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Sultana M, Nichols M, Jacobs J, Karacabeyli D, Allender S, Novotny R, Brown V. The range of outcomes and outcome measurement instruments collected in multisectoral community-based obesity prevention interventions in children: A systematic review. Obes Rev 2024; 25:e13731. [PMID: 38432682 DOI: 10.1111/obr.13731] [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: 04/05/2023] [Revised: 01/14/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
Multicomponent and multisectoral community-based interventions (CBIs) have proven potential in preventing overweight and obesity in children. Synthesizing evidence on the outcomes collected and reported in such CBIs is critical for the evidence of effectiveness and cost-effectiveness. This systematic review aimed to identify the range of outcomes and outcome measurement instruments collected and reported in multisectoral and multicomponent CBIs for obesity prevention in children. A systematic search updated an existing review and extended the search to 11 academic databases (2017-2023) and gray literature. Outcomes were classified into outcome domains, and common measurement instruments were summarized. Seventeen outcome domains from 140 unique outcomes were identified from 45 included interventions reported in 120 studies. The most frequently collected outcome domains included anthropometry and body composition (91% of included interventions), physical activity (84%), dietary intake (71%), environmental (71%), and sedentary behavior (62%). The most frequently collected outcomes from each of these domains included body mass index (89%), physical activity (73%), fruit and vegetable intake (58%), school environment (42%), and screen time (58%). Outcome measurement instruments varied, particularly for behavioral outcomes. Standardization of reported outcomes and measurement instruments is recommended to facilitate data harmonization and support quantifying broader benefits of CBIs for obesity prevention.
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Affiliation(s)
- Marufa Sultana
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Melanie Nichols
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Jane Jacobs
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Derin Karacabeyli
- Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Vicki Brown
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
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Lin SF, Zive MM, Schmied E, Helm J, Ayala GX. The Effects of a Multisector, Multilevel Intervention on Child Dietary Intake: California Childhood Obesity Research Demonstration Study. Nutrients 2023; 15:4449. [PMID: 37892523 PMCID: PMC10610147 DOI: 10.3390/nu15204449] [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] [Received: 09/08/2023] [Revised: 10/13/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023] Open
Abstract
Consuming too few fruits and vegetables and excess fat can increase the risk of childhood obesity. Interventions which target mediators such as caregivers' dietary intake, parenting strategies, and the family meal context can improve children's diets. A quasi-experimental, pre-post intervention with four conditions (healthcare (HC-only), public health (PH-only), HC + PH, and control) was implemented to assess the effects of the interventions and the effects of the mediators. HC (implemented with the Obesity Care Model) and PH interventions entailed capacity building; policy, system, and environment changes; and a small-scale media campaign to promote healthy eating. Linear mixed models were used to assess intervention effects and the mediation analysis was performed. Predominantly Hispanic/Latino children and caregivers from rural communities in Imperial County, California, were measured at baseline (N = 1186 children/848 caregivers) and 12 months post-baseline (N = 985/706, respectively). Children who were overweight/obese in the HC-only condition (M = 1.32) consumed more cups of fruits at the 12-month follow-up than those in the control condition (M = 1.09; p = 0.04). No significant mediation was observed. Children in the PH-only condition consumed a significantly higher percentage of energy from fat (M = 36.01) at the follow-up than those in the control condition (M = 34.94, p < 0.01). An obesity intervention delivered through healthcare settings slightly improved fruit intake among at-risk children, but the mechanisms of effect remain unclear.
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Affiliation(s)
- Shih-Fan Lin
- Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA; (E.S.); (G.X.A.)
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - Michelle Murphy Zive
- Herbert Wertheim School of Public Health, University of California, San Diego, CA 92093, USA;
| | - Emily Schmied
- Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA; (E.S.); (G.X.A.)
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - Jonathan Helm
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA;
| | - Guadalupe X. Ayala
- Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA; (E.S.); (G.X.A.)
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA 92182, USA
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Ad G, Dc G, Nj J, Se W, Tr B, Slusser W, Pj C. A Hybrid Mobile Phone Feasibility Study Focusing on Latino Mothers, Fathers, and Grandmothers to Prevent Obesity in Preschoolers. Matern Child Health J 2023; 27:1621-1631. [PMID: 37347374 PMCID: PMC10359399 DOI: 10.1007/s10995-023-03700-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE To pilot the feasibility of a mobile phone childhood obesity intervention for family caregivers of Latino preschool-aged children. METHODS An evidence-based early childhood obesity intervention was adapted to have cultural relevance and a shorter-length curriculum for mothers, fathers, and grandmothers of 2- to 5-year-old Latino children. Traditional in-person group sessions (four weeks) were combined with eight weeks of mobile phone content to support parenting skills and evidence-based and age-appropriate nutritional practices in either English or Spanish. A convenience sample of Latino families were recruited from WIC and Early Education Centers in East Los Angeles. Feasibility measures were collected. Child and caregiver height and weight were measured, and caregiver surveys of child dietary intake were collected at baseline, 1- and 6-month post-baseline. Changes in child's dietary intake and BMI, as well as caregiver BMI, were examined using a mixed effects linear regression model with family random intercept and nested random slope for time period of measurement. RESULTS The program was delivered to 64 low-income Latino families (46 mothers, 34 fathers, 16 grandmothers, and 48 children). Children had a reduction in raw BMI, BMI percentile, and BMI z-scores at 6-months post-baseline compared to baseline measurements. The study also demonstrated stable BMI outcomes among all caregivers. CONCLUSION The pilot study shows promise in preventing childhood obesity, and having a multi-generational impact on weight outcomes. Leveraging the high-use of mobile phones has the potential to shorten in-person interventions, and engage fathers and grandmothers who play an important role in shaping healthy weight practices in young children.
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Affiliation(s)
- Guerrero Ad
- UCLA Department of Pediatrics and Children's Discovery and Innovation Institute, Los Angeles, CA, USA.
| | - Glik Dc
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Jackson Nj
- UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, CA, USA
| | - Whaley Se
- Division of Research and Evaluation, Public Health Foundation Enterprises WIC, Irwindale, CA, USA
| | - Belin Tr
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - W Slusser
- UCLA Department of Pediatrics and Children's Discovery and Innovation Institute, Los Angeles, CA, USA
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- UCLA Semel Healthy Campus Initiative Center, Los Angeles, CA, USA
| | - Chung Pj
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
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El-Khayat Y, Franco N, Miller L. Community Conversations About COVID-19. Med Ref Serv Q 2022; 41:223-235. [PMID: 35980632 DOI: 10.1080/02763869.2022.2095815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
"Community Conversations About COVID-19" was a multi-group program designed to address the need for culturally sensitive health information about COVID-19 for Latinx and Native American communities. Three medical librarians worked closely with Latinx and/or Spanish-speaking promotores, also known as community health workers (CHWs), and native patient navigators (NPNs) from Native American communities in Tucson, Arizona. In addition, the librarians collaborated with second-year medical students from the University of Arizona College of Medicine - Phoenix. The focus was to train the CHWs, NPNs, and students on how to access health information resources from the National Library of Medicine, National Institutes of Health, Centers for Disease Control and Prevention, and other reliable agencies. The second segment of the program provided the opportunity for the groups to learn from each other's experiences working with health information through this pandemic, which is especially important given the fact the CHWs and NPNs live in, care for, and were brought up in these communities.
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Affiliation(s)
| | - Nora Franco
- ZSFG Library, University of California San Francisco, USA
| | - Lara Miller
- Oxford College Library, Emory University, Georgia, USA
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Systematic review of parental influences on Hispanic children's nutritional and physical health. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Dishing on dinner: a life course approach to understanding the family meal context among families with preschoolers. Public Health Nutr 2020; 24:1338-1348. [PMID: 32686634 DOI: 10.1017/s1368980020001779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Family meals promote healthful dietary intake and well-being among children. Despite these benefits, family meal participation typically declines as children age. This study utilises life course theory to explore parents' perceptions of family meals in order to understand how parents' past experiences with family meals (in childhood and earlier in adulthood) influence their current beliefs and practices regarding mealtimes with their own children. DESIGN Semi-structured qualitative interviews. SETTING In-person interviews were conducted in participants' homes. PARTICIPANTS Twenty families (twenty-one mothers and fifteen fathers) with a child aged between 18 months and 5 years. RESULTS Thematic analysis revealed that families seemed to primarily approach mealtimes from one of three overarching orientations: meals for (1) Togetherness, (2) Nutrition Messaging or (3) Necessity. These orientations were informed by parents' own mealtime experiences and significant life transitions (e.g. parenthood). The current family meal context, including the messages parents shared with their children during mealtimes and the challenges experienced with mealtimes, characterised the orientations and families' approaches to mealtimes. CONCLUSIONS Parents' own early life experiences and significant life transitions influence why families eat meals together and have important implications for the intergenerational transmission of mealtime practices. Results may help to inform the content and timing of intervention strategies to support the continuation of frequent family meals beyond the preschool years.
