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Kong A, Sanchez-Flack J, Fitzgibbon M, Schiffer L, Hubbard C. Race/Ethnicity Modifies the Relationship Between Diet Quality at the Home- and Individual-Levels and Weight Status Among African American and Hispanic/Latinx Households With Preschool-Age Children. Child Obes 2023. [PMID: 37856653 DOI: 10.1089/chi.2023.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Background: Higher obesity prevalence and poorer diet quality disproportionately impacting groups based on income and race/ethnicity may be partially attributed to the home food environment. This study examined home- and individual-level diet quality with weight status among racially/ethnically diverse households. Methods: This cross-sectional study included African American (AA) and Hispanic/Latinx (H/L) households with preschool-age children (n = 97). Home-level diet quality was based on comprehensive home food inventories and individual-level diet quality was based on 24-hour dietary recalls; scores were estimated with the Healthy Eating Index. Child and adult appropriate weight categories based on BMI were estimated with measured heights and weights. Multiple linear regression models (independent variable: weight status, outcome: diet quality scores) with an interaction term for weight status and race/ethnicity and adjusting for potential confounding factors were used to estimate adjusted mean diet quality scores. Postestimation pairwise comparisons of these scores were used to look for within and between group differences by weight status and race/ethnicity. Results: Home-level diet quality scores were significantly higher among H/L households compared to AA counterparts regardless of weight status. AA parents with BMI <30 and AA children with BMI <85th percentile had poorer individual-level diet quality scores compared to AA parents and children of lower weight status and all H/L parents and children. Conclusions: These findings offer evidence that race/ethnicity modifies the relationship between diet quality and weight among AA and H/L households. Future research needs to examine the distinctive ways race/ethnicity shapes the relationship between weight and diet quality in these households.
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Affiliation(s)
- Angela Kong
- Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, Illinois, USA
- University of Illinois Cancer Center, Chicago, Illinois, USA
- Institute for Health Research and Policy, Chicago, Illinois, USA
| | - Jennifer Sanchez-Flack
- University of Illinois Cancer Center, Chicago, Illinois, USA
- Institute for Health Research and Policy, Chicago, Illinois, USA
- Department of Pediatrics, University of Illinois Chicago, Chicago, Illinois, USA
| | - Marian Fitzgibbon
- University of Illinois Cancer Center, Chicago, Illinois, USA
- Institute for Health Research and Policy, Chicago, Illinois, USA
- Department of Pediatrics, University of Illinois Chicago, Chicago, Illinois, USA
| | - Linda Schiffer
- Department of Pediatrics, University of Illinois Chicago, Chicago, Illinois, USA
| | - Colin Hubbard
- Department of Medicine, Division of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
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Magaña S, Errisuriz VL, Yu APL, Heydaria N, Zeng W, Mirza M, Vanegas S, Brown S, Parra-Medina D, Suarez-Balcazar Y. Associations between parenting strategies and BMI percentile among Latino children and youth with intellectual and developmental disabilities. Front Pediatr 2023; 11:1189686. [PMID: 37576140 PMCID: PMC10413978 DOI: 10.3389/fped.2023.1189686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Maintaining healthy weight is a challenge for all children, and particularly for children with IDD compared to nondisabled children and for Latino children compared to non-Latino White children. Parenting practices related to food intake and physical activity have been found to be important in maintaining children's weight. In this study, we describe the prevalence of overweight and obesity status among Latino children with IDD and their maternal caregivers and determine the relationship between food and physical activity parenting practices and childhood obesity among Latino children with IDD. Methods We interviewed 94 Latino parent/child dyads and collected information about parenting practices, home environment, and parent and child height and weight using standardized measures. Parent body mass index (BMI) and child BMI percentile were calculated from height and weight. Results The combined overweight/obesity status for children in our sample was high (60.3%) compared to national rates among nondisabled Latino children (56%) and non-Latino White children with autism (37%). Contrary to research on nondisabled children, we found that greater parental use of controlling dietary strategies was associated with lower BMI percentile in Latino children with IDD. These findings may be indicative of the fact that children with IDD tend to have unique dietary behaviors that warrant more disability and culturally sensitive strategies. Discussion Our findings suggest that overweight and obesity is especially prevalent for Latino children with IDD and that more research is needed on family factors that promote health in Latino families of children with IDD.
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Affiliation(s)
- Sandy Magaña
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Vanessa L. Errisuriz
- Latino Research Institute, University of Texas at Austin, Austin, TX, United States
| | - Amy Pei-Lung Yu
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Nazanin Heydaria
- School of Social Work, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Weiwen Zeng
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Mansha Mirza
- Department of Occupational Therapy, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL, United States
| | - Sandra Vanegas
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Stephany Brown
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Deborah Parra-Medina
- Latino Research Institute, University of Texas at Austin, Austin, TX, United States
| | - Yolanda Suarez-Balcazar
- Department of Occupational Therapy, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL, United States
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Carr KA, Black W, Guth C, Shapiro L, Leone LA, Temple JL, Epstein LH. Reinforcing value of food, enriched home environment, and changes in percent overweight in children. Obesity (Silver Spring) 2023; 31:1075-1084. [PMID: 36855013 DOI: 10.1002/oby.23685] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE The decision to eat is often a choice made in the context of food and non-food alternatives. However, no research, to the authors' knowledge, has assessed the combination of the motivation to eat, as indexed by the relative reinforcing value of food (RRVFOOD ), and the enriched home environment, i.e., access to activities that can serve as alternatives to eating on weight gain. METHODS This study used a cross-sectional design to study how RRVFOOD and the enriched home environment predict percent overweight change over 2 years in 291 children aged 6 to 9 years and of varying socioeconomic status. RESULTS Results showed that RRVFOOD and access to food were positively associated with baseline percent overweight, and an enriched home environment was negatively related to baseline percent overweight. RRVFOOD and an enriched home environment interacted to predict change in percent overweight. Children with a high relative RRVFOOD and a relatively non-enriched environment showed the greatest relative weight gain. CONCLUSIONS These results suggest that providing an enriched home environment may reduce the effects of food reinforcement and being motivated to eat on weight gain in childhood, and this represents a novel approach to intervention that can be used to strengthen current behavioral approaches to prevent obesity in children.
