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Wali N, Huda MN, Gill T, Green J, Renzaho AMN. A systematic review of recruitment and retention of ethnic minorities and migrants in obesity prevention randomised controlled trials. Int J Obes (Lond) 2024; 48:1065-1079. [PMID: 38834795 PMCID: PMC11281904 DOI: 10.1038/s41366-024-01545-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Participants' recruitment and retention into community-based interventions can be challenging, especially in research involving ethnic minorities and migrants. Despite known challenges, there are limited reviews that probe recruitment and retention strategies involving ethnic minorities and migrants in the Organisation for Economic Cooperation and Development (OECD) countries. This systematic review aimed to measure recruitment and retention rates and identify the barriers and facilitators to effective recruitment and retention of ethnic minorities and migrants in community-based obesity prevention Randomised Control Trials (RCTs) in OECD countries. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases (CINAHL, Cochrane, Embase, Medline and PsychInfo) were searched from January 2000 to March 2022, in addition to Google and Google Scholar. Methodological quality and risk of bias were assessed, and pooled analysis and meta-ethnographic analysis were conducted on the included studies. RESULTS Twenty-five studies were included in the review. The pooled analysis found a 64% rate of recruitment of ethnic minorities in RCTs, with a retention rate of 71%. Key facilitators identified were-use of multiple communication channels, incentives, recruiting community champions, participant convenience and employing culturally sensitive strategies. Key barriers to participation were limited access to study sites, time constraints, limited trust, perceived fear, and anxiety. CONCLUSION Findings suggest the importance of undertaking culturally appropriate recruitment and retention strategies to minimise barriers and facilitate effective recruitment and retention of low-income ethnic minorities and migrants in community-based research.
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Affiliation(s)
- Nidhi Wali
- School of Social Sciences, Humanitarian and Development Research Initiative (HADRI), Western Sydney University, Sydney, NSW, 2751, Australia.
| | - Md Nazmul Huda
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Timothy Gill
- Charles Perkins Centre, University of Sydney, Sydney, NSW, 2050, Australia
| | - Julie Green
- Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- Department of Paediatric, University of Melbourne, Parkville, VIC, 3052, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Andre M N Renzaho
- Translational Health Research Institute (THRI), Western Sydney University, Campbelltown, NSW, 2560, Australia
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Fukkink RG, Booij YS, Leistra LHM, van Verseveld MDA. Profiles of Cultural Adaptation and Parenting Approach for Childhood Obesity in Lifestyle Interventions for Families With Young Children: A Systematic Review. FAMILY & COMMUNITY HEALTH 2024; 47:95-107. [PMID: 38372327 PMCID: PMC10916755 DOI: 10.1097/fch.0000000000000397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Various interventions aim to reduce obesity and promote healthy lifestyles among different cultural groups. METHODS We have conducted a systematic literature review, following PRISMA guidelines (registered at https://doi.org/10.17605/OSF.IO/HB9AX), to explore profiles of cultural adaptation and parenting approach of lifestyle interventions for families with young children (1-4 years). RESULTS Our search (in CINAHL, ERIC, PsycINFO, PubMed, Scopus, and SSCI) yielded 41 studies reporting 31 interventions. Drawing on Intervention Mapping, we applied a newly developed framework with various indicators of cultural adaptation and a parenting approach to analyze interventions. Our review shows clear differences in the level of cultural adaptation. A categorical principal component analysis revealed 6 different empirical profiles of cultural adaptation. CONCLUSIONS Based on our profiles, we discuss how cultural adaptation can be strengthened in the design of future early interventions aimed at promoting a healthy lifestyle.