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Morgan EH, Schoonees A, Sriram U, Faure M, Seguin‐Fowler RA. Caregiver involvement in interventions for improving children's dietary intake and physical activity behaviors. Cochrane Database Syst Rev 2020; 1:CD012547. [PMID: 31902132 PMCID: PMC6956675 DOI: 10.1002/14651858.cd012547.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Poor diet and insufficient physical activity are major risk factors for non-communicable diseases. Developing healthy diet and physical activity behaviors early in life is important as these behaviors track between childhood and adulthood. Parents and other adult caregivers have important influences on children's health behaviors, but whether their involvement in children's nutrition and physical activity interventions contributes to intervention effectiveness is not known. OBJECTIVES • To assess effects of caregiver involvement in interventions for improving children's dietary intake and physical activity behaviors, including those intended to prevent overweight and obesity • To describe intervention content and behavior change techniques employed, drawing from a behavior change technique taxonomy developed and advanced by Abraham, Michie, and colleagues (Abraham 2008; Michie 2011; Michie 2013; Michie 2015) • To identify content and techniques related to reported outcomes when such information was reported in included studies SEARCH METHODS: In January 2019, we searched CENTRAL, MEDLINE, Embase, 11 other databases, and three trials registers. We also searched the references lists of relevant reports and systematic reviews. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs evaluating the effects of interventions to improve children's dietary intake or physical activity behavior, or both, with children aged 2 to 18 years as active participants and at least one component involving caregivers versus the same interventions but without the caregiver component(s). We excluded interventions meant as treatment or targeting children with pre-existing conditions, as well as caregiver-child units residing in orphanages and school hostel environments. DATA COLLECTION AND ANALYSIS We used standard methodological procedures outlined by Cochrane. MAIN RESULTS We included 23 trials with approximately 12,192 children in eligible intervention arms. With the exception of two studies, all were conducted in high-income countries, with more than half performed in North America. Most studies were school-based and involved the addition of healthy eating or physical education classes, or both, sometimes in tandem with other changes to the school environment. The specific intervention strategies used were not always reported completely. However, based on available reports, the behavior change techniques used most commonly in the child-only arm were "shaping knowledge," "comparison of behavior," "feedback and monitoring," and "repetition and substitution." In the child + caregiver arm, the strategies used most commonly included additional "shaping knowledge" or "feedback and monitoring" techniques, as well as "social support" and "natural consequences." We considered all trials to be at high risk of bias for at least one design factor. Seven trials did not contribute any data to analyses. The quality of reporting of intervention content varied between studies, and there was limited scope for meta-analysis. Both validated and non-validated instruments were used to measure outcomes of interest. Outcomes measured and reported differed between studies, with 16 studies contributing data to the meta-analyses. About three-quarters of studies reported their funding sources; no studies reported industry funding. We assessed the quality of evidence to be low or very low. Dietary behavior change interventions with a caregiver component versus interventions without a caregiver component Seven studies compared dietary behavior change interventions with and without a caregiver component. At the end of the intervention, we did not detect a difference between intervention arms in children's percentage of total energy intake from saturated fat (mean difference [MD] -0.42%, 95% confidence interval [CI] -1.25 to 0.41, 1 study, n = 207; low-quality evidence) or from sodium intake (MD -0.12 g/d, 95% CI -0.36 to 0.12, 1 study, n = 207; low-quality evidence). No trial in this comparison reported data for children's combined fruit and vegetable intake, sugar-sweetened beverage (SSB) intake, or physical activity levels, nor for adverse effects of interventions. Physical activity interventions with a caregiver component versus interventions without a caregiver component Six studies compared physical activity interventions with and without a caregiver component. At the end of the intervention, we did not detect a difference between intervention arms in children's total physical activity (MD 0.20 min/h, 95% CI -1.19 to 1.59, 1 study, n = 54; low-quality evidence) or moderate to vigorous physical activity (MVPA) (standard mean difference [SMD] 0.04, 95% CI -0.41 to 0.49, 2 studies, n = 80; moderate-quality evidence). No trial in this comparison reported data for percentage of children's total energy intake from saturated fat, sodium intake, fruit and vegetable intake, or SSB intake, nor for adverse effects of interventions. Combined dietary and physical activity interventions with a caregiver component versus interventions without a caregiver component Ten studies compared dietary and physical activity interventions with and without a caregiver component. At the end of the intervention, we detected a small positive impact of a caregiver component on children's SSB intake (SMD -0.28, 95% CI -0.44 to -0.12, 3 studies, n = 651; moderate-quality evidence). We did not detect a difference between intervention arms in children's percentage of total energy intake from saturated fat (MD 0.06%, 95% CI -0.67 to 0.80, 2 studies, n = 216; very low-quality evidence), sodium intake (MD 35.94 mg/d, 95% CI -322.60 to 394.47, 2 studies, n = 315; very low-quality evidence), fruit and vegetable intake (MD 0.38 servings/d, 95% CI -0.51 to 1.27, 1 study, n = 134; very low-quality evidence), total physical activity (MD 1.81 min/d, 95% CI -15.18 to 18.80, 2 studies, n = 573; low-quality evidence), or MVPA (MD -0.05 min/d, 95% CI -18.57 to 18.47, 1 study, n = 622; very low-quality evidence). One trial indicated that no adverse events were reported by study participants but did not provide data. AUTHORS' CONCLUSIONS Current evidence is insufficient to support the inclusion of caregiver involvement in interventions to improve children's dietary intake or physical activity behavior, or both. For most outcomes, the quality of the evidence is adversely impacted by the small number of studies with available data, limited effective sample sizes, risk of bias, and imprecision. To establish the value of caregiver involvement, additional studies measuring clinically important outcomes using valid and reliable measures, employing appropriate design and power, and following established reporting guidelines are needed, as is evidence on how such interventions might contribute to health equity.
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Affiliation(s)
- Emily H Morgan
- University of VermontDepartment of Nutrition and Food Sciences225B Marsh Life Science109 Carrigan DriveBurlingtonVTUSA05405
| | - Anel Schoonees
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownWestern CapeSouth Africa7505
| | - Urshila Sriram
- Cornell UniversityDivision of Nutritional Sciences2250 N Triphammer Rd, Apt E8IthacaNew YorkUSA14850
- Texas A&M AgriLife ResearchCollege StationTXUSA
| | - Marlyn Faure
- Stellenbosch UniversityDean's Division, Faculty of Medicine and Health SciencesFrancie van Zijl Drive, ParowCape TownWestern CapeSouth Africa14853
| | - Rebecca A Seguin‐Fowler
- Texas A&M AgriLife ResearchCollege StationTXUSA
- Texas A&M UniversityDepartment of Nutrition and Food Science, College of Agriculture and Life SciencesAgriculture and Life Sciences Building600 John Kimbrough Boulevard, Suite 512College StationTXUSA77843‐2142
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Confiac N, Turk MT, Zoucha R, McFarland M. Mexican American Parental Knowledge and Perceptions of Childhood Obesity: An Integrative Review. HISPANIC HEALTH CARE INTERNATIONAL 2019; 18:105-116. [PMID: 31537084 DOI: 10.1177/1540415319873400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION For the past two decades, childhood obesity has remained a national public health concern, particularly among Hispanic populations. Multiple cross-sectoral obesity prevention strategies have been implemented yet remain unsuccessful in generating sustainable lifestyle changes. METHOD The purpose of this integrative review, using the Whittemore and Knafl method, was to examine the literature from 2009 to 2018 regarding Mexican American parental knowledge and perceptions of childhood obesity. The CINAHL, PubMed, PsycINFO, and ERIC databases were used to search the literature, and 13 peer-reviewed articles met the inclusion criteria. RESULTS Three main themes emerged from the literature synthesis: (1) parental misperception of child body weight and size, (2) influence of cultural health and growth beliefs on parental perception of child weight, and (3) parental perspectives of causes and consequences of childhood obesity and how to address it. However, cultural variations in parental perceptions were found; therefore, attempts to generalize Mexican Americans' cultural practices should be avoided. CONCLUSION Studies using qualitative approaches are needed to gain deeper insights about Mexican American culture regarding children's health as it relates to body weight, the roles of different family members in the Mexican American childrearing tradition, and the impact of their associated health beliefs.
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Caregiving and infants' neurodevelopment in rural Costa Rica: Results from the Infants’ Environmental Health Study (ISA). Neurotoxicology 2019; 74:100-107. [DOI: 10.1016/j.neuro.2019.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 05/06/2019] [Accepted: 06/03/2019] [Indexed: 02/06/2023]
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Risica PM, Tovar A, Palomo V, Dionne L, Mena N, Magid K, Ward DS, Gans KM. Improving nutrition and physical activity environments of family child care homes: the rationale, design and study protocol of the 'Healthy Start/Comienzos Sanos' cluster randomized trial. BMC Public Health 2019; 19:419. [PMID: 30999881 PMCID: PMC6472069 DOI: 10.1186/s12889-019-6704-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 03/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early childhood is a crucial time to foster healthy eating and physical activity (PA) habits, which are critical for optimal child health, growth and development. Child care facilities are important settings to promote healthy eating and PA and prevent childhood obesity; however, almost all prior intervention studies have focused on child care centers and not family child care homes (FCCH), which care for over 1.6 million U.S. children. METHODS This paper describes Healthy Start/Comienzos Sanos, a cluster-randomized trial evaluating the efficacy of a multicomponent intervention to improve nutrition and PA environments in English and Spanish-speaking FCCH. Eligible child care providers complete baseline surveys and receive a two-day FCCH observation of the home environment and provider practices. Parent-consented 2-5 year-old children are measured (height, weight, waist circumference), wear accelerometers and have their dietary intake observed during child care using validated protocols. FCCH providers are then randomly assigned to receive an 8-month intervention including written materials tailored to the FCCH providers' need and interest, videos, peer support coaching using brief motivational interviewing, and periodic group meetings focused on either nutrition and PA (Intervention) or reading readiness (Comparison). Intervention materials focus on evidence-based nutrition and physical activity best practices. The initial measures (surveys, two-day observation of the FCCH and provider practices, child diet observation, physical measures, and accelerometer) are assessed again 8 and 12 months after the intervention starts. Primary outcomes are children's diet quality (Healthy Eating Index), time in moderate and vigorous PA and sedentary PA during child care. Secondary outcomes include FCCH provider practices and foods served, and PA environments and practices. Possible mediators (provider attitudes, self-efficacy, barriers and facilitators) are also being explored. Process evaluation measures to assess reach, fidelity and dose, and their relationship with dietary and PA outcomes are included. DISCUSSION Healthy Start/Comienzos Sanos fills an important gap in the field of childhood obesity prevention by rigorously evaluating an innovative multicomponent intervention to improve the nutrition and physical activity environments of FCCH. TRIAL REGISTRATION (# NCT02452645 ) ClinicalTrials.gov Trial registered on May 22, 2015.
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Affiliation(s)
- Patricia Markham Risica
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI 02912 USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912 USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881 USA
| | - Vanessa Palomo
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI 02912 USA
| | - Laura Dionne
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI 02912 USA
| | - Noereem Mena
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881 USA
| | - Kate Magid
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912 USA
| | - Diane Stanton Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7461 USA
| | - Kim M. Gans
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI 02912 USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912 USA
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269 USA
- Institute for Collaboration in Health, Interventions and Policy, University of Connecticut, Storrs, CT 06269 USA
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Conlon BA, Mcginn AP, Isasi CR, Mossavar-Rahmani Y, Lounsbury DW, Ginsberg MS, Diamantis PM, Groisman-Perelstein AE, Wylie-Rosett J. Home Environment Factors and Health Behaviors of Low-income, Overweight, and Obese Youth. Am J Health Behav 2019; 43:420-436. [PMID: 30808480 DOI: 10.5993/ajhb.43.2.17] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives: Home environment may influence children's health behaviors associated with obesity. In this study, we examined home environment factors associated with diet and physical activity behaviors of overweight or obese youth. Methods: We analyzed baseline data from child and parent/caregiver dyads enrolled in an urban family weight management program. Multivariable logistic regression examined how home environment (parenting practices, family meal habits, and home availability of fruits/vegetables, sugar-sweetened beverages (SSBs), screen media, and physical activity resources) are related to children's intake of fruit, vegetables, and SSBs, and moderate-vigorous physical activity and sedentary time (ST) after adjusting for potential confounders. Results: Children were more likely to consume fruit if their families frequently ate meals together and infrequently watched TV during meals, and more likely to consume vegetables with high fruit/vegetable availability and low SSB availability. Children were more likely to engage in ST if parents practiced monitoring and frequently watched TV during meals. Conclusions: Overweight or obese children appear to have healthier habits if their families eat meals together without watching TV and if healthy food choices are available in the home. Encouraging parents to focus these practices may promote healthier body weight in children.