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Affiliation(s)
- Katelyn A Carr
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Whitney Black
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Catherine Guth
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Lilianna Shapiro
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Lucia A Leone
- Department of Community Health and Health Behavior, University at Buffalo School of Public Health and Health Professions, Buffalo, New York, USA
| | - Jennifer L Temple
- Department of Community Health and Health Behavior, University at Buffalo School of Public Health and Health Professions, Buffalo, New York, USA
- Department of Exercise and Nutrition Sciences, University at Buffalo School of Public Health and Health Sciences, Buffalo, New York, USA
| | - Leonard H Epstein
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
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The Family Nutrition and Physical Activity Survey: Comparisons with Obesity and Physical Activity in Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:89-95. [PMID: 34982325 PMCID: PMC9940245 DOI: 10.1007/s10803-021-05415-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 02/03/2023]
Abstract
Adolescents with autism spectrum disorder (ASD) are at a heightened risk for obesity. Family-level measures of nutrition and physical activity may help explain factors contributing to disproportionate rates of weight gain. Twenty adolescents with ASD participated in baseline testing for a study to assess the feasibility of remotely-delivered yoga. Parents completed the Family Nutrition and Physical Activity (FNPA) survey and anthropometrics and physical activity were assessed in the adolescents. A median split was applied to the FNPA score to create high and low obesogenic environments and nonparametric O'Brien's multiple endpoint tests were used to evaluate the differences. Between-group differences were found in anthropometrics (p = 0.01) but not physical activity (p = 0.72). Implications for a multifaceted family-based approach to obesity prevention are discussed.
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Cáceres NA, Yu Q, Capaldi J, Diniz MA, Raynor H, Foster GD, Seitz AR, Salvy SJ. Evaluating environmental and inhibitory control strategies to improve outcomes in a widely available weight loss program. Contemp Clin Trials 2022; 119:106844. [DOI: 10.1016/j.cct.2022.106844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/10/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022]
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Risk Behavioral Contexts in Adolescence of Obese Adults. J Adolesc Health 2022; 70:817-824. [PMID: 35165031 DOI: 10.1016/j.jadohealth.2021.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/14/2021] [Accepted: 11/23/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Previous research suggests that poor nutrition, physical activity, sleep, and social/emotional climate are associated with weight gain. However, few empirical studies have examined how these factors relate to each other in adolescents who are later obese. Are these factors uniformly present, or do some co-occur or occur independently? This study seeks to identify subgroups of obese individuals at ages 24-32 years who exhibited unique, co-occurring behavioral and emotional contexts for obesity at ages 14-17 years. METHODS To identify subgroups of behavioral and contextual profiles in adolescence, the study applies latent class analysis to a sample of individuals who were obese in the fourth wave of the National Longitudinal Study of Adolescent to Adult Health (Add Health, N = 1,889). The study then explored covariates (e.g., gender, race) of class membership. RESULTS Considerable heterogeneity exists in risk profiles of adolescents obese as adults. For example, 21.1 percent of the sample is in a class with no differentiating risk factors, whereas two classes containing 22.1 percent of the sample exhibit high levels of depression, and nearly all the emotional factors are considered. Although some covariates are predictive of class membership, clear patterns are difficult to discern. However, poor physical health is clearly predictive of membership in the classes exhibiting a high risk of depression. DISCUSSION Clinicians should be aware that at younger ages, people who are ultimately obese display a range of factors linked to obesity. Although some exhibit behaviors such as high screen time and processed food consumption, others exhibit mainly poor social/emotional climate.
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Kong A, Fitzgibbon M, Hubbard C, Campbell RT, Kessee N, Schiffer L. Validation of a self-report home food availability checklist against in-home food inventories conducted in low-income Black/African American and Hispanic/Latinx households with preschool-age children. Appetite 2022; 172:105964. [PMID: 35124159 PMCID: PMC8898284 DOI: 10.1016/j.appet.2022.105964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/12/2021] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Abstract
Home food availability (HFA) checklists can be completed by self-report to assess the home food environment. Checklists developed for Black/African American (B/AA) and Hispanic/Latinx (H/L) households are seldom validated against objective approaches such as exhaustive in-home food inventories. This study validated a self-report HFA checklist developed for B/AA and H/L households (n = 97) against researcher-completed HFA checklists verified by exhaustive in-home food inventories. Mean estimates of sensitivity, specificity, and area of the receiver operating curve (ROC), and interrater agreement (Gwet AC1) were calculated to examine the accuracy and agreement of self-reported checklists against direct observation of individual food items. Mean differences in HFA food group scores were compared (self-report vs observed) to examine group-level relative validity. The predictive validity of this self-reported measure on observed scores and dietary intake were also examined with linear regression. The average values for ROC area (average of sensitivity and specificity) ranged from acceptable (0.76 for sweets) to excellent (0.81 for vegetables, fruits). Average interrater agreement values ranged from moderate (0.41-0.60: sweets) to substantial (0.61-0.79: vegetables, fruit, SSBs, savory foods). Self-reported mean scores, compared to observed scores, were higher for vegetables (mean diff: 1.04) and lower for sweets (mean diff: 0.38, p = 0.01), but regression analyses demonstrated that self-reported scores were good predictors of observed scores with absolute error (based on standard deviation of residuals) ranging from ±1.27 to 1.69 points. Self-reported scores also predicted multiple aspects of dietary intake but more so among H/L households. In conclusion, the HFA checklist obtained via self-report performed well based on multiple indicators of validity suggesting that this self-reported measure can be used to assess home food environments among of B/AA and H/L households.