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Affiliation(s)
- Ruben G. Fukkink
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands (Dr Fukkink and Ms Leistra); Centre of Expertise Urban Education, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands (Dr Fukkink); Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands (Ms Booij); and Norwegian University of Science and Technology, Trondheim, Norway (Dr van Verseveld)
| | - Yvonne S. Booij
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands (Dr Fukkink and Ms Leistra); Centre of Expertise Urban Education, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands (Dr Fukkink); Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands (Ms Booij); and Norwegian University of Science and Technology, Trondheim, Norway (Dr van Verseveld)
| | - Loes H. M. Leistra
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands (Dr Fukkink and Ms Leistra); Centre of Expertise Urban Education, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands (Dr Fukkink); Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands (Ms Booij); and Norwegian University of Science and Technology, Trondheim, Norway (Dr van Verseveld)
| | - Marloes D. A. van Verseveld
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands (Dr Fukkink and Ms Leistra); Centre of Expertise Urban Education, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands (Dr Fukkink); Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands (Ms Booij); and Norwegian University of Science and Technology, Trondheim, Norway (Dr van Verseveld)
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Henes ST, Stotz SA, Riggs SE, Yang HM. eHealth, family-based interventions, and multilevel approaches to pediatric weight management: a scoping review. Nutr Rev 2024:nuad160. [PMID: 38269577 DOI: 10.1093/nutrit/nuad160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE This scoping review examines the current literature on technology-based, eHealth interventions that integrate community and clinical approaches for family-based pediatric weight management. BACKGROUND Telehealth and eHealth interventions for weight management are increasingly commonplace; however, it is unclear in the current literature how family-based, pediatric, healthy-weight interventions integrate technology. Additionally, multilevel approaches to address childhood obesity, including working with clinical and community partners, are currently considered best practice and within the socioecological framework for sustainability of outcomes. Little is known how current family based pediatric healthy weight interventions integrate eHealth and multi-level approaches. METHODS Guided by Arksey and O'Malley's scoping review framework, a scoping literature review was conducted. Four databases were searched to identify studies conducted between 2010 and 2022 that addressed multilevel, family-based, pediatric weight management interventions that also integrated technology. Studies were excluded that did not include at least 2 of the 4 components and that did not include technology to some degree. RESULTS A total of 15 articles were included in the scoping review. All articles included some type of technology in the intervention. Twelve articles included a family-based approach, and only 1 article fully used a holistic approach to family-based, pediatric weight management that included technology and integrated clinical and community approaches to address the complexity of childhood obesity. CONCLUSIONS There are several family-based, pediatric weight management interventions that incorporate an eHealth component. There is a gap in the literature about programs that use both technology and integrate multilevel clinical and community approaches for treatment. Additionally, gaps exist in information about adolescent, family-based, weight management interventions, and there are opportunities for nutrition and dietetic professionals to become more involved with technological and multilevel approaches in family-based pediatric weight management.
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Affiliation(s)
- Sarah T Henes
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Sarah A Stotz
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Sandra E Riggs
- University Libraries, Research and Instruction, University of Georgia, Athens, GA, USA
| | - Hsuan-Mein Yang
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
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Adams LE, Sommer EC, Truesdale KP, Barkin SL, Heerman WJ. Validation of a new scoring approach of a child dietary questionnaire for use in early childhood among low-income, Latino populations. BMC Nutr 2022; 8:125. [PMID: 36316788 PMCID: PMC9620651 DOI: 10.1186/s40795-022-00618-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Measuring diet quality in early childhood requires time-intensive and costly measurements (e.g., 24-hour diet recall) that are especially burdensome for low-income, minority populations. This study aimed to validate a new method for calculating overall diet quality among low-income, Latino preschoolers. METHODS This study was an observational study using data from a randomized controlled trial. Participants included parents of Latino preschoolers who reported child diet quality at baseline, 4-month, 7-month, 12-month, and 13-month follow-up. At each timepoint parents responded to a 28-item child dietary questionnaire (CDQ), based on the National Health and Nutrition Examination Survey (NHANES) dietary module, which generated the number of times/day that a child ate each of 28 foods in the past month. These 28 items were then used to create a total standardized child diet quality index (possible range 0-100), using a percent of maximum method. Parents were asked to complete three 24-hour diet recalls at the 13-month follow-up, from which the 2015 Healthy Eating Index (HEI) was derived. Construct validity was evaluated by Spearman's rank correlations between the new child diet quality index and the 2015 HEI at the 13-month follow-up. Test-retest reliability was assessed by intraclass correlation coefficients (ICC) for sequential pairs of time points. RESULTS Among 71 eligible parent-child pairs, mean child age was 4.2 (SD = 0.8) years, 50.7% of children were female, and mean child body mass index (BMI) was 17.8 (SD = 2.0) kg/m2. Mean Child Diet Quality Index was 45.2 (SD = 3.2) and mean HEI was 68.4 (SD = 10.5). Child Diet Quality Index and HEI total scores were significantly correlated (r = 0.37; p = 0.001). Test-retest ICCs were statistically significant between all sequential pairs of time points. CONCLUSION The new approach for calculating a measure of overall diet quality from the previously-validated 28-item dietary questionnaire demonstrated modest construct validity. When time and resources are limited, this new measure of overall diet quality may be an appropriate choice among low-income, Latino preschoolers. TRIAL REGISTRATION This reports presents observational data collected as a part of a clinical trial, which was registered on clinicaltrials.gov prior to participant enrollment (NCT03141151).