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Affiliation(s)
- Beth A. Conlon
- Postgraduate Student, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY;,
| | - Aileen P. Mcginn
- Associate Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Carmen R. Isasi
- Associate Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Yasmin Mossavar-Rahmani
- Associate Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - David W. Lounsbury
- Assistant Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Mindy S. Ginsberg
- Senior Associate, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Pamela M. Diamantis
- Attending Physician, Department of Pediatrics, Children's Health Services Jacobi Medical Center, Bronx, NY
| | | | - Judith Wylie-Rosett
- Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
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Brigden A, Parslow RM, Linney C, Higson-Sweeney N, Read R, Loades M, Davies A, Stoll S, Beasant L, Morris R, Ye S, Crawley E. How are behavioural interventions delivered to children (5-11 years old): a systematic mapping review. BMJ Paediatr Open 2019; 3:e000543. [PMID: 31909219 PMCID: PMC6937047 DOI: 10.1136/bmjpo-2019-000543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/11/2019] [Accepted: 10/18/2019] [Indexed: 01/19/2023] Open
Abstract
CONTEXT Behavioural interventions are used to prevent, manage and treat a wide variety of conditions including obesity, diabetes, chronic pain, asthma and emotional difficulties. There has been inadequate attention to the delivery of behavioural interventions to younger children (5-11 years old). OBJECTIVE Our objectives were to describe the characteristics of behavioural interventions for children aged 5-11 years. DATA SOURCES We searched five databases: CINAHL, EMBASE, PsycINFO, MEDLINE and Cochrane Library, from January 2005 to August 2019. STUDY SELECTION The inclusion criteria were (1) children aged 5-11, (2) cognitive and/or behavioural interventions, (3) randomised controlled trials and (4) 2005 onward. Two researchers independently identified studies for inclusion. DATA EXTRACTION Two researchers independently extracted data from eligible papers. RESULTS The search identified 10 541 papers. We extracted information on 117 interventions (from 152 papers). Many of the interventions were categorised as complex. This was particularly true for clinical populations; 78.7% were delivered to both the child and parent, and 33.9% took place across multiple settings, typically health and school settings. Most (70.9%) were 'First Wave' (behavioural) interventions, and few (4.3%) were 'Third Wave' (characterised by metacognition, acceptance and mindfulness). Thirty-nine per cent used interactive techniques (play, arts, story and/or games). Purely digital and paper-based interventions were rare, but around a third used these tools as supplements to face-face delivery. There were differences in interventions for younger (5-7 years) and older (8-11 years) children. CONCLUSIONS Interventions designed and delivered to children should be developmentally sensitive. This review highlights characteristics of interventions delivered to children 5-11 years old: the involvement of the child's parent, using behavioural (rather than cognitive) modalities, using interactive techniques and some interventions were delivered across multiple settings.
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Affiliation(s)
- Amberly Brigden
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Roxanne Morin Parslow
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Catherine Linney
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Rebecca Read
- Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Maria Loades
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Anna Davies
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Stoll
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lucy Beasant
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard Morris
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Siyan Ye
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Esther Crawley
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
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Walton K, Horton NJ, Rifas-Shiman SL, Field AE, Austin SB, Haycraft E, Breen A, Haines J. Exploring the Role of Family Functioning in the Association Between Frequency of Family Dinners and Dietary Intake Among Adolescents and Young Adults. JAMA Netw Open 2018; 1:e185217. [PMID: 30646382 PMCID: PMC6324390 DOI: 10.1001/jamanetworkopen.2018.5217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Eating meals, particularly dinner, with family members has been associated with improved dietary intake among youths. However, existing studies have not examined how family functioning may moderate or confound this association. OBJECTIVE To examine whether level of family functioning is associated cross-sectionally with frequency of family dinners and dietary intake among a US national sample of adolescents and young adults. DESIGN, SETTING, AND PARTICIPANTS Data from the 2011 questionnaire in the Growing Up Today Study 2 were used for this cross-sectional study. Linear regression models examined the extent to which family dinner frequency was associated with self-reported intake of fruits and vegetables, sugar-sweetened beverages, fast food, and takeout food among 2728 adolescents and young adults (age, 14-24 years). To explore effect modification by family functioning, an interaction term for family functioning and family dinner frequency was included for each dietary outcome. To explore confounding, models adjusted for family functioning were run. All models were stratified by sex and included participant age, educational attainment of mother's spouse or partner, and family structure as covariates. Statistical analysis was conducted between January 1, 2017, and August 31, 2018. MAIN OUTCOMES AND MEASURES Dietary intake measured by consumption of fruits and vegetables, sugar-sweetened beverages, takeout food, and fast food; family dinner frequency per week; and family functioning. RESULTS Among the 2728 participants, there were 1559 female and 1169 male participants who were 14 to 24 years of age (mean [SD] age, 19.4 [1.9] years) and were living with their parents in 2011. Most participants (2453 of 2649 [92.6%]) identified as white. More frequent family dinners were associated with higher-quality dietary intake regardless of level of family functioning; interactions between family functioning and family dinner frequency were not significant. Associations between family meal frequency and dietary intake outcomes did not change substantively when adjusting for family functioning. In adjusted models, more frequent family dinners were associated with higher intakes of fruits (female participants: β, 0.09 servings/d; 95% CI, 0.04-0.15 servings/d; male participants: β, 0.07 servings/d; 95% CI, 0.01-0.12 servings/d) and vegetables (female participants: β, 0.21 servings/d; 95% CI, 0.12-0.30 servings/d; male participants: β, 0.19 servings/d; 95% CI, 0.09-0.30 servings/d), and lower intakes of fast food (female participants: β, -0.04 times/wk; 95% CI, -0.07 to 0.00 times/wk; male participants: β, -0.10 times/wk; 95% CI, -0.15 to -0.04 times/wk) and takeout foods (female participants: β, -0.04 times/wk; 95% CI, -0.07 to -0.01 times/wk; male participants: β, -0.06 times/wk; 95% CI, -0.10 to -0.02 times/wk). More frequent family dinners were associated with lower intake of sugar-sweetened beverages for male participants only (β, -0.07 servings/d; 95% CI, -0.13 to -0.02 servings/d). CONCLUSIONS AND RELEVANCE More frequent family dinners are associated with healthful dietary intakes among youths, regardless of level of family functioning. Family dinners may be an appropriate intervention target for improving dietary intake among youths.
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Affiliation(s)
- Kathryn Walton
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Nicholas J. Horton
- Department of Mathematics and Statistics, Amherst College, Amherst, Massachusetts
| | - Sheryl L. Rifas-Shiman
- Harvard Pilgrim Health Care Institute, Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
| | - Alison E. Field
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - S. Bryn Austin
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Andrea Breen
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
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Arredondo EM, Ayala GX, Soto S, Slymen DJ, Horton LA, Parada H, Campbell N, Ibarra L, Engelberg M, Elder JP. Latina mothers as agents of change in children's eating habits: findings from the randomized controlled trial Entre Familia: Reflejos de Salud. Int J Behav Nutr Phys Act 2018; 15:95. [PMID: 30285755 PMCID: PMC6167856 DOI: 10.1186/s12966-018-0714-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 08/15/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Few children consume sufficient servings of fruits and vegetables. Interventions aiming to improve children's dietary intake often target parent level factors, but limited research has examined the mediating role of parental factors on children's dietary intake. This study examined 10-month follow up data from the Entre Familia: Reflejos de Salud (Within the Family: Reflections of Health) trial to investigate (1) intervention effects on children's dietary intake, both sustained and new changes, and (2) whether changes in mothers' dietary intake, her parenting strategies, and behavioral strategies to promoting healthy eating in the home mediated changes in children's dietary intake. METHODS Participants were 361 Mexican-origin families living in Imperial County, California. Families were randomly assigned to a 4-month dietary intervention or a delayed treatment control group. The intervention was delivered by promotoras (community health workers) via home visits and telephone calls. Assessments occurred at baseline, and 4- and 10-months post-baseline. RESULTS At 10-months post-baseline, sustained intervention effects were observed on children's reported intake of varieties of vegetables, with differences getting larger over time. However, differential intervention effects on fast food were not sustained due to significant reductions in the control group compared with smaller changes in the intervention group. New intervention effects were observed on servings of sugar-sweetened beverages. However, the intervention continued to have no effect on children's reported fruit and vegetable servings, and varieties of fruits consumed. Mother-reported behavioral strategies to increase fiber and lower fat mediated the relationship between the intervention and children's intake of varieties of vegetables. Mothers' percent energy from fat and behavioral strategies to lower fat were mediators of children's daily servings of sugar-sweetened beverages. CONCLUSIONS This study suggests that a promotora-led family based intervention can provide mothers with skills to promote modest changes in children's diet. Examining the parent related mechanisms of change will inform future interventions on important targets for improving children's diet. TRIAL REGISTRATION https://clinicaltrials.gov/ . NCT02441049 . Retrospectively registered 05.06.2015.
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Affiliation(s)
- Elva M Arredondo
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Ct., Suite 221, San Diego, CA, 92123, USA.
| | - Guadalupe X Ayala
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Ct., Suite 221, San Diego, CA, 92123, USA
| | - Sandra Soto
- School of Nursing, University of North Carolina, Carrington Hall, Campus Box #7460, Chapel Hill, NC, 97599, USA
| | - Donald J Slymen
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Ct., Suite 221, San Diego, CA, 92123, USA
| | - Lucy A Horton
- Institute for Behavioral and Community Health, 9245 Sky Park Ct, Suite 221, San Diego, CA, 92123, USA
| | - Humberto Parada
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Nadia Campbell
- Institute for Behavioral and Community Health, 9245 Sky Park Ct, Suite 221, San Diego, CA, 92123, USA
| | - Leticia Ibarra
- Clínicas de Salud del Pueblo, Inc., 1166 K Street, Brawley, CA, 92227, USA
| | - Moshe Engelberg
- Research Works, 12396 World Trade Dr #313, San Diego, CA, 92128, USA
| | - John P Elder
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Ct., Suite 221, San Diego, CA, 92123, USA
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Smith JD, Egan KN, Montaño Z, Dawson-McClure S, Jake-Schoffman DE, Larson M, St. George SM. A developmental cascade perspective of paediatric obesity: a conceptual model and scoping review. Health Psychol Rev 2018; 12:271-293. [PMID: 29583070 PMCID: PMC6324843 DOI: 10.1080/17437199.2018.1457450] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/22/2018] [Indexed: 12/12/2022]
Abstract
Considering the immense challenge of preventing obesity, the time has come to reconceptualise the way we study the obesity development in childhood. The developmental cascade model offers a longitudinal framework to elucidate the way cumulative consequences and spreading effects of risk and protective factors, across and within biopsychosocial spheres and phases of development, can propel individuals towards obesity. In this article, we use a theory-driven model-building approach and a scoping review that included 310 published studies to propose a developmental cascade model of paediatric obesity. The proposed model provides a basis for testing hypothesised cascades with multiple intervening variables and complex longitudinal processes. Moreover, the model informs future research by resolving seemingly contradictory findings on pathways to obesity previously thought to be distinct (low self-esteem, consuming sugary foods, and poor sleep cause obesity) that are actually processes working together over time (low self-esteem causes consumption of sugary foods which disrupts sleep quality and contributes to obesity). The findings of such inquiries can aid in identifying the timing and specific targets of preventive interventions across and within developmental phases. The implications of such a cascade model of paediatric obesity for health psychology and developmental and prevention sciences are discussed.
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Affiliation(s)
- Justin D. Smith
- Department of Psychiatry and Behavioral Sciences, Department of Preventive Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA, (312)503-4041.
| | - Kaitlyn N. Egan
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA, (619)733-3977.
| | - Zorash Montaño
- Children’s Hospital of Los Angeles, University of Southern California, Los Angeles, California, USA, (323)804-6666.
| | - Spring Dawson-McClure
- Center for Early Childhood Health & Development, New York University Langone Medical Center, New York, New York, USA, (919)930-7240.
| | - Danielle E. Jake-Schoffman
- Division of Preventive & Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA, (508)856-6517.
| | - Madeline Larson
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA, (253)225-0119.
| | - Sara M. St. George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA, (305)243-0726.