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Affiliation(s)
- Angela Kong
- University of Illinois at Chicago, Department of Pharmacy Systems, Outcomes, and Policy, 833 S Wood St, Chicago, IL, 60612, USA; University of Illinois at Chicago, Institute for Health Research and Policy, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Marian Fitzgibbon
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA; University of Illinois Cancer Center, 914 S. Wood St. MC 700, Chicago, IL, 601612, USA; University of Illinois at Chicago, Department of Pediatrics, 1835 W Polk St. Chicago, IL, 60612, USA.
| | - Colin Hubbard
- University of California San Francisco, Department of Medicine, 400 Parnassus Ave. San Francisco, CA, 94143, USA.
| | - Richard T Campbell
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Nicollette Kessee
- University of Illinois Cancer Center, 914 S. Wood St. MC 700, Chicago, IL, 601612, USA.
| | - Linda Schiffer
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
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Timm A, Kragelund Nielsen K, Joenck L, Husted Jensen N, Jensen DM, Norgaard O, Terkildsen Maindal H. Strategies to promote health behaviors in parents with small children-A systematic review and realist synthesis of behavioral interventions. Obes Rev 2022; 23:e13359. [PMID: 34734473 DOI: 10.1111/obr.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/12/2021] [Accepted: 08/21/2021] [Indexed: 11/28/2022]
Abstract
In this systematic review and realist synthesis, we aimed to identify strategies to improve dietary and physical activity behaviors for parents with small children. A systematic literature search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO in July 2021. Included studies had to: (i) target one or both parents with at least one child (0-3 years), (ii) aim to improve diet and physical activity, and (iii) report on diet and physical activity outcomes. Intervention context, delivery, and outcomes were extracted, and behavior change techniques were coded. A program theory was developed, and context-mechanism-outcome configurations were identified. In total, 17 interventions reported in 28 studies (19 effectiveness studies; nine protocols) were included. Nine interventions showed small improvements: in diet (n = 5), physical activity (n = 2), or both (n = 2) in mothers. The realist synthesis revealed three strategies to improve health behaviors: (1) using knowledge and role modelling to improve family dynamics, (2) providing various home-based activities to change home environment, and (3) offering flexible delivery, for example, phone or website-based to increase social support. Future interventions for parents with small children should consider involving the whole family, focusing on home-based and practical components, and offering various delivery modes. The protocol for the systematic review and realist synthesis was registered in Research Registry (registration ID: reviewregistry860) March 30th, 2020.
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Affiliation(s)
- Anne Timm
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Larke Joenck
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | | | - Dorte Moeller Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ole Norgaard
- Department of Education, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Helle Terkildsen Maindal
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
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A Reliable and Valid Parent Self-Report Tool to Assess Children's Global Health Needs. J Pediatr Nurs 2021; 56:e35-e41. [PMID: 32773207 DOI: 10.1016/j.pedn.2020.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE This study aimed to develop and validate a parent self-report questionnaire to explore global health needs in 2- to 6-year-old children. DESIGN AND METHODS The development of the tool started with a conceptualization phase, followed by the design, pilot testing and psychometric validation of the questionnaire. The construct validity was assessed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out to explore the construct validity of the questionnaire. The normed fit index (NFI), root mean square error of approximation (RMSEA), chi square test and comparative fit index (CFI) were used to test the goodness-of-fit. Reliability was explored through Cronbach's alpha for internal consistency. RESULTS A total of 973 parents completed the 119 items of the Necesidades de salud de la Población Infantil (NPI) questionnaire for the psychometric validation stage. The EFA identified seven factors: Lifestyles, Promotion of healthy lifestyles and influence of significant persons, Children's socioemotional aspects, Parents' socioemotional aspects, Parental self-efficacy, Situational influences, Professional advice. All the factors showed good internal consistency (Cronbach's alpha >0.7). The CFA showed good adjustment to the model (RMSEA = 0.048). The values of NFI and CFI were 0.741 and 0.779 respectively. CONCLUSIONS The NPI questionnaire is a reliable and valid instrument. PRACTICE IMPLICATIONS The seven-factor questionnaire will be useful for analyzing children's global health needs, designing health promotion programs according to identified needs and assessing related interventions.
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Blitstein JL, Guthrie JF, Rains C. Low-Income Parents' Use of Front-of-Package Nutrition Labels in a Virtual Supermarket. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:850-858. [PMID: 32475704 DOI: 10.1016/j.jneb.2020.04.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To examine the impact front-of-package nutrition labels (FOPLs) have on decision-making abilities among low-income parents in a virtual supermarket. DESIGN A 4-by-2 experimental design with 3 FOPLs (summary, nutrient-specific, hybrid) and a no-FOPL comparison. Within the FOPL condition, participants either shopped with a time limit (10 minutes) or with no time limit. SETTING A web-based, 3-dimensional virtual supermarket. PARTICIPANTS Parents (n = 1,452) from low-income households with at least 1 child aged 4-12 years. MAIN OUTCOMES MEASURED Index derived from the United Kingdom's Nutrient Profiling Model that summarized the overall nutrient profile of the participant's shopping basket. ANALYSIS Analysis of covariance with post hoc estimations (pairwise) of condition means adjusted for multiple comparisons. RESULTS All FOPLs led to healthier nutrient profiles than the no-FOPL condition (P < .001). Simple FOPLs (ie, summary, hybrid) led to healthier nutrient profiles than nutrient-specific FOPLs (P = .02 and P < .001, respectively). Among parents exposed to simple FOPLs, those under time pressure made less healthy choices than those who were not under time pressure (P = .05 and P = .03, respectively). Time pressure did not affect parents exposed to nutrient-specific FOPLs (P = .69). CONCLUSIONS AND IMPLICATIONS Front-of-package nutrition labels can aid parents in selecting healthier products. Simple FOPLs provide greater utility for selecting healthier products than FOPLs that present an array of nutrient information. Time pressure can influence how parents interact with different types of label information.