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Affiliation(s)
- Laura E. Adams
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 37232-9225 Nashville, TN USA
| | - Evan C. Sommer
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 37232-9225 Nashville, TN USA
| | - Kimberly P. Truesdale
- grid.410711.20000 0001 1034 1720Department of Nutrition, University of North Carolina, McGavran-Greenberg Hall, 2209, 27599 Chapel Hill, NC USA
| | - Shari L. Barkin
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 37232-9225 Nashville, TN USA
| | - William J. Heerman
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 37232-9225 Nashville, TN USA
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Wang X, Ammerman A, Orr CJ. Family‐based interventions for preventing overweight or obesity among preschoolers from racial/ethnic minority groups: A scoping review. Obes Sci Pract 2022; 8:371-386. [PMID: 35664252 PMCID: PMC9159561 DOI: 10.1002/osp4.578] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/10/2021] [Accepted: 11/21/2021] [Indexed: 11/11/2022] Open
Abstract
Objective This scoping review aimed to synthesize the published literature on family‐based childhood obesity prevention interventions from 2015 to 2021 that focused on children 2–5 years of age from racial and/or ethnic minority households. Methods A PICOS (population, intervention, comparison, outcome, and setting) framework was used to guide the development of the research question, search strategy, and inclusion/exclusion criteria. To be included, the study must have been a randomized controlled trial or quasi‐experimental trial that enrolled participants 2–5 years of age and their caregivers who identified as being from a racial and/or ethnic minority group in the United States. The study must have also examined a family‐based intervention that incorporated components to prevent childhood obesity (i.e., fruits and vegetable intake, parental responsive feeding, physical activity), be conducted in a remote (i.e., online, text, mail), home, community, primary care setting, or early childhood education institution setting, and report on body mass index (BMI, kg/m2), BMI z‐score, anthropometric measures (weight, waist circumference, fat mass, etc.), changes in health behaviors, or increase in nutritional knowledge. Results Fourteen individual studies were identified. Most interventions used multiple components for promoting nutritional knowledge and behavioral changes among families. Eight interventions included culturally tailored components targeting four aspects: (1) language barriers, (2) food choices, (3) relationships between family members, and (4) rapport building. Conclusions There is limited research in this field focusing on children from racial and/or ethnic minority groups. Future efforts should invest in developing culturally appropriate interventions for these groups.
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Affiliation(s)
- Xiran Wang
- Department of Nutrition University of North Carolina at Chapel Hill Gillings School of Public Health Chapel Hill North Carolina USA
| | - Alice Ammerman
- Health Promotion and Disease Prevention University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Colin J. Orr
- Department of Pediatrics University of North Carolina at Chapel Hill School of Medicine Chapel Hill North Carolina USA
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Teeters LAP, Burgess LE, Escarfuller J, Cole J, Schlundt D, Singer-Gabella M, Heerman WJ. Relational Approaches to Community-Based Health Promotion Across Scales of Practice. MIND, CULTURE, AND ACTIVITY 2021; 28:268-279. [PMID: 35002208 PMCID: PMC8735706 DOI: 10.1080/10749039.2021.1874418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In this article, we describe a personalized approach to meeting individual and community health needs that foregrounds relational learning. This article analyzes how relational approaches to learning expand participants' objectives and result in more enduring learning. We report on mixed methods data from interviews, focus groups, surveys, and goal setting and monitoring. Analyses reveal that relationships de confianza served as a central tool in supporting participants' agency to enact change across scales of practice to promote the health of themselves, their families, and their communities.
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Affiliation(s)
- Leah A P Teeters
- Department of Neuroscience and Psychology, University of Colorado Boulder, 345 UCB Muenzinger, Boulder, CO 80309-0345
| | - Laura E Burgess
- Division of General Pediatrics, Vanderbilt University, 2146 Belcourt Ave, 2nd Floor Nashville, TN 37212
| | - Juan Escarfuller
- Division of General Pediatrics, Vanderbilt University, 2146 Belcourt Ave, 2nd Floor Nashville, TN 37212
| | - Jesse Cole
- Jacobs School of Medicine and Biomedical Sciences, SUNY at Buffalo, 955 Main Street, Suite 6186, Buffalo, New York 14203
| | - David Schlundt
- Department of Psychology, Vanderbilt University, 230 Appleton Pl, Nashville, TN 37203
| | - Marcy Singer-Gabella
- Department of Teaching & Learning, Vanderbilt University, 230 Appleton Pl, Nashville, TN 37203
| | - William J Heerman
- Division of General Pediatrics, Vanderbilt University, 2146 Belcourt Ave, 2nd Floor Nashville, TN 37212
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Heerman WJ, Teeters L, Sommer EC, Burgess LE, Escarfuller J, Van Wyk C, Barkin SL, Duhon AA, Cole J, Samuels LR, Singer-Gabella M. Competency-Based Approaches to Community Health: A Randomized Controlled Trial to Reduce Childhood Obesity among Latino Preschool-Aged Children. Child Obes 2019; 15:519-531. [PMID: 31381365 PMCID: PMC6862953 DOI: 10.1089/chi.2019.0064] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Health behavior change interventions that target childhood obesity in minority populations have led to inconsistent and short-lived results. The purpose of this study was to test a novel intervention that was personalized and family-based in a Latino population to reduce childhood obesity. Methods: Competency-Based Approaches to Community Health (COACH) was a randomized controlled trial. Latino parent-child pairs were recruited from community settings in Nashville, TN. Child eligibility criteria included age 3-5 years and a BMI ≥50th percentile. The intervention included 15 weekly, 90-minute sessions followed by 3 months of twice-monthly health coaching calls. The control group was a twice-monthly school readiness curriculum for 3 months. Sessions were conducted by a health coach in local community centers, with groups of 8-11 parent-child pairs. The primary outcome was child BMI trajectory across 12 months, measured at four times. The intervention's effect was assessed by using a longitudinal, linear mixed-effects growth model, adjusting for child gender, baseline child and parent age, and baseline parent BMI and education. Results: Of the 305 parent-child pairs assessed for eligibility, 117 were randomized (59 intervention, 58 control). Child BMI was available for 91.5% at 1-year follow-up. Mean baseline child age was 4.2 [standard deviation (SD) = 0.8] years, and 53.8% of children were female. Mean baseline child BMI was 18.1 (SD = 2.6) kg/m2. After adjusting for covariates, the intervention's effect on linear child BMI growth was -0.41 kg/m2 per year (95% confidence interval -0.82 to 0.01; p = 0.05). Conclusions: Over 1-year follow-up, the intervention resulted in slower linear BMI growth for Latino preschool-aged children from poverty.
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Affiliation(s)
- William J. Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.,Address correspondence to: William J. Heerman, MD, MPH, Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Avenue, 2nd Floor, Nashville, TN 37209
| | - Leah Teeters
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Evan C. Sommer
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Laura E. Burgess
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Juan Escarfuller
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Chelsea Van Wyk
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Shari L. Barkin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Ashley A. Duhon
- School of Medicine, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA
| | - Jesse Cole
- Jacobs School of Medicine and Biomedical Sciences, SUNY at Buffalo, Buffalo, NY
| | - Lauren R. Samuels
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
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Heerman WJ, Cole J, Teeters L, Lane T, Burgess LE, Escarfuller J, Bonnet K, Barkin SL, Schlundt DG. Qualitative analysis of COACH: A community-based behavioral intervention to reduce obesity health disparities within a marginalized community. Contemp Clin Trials Commun 2019; 16:100452. [PMID: 31650072 PMCID: PMC6804499 DOI: 10.1016/j.conctc.2019.100452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/31/2019] [Accepted: 09/14/2019] [Indexed: 12/12/2022] Open
Abstract