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Lindsay AC, Wallington SF, Lees FD, Greaney ML. Exploring How the Home Environment Influences Eating and Physical Activity Habits of Low-Income, Latino Children of Predominantly Immigrant Families: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050978. [PMID: 29757941 PMCID: PMC5982017 DOI: 10.3390/ijerph15050978] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 12/25/2022]
Abstract
Latinos are the largest and fastest growing minority population group in the United States, and children in low-income Latino families are at elevated risk of becoming overweight or having obesity. A child’s home is an important social environment in which he/she develops and maintains dietary and physical activity (PA) habits that ultimately impact weight status. Previous research suggests the parents are central to creating a home environment that facilitates or hinders the development of children’s early healthy eating and PA habits. Therefore, the purpose of this study was to explore low-income Latino parents’ beliefs, parenting styles, and parenting practices related to their children’s eating and PA behaviors while at home. Methods: Qualitative study using focus group discussions (FGDs) with 33 low-income Latino parents of preschool children 2 to 5 years of age. FGDs were transcribed verbatim and analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and PA for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment may influence low-income Latino preschool children’s eating and PA habits, which may be useful for health promotion and disease prevention efforts targeting low-income Latino families with young children, and for developing home-based and parenting interventions to prevent and control childhood obesity among this population group. Pediatric healthcare providers can play an important role in facilitating communication, providing education, and offering guidance to low-income Latino parents that support their children’s development of early healthy eating and PA habits, while taking into account daily life barriers faced by families. Moreover, pediatric healthcare providers also can play an important role in the integration and coordination of home-visitations to complement office-based visits and provide a continuum of care to low-income Latino families.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts⁻Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Sherrie F Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA.
| | - Faith D Lees
- Program in Gerontology, University of Rhode Island, Kingston, RI 02881, USA.
| | - Mary L Greaney
- Health Studies & Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
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Ruiz‐Zaldibar C, Serrano‐Monzó I, Mujika A. Parental competence programs to promote positive parenting and healthy lifestyles in children: a systematic review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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18
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Ruiz-Zaldibar C, Serrano-Monzó I, Mujika A. Parental competence programs to promote positive parenting and healthy lifestyles in children: a systematic review. J Pediatr (Rio J) 2018; 94:238-250. [PMID: 29112860 DOI: 10.1016/j.jped.2017.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 06/19/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To analyze the available evidence regarding the efficacy of interventions on parents whose children were aged 2-5 years to promote parental competence and skills for children's healthy lifestyles. SOURCE Articles published in English and Spanish, available at PubMed, Psycinfo, CINAHL, Web of Science, Eric, and Cochrane Library were reviewed. SUMMARY OF THE FINDINGS The literature search yielded 2282 articles. Forty-one full texts were retrieved and assessed for inclusion using the PRISMA flow diagram. Twenty-six articles were excluded, as they did not meet the inclusion criteria. In the end, 15 studies were included. The studies were conducted between 2003 and 2016, nine in North America, four in Europe, and two in Asia. Extracted data were synthesized in a tabular format. CASPe guide was used to assess the quality of studies that was moderate overall. Parental self-efficacy was the main construct assessed in most studies. Four studies reported an increase in parental self-efficacy, although most of them were studies without control groups. CONCLUSIONS Outcomes of interventions to improve parental competence in order to promote children's lifestyles are promising, but inconsistent. Additional studies with higher methodological and conceptual quality are needed.
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Affiliation(s)
- Cayetana Ruiz-Zaldibar
- Universidad de Navarra, Facultad de Enfermería, Pamplona, Spain; Universidad de Navarra, Grupo de Investigación IMPULS, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
| | - Inmaculada Serrano-Monzó
- Universidad de Navarra, Facultad de Enfermería, Pamplona, Spain; Universidad de Navarra, Grupo de Investigación IMPULS, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Agurtzane Mujika
- Universidad de Navarra, Facultad de Enfermería, Pamplona, Spain; Universidad de Navarra, Grupo de Investigación IMPULS, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
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19
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Taverno Ross SE, Barone Gibbs B, Documet PI, Pate RR. ANDALE Pittsburgh: results of a promotora-led, home-based intervention to promote a healthy weight in Latino preschool children. BMC Public Health 2018; 18:360. [PMID: 29548321 PMCID: PMC5857096 DOI: 10.1186/s12889-018-5266-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 03/07/2018] [Indexed: 11/11/2022] Open
Abstract
Background Latino preschool children have higher rates of obesity than preschool children from other racial/ethnic groups; however, few effective, culturally appropriate interventions exist targeting this group. The purpose of this study was to test the feasibility of a 10-week, promotora-mediated, home-based intervention to promote a healthy weight in Latino preschool children. Methods Trained promotoras (community health workers) delivered 10, 90-min weekly interactive and tailored sessions to Latino families living in Allegheny County. Participants were recruited through promotoras’ own social networks and community gatherings, flyers, and word of mouth. Primary outcome measures included child body mass index (BMI) z-score and percentile. Secondary outcome measures included child objectively measured physical activity and dietary intake, and the home social and physical environment (e.g., parent health behaviors, parent self-efficacy, parental support, physical activity equipment in the home). The final analysis sample included 49 of 51 participants who completed both baseline and follow-up assessments. Results Participants included mothers (33.5 ± 6.1 years old) and their preschool-aged children who were primarily 1st generation immigrants from Mexico (65%). The primary analyses of BMI percentile and z-score showed no change post-intervention. However, there was a significant decrease in child BMI percentile for overweight and obese children from baseline to follow-up (p < .05). We also saw significant pre/post increases in child daily fruit and vegetable intake, and parent moderate-to-vigorous physical activity, fruit and vegetable servings per day, and self-efficacy; and significant decreases in child saturated fat and added-sugar intake, and child and parent screen time (p’s < .05). Conclusions Despite the short duration of the intervention and follow-up, this pilot study showed promising effects of a promotora-mediated intervention to promote a healthy weight in Latino preschool children. Electronic supplementary material The online version of this article (10.1186/s12889-018-5266-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sharon E Taverno Ross
- Department of Health and Physical Activity, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, 15261, USA.
| | - Bethany Barone Gibbs
- Department of Health and Physical Activity, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, 15261, USA
| | - Patricia I Documet
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
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Lindsay AC, Wasserman M, Muñoz MA, Wallington SF, Greaney ML. Examining Influences of Parenting Styles and Practices on Physical Activity and Sedentary Behaviors in Latino Children in the United States: Integrative Review. JMIR Public Health Surveill 2018; 4:e14. [PMID: 29382629 PMCID: PMC5811651 DOI: 10.2196/publichealth.8159] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/26/2017] [Accepted: 11/16/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Research indicates that parents influence their children's physical activity (PA) and sedentary behaviors (SB) through their parenting styles and practices. OBJECTIVE The objectives of this paper were to evaluate existing research examining the associations between parenting styles, parenting practices, and PA and SB among Latino children aged between 2 and 12 years, highlight limitations of the existing research, and generate suggestions for future research. METHODS The method of this integrative review was informed by methods developed by Whittemore and Knafl, which allow for the inclusion of qualitative, quantitative, and mixed-methods studies. Using the Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines, five electronic academic databases (PubMed, SPORTDiscus, PsycINFO, PsycARTICLES, and CINAHL) were searched for peer-reviewed, full-text papers published in English. Of the 641 unique citations identified, 67 full-text papers were retrieved, and 16 were selected for review. RESULTS The majority of the 16 reviewed studies were conducted with predominantly Mexican American or Mexican immigrant samples, and only 1 study examined the association between parenting styles and Latino children's PA and SB. Most (n=15) reviewed studies assessed the influence of parenting practices on children's PA and SB, and they provide good evidence that parenting practices such as offering verbal encouragement, prompting the child to be physically active, providing logistic support, engaging and being involved in PA, monitoring, and offering reinforcement and rewards encourage, facilitate, or increase children's PA. The examined studies also provide evidence that parenting practices, such as setting rules and implementing PA restrictions due to safety concerns, weather, and using psychological control discourage, hinder, or decrease children's PA. CONCLUSIONS Because this review found a very small number of studies examining the relationship between parenting styles and Latino children's PA and SB, additional research is needed. Given that the majority of reviewed studies were conducted with predominantly Mexican American or Mexican immigrant samples, additional research examining parenting styles, parenting practices, and PA and SB among multiethnic Latino groups is needed to design interventions tailored to the needs of this ethnically diverse population group.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, United States.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Minerva Wasserman
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Mario A Muñoz
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Sherrie F Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Georgetown University, Washington, DC, United States
| | - Mary L Greaney
- Department of Kinesiology, University of Rhode Island, Kingston, RI, United States
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Caplan MA, Purser G, Kindle PA. Personal Accounts of Poverty: A Thematic Analysis of Social Media. ACTA ACUST UNITED AC 2017; 14:433-456. [PMID: 29140758 DOI: 10.1080/23761407.2017.1380547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The field of social work seeks to enhance human well-being by addressing the needs of people living in poverty. Three billion people around the world use the internet daily, and 65% of them use social media. This article qualitatively identifies emergent themes about the lived experiences of poverty from people who reported either being poor or having have been poor, using selected social media posts (N = 1,495) on the website Reddit. We found that the experiences of poverty bring arduousness and hardship, which necessitates an arsenal of survival strategies and skills. It was also found that some people who were poor experienced the saving grace of unexpected charitable acts, which eased their burden. Moreover, these experiences manifest in vestigial feelings and behaviors even when one is no longer poor. An understanding of the lived experiences by poor people themselves is a foundational task for social work educators, practitioners, and researchers.
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Affiliation(s)
- Mary A Caplan
- a School of Social Work , University of Georgia , Athens , Georgia , USA
| | - Gregory Purser
- a School of Social Work , University of Georgia , Athens , Georgia , USA
| | - Peter A Kindle
- b Department of Social Work , University of South Dakota , Vermillion , South Dakota , USA
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A qualitative study conducted in the USA exploring Latino fathers' beliefs, attitudes and practices related to their young children's eating, physical activity and sedentary behaviours. Public Health Nutr 2017; 21:403-415. [PMID: 28994358 DOI: 10.1017/s1368980017002579] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Increasing evidence documents fathers' influential role in their children's eating, physical activity (PA) and sedentary behaviours (SB). We aimed to expand limited existing research examining fathers' influence in these areas by exploring Latino fathers' beliefs, attitudes and practices related to eating, PA and SB of their young children. DESIGN Seven focus group discussions were conducted in Spanish with Latino fathers (n 28) of children aged 2-8 years. Audio recordings were transcribed and translated verbatim without identifiers. Data were analysed using thematic analysis to identify key concepts and themes using NVivo 11 software. RESULTS Fathers expressed positive beliefs and attitudes about the importance of healthy eating for their young children, themselves and their families. Nevertheless, the majority reported familial practices including eating out, getting take-out, etc. that have been linked to increased obesity risk among Latino children. Fathers were more involved and engaged in children's PA than eating and feeding. However, several fathers reported engaging predominantly in sedentary activities with their children, appeared permissive of children's sedentary habits and struggled to set limits on children's screen-time. CONCLUSIONS We provide new information on Latino fathers' beliefs and child feeding and PA practices that may provide important targets for interventions aimed at promoting healthful eating and PA behaviours of Latino children. Future research should further quantify the influence of Latino fathers' parenting styles and practices on development of children's eating, PA and SB. This information is needed to identify risk factors amenable to interventions and to design culturally appropriate parenting and family-based interventions targeting Latino children's home environment and designed to meet this ethnic group's specific needs.