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Affiliation(s)
| | - Joanne F Guthrie
- Economic Research Service, US Department of Agriculture, Washington, DC
| | - Caroline Rains
- Public Health Research Division, RTI International, Research Triangle Park, NC
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Zarychta K, Banik A, Kulis E, Boberska M, Radtke T, Chan CKY, Lobczowska K, Luszczynska A. Do Parent-Child Dyads with Excessive Body Mass Differ from Dyads with Normal Body Mass in Perceptions of Obesogenic Environment? Nutrients 2020; 12:nu12072149. [PMID: 32707698 PMCID: PMC7400889 DOI: 10.3390/nu12072149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 11/16/2022] Open
Abstract
Background: This study addressed differences between parent–child dyads with excessive body mass (overweight or obesity) and dyads with normal body mass in obesity determinants, derived from social-ecological models. It was hypothesized that parents and their 5–11 years-old children with excessive body mass would (1) report lower availability of healthy food at home, (2) perceive fewer school/local community healthy eating promotion programs, (3) report lower persuasive value of food advertising. Methods: Data were collected twice (T1, baseline; T2, 10-month follow-up), including n = 129 parent–child dyads with excessive body mass and n = 377 parent–child dyads with normal body mass. Self-reported data were collected from parents and children; with body weight and height assessed objectively. General linear models (including analysis of variance with repeated measures) were performed to test the hypotheses. Results: Compared to dyads with normal body mass, dyads of parents and children with excessive body mass perceived lower availability of healthy food at home and fewer healthy eating promotion programs at school/local community (T1 and T2). These effects remained significant after controlling for sociodemographic variables. No significant differences in persuasive value of food advertising were found. Conclusions: Perceptions of availability of healthy food at home and healthy nutrition promotion may be relatively low in parent–child dyads with excessive weight which, in turn, may constitute a risk factor for maintenance of obesity.
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Affiliation(s)
- Karolina Zarychta
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, 53-238 Wroclaw, Poland; (A.B.); (E.K.); (M.B.); (K.L.)
- Correspondence: (K.Z.); (A.L.)
| | - Anna Banik
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, 53-238 Wroclaw, Poland; (A.B.); (E.K.); (M.B.); (K.L.)
| | - Ewa Kulis
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, 53-238 Wroclaw, Poland; (A.B.); (E.K.); (M.B.); (K.L.)
| | - Monika Boberska
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, 53-238 Wroclaw, Poland; (A.B.); (E.K.); (M.B.); (K.L.)
| | - Theda Radtke
- School of Psychology and Psychotherapy, Witten/Herdecke University, 58456 Witten, Germany;
| | - Carina K. Y. Chan
- School of Psychology and Public Health, La Trobe University, Flora Hill, VIC 3550, Australia;
| | - Karolina Lobczowska
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, 53-238 Wroclaw, Poland; (A.B.); (E.K.); (M.B.); (K.L.)
| | - Aleksandra Luszczynska
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, 53-238 Wroclaw, Poland; (A.B.); (E.K.); (M.B.); (K.L.)
- Trauma, Health, & Hazards Center, University of Colorado at Colorado Springs, Colorado Springs, CO 80918, USA
- Correspondence: (K.Z.); (A.L.)
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Association between food availability and young people's fruits and vegetables consumption: understanding the mediation role of the theory of planned behaviour. Public Health Nutr 2020; 23:2155-2164. [PMID: 32450936 DOI: 10.1017/s1368980019005263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the relationship between fruits and vegetables (F&V) availability at home and young people's F&V consumption behaviour, and how the theory of planned behaviour (TPB) constructs could potentially mediate the relationship. DESIGN Cross-sectional face-to-face survey questionnaire to assess the TPB constructs and home food availability assessed using open inventories method. F&V availability was categorised into low and high levels based on median split. SETTING Singapore. PARTICIPANTS Two hundred and ten households (each consisting one parent-child pair) recruited via stratified cluster sampling with child participants ranging from 9 to 16 years of age. RESULTS Mediation analyses were conducted using structural equation modelling. The relationship between home F&V availability and F&V consumption behaviour did not have a significant direct association, but there were significant indirect effects through the routes of perceived behavioural control (PBC) and intention as well as attitude and intention. Specifically, higher level of F&V availability at home was related to more positive PBC and attitude towards F&V, and subsequently greater intention to consume F&V and higher consumption of F&V. CONCLUSIONS Parents should make F&V more readily available at home as increased exposure to F&V could be related to enhanced liking, sense of control and intention to consume F&V and facilitate children's healthy diet.
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McAtee JR, Tao MH, King C, Chai W. Association of Home Food Availability with Prediabetes and Diabetes among Adults in the United States. Nutrients 2020; 12:nu12051209. [PMID: 32344821 PMCID: PMC7281998 DOI: 10.3390/nu12051209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 11/16/2022] Open
Abstract
This study examined associations of home food availabilities with prediabetes and diabetes among 8929 adults (20–70 years) participating in 2007–2010 National Health and Nutrition Examination Surveys. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression. Relative to non-diabetic participants (individuals without diabetes or prediabetes), prediabetes participants were associated with lower availabilities of green vegetables (OR = 0.82; 95% CI = 0.73–0.91; p = 0.0006) and fat-free/low-fat milk (OR = 0.80, 95% CI = 0.65–0.89; p = 0.001) and higher sugary drink availability (OR = 1.24, 95% CI = 1.04–1.48; p = 0.02), adjusting for age, sex, and ethnicity (Model 1). The associations remained significant for vegetables (p = 0.005) and fat-free/low-fat milk (p = 0.02) adjusting for additional confounders (body mass index, education, Model 2). Adjusting for dietary components did not change the above results (in model 2) significantly. Participants with high healthy food availability scores had approximately 31% reduction (p = 0.003) in odds of prediabetes compared to those with low scores in Model 1. No associations were detected for diabetes except for fat-free/low-fat milk availability, for which an inverse association was observed in Model 1 (OR = 0.80, 95% CI = 0.65–0.99; p = 0.04). The results show prediabetes participants had lower availability of healthy foods and higher availability of unhealthy foods, suggesting the need to improve healthy food availability at home for this population.