Background The purpose of this study was to conduct a qualitative evaluation of a behavioral intervention to prevent and treat childhood obesity in minority children. Using qualitative methods to augment understanding of intervention success may be one way to gain insight into the types of behavior change strategies that are most effective in childhood obesity interventions. Methods COACH was a randomized controlled trial of 117 Latino parent-child (ages 3–5) pairs in Nashville, TN that resulted in improved child BMI in intervention vs. control families at 1-year follow-up. All participant parents were invited to focus groups after the trial. Discussions were audiotaped, transcribed, and translated into English. A hierarchical coding scheme was generated, and qualitative analysis done using an inductive/deductive approach. Both theme saturation and consensus between the coders were achieved. Responses were compared between intervention and control groups. Results We conducted seven focus groups with 43 participants. 4 themes emerged from the intervention group: 1) perceived barriers to health behavior change; 2) strategies learned to overcome perceived barriers; 3) behavioral changes made in response to the program; and 4) knowledge, skills, and agency for family health behaviors. 4 themes emerged from the control group: 1) a desire to engage in health behaviors without specific strategies; 2) common set of barriers to health behavior change; 3) engagement in literacy activities, including creative problem-solving strategies; and 4) changes made in response to study visits. Analysis of coded data showed the intervention increased healthy behaviors (e.g., fruit/vegetable consumption) despite barriers (e.g., time, cost, culture, family dynamics). Intervention participants described using specific behavior change strategies promoted by the intervention including: substituting ingredients in culturally-normative recipes; avoiding grocery shopping when hungry; and coping with inability to meet goals with acceptance and problem-solving. Control participants reported little success in achieving healthy changes for their family. Intervention participants described successful health behavior changes that were shared across generations and were maintained after the program. Intervention participants reported increased awareness of their own agency in promoting their health. Conclusions Qualitative evaluation of COACH provides a more detailed understanding of the intervention's quantitative effectiveness: child and adult health behaviors and personal agency were improved.
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Affiliation(s)
- William J. Heerman
- Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Corresponding author. 2146 Belcourt Ave, 2nd Floor, Nashville, TN, 37209, USA.
| | - Jesse Cole
- Jacobs School of Medicine and Biomedical Sciences, SUNY at Buffalo, Buffalo, NY, USA
| | - Leah Teeters
- School of Education, University of Colorado Boulder, USA
| | - Tara Lane
- Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Laura E. Burgess
- Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Juan Escarfuller
- Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kemberlee Bonnet
- Qualitative Research Core, Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | | | - David G. Schlundt
- Qualitative Research Core, Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Lindsay AC, Arruda CAM, De Andrade GP, Machado MMT, Greaney ML. Parenting practices that may encourage and discourage physical activity in preschool-age children of Brazilian immigrant families: A qualitative study. PLoS One 2019; 14:e0214143. [PMID: 30893366 PMCID: PMC6426301 DOI: 10.1371/journal.pone.0214143] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 02/25/2019] [Indexed: 11/29/2022] Open
Abstract
Brazilians are a rapidly increasing Latino immigrant group in the United States (US), yet little research has examined factors influencing physical activity (PA) levels and behaviors of children growing up in Brazilian immigrant families. This information is needed to develop culturally sensitive interventions tailored to this population. Therefore, this qualitative study explored PA parenting practices used by Brazilian immigrant mothers living in the US. Thirty-seven Brazilian immigrant mothers with at least one child between the ages of 2 and 5 years participated in 1of 7 focus group discussions. Thematic analysis identified seven parenting practices that mothers employ that may encourage or facilitate physical activity their preschool-aged children's PA including: 1) modeling PA; 2) engaging and being physically active with child; 3) providing logistic support; 4) encouraging, praising, and offering motivational support; 5) watching, supervising, and teaching children how to engage in PA; 6) monitoring and setting limits to child's screen time; and 7) prompting child to be physically active. In addition, analysis identified four parenting practices that may discourage or inhibit children's PA including: 1) modeling of sedentary behaviors; 2) having rules and restrictions due to safety- and weather-related concerns; 3) limiting child's outdoor time due to parental time constraints; and 4) restricting child's outdoor and play time as punishment. Furthermore, analyses demonstrated that social contextual factors (e.g., income, housing, neighborhood safety, etc.) influence mothers' PA parenting practices and consequently, their children's PA. This is the first qualitative study, to our knowledge, to explore PA parenting practices of Brazilian-born immigrant mothers living in the US. Future research should further explore PA parenting practices of Brazilian immigrant parents including quantifying PA parenting practices that encourage and discourage PA, as well as examining the influence of fathers' PA parenting practices on young children's PA.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts, Boston, MA, United States of America
| | | | | | | | - Mary L. Greaney
- Health Studies & Department of Kinesiology, University of Rhode Island, Kingston, RI, United States America
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