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Taverno Ross SE, Documet PI, Pate RR, Smith-Tapia I, Wisniewski LM, Gibbs BB. Study Protocol for a Home-based Obesity Prevention Program in Latino Preschool Children. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2017; 2:85-91. [PMID: 29082322 DOI: 10.1249/tjx.0000000000000038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This paper describes the study design for ANDALE Pittsburgh, a culturally-appropriate, family-based intervention to promote a healthy weight in Latino preschool children. METHODS/DESIGN The study was organized into two major phases: Phase I: Conduct focus groups with 30 Latino parents of preschool children to inform the development of a culturally-appropriate intervention; Phase II: Test the feasibility and effectiveness of the intervention with 50 families. Participants were recruited from an emerging Latino community through community gatherings, flyers, and word of mouth. Six promotoras (females >18 years, active in community) received 25 hours of training using the intervention curriculum finalized after Phase I. Promotoras delivered the home-based intervention to families over 10, 90-minute weekly sessions that included education, practice, and action (i.e., goal setting). Behavior modification constructs and strategies (e.g., goal setting, problem solving, social support), and building of self-efficacy through healthy recipe preparation and physical activity breaks, were also included. Outcomes (e.g., child BMI) were assessed pre- and post-intervention. Process evaluation assessed fidelity, dose, reach, recruitment, and contextual factors using multiple data sources and mixed methods. DISCUSSION The ANDALE Pittsburgh study will expand the body of knowledge on interventions to promote a healthy weight in Latino preschool children living in an emerging Latino community. If successful, this approach will be evaluated in a future, larger-scale intervention and provide a potential model to help to address and prevent obesity in this population.
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Affiliation(s)
- Sharon E Taverno Ross
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | - Patricia I Documet
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Russell R Pate
- Department of Exercise Science, University of Pittsburgh, Pittsburgh, PA
| | - Ivonne Smith-Tapia
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | | | - Bethany B Gibbs
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
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McClendon ME, Umstattd Meyer MR, Ylitalo KR, Sharkey JR. Physical Activity of Mexican-Heritage Youth During the Summer and School-Year: The Role of Parenting Strategies. J Community Health 2017; 42:1102-1110. [PMID: 28484886 DOI: 10.1007/s10900-017-0358-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Mexican-heritage youth living along the U.S.-Mexico border have higher rates of obesity than non-Hispanic Whites. Parenting strategies may influence youth physical activity (PA) and sedentary behaviors (SB) mitigating these obesity rates; however, parenting strategies have not been well examined in Hispanic cultures. Therefore, we examined relationships between parenting strategies and PA and SB of Mexican-heritage youth. Mother-child dyads (n = 121 dyads) were surveyed during the summer and school-year. Quantile regression estimated relationships between parenting strategies, and PA and SB. Summer. Reinforcement was negatively associated with moderate-to-vigorous PA (MVPA) among more active youth (β = -364.4); limit setting was negatively associated with SB among less sedentary youth (β = -23.3); and use of discipline was negatively associated with sedentary screen time in youth reporting less screen use (β = -3.2). School-year. Males reported more MVPA (773.9 min/week) than females (738.7 min/week). Reinforcement was positively associated with weekly MVPA among more active youth (β = 173.6), fewer sedentary minutes/week among all youth, and fewer sedentary screen time minutes among less sedentary youth (β = -6.4). Parenting strategies are related with PA and SB. Investigators should focus on identifying modifiable parenting strategies to address the various needs presented during summertime and school-year for Mexican-heritage youth.
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Affiliation(s)
- Megan Elizabeth McClendon
- Department of Health, Human Performance, & Recreation, Baylor University, One Bear Place, #97313, Waco, TX, 76798, USA
| | - M Renée Umstattd Meyer
- Department of Health, Human Performance, & Recreation, Baylor University, One Bear Place, #97313, Waco, TX, 76798, USA.
| | - Kelly R Ylitalo
- Department of Health, Human Performance, & Recreation, Baylor University, One Bear Place, #97313, Waco, TX, 76798, USA
| | - Joseph R Sharkey
- Texas A&M University, School of Public Health, College Station, Texas, USA
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Magaña S, Lopez K, Machalicek W. Parents Taking Action: A Psycho-Educational Intervention for Latino Parents of Children With Autism Spectrum Disorder. FAMILY PROCESS 2017; 56:59-74. [PMID: 26269291 DOI: 10.1111/famp.12169] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The increased prevalence of autism spectrum disorder (ASD) among Latino children, later diagnosis, limited access to bicultural specialist support, and worsened health outcomes when compared to non-Latinos points to the need for a culturally relevant parent education intervention. This pilot study examined the feasibility, acceptability, and preliminary outcomes of a culturally derived intervention, Parents Taking Action, for 19 Spanish-speaking mothers of children with ASD. This study introduces the Promotora de Salud Model of intervention delivery to the autism field. A mixed-methods design including one group pre- and posttest design and focus groups was used to evaluate the outcomes of PTA. We found that the intervention was both feasible to implement and acceptable to participants. We also found significant increases in empowerment oriented outcomes for parents between pre- and posttest suggesting that the intervention is promising. Suggestions for future research and practice are offered.
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Affiliation(s)
- Sandra Magaña
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL
| | - Kristina Lopez
- School of Social Work, California State University, Long Beach, CA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR
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26
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Flores-Peña Y, Ortiz-Félix RE, Cárdenas-Villarreal VM, Ávila-Alpirez H, Alba-Alba CM, Hernández-Carranco RG. Maternal Eating and Physical Activity Strategies and their Relation with Children's Nutritional Status. Rev Lat Am Enfermagem 2016; 22:286-92. [PMID: 26107837 PMCID: PMC4292591 DOI: 10.1590/0104-1169.3415.2414] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 01/28/2014] [Indexed: 11/22/2022] Open
Abstract
Objectives to describe the maternal eating and physical activity strategies
(monitoring, discipline, control, limits and reinforcement) [MEES]; to
determine the relation between MEES and the child's nutritional status [body
mass index (BMI) and body fat percentage (BFP)]; to verify whether the MEES
differ according to the child's nutritional status. Method participants were 558 mothers and children (3 to 11 years of age) who
studied at public schools. The Parental Strategies for Eating and Activity
Scale (PEAS) was applied and the child's weight, height and BFP were
measured. For analysis purposes, descriptive statistics were obtained, using
multiple linear regression and the Kruskal-Wallis test. Results the highest mean score was found for reinforcement (62.72) and the lowest
for control (50.07). Discipline, control and limits explained 12% of the
BMI, while discipline and control explained 6% of the BFP. Greater control
is found for obese children (χ2=38.36, p=0.001) and greater
reinforcement for underweight children (χ2=7.19, p<0.05).
Conclusions the mothers exert greater control (pressure to eat) over obese children and
greater recognition (congratulating due to healthy eating) in underweight
children. Modifications in parental strategies are recommended with a view
to strengthening healthy eating and physical activity habits.
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Affiliation(s)
- Yolanda Flores-Peña
- Facultad de Enfermería, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
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Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. HEALTH EDUCATION & BEHAVIOR 2015; 43:94-106. [DOI: 10.1177/1090198115596737] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. The purpose of this study was to evaluate the efficacy of the Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention at 1-year, postintervention follow-up. Method. A mixed between–within subjects design was used to evaluate the trial. Independent variables included a two-level, group assignment: EMPOWER (experimental intervention) based on social cognitive theory (SCT) as well as a knowledge-based intervention Healthy Lifestyles (active control intervention). Dependent variables were evaluated across four levels of time: baseline (Week 0), posttest (Week 4), 1-month follow-up (Week 8), and 1-year follow-up (Week 60). Dependent variables included five maternal-facilitated SCT constructs (environment, emotional coping, expectations, self-control, and self-efficacy) as well as four child behaviors (minutes of child physical activity, cups of fruits and vegetables consumed, 8-ounce glasses of sugar-sweetened beverages consumed, and minutes of screen time). Null hypotheses implied no significant group-by-time interactions for the dependent variables under investigation. Results. A significant group-by-time interaction for child fruit and vegetable consumption was found in the experimental group ( p = .012) relative to the control group. At 1 year, results suggested an overall increase of 1.847 cups of fruits and vegetables (95% confidence interval = 1.207-2.498) in the experimental group ( p < .001). Analysis suggested changes in the maternal-facilitated home environment accounted for 13.3% of the variance in the change in child fruit and vegetable consumption. Improvements in child physical activity, sugar-free beverage intake, and screen time first detected at 1-month follow-up in both groups were no longer significant at 1-year follow-up. Conclusions. An online family-and-home-based intervention was efficacious for improving child fruit and vegetable consumption. Follow-up booster sessions may assist in maintaining treatment effects.
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28
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Conlon BA, McGinn AP, Lounsbury DW, Diamantis PM, Groisman-Perelstein AE, Wylie-Rosett J, Isasi C. The Role of Parenting Practices in the Home Environment among Underserved Youth. Child Obes 2015; 11:394-405. [PMID: 26258561 PMCID: PMC4528989 DOI: 10.1089/chi.2014.0093] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The home environment, which includes parenting practices, is an important setting in which children develop their health behaviors. We examined the role of parenting practices in the home environment among underserved youth. METHODS We examined baseline data of a family-focused pediatric obesity intervention. Parenting practices (monitoring, discipline, limit setting of soda/snacks [SS] and screen media [SM], pressure to eat, and reinforcement) and availability of fruits/vegetables (FV) and sugar-sweetened beverages (SSBs), family meals, television (TV) watching during meals, TVs in the home, owning active video games/sports equipment, and household food security were assessed in 301 parent/caregivers of overweight/obese children (ages 7-12 years; BMI≥85th percentile). Associations were evaluated using Spearman's rank correlation coefficients and logistic regression models adjusted for potential confounders. RESULTS Parents/caregivers (ages 22-67 years) were largely Hispanic/Latino (74.1%), female (92.4%), and reported high levels of limit setting SS and low levels of pressure to eat. Parent age, gender, country of birth, and years living in the United States accounted for differences among several parenting practices. Adjusted logistic regression models identified several statistically significant associations, including: Monitoring was positively associated with availability FV (odds ratio [OR]=2.19; 95% confidence interval [CI], 1.25, 3.82); limit setting SS was inversely associated with availability of SSBs (OR=0.40; 95% CI, 0.21, 0.75); and limit setting SM was inversely associated with TV viewing during family meals (OR=0.51; 95% CI, 0.31, 0.85). Nearly 40% of our population was food insecure, and food insecurity was positively associated with pressure to eat (OR=1.77; 95% CI, 1.01, 3.15). CONCLUSIONS Parenting practices play an important role in the home environment, and longitudinal studies are needed to examine these associations in the context of family-focused pediatric obesity interventions.
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Affiliation(s)
- Beth A. Conlon
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Aileen P. McGinn
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - David W. Lounsbury
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Pamela M. Diamantis
- Department of Pediatrics, Children's Health Services, Jacobi Medical Center, Bronx, NY
| | | | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Carmen Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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29
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Dwyer L, Oh A, Patrick H, Hennessy E. Promoting family meals: a review of existing interventions and opportunities for future research. Adolesc Health Med Ther 2015; 6:115-31. [PMID: 26124690 PMCID: PMC4482375 DOI: 10.2147/ahmt.s37316] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Evidence suggests that regular family meals protect against unhealthy eating and obesity during childhood and adolescence. However, there is limited information on ways to promote family meals as part of health promotion and obesity prevention efforts. The primary aim of this review was to synthesize the literature on strategies to promote family meals among families with school-aged children and adolescents. First, we reviewed interventions that assess family meals as an outcome and summarized strategies that have been used in these interventions. Second, we reviewed correlates and barriers to family meals to identify focal populations and target constructs for consideration in new interventions. During May 26-27, 2014, PubMed and PsycInfo databases were searched to identify literature on family meals published between January 1, 2000 and May 27, 2014. Two reviewers coded 2,115 titles/abstracts, yielding a sample of 139 articles for full-text review. Six interventions and 43 other studies presenting data on correlates of or barriers to family meals were included in the review. Four interventions resulted in greater family meal frequency. Although there were a small number of interventions, intervention settings were diverse and included the home, community, medical settings, the workplace, and the Internet. Common strategies were goal setting and interactive group activities, and intervention targets included cooking and food preparation, cost, shopping, and adolescent influence. Although methodological nuances may contribute to mixed findings, key correlates of family meals were employment, socioeconomic and demographic factors, family structure, and psychosocial constructs. Barriers to consider in future interventions include time and scheduling challenges, cost, and food preferences. Increasing youth involvement in mealtime, tailoring interventions to family characteristics, and providing support for families experiencing time-related barriers are suggested strategies for future research.
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Affiliation(s)
- Laura Dwyer
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - April Oh
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Heather Patrick
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
- Live Healthier, Bethesda, MD, USA
| | - Erin Hennessy
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
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Blanck HM, Collins JL. The Childhood Obesity Research Demonstration project: linking public health initiatives and primary care interventions community-wide to prevent and reduce childhood obesity. Child Obes 2015; 11:1-3. [PMID: 25679058 DOI: 10.1089/chi.2014.0122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Heidi M Blanck
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion , Centers for Disease Control and Prevention, Atlanta, GA
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31
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Ayala GX, Ibarra L, Binggeli-Vallarta A, Moody J, McKenzie TL, Angulo J, Hoyt H, Chuang E, Ganiats TG, Gahagan S, Ji M, Zive M, Schmied E, Arredondo EM, Elder JP. Our Choice/Nuestra Opción: the Imperial County, California, Childhood Obesity Research Demonstration study (CA-CORD). Child Obes 2015; 11:37-47. [PMID: 25584664 PMCID: PMC4323021 DOI: 10.1089/chi.2014.0080] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Despite recent declines among young children, obesity remains a public health burden in the United States, including among Latino/Hispanic children. The determining factors are many and are too complex to fully address with interventions that focus on single factors, such as parenting behaviors or school policies. In this article, we describe a multisector, multilevel intervention to prevent and control childhood obesity in predominantly Mexican-origin communities in Southern California, one of three sites of the CDC-funded Childhood Obesity Research Demonstration (CA-CORD) study. METHODS CA-CORD is a partnership between a university-affiliated research institute, a federally qualified health center, and a county public health department. We used formative research, advisory committee members' recommendations, and previous research to inform the development of the CA-CORD project. Our theory-informed multisector, multilevel intervention targets improvements in four health behaviors: fruit, vegetable, and water consumption; physical activity; and quality sleep. Intervention partners include 1200 families, a federally qualified health center (including three clinics), 26 early care and education centers, two elementary school districts (and 20 elementary schools), three community recreation centers, and three restaurants. Intervention components in these sectors target changes in behaviors, policies, systems, and the social and physical environment. Evaluation activities include assessment of the primary outcome, BMI z-score, at baseline, 12-, and 18-months post-baseline, and sector evaluations at baseline, 12, and 24 months. CONCLUSIONS Identifying feasible and effective strategies to prevent and control childhood obesity has the potential to effect real changes in children's current and future health status.
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Affiliation(s)
- Guadalupe X. Ayala
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, and the Institute for Behavioral and Community Health, San Diego, CA
| | - Leticia Ibarra
- Programs Department, Clínicas de Salud Del Pueblo, Inc., Brawley, CA
| | | | - Jamie Moody
- Institute for Behavioral and Community Health, San Diego, CA
| | - Thomas L. McKenzie
- School of Exercise and Nutrition Sciences, San Diego State University, and the Institute for Behavioral and Community Health, San Diego, CA
| | | | - Helina Hoyt
- College of Nursing, San Diego State University, Imperial Valley Campus, Calexico, CA
| | - Emmeline Chuang
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA
| | - Theodore G. Ganiats
- Department of Family and Preventive Medicine, School of Medicine, University of California San Diego, La Jolla, CA
| | - Sheila Gahagan
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL
| | - Michelle Zive
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA
| | - Emily Schmied
- San Diego State University–University of California at San Diego, Joint Doctoral Program in Public Health (Health Behavior) and the Institute for Behavioral and Community Health, San Diego, CA
| | - Elva M. Arredondo
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, and the Institute for Behavioral and Community Health, San Diego, CA
| | - John P. Elder
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, and the Institute for Behavioral and Community Health, San Diego, CA
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Chuang E, Ayala GX, Schmied E, Ganter C, Gittelsohn J, Davison KK. Evaluation protocol to assess an integrated framework for the implementation of the Childhood Obesity Research Demonstration project at the California (CA-CORD) and Massachusetts (MA-CORD) sites. Child Obes 2015; 11:48-57. [PMID: 25423618 PMCID: PMC4323117 DOI: 10.1089/chi.2014.0049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The long-term success of child obesity prevention and control efforts depends not only on the efficacy of the approaches selected, but also on the strategies through which they are implemented and sustained. This study introduces the Multilevel Implementation Framework (MIF), a conceptual model of factors affecting the implementation of multilevel, multisector interventions, and describes its application to the evaluation of two of three state sites (CA and MA) participating in the Childhood Obesity Research Demonstration (CORD) project. METHODS/DESIGN A convergent mixed-methods design is used to document intervention activities and identify determinants of implementation effectiveness at the CA-CORD and MA-CORD sites. Data will be collected from multiple sectors and at multiple levels of influence (e.g., delivery system, academic-community partnership, and coalition). Quantitative surveys will be administered to coalition members and staff in participating delivery systems. Qualitative, semistructured interviews will be conducted with project leaders and key informants at multiple levels (e.g., leaders and frontline staff) within each delivery system. Document analysis of project-related materials and in vivo observations of training sessions will occur on an ongoing basis. Specific constructs assessed will be informed by the MIF. Results will be shared with project leaders and key stakeholders for the purposes of improving processes and informing sustainability discussions and will be used to test and refine the MIF. CONCLUSIONS Study findings will contribute to knowledge about how to coordinate and implement change strategies within and across sectors in ways that effectively engage diverse stakeholders, minimize policy resistance, and maximize desired intervention outcomes.
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Affiliation(s)
- Emmeline Chuang
- Department of Health Policy and Management, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA
- Division of Health Promotion and Behavioral Sciences, San Diego State University Graduate School of Public Health, San Diego, CA
| | - Guadalupe X. Ayala
- Division of Health Promotion and Behavioral Sciences, San Diego State University Graduate School of Public Health, San Diego, CA
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, CA
| | - Emily Schmied
- Division of Health Promotion and Behavioral Sciences, San Diego State University Graduate School of Public Health, San Diego, CA
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, CA
- Department of Family and Preventive Medicine, University of California at San Diego School of Medicine, San Diego, CA
| | - Claudia Ganter
- Departments of Nutrition and of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
| | - Joel Gittelsohn
- Bloomberg School of Public Health and the Global Obesity Prevention Center, Johns Hopkins University, Baltimore, MD
| | - Kirsten K. Davison
- Departments of Nutrition and of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
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Elder JP, Ayala GX, McKenzie TL, Litrownik AJ, Gallo LC, Arredondo EM, Talavera GA, Kaplan RM. A three-decade evolution to transdisciplinary research: community health research in California-Mexico border communities. Prog Community Health Partnersh 2015; 8:397-404. [PMID: 25435566 DOI: 10.1353/cpr.2014.0039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The Institute for Behavioral and Community Health (IBACH) is a transdisciplinary organization with a team-oriented approach to the translation of research to practice and policy within the context of behavioral medicine. OBJECTIVES This paper tracks the growth of IBACH in the context of evolving, multi-university transdisciplinary research efforts from a behavioral medicine research focus to community approaches to disease prevention and control, ultimately specializing in Latino health research and practice. We describe how this growth was informed by our partnerships with community members and organizations, and training a diverse array of students and young professionals. METHODS Since 1982, IBACH's research has evolved to address a greater breadth of factors associated with health and well-being. This was driven by our strong community focus and emphasis on collaborations, the diversity of our investigative teams, and our emphasis on training. Although behavioral science still forms the core of IBACH's scientific orientation, research efforts extend beyond those traditionally examined. CONCLUSIONS IBACH's "team science" successes have been fueled by a specific population emphasis, making IBACH one of the nation's leaders in Latino health behavior research.
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Bender MS, Martinez S, Kennedy C. Designing a Culturally Appropriate Visually Enhanced Low-Text Mobile Health App Promoting Physical Activity for Latinos: A Qualitative Study. J Transcult Nurs 2015; 27:420-8. [PMID: 25556208 DOI: 10.1177/1043659614565249] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rapid proliferation of smartphone ownership and use among Latinos offers a unique opportunity to employ innovative visually enhanced low-text (VELT) mobile health applications (mHealth app) to promote health behavior change for Latinos at risk for lifestyle-related diseases. Using focus groups and in-depth interviews with 16 promotores and 5 health care providers recruited from California clinics, this qualitative study explored perceptions of visuals for a VELT mHealth app promoting physical activity (PA) and limiting sedentary behavior (SB) for Latinos. In this Phase 1 study, participants endorsed visuals portraying PA guidelines and recommended visuals depicting family and socially oriented PA. Overall, participants supported a VELT mHealth app as an alternative to text-based education. Findings will inform the future Phase 2 study development of a culturally appropriate VELT mHealth app to promote PA for Latinos, improve health literacy, and provide an alternative to traditional clinic text-based health education materials.
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Knowlden AP, Sharma M. Social Cognitive Maternal-Mediated Nutritional Correlates of Childhood Obesity. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2015; 35:177-91. [DOI: 10.1177/0272684x15569678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this investigation was to examine the extent to which the maternal-facilitated, social cognitive theory constructs of environment, emotional coping, expectations, self-control, and self-efficacy predicted child fruit and vegetable consumption and sugar-free beverage intake. Instrumentation comprised three stages of data collection and analysis. Stage 1 included item generation, face and content validity by a panel of six experts, and readability by Flesch Reading Ease and Flesch–Kincaid Grade Level tests. Stage 2 assessed stability of the theoretical constructs using the test–retest procedure with 30 participants. Structural equation modeling was used during Stage 3 to conduct confirmatory factor analysis and to establish predictive validity of the models. A total of 224 respondents participated in this study. Maternal-facilitated home environment and self-efficacy were significant predictors of child fruit and vegetable consumption while maternal-mediated home environment and emotional coping were significant predictors of child sugar-free beverage intake.
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Affiliation(s)
- Adam P. Knowlden
- Department of Health Science, The University of Alabama, Tuscaloosa, AL, USA
| | - Manoj Sharma
- Health Promotion & Education Program & Public Health Sciences, The University of Cincinnati, OH, USA
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Lloyd AB, Lubans DR, Plotnikoff RC, Morgan PJ. Impact of the 'Healthy Dads, Healthy Kids' lifestyle programme on the activity- and diet-related parenting practices of fathers and mothers. Pediatr Obes 2014; 9:e149-55. [PMID: 24980063 DOI: 10.1111/ijpo.248] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 04/11/2014] [Accepted: 05/21/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim was to evaluate the impact of the 'Healthy Dads, Healthy Kids' programme on fathers' and mothers' activity- and diet-related parenting practices. METHODS Overweight/obese fathers (n = 87) and their primary school-aged children (56% boys) were randomized to either (i) 7-week programme (n = 45) or (ii) control group (n = 42). The programme involved four sessions for fathers only and three for fathers/children. Mothers were not directly involved. Parenting practices of both fathers and mothers were measured using the parenting strategies for eating and activity scale at baseline and 14-week follow-up. RESULTS Intention-to-treat analysis using linear mixed models revealed significant group-by-time effects for fathers' limit setting (P = 0.048, d = 0.36) and reinforcement for multiple lifestyle behaviours (P = 0.001, d = 0.79). No significant intervention effects were found for fathers' control, monitoring, discipline or mothers' parenting practices (P > 0.05). CONCLUSIONS The Healthy Dads, Healthy Kids programme had a positive impact on some parenting practices for fathers but not mothers.
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Affiliation(s)
- A B Lloyd
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia; School of Education, Faculty of Education & Arts, University of Newcastle, Callaghan, NSW, Australia
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Ayala GX, Ibarra L, Horton L, Arredondo EM, Slymen DJ, Engelberg M, Rock CL, Hernandez E, Parada H, Elder JP. Evidence supporting a promotora-delivered entertainment education intervention for improving mothers' dietary intake: the Entre Familia: Reflejos de Salud Study. JOURNAL OF HEALTH COMMUNICATION 2014; 20:165-176. [PMID: 25375276 DOI: 10.1080/10810730.2014.917747] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Entertainment education and the promotora model are 2 evidence-based health communication strategies. This study examined their combined effect on promoting healthy eating among mothers in a family-based intervention. Participants were 361 Mexican-origin families living in Imperial County, California, who were randomly assigned to an intervention or delayed treatment condition. The intervention involved promotoras (community health workers) who delivered 11 home visits and 4 telephone calls. Home visits included a 12-minute episode of a 9-part situation comedy depicting a family struggling with making healthy eating choices; an accompanying family workbook was reviewed to build skills and left with the family. Baseline and immediate postintervention data were collected from the mothers, including the primary outcome of daily servings of fruits and vegetables. Other dietary and psychosocial factors related to healthy eating were examined. At postintervention, mothers in the intervention reported increases in daily vegetable servings (p ≤ .05); however, no changes were observed in fruit consumption. Improvements were observed in behavioral strategies to increase fiber (p ≤ .001) and to decrease fat intake (p ≤ .001), unhealthy eating behaviors (p ≤ .001), and individual (p ≤ .05) and family-related (p ≤ .01) perceived barriers to healthy eating. Entertainment education and promotoras engaged families and improved mothers' diets. Further research should examine the dose needed for greater changes.
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Dulin Keita A, Risica PM, Drenner KL, Adams I, Gorham G, Gans KM. Feasibility and acceptability of an early childhood obesity prevention intervention: results from the healthy homes, healthy families pilot study. J Obes 2014; 2014:378501. [PMID: 25405026 PMCID: PMC4227329 DOI: 10.1155/2014/378501] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/01/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study examined the feasibility and acceptability of a home-based early childhood obesity prevention intervention designed to empower low-income racially/ethnically diverse parents to modify their children's health behaviors. METHODS We used a prospective design with pre-/posttest evaluation of 50 parent-child pairs (children aged 2 to 5 years) to examine potential changes in dietary, physical activity, and sedentary behaviors among children at baseline and four-month follow-up. RESULTS 39 (78%) parent-child pairs completed evaluation data at 4-month follow-up. Vegetable intake among children significantly increased at follow-up (0.54 cups at 4 months compared to 0.28 cups at baseline, P = 0.001) and ounces of fruit juice decreased at follow-up (11.9 ounces at 4 months compared to 16.0 ounces at baseline, P = 0.036). Sedentary behaviors also improved. Children significantly decreased time spent watching TV on weekdays (P < 0.01) and also reduced weekend TV time. In addition, the number of homes with TV sets in the child's bedroom also decreased (P < 0.0013). CONCLUSIONS The findings indicate that a home-based early childhood obesity prevention intervention is feasible, acceptable and demonstrates short-term effects on dietary and sedentary behaviors of low-income racially/ethnically diverse children.
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Affiliation(s)
- Akilah Dulin Keita
- Institute for Community Health Promotion, Department of Behavioral and Social Sciences, Brown University, P.O. Box G-S121-8, Providence, RI 02908, USA
| | - Patricia M. Risica
- Institute for Community Health Promotion, Department of Behavioral and Social Sciences, Brown University, P.O. Box G-S121-8, Providence, RI 02908, USA
| | - Kelli L. Drenner
- Kinesiology & Health Science, Stephen F. Austin State University, P.O. Box 13015 SFA Station, Nacogdoches, TX 75962, USA
| | - Ingrid Adams
- School of Human Environmental Sciences, University of Kentucky, Lexington, KY 40506, USA
| | - Gemma Gorham
- Institute for Community Health Promotion, Department of Behavioral and Social Sciences, Brown University, P.O. Box G-S121-8, Providence, RI 02908, USA
| | - Kim M. Gans
- Center for Health, Intervention, and Prevention, Department of Human Development and Family Studies, University of Connecticut, 348 Mansfield Road, Unit 1058, Room 320, Storrs, CT 06269, USA
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Bender MS, Clark MJ, Gahagan S. Community engagement approach: developing a culturally appropriate intervention for Hispanic mother-child dyads. J Transcult Nurs 2014; 25:373-82. [PMID: 24595163 PMCID: PMC4155071 DOI: 10.1177/1043659614523473] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Childhood obesity affects approximately 20% of U.S. preschool children. Early prevention is needed to reduce young children's risks for obesity, especially among Hispanic preschool children who have one of the highest rates of obesity. Vida Saludable was an early childhood obesity intervention designed to be culturally appropriate for low-income Hispanic mothers with preschool children to improve maternal physical activity and reduce children's sugar-sweetened beverage consumption. It was conducted at a large southwestern United States urban health center. Presented here are the methods and rationale employed to develop and culturally adapt Vida Saludable, followed by scoring and ranking of the intervention's cultural adaptations. An empowered community helped design the customized, culturally relevant program via a collaborative partnership between two academic research institutions, a community health center, and stakeholders. Improved health behaviors in the participants may be attributed in part to this community-engagement approach. The intervention's cultural adaptations were scored and received a high comprehensive rank. Postprogram evaluation of the intervention indicated participant satisfaction. The information presented provides investigators with guidelines, a template, and a scoring tool for developing, implementing, and evaluating culturally adapted interventions for ethnically diverse populations.
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Affiliation(s)
- Melinda S. Bender
- University of California San Francisco, Department Family Health Care Nursing, 2 koret Way. N411Y, Box 0606, San Francisco, CA 94143-0606, Ph: (415) 466-6082, Fax: (415) 466-6082
| | - Mary Jo Clark
- University of San Diego, School of Nursing, 5998 Alcala Park, San Diego, CA 92110-8492, Ph (619) 260-4574
| | - Sheila Gahagan
- University of California San Diego, Department of Pediatrics, Division of Child Development and Community Health, 9500 Gilman Drive, #0927, La Jolla, CA 92093-0927, Ph: (619) 681-0673, Fax: (619) 681-0666
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Knowlden AP, Sharma M, Cottrell RR, Wilson BRA, Johnson ML. Impact evaluation of Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. HEALTH EDUCATION & BEHAVIOR 2014; 42:171-84. [PMID: 25161168 DOI: 10.1177/1090198114547816] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The family and home environment is an influential antecedent of childhood obesity. The purpose of this study was to pilot test The Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention; a newly developed, theory-based, online program for prevention of childhood obesity. METHOD The two-arm, parallel group, randomized, participant-blinded trial targeted mothers with children between 4 and 6 years of age. Measures were collected at baseline, 4 weeks, and 8 weeks to evaluate programmatic effects on constructs of social cognitive theory (SCT) and obesity-related behaviors. Process evaluation transpired concurrently with each intervention session. RESULTS Fifty-seven participants were randomly assigned to receive either experimental EMPOWER (n = 29) or active control Healthy Lifestyles (n = 28) intervention. Significant main effects were identified for child physical activity, sugar-free beverage consumption, and screen time, indicating that both groups improved in these behaviors. A significant group-by-time interaction was detected for child fruit and vegetable (FV) consumption as well as the SCT construct of environment in the EMPOWER cohort. An increase of 1.613 cups of FVs (95% confidence interval = [0.698, 2.529]) was found in the experimental group, relative to the active control group. Change score analysis found changes in the home environment accounted for 31.4% of the change in child FV intake for the experimental group. CONCLUSIONS Child physical activity, sugar-free beverage consumption, and screen time improved in both groups over the course of the trial. Only the theory-based intervention was efficacious in increasing child FV consumption. The EMPOWER program was robust for inducing change in the home environment leading to an increase in child FV intake (Cohen's f = 0.160).
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Maternal and paternal parenting practices and their influence on children's adiposity, screen-time, diet and physical activity. Appetite 2014; 79:149-57. [DOI: 10.1016/j.appet.2014.04.010] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 03/06/2014] [Accepted: 04/14/2014] [Indexed: 01/24/2023]
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Role of suppressor variables in primary prevention obesity research: examples from two predictive models. ISRN OBESITY 2014; 2014:567523. [PMID: 24634793 PMCID: PMC3929355 DOI: 10.1155/2014/567523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 12/17/2013] [Indexed: 11/18/2022]
Abstract
Pediatric obesity is a pertinent public health challenge. Child physical activity and screen time behaviors enacted within the context of the family and home environment are important determinants of pediatric obesity. The purpose of this study was to operationalize five, maternal-facilitated, social cognitive theory constructs for predicting physical activity and screen time behaviors in children. A secondary purpose was to elucidate the function of suppressor variables in the design and implementation of family- and home-based interventions seeking to prevent pediatric obesity. Instrumentation included face and content validity of the measurement tool by a panel of experts, test-retest reliability of the theoretical constructs, and predictive validity of the constructs through structural equation modeling. Physical activity and screen time were modeled separately according to the five selected social cognitive theory constructs. Data were collected from 224 mothers with children between four and six years of age. Specification indices indicated satisfactory fit for the final physical activity and screen time models. Through a series of four procedures, the structural models identified emotional coping and expectations as suppressor variables for self-efficacy. Suppressor variables can complement program design recommendations by providing a suggested ordering to construct integration within an intervention.
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Turner BJ, Navuluri N, Winkler P, Vale S, Finley E. A qualitative study of family healthy lifestyle behaviors of Mexican-American and Mexican immigrant fathers and mothers. J Acad Nutr Diet 2014; 114:562-9. [PMID: 24529984 DOI: 10.1016/j.jand.2013.12.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 11/25/2013] [Indexed: 11/18/2022]
Abstract
This study qualitatively examines contrasting parental decision-making styles about family food choices and physical activities as well as willingness to change behaviors among Mexican-American and Mexican immigrant mothers and fathers of school-aged children. Twelve sex-specific focus groups were held in English or Spanish in 2012. Qualitative analysis informed by grounded theory examined parenting styles (ie, authoritative, authoritarian, or permissive), barriers to healthy lifestyle, and parents' stage of change about healthy lifestyles. One third of the 33 participating couples were born in Mexico. The majority of mothers and fathers described being permissive and allowing unhealthy food choices, and a minority of mothers reported more authoritarian approaches to promoting a healthier diet for their children. Mothers were more permissive than fathers about family physical activities and less engaged in these activities. Most mothers and fathers described only contemplating a healthier diet and more physical activity, while wanting their children to have a healthier lifestyle. These data suggest that clinicians need to assess and address differential parental roles when promoting a healthy lifestyle for children. Clinicians should also adopt culturally competent approaches to overcome barriers to parental engagement in diverse aspects of a healthy family lifestyle.
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O’Mara-Eves A, Brunton G, McDaid D, Oliver S, Kavanagh J, Jamal F, Matosevic T, Harden A, Thomas J. Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis. PUBLIC HEALTH RESEARCH 2013. [DOI: 10.3310/phr01040] [Citation(s) in RCA: 156] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundCommunity engagement has been advanced as a promising way of improving health and reducing health inequalities; however, the approach is not yet supported by a strong evidence base.ObjectivesTo undertake a multimethod systematic review which builds on the evidence that underpins the current UK guidance on community engagement; to identify theoretical models underpinning community engagement; to explore mechanisms and contexts through which communities are engaged; to identify community engagement approaches that are effective in reducing health inequalities, under what circumstances and for whom; and to determine the processes and costs associated with their implementation.Data sourcesDatabases including the Cochrane Database of Systematic Reviews (CDSR), The Campbell Library, the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment (HTA) database, the NHS Economic Evaluation Database (NHS EED) and EPPI-Centre’s Trials Register of Promoting Health Interventions (TRoPHI) and Database of Promoting Health Effectiveness Reviews (DoPHER) were searched from 1990 to August 2011 for systematic reviews and primary studies. Trials evaluating community engagement interventions reporting health outcomes were included.Review methodsStudy eligibility criteria: published after 1990; outcome, economic, or process evaluation; intervention relevant to community engagement; written in English; measured and reported health or community outcomes, or presents cost, resource, or implementation data characterises study populations or reports differential impacts in terms of social determinants of health; conducted in an Organisation for Economic Co-operation and Development (OECD) country. Study appraisal: risk of bias for outcome evaluations; assessment of validity and relevance for process evaluations; comparison against an economic evaluation checklist for economic evaluations. Synthesis methods: four synthesis approaches were adopted for the different evidence types: theoretical, quantitative, process, and economic evidence.ResultsThe theoretical synthesis identified key models of community engagement that are underpinned by different theories of changes. Results from 131 studies included in a meta-analysis indicate that there is solid evidence that community engagement interventions have a positive impact on health behaviours, health consequences, self-efficacy and perceived social support outcomes, across various conditions. There is insufficient evidence – particularly for long-term outcomes and indirect beneficiaries – to determine whether one particular model of community engagement is likely to be more effective than any other. There are also insufficient data to test the effects on health inequalities, although there is some evidence to suggest that interventions that improve social inequalities (as measured by social support) also improve health behaviours. There is weak evidence from the effectiveness and process evaluations that certain implementation factors may affect intervention success. From the economic analysis, there is weak but inconsistent evidence that community engagement interventions are cost-effective. By combining findings across the syntheses, we produced a new conceptual framework.LimitationsDifferences in the populations, intervention approaches and health outcomes made it difficult to pinpoint specific strategies for intervention effectiveness. The syntheses of process and economic evidence were limited by the small (generally not rigorous) evidence base.ConclusionsCommunity engagement interventions are effective across a wide range of contexts and using a variety of mechanisms. Public health initiatives should incorporate community engagement into intervention design. Evaluations should place greater emphasis on long-term outcomes, outcomes for indirect beneficiaries, process evaluation, and reporting costs and resources data. The theories of change identified and the newly developed conceptual framework are useful tools for researchers and practitioners. We identified trends in the evidence that could provide useful directions for future intervention design and evaluation.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- A O’Mara-Eves
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
| | - G Brunton
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
| | - D McDaid
- Personal Social Services Research Unit and European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, UK
| | - S Oliver
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
| | - J Kavanagh
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
| | - F Jamal
- Institute for Health and Human Development, University of East London, London, UK
| | - T Matosevic
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - A Harden
- Institute for Health and Human Development, University of East London, London, UK
- Barts Health NHS Trust, London, UK
| | - J Thomas
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
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Hammons AJ, Wiley AR, Fiese BH, Teran-Garcia M. Six-week Latino family prevention pilot program effectively promotes healthy behaviors and reduces obesogenic behaviors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2013; 45:745-750. [PMID: 23726891 DOI: 10.1016/j.jneb.2013.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 01/25/2013] [Accepted: 01/27/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To test the effectiveness of a 6-week family-based healthy eating pilot program aimed to reduce obesogenic behaviors among Latino parents and children. METHODS A 6-week healthy eating pilot program focused on dietary changes within Latino families with a 6- to 13-year-old child. A 1-group, pre-posttest design with 2-month follow-up examining fruit, vegetable, and sugar-sweetened beverage consumption. RESULTS The program was effective at increasing parent-report of child fruit consumption, (P < .001, effect size = .26), vegetable consumption, (P = .001, effect size = .20), and decreasing sugar-sweetened beverage consumption, (P = .002, effect size = .16). CONCLUSIONS AND IMPLICATIONS This family-based prevention program was effective at improving healthy eating in Latino families, especially for children. The curriculum can be used in future prevention programs for Latino families with a 6- to 13-year-old child.
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Affiliation(s)
- Amber J Hammons
- Child, Family, and Consumer Sciences, California State University, Fresno, CA
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Dooyema CA, Belay B, Foltz JL, Williams N, Blanck HM. The childhood obesity research demonstration project: a comprehensive community approach to reduce childhood obesity. Child Obes 2013; 9:454-9. [PMID: 24094146 DOI: 10.1089/chi.2013.0060] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Carrie A Dooyema
- 1 Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, GA
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Trost SG, McDonald S, Cohen A. Measurement of general and specific approaches to physical activity parenting: a systematic review. Child Obes 2013; 9 Suppl:S40-50. [PMID: 23944923 PMCID: PMC3746243 DOI: 10.1089/chi.2013.0027] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Parents play a significant role in shaping youth physical activity (PA). However, interventions targeting PA parenting have been ineffective. Methodological inconsistencies related to the measurement of parental influences may be a contributing factor. The purpose of this article is to review the extant peer-reviewed literature related to the measurement of general and specific parental influences on youth PA. METHODS A systematic review of studies measuring constructs of PA parenting was conducted. Computerized searches were completed using PubMed, MEDLINE, Academic Search Premier, SPORTDiscus, and PsycINFO. Reference lists of the identified articles were manually reviewed as well as the authors' personal collections. Articles were selected on the basis of strict inclusion criteria and details regarding the measurement protocols were extracted. A total of 117 articles met the inclusionary criteria. Methodological articles that evaluated the validity and reliability of PA parenting measures (n=10) were reviewed separately from parental influence articles (n=107). RESULTS A significant percentage of studies used measures with indeterminate validity and reliability. A significant percentage of articles did not provide sample items, describe the response format, or report the possible range of scores. No studies were located that evaluated sensitivity to change. CONCLUSION The reporting of measurement properties and the use of valid and reliable measurement scales need to be improved considerably.
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Affiliation(s)
- Stewart G. Trost
- School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
| | - Samantha McDonald
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR
| | - Alysia Cohen
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR
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Holub CK, Elder JP, Arredondo EM, Barquera S, Eisenberg CM, Sánchez Romero LM, Rivera J, Lobelo F, Simoes EJ. Obesity control in Latin American and U.S. Latinos: a systematic review. Am J Prev Med 2013; 44:529-37. [PMID: 23597819 PMCID: PMC4808744 DOI: 10.1016/j.amepre.2013.01.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 01/22/2013] [Accepted: 01/29/2013] [Indexed: 10/27/2022]
Abstract
CONTEXT Latinos are the largest and fastest-growing ethnically diverse group in the U.S.; they are also the most overweight. Mexico is now second to the U.S. in experiencing the worst epidemic of obesity in the world. Objectives of this study were to (1) conduct a systematic review of obesity-related interventions targeting Latinos living in the U.S. and Latin America and (2) develop evidence-based recommendations to inform culturally relevant strategies targeting obesity. EVIDENCE ACQUISITION Obesity-related interventions, published between 1965 and 2010, were identified through searches of major electronic databases in 2010-2011. Selection criteria included evaluation of obesity-related measures; intervention conducted in a community setting; and at least 50.0% Latino/Latin American participants, or with stratified results by race/ethnicity. EVIDENCE SYNTHESIS Body of evidence was based on the number of available studies, study design, execution, and effect size. Of 19,758 articles, 105 interventions met final inclusion criteria. Interventions promoting physical activity and/or healthy eating had strong or sufficient evidence for recommending (1) school-based interventions in the U.S. and Latin America; (2) interventions for overweight or obese children in the healthcare context in Latin America; (3) individual-based interventions for overweight or obese adults in the U.S.; (4) individual-based interventions for adults in Latin America; and (5) healthcare-based interventions for overweight or obese adults in Latin America. CONCLUSIONS Most intervention approaches combined physical activity and healthy eating to address both sides of the energy-balance equation. Results can help guide comprehensive evidence-based efforts to tackle the obesity epidemic in the U.S. and Latin America.
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Affiliation(s)
- Christina K Holub
- Institute for Behavioral and Community Health, San Diego State University, San Diego, CA 92123, USA
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Bender MS, Nader PR, Kennedy C, Gahagan S. A culturally appropriate intervention to improve health behaviors in Hispanic mother-child dyads. Child Obes 2013; 9:157-63. [PMID: 23514697 PMCID: PMC3621339 DOI: 10.1089/chi.2012.0118] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Obesity interventions targeting Hispanic preschool children are still nascent, and few are culturally appropriate. We evaluated the feasibility of a culturally relevant 9-month intervention program to improve health behaviors in low-income Mexican mothers with 3- to 5-year-old children. METHODS A community engagement approach was used to culturally and linguistically tailor an intervention program that was pilot tested with 33 mother-child dyads enrolled from a large California urban health center. A one-group, pretest-posttest design assessed changes in children's consumption of sugar-sweetened beverages (SSB), mothers' pedometer steps, and BMI. Data were collected at baseline, postintervention and at 6 months postintervention. RESULTS At postintervention, SSB consumption had significantly decreased for soda and other sugary drinks with a modest reduction for 100% juice. Consumption of water had significantly increased, whereas milk had an increased trend. Maternal step counts significantly increased for weekdays by 69% and weekend days by 49%. Overall, maternal BMI decreased while children's BMI% remained stable. At 6 months postintervention, children's soda and juice consumption reverted toward baseline levels, as did maternal step counts, but children's consumption of sugary drinks remained lower, while water and milk remained higher. CONCLUSIONS Findings suggest that a culturally relevant intervention was feasible for improving target health behaviors in a low-income Mexican community. Future work should assess an enhanced intervention including a maintenance phase for long-term adherence to health behavior changes and influence on maternal and child BMI.
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Affiliation(s)
- Melinda S Bender
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA 94143-0606, USA.
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Johnson CM, Sharkey JR, Dean WR, St John JA, Castillo M. Promotoras as research partners to engage health disparity communities. J Acad Nutr Diet 2013; 113:638-42. [PMID: 23375463 DOI: 10.1016/j.jand.2012.11.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 11/20/2012] [Indexed: 11/24/2022]
Affiliation(s)
- Cassandra M Johnson
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, NC, USA
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