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Affiliation(s)
- Jennifer R. McAtee
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 1700 N 35th Street, Lincoln, NE 68583, USA;
| | - Meng-Hua Tao
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard., Fort Worth, TX 76107, USA;
| | - Christian King
- Department of Health Management and Informatics, University of Central Florida, 500 W Livingston Street, Suite 402G, Orlando, FL 32801, USA;
| | - Weiwen Chai
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 1700 N 35th Street, Lincoln, NE 68583, USA;
- Correspondence: ; Tel.: +1-402-472-7822
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14
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Carr KA, Epstein LH. Choice is relative: Reinforcing value of food and activity in obesity treatment. AMERICAN PSYCHOLOGIST 2020; 75:139-151. [PMID: 32052990 PMCID: PMC7313531 DOI: 10.1037/amp0000521] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Persons with obesity find high-energy-dense food and sedentary behaviors highly reinforcing. Diets and exercise programs deprive individuals of many favorite foods and activities, which can counterproductively heighten their value and lead to relapse. Since the value of reinforcers depend on the alternatives available, one approach to reducing food and sedentary activity reinforcement is to build healthy alternative reinforcers. Current behavioral treatment programs for children and adults do not attempt to build alternative reinforcers as substitutes for unhealthy behaviors to reduce the impact of food or activity deprivation on the motivation to eat or be inactive. A goal of the next generation of obesity treatment programs should focus on development of healthy behaviors as reinforcers so that people will be motivated to engage in them. This article provides an overview of relationships among reinforcers, how understanding substitutes and complements can influence eating and activity, and how enriching a person's environment and providing choice architecture can enhance weight control. Ideas for translation of these basic behavioral economic principles to obesity treatment programs are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Katelyn A Carr
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
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15
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Stark LJ, Filigno SS, Kichler JC, Bolling C, Ratcliff MB, Robson SM, Simon SL, McCullough MB, Clifford LM, Stough CO, Zion C, Mara CA. Maintenance Following a Randomized Trial of a Clinic and Home-based Behavioral Intervention of Obesity in Preschoolers. J Pediatr 2019; 213:128-136.e3. [PMID: 31230889 PMCID: PMC6765427 DOI: 10.1016/j.jpeds.2019.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/26/2019] [Accepted: 05/02/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess maintenance of improved weight outcomes in preschoolers with obesity 6 and 12 months following a randomized clinical trial comparing a home- and clinic-based behavioral intervention (Learning about Activity and Understanding Nutrition for Child Health [LAUNCH]) to motivational interviewing and standard care. STUDY DESIGN Randomized controlled trial with children between the ages of 2 and 5 years above the 95th percentile for body mass index for age and sex recruited from 27 pediatrician offices across 10 recruitment cycles between March 12, 2012, and June 8, 2015, were followed 6 and 12 months post-treatment. Child and caregiver weight, height, and caloric intake, child physical activity, and home environment were assessed. The primary outcome was maintenance of greater reduction of percent over the 50th percentile body mass index (BMI%50th) by LAUNCH compared with motivational interviewing and standard care at the 6- and 12-month follow-up. RESULTS Significantly lower child BMI%50th was maintained for LAUNCH compared with motivational interviewing at 12-month follow-up and to standard care at the 6-month follow-up; however, the effect sizes were maintained for comparison with standard care at 12-month follow-up. LAUNCH had significantly lower daily caloric intake compared with motivational interviewing and standard care at both follow-ups and maintained significantly fewer high-calorie foods in the home compared with standard care at 6 and 12 months and compared with motivational interviewing at 12 months. However, caloric intake increased by 12% from post-treatment. LAUNCH caregivers did not maintain improved BMI at follow-up. CONCLUSIONS LAUNCH showed success in reducing weight in preschoolers. However, maintaining treatment gains post-treatment is more difficult. Treatment may need to last longer than 6 months to achieve optimal results. TRIAL REGISTRATION Clinicaltrials.gov: NCT01546727.
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Affiliation(s)
- Lori J. Stark
- Department of Pediatrics, Division of Behavioral Medicine
and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and
University of Cincinnati College of Medicine, Cincinnati, OH
| | - Stephanie Spear Filigno
- Department of Pediatrics, Division of Behavioral Medicine
and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and
University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jessica C. Kichler
- Department of Pediatrics, Division of Behavioral Medicine
and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and
University of Cincinnati College of Medicine, Cincinnati, OH
| | | | | | - Shannon M. Robson
- Department of Behavioral Health and Nutrition, University
of Delaware, Newark, Delaware
| | - Stacey L. Simon
- Department of Pediatrics, Division of Pulmonary Medicine,
Children’s Hospital Colorado, Aurora, CO
| | | | - Lisa M. Clifford
- Department of Pediatrics, Division of Behavioral Medicine
and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and
University of Cincinnati College of Medicine, Cincinnati, OH
| | | | - Cynthia Zion
- Department of Pediatrics, Division of Behavioral Medicine
and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and
University of Cincinnati College of Medicine, Cincinnati, OH
| | - Constance A. Mara
- Department of Pediatrics, Division of Behavioral Medicine
and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and
University of Cincinnati College of Medicine, Cincinnati, OH
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16
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Odar Stough C, McCullough MB, Robson SL, Bolling C, Spear Filigno S, Kichler JC, Zion C, Clifford LM, Simon SL, Ittenbach RF, Stark LJ. Are Preschoolers Meeting the Mark? Comparing the Dietary, Activity, and Sleep Behaviors of Preschoolers With Obesity to National Recommendations. J Pediatr Psychol 2019; 43:452-463. [PMID: 29048553 DOI: 10.1093/jpepsy/jsx130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/30/2017] [Indexed: 01/10/2023] Open
Abstract
Objective National health organizations and expert committees have issued recommendations for health behaviors related to obesity risk. Behavioral and family-based weight management interventions for preschoolers often target improving adherence to these recommendations, but it is unknown how the health behaviors of preschoolers with obesity enrolled in weight control treatments (WCTs) compare with these guidelines. In this study, the dietary intake, activity, and sleep behaviors of preschoolers with obesity enrolled in a family-based behavioral WCT are described and compared with national health behavior recommendations. Methods Health behaviors of 151 preschoolers with obesity (M age = 4.60, SD = 0.93) enrolled in a clinical trial of a weight management program were measured at baseline through caregiver-report questionnaires, three 24-hr dietary recalls, and accelerometers. Results In total, 70% of the sample exceeded daily caloric recommendations, only 10 and 5% met recommendations for fruit and vegetable intake, respectively, and only 30% met the recommendation of consuming no sugar-sweetened beverages. The majority of the sample met the daily recommendations for 60 min of moderate-to-vigorous activity (80%), < 2 hr of screen time (68%), and sleep duration (70%). Conclusions Behavioral weight management interventions for preschoolers with obesity should target the health behaviors where children are not meeting recommendations.
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Affiliation(s)
| | - Mary Beth McCullough
- Department of Psychiatry and Human Behavior, Hasbro Children's Hospital/Alpert Medical School of Brown University
| | - Shannon L Robson
- Department of Behavioral Health and Nutrition, University of Delaware
| | | | - Stephanie Spear Filigno
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine
| | - Jessica C Kichler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine
| | - Cynthia Zion
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Lisa M Clifford
- Department of Clinical and Health Psychology, University of Florida
| | - Stacey L Simon
- Department of Pediatrics, Division of Pulmonary Medicine, Children's Hospital Colorado
| | - Richard F Ittenbach
- Department of Pediatrics, University of Cincinnati College of Medicine.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center
| | - Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine
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17
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Bekelman TA, Bellows LL, Clark L, Thompson DA, Kemper G, McCloskey ML, Johnson SL. An Ecocultural Perspective on Eating-Related Routines Among Low-Income Families With Preschool-Aged Children. QUALITATIVE HEALTH RESEARCH 2019; 29:1345-1357. [PMID: 30499371 PMCID: PMC6538438 DOI: 10.1177/1049732318814540] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Eating-related routines, such as regular mealtimes, can protect against obesity. Little is known about eating-related routines among preschoolers or the factors that shape those routines. Ecocultural Theory and qualitative interviews with 30 caregivers of preschoolers in Colorado were used to describe eating-related routines at home and parents' perspectives on the factors that shape routines. Qualitative content analysis was used to analyze and interpret data. Consistent with clinical recommendations, parents' goals included dinner meals where adults and preschoolers eat the same food, in the same place, at the same time. However, parents' employment schedules and challenges in managing preschoolers' behavior prevented parents from consistently enacting recommended routines. Educating parents alone may not be sufficient to ensure optimal eating-related routines among preschoolers, and the household context needs to be considered. Families organized routines according to cultural values and available resources.
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Affiliation(s)
- Traci A Bekelman
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Lauren Clark
- 3 The University of Utah, Salt Lake City, Utah, USA
| | - Darcy A Thompson
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Geri Kemper
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Susan L Johnson
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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18
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Nepper MJ, McAtee JR, Wheeler L, Chai W. Mobile Phone Text Message Intervention on Diabetes Self-Care Activities, Cardiovascular Disease Risk Awareness, and Food Choices among Type 2 Diabetes Patients. Nutrients 2019; 11:E1314. [PMID: 31212683 PMCID: PMC6627048 DOI: 10.3390/nu11061314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/29/2019] [Accepted: 05/08/2019] [Indexed: 11/13/2022] Open
Abstract
This study examines the effects of educational text messages on diabetes self-care activities, cardiovascular disease (CVD) risk awareness, and home food availabilities related to food choices among patients with type 2 diabetes. Quasi-experimental design was used with 40 patients (58.0 ± 10.6 years) in the intervention group and 39 (55.7 ± 12.2 years) in the control group. In addition to the usual care provided for all participants, the intervention group received three educational text messages weekly for 12 weeks. Pre- and post-intervention measures were collected for both groups. Ninety-four percent of the participants receiving text messages indicated the usefulness of this program. The intervention group either maintained the same level or demonstrated small improvements in diabetes self-care activities after the intervention. Significant increases in scores of CVD risk awareness (57% increase; p = 0.04) and availabilities of fresh fruits (320% increase; p = 0.01) and fresh vegetables (250% increase; p = 0.02) in the home and weekly total (16% increase; p = 0.02) and moderate/vigorous (80% increase; p = 0.006) physical activity levels were observed for the intervention group relative to the control group. The pilot results suggest the feasibility and usefulness of the text message program for diabetes education. The study is registered with Clinical Trials.gov (NCT03039569).
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Affiliation(s)
- Martha J Nepper
- Nebraska Methodist Health System, 8111 Dodge Street, Omaha, NE 68114, USA.
| | - Jennifer R McAtee
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 1700 N 35th Street, Lincoln, NE 68583, USA.
| | - Lorey Wheeler
- Nebraska Academy for Methodology, Analytics & Psychometrics, Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska-Lincoln, Lincoln, NE 68583, USA.
| | - Weiwen Chai
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 1700 N 35th Street, Lincoln, NE 68583, USA.
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19
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Nurturing Children's Healthy Eating: Position statement. Appetite 2019; 137:124-133. [DOI: 10.1016/j.appet.2019.02.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 12/14/2022]
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20
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Boles RE, Johnson SL, Burdell A, Davies PL, Gavin WJ, Bellows LL. Home food availability and child intake among rural families identified to be at-risk for health disparities. Appetite 2019; 134:135-141. [DOI: 10.1016/j.appet.2018.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/28/2018] [Accepted: 12/07/2018] [Indexed: 01/28/2023]
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21
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Robson SM, Ziegler ML, McCullough MB, Stough CO, Zion C, Simon SL, Ittenbach RF, Stark LJ. Changes in diet quality and home food environment in preschool children following weight management. Int J Behav Nutr Phys Act 2019; 16:16. [PMID: 30717746 PMCID: PMC6360745 DOI: 10.1186/s12966-019-0777-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 01/30/2019] [Indexed: 01/21/2023] Open
Abstract
Background Family-based obesity treatment interventions can successfully reduce energy intake in preschoolers. An implicit goal of obesity treatment interventions is to improve diet quality, but diet quality has been less examined as a treatment outcome in studies of preschoolers. The purpose of this study was to conduct a secondary analysis comparing the change in diet quality and home food environment in preschoolers assigned to a behavioral family-based obesity intervention (LAUNCH), motivational interviewing (MI) condition, or standard care (STC) condition. Methods Three 24-h dietary recalls were completed at baseline and 6-months and were analyzed using NDS-R software; diet quality was assessed using the Healthy Eating Index-2010 (HEI-2010). Availability of foods and beverages in the home was assessed through direct observation using the Home Health Environment tool that classifies foods and beverages as ‘red’ or ‘green’ based upon fat and sugar content. Repeated measures linear mixed effects models were used to examine changes in diet quality and home food environment between conditions (LAUNCH, MI, STC). Results At 6-months, preschoolers in the LAUNCH condition had a higher HEI-2010 total score (62.8 ± 13.7) compared to preschoolers in the MI (54.7 ± 13.4, P = 0.022) and STC (55.8 ± 11.6, P = 0.046) conditions. Regarding the home food environment, families in LAUNCH had significantly less ‘red’ foods in their home at 6-months (12.5 ± 3.4 ‘red’ foods) compared to families in MI (14.0 ± 3.7 ‘red’ foods, P = 0.030), and STC (14.3 ± 3.4 ‘red’ foods, P = 0.006). There were no statistically significant differences across home food environments for number of ‘green’ foods. Conclusion Family-based obesity treatment interventions for preschoolers can improve overall diet quality and alter the home food environment through reductions in ‘red’ foods. Trial registration Clinicaltrials.gov, NCT01546727. Registered March 7, 2012.
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Affiliation(s)
- Shannon M Robson
- Department of Behavioral Health and Nutrition, University of Delaware, 26 N College Avenue, Newark, DE, 19716, USA.
| | - Melissa L Ziegler
- Biostatistics Core, College of Health Sciences, University of Delaware, 540 S. College Avenue, Newark, DE, 19713, USA
| | - Mary Beth McCullough
- Psychology Department, Suffolk University, 73 Tremont Street, Boston, MA, 02108, USA
| | - Cathleen Odar Stough
- Department of Psychology, University of Cincinnati, 47 W Corry Blvd Edwards 1 Bldg Suite 4130, P.O. Box 210376, Cincinnati, OH, 45219, USA
| | - Cynthia Zion
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 3015, Cincinnati, OH, 45229, USA
| | - Stacey L Simon
- Department of Pediatrics, Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13123 E 16th Ave B395 Aurora, Aurora, CO, 80045, USA
| | - Richard F Ittenbach
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 5041, Cincinnati, OH, 45229, USA
| | - Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 3015, Cincinnati, OH, 45229, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA
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22
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Salvy SJ, Dutton GR, Borgatti A, Kim YI. Habit formation intervention to prevent obesity in low-income preschoolers and their mothers: A randomized controlled trial protocol. Contemp Clin Trials 2018; 70:88-98. [PMID: 29802965 PMCID: PMC6060620 DOI: 10.1016/j.cct.2018.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Low-income and racial/ethnic minority mothers and their young children are at increased risk for obesity. Lack of access to evidence-based obesity prevention and treatment services further contributes to these disparities. METHODS This two-arm, parallel, randomized controlled trial (RCT) tests the effectiveness of a simple obesity intervention (HABITS) delivered as part of ongoing home visitation services, compared to the existing home visitation services without obesity-related content on mothers' and children's obesity risks. HABITS focuses on habit formation and modifications of food and activity cues in the home to support habit formation. Habit formation is focused on improving five behaviors: 1) fruits/vegetables, 2) fried foods, 3) sugar-sweetened beverages, 4) physical activity and 5) self-monitoring. Participants will be 298 mothers (>50% African American; 100% low income) and their children (3-5yo at baseline) enrolled in a home visitation program in central Alabama. Home visitors will be randomly assigned to deliver the home visitation curriculum with or without HABITS as part of their weekly home visits for 9 months. Assessments of mothers (weight, waist circumference, and habit strength of targeted behaviors), children (rate of weight gain), and the food/activity household environment will be conducted at enrollment, post-intervention (9 month), and one year post-intervention follow-up. DISCUSSION This research is poised to have a substantial impact because the delivery modalities of current obesity efforts disproportionally restrict the reach and engagement of underserved, low-income children and their caregivers who are most at-risk for health and obesity disparities.
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Affiliation(s)
- Sarah-Jeanne Salvy
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 616, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| | - Gareth R Dutton
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 615, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| | - Alena Borgatti
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 640, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| | - Young-Il Kim
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 616, 1717 11th Avenue South, Birmingham, AL 35205, United States.
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23
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Markowska M, Przychodni AM, Nowak-Starz G, Cieśla E. The frequency of overweight and obesity occurrence among Polish children (age 6–7 years) in relation to the place of residence, the education level of parents and the number children in the family. ANTHROPOLOGICAL REVIEW 2017. [DOI: 10.1515/anre-2017-0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
This study sought to evaluate the number of those overweight and the rate of obesity among 6- and 7-year-olds living in Poland with regard to their place of residence, the parental level of education and the number of children in the family. The analysis was based on a survey of 64 544 children (33 051 boys and 31 493 girls) living in Poland. Overweight and obesity were defined based on body mass index (BMI) using the IOTF cut-off points. To evaluate the rates of overweight and obesity occurrence in children with regard to family socio-economic status, parental level of education, the number of children in the family, and the place of residence (divided into city and village) was used. ‘Only children’ were the most likely group to be overweight or obese. These children were twice as likely to be obese as their peers living in families with four or more children. Overweight and obesity occurred more often amongst children living in cities rather than those living in rural areas. Moreover, these conditions were more frequent among children whose parents had higher levels of education. The most significant predictors of childhood overweight and obesity were the number of children in the family and the educational level of the mother
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Affiliation(s)
| | | | | | - Elżbieta Cieśla
- Faculty of Health Sciences, Jan Kochanowski University in Kielce , Poland
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24
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Abstract
Habits are largely absent from modern social and personality psychology. This is due to outdated perspectives that placed habits in conflict with goals. In modern theorizing, habits are represented in memory as implicit context–response associations, and they guide responding in conjunction with goals. Habits thus have important implications for our field. Emerging research shows that habits are an important mechanism by which people self-regulate and achieve long-term goals. Also, habits change through specific interventions, such as changes in context cues. I speculate that understanding of habits also holds promise for reducing intergroup discrimination and for understanding lay theories of the causes for action. In short, by recognizing habit, the field gains understanding of a central mechanism by which actions persist in daily life.
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Affiliation(s)
- Wendy Wood
- University of Southern California, Los Angeles, USA
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25
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Best M, Papies EK. Right Here, Right Now: Situated Interventions to Change Consumer Habits. ACTA ACUST UNITED AC 2017. [DOI: 10.1086/695443] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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26
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Are Family Routines Modifiable Determinants of Preschool Children’s Eating, Dietary Intake, and Growth? A Review of Intervention Studies. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0207-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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27
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Roberts JD, Rodkey L, Ray R, Knight B, Saelens BE. Electronic media time and sedentary behaviors in children: Findings from the Built Environment and Active Play Study in the Washington DC area. Prev Med Rep 2017; 6:149-156. [PMID: 28316911 PMCID: PMC5350570 DOI: 10.1016/j.pmedr.2017.02.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/15/2017] [Accepted: 02/18/2017] [Indexed: 11/04/2022] Open
Abstract
An objective of the Built Environment and Active Play (BEAP) Study was to examine whether home built environment, bedroom electronic presence, parental rules and demographics predicted children's sedentary behavior (SB). In 2014, BEAP Study questionnaires were mailed to 2000 parents of children (7–12 years) within the Washington DC area. SB-Duration (hours/day) and SB-Frequency (days/week) were assessed by two questions with multiple subparts relating to SB activity type (e.g. car riding) and SB companionship (e.g. friends). Built environment, bedroom electronic presence, parental rules and demographic data were obtained through questionnaire items and ordered logistic regression models were used to examine whether these variables were associated with SB. Study sample included 144 children (female (50%); average age (9.7 years); White (56.3%); Black/African-American (23.7%); Asian-Americans (10.4%)). Nearly 40% of the sample reported daily solitary SB with car riding being the most frequently reported type of SB. Children living on streets without a dead-end/cul-de-sac exhibited a higher odds in SB-Duration using electric media [2.61 (CI: 1.31, 5.18)] and having no television in a child's bedroom was associated with a lower odds in SB-Frequency [0.048 (CI: 0.006, 0.393)] and SB-Duration [0.085 (CI: 0.018, 0.395)]. Non-Hispanic/Latino children were also found to have higher odds in solitary SB-Frequency when parental rules of electronic use were modeled [8.56 (CI: 1.11, 66.01)]. Based on results from this cross-sectional study, home neighborhood built environment, bedroom electronic presence and absence of parental rules can significantly predict children's SB. Children living on streets without dead-end/cul-de-sac exhibited sedentary behavior. Car riding most frequently reported type of daily sedentary behavior. Bedroom electronics and lack of parental rules associated with sedentary behavior.
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Affiliation(s)
- Jennifer D Roberts
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Lindsey Rodkey
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Rashawn Ray
- Department of Sociology, University of Maryland, College Park, MD, USA
| | - Brandon Knight
- Department of Preventive Medicine and Biometrics, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Brian E Saelens
- Department of Pediatrics, University of Washington, Seattle, WA, USA; Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA
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Gebremariam MK, Vaqué-Crusellas C, Andersen LF, Stok FM, Stelmach-Mardas M, Brug J, Lien N. Measurement of availability and accessibility of food among youth: a systematic review of methodological studies. Int J Behav Nutr Phys Act 2017; 14:22. [PMID: 28196495 PMCID: PMC5309994 DOI: 10.1186/s12966-017-0477-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 02/03/2017] [Indexed: 11/10/2022] Open
Abstract
Background Comprehensive and psychometrically tested measures of availability and accessibility of food are needed in order to explore availability and accessibility as determinants and predictors of dietary behaviors. The main aim of this systematic review was to update the evidence regarding the psychometric properties of measures of food availability and accessibility among youth. A secondary objective was to assess how availability and accessibility were conceptualized in the included studies. Methods A systematic literature search was conducted using Medline, Embase, PsycINFO and Web of Science. Methodological studies published between January 2010 and March 2016 and reporting on at least one psychometric property of a measure of availability and/or accessibility of food among youth were included. Two reviewers independently extracted data and assessed study quality. Existing criteria were used to interpret reliability and validity parameters. Results A total of 20 studies were included. While 16 studies included measures of food availability, three included measures of both availability and accessibility; one study included a measure of accessibility only. Different conceptualizations of availability and accessibility were used across the studies. The measures aimed at assessing availability and/or accessibility in the home environment (n = 11), the school (n = 4), stores (n = 3), childcare/early care and education services (n = 2) and restaurants (n = 1). Most studies followed systematic steps in the development of the measures. The most common psychometrics tested for these measures were test-retest reliability and criterion validity. The majority of the measures had satisfactory evidence of reliability and/or validity. None of the included studies assessed the responsiveness of the measures. Conclusions The review identified several measures of food availability or accessibility among youth with satisfactory evidence of reliability and/or validity. Findings indicate a need for more studies including measures of accessibility and addressing its conceptualization. More testing of some of the identified measures in different population groups is also warranted, as is the development of more measures of food availability and accessibility in the broader environment such as the neighborhood food environment.
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Affiliation(s)
- Mekdes K Gebremariam
- Department of Nutrition, Faculty of Medicine, University of Oslo, PO Box 1046, Blindