse
Affiliation(s)
- Logan N Thomas
- College of Nursing, East Tennessee State University, United States.
| | - Andrew Donadio
- College of Nursing, Tennessee Technological University, United States
| | - Teresa Carnevale
- College of Nursing, Tennessee Technological University, United States
| | - Penelope Neal
- College of Nursing, Tennessee Technological University, United States
| |
Collapse
|
50
|
Sahinyazan FG, Araz OM. An alternative vaccine prioritization approach in response to COVID-19 pandemic. JOURNAL OF HUMANITARIAN LOGISTICS AND SUPPLY CHAIN MANAGEMENT 2022. [DOI: 10.1108/jhlscm-02-2022-0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PurposeThe purpose of this study is to evaluate the impact of food access and other vulnerability measures on the COVID-19 progression to inform the public health decision-makers while setting priority rules for vaccine schedules.Design/methodology/approachIn this paper, the authors used the Supplemental Nutrition Assistance Program (SNAP) data combined with the Centers for Disease Control and Prevention (CDC)’s social vulnerability score variables and diabetes and obesity prevalence in a set of models to assess the associations with the COVID-19 prevalence and case-fatality rates in the United States (US) counties. Using the case prevalence estimates provided by these models, the authors developed a COVID-19 vulnerability score. The COVID-19 vulnerability score prioritization is then compared with the pro-rata approach commonly used for vaccine distribution.FindingsThe study found that the population proportion residing in a food desert is positively correlated with the COVID-19 prevalence. Similarly, the population proportion registered to SNAP is positively correlated with the COVID-19 prevalence. The findings demonstrate that commonly used pro-rata vaccine allocation can overlook vulnerable communities, which can eventually create disease hot-spots.Practical implicationsThe proposed methodology provides a rapid and effective vaccine prioritization scoring. However, this scoring can also be considered for other humanitarian programs such as food aid and rapid test distribution in response to the current and future pandemics.Originality/valueHumanitarian logistics domain predominantly relies on equity measures, where each jurisdiction receives resources proportional to their population. This study provides a tool to rapidly identify and prioritize vulnerable communities while determining vaccination schedules.
Collapse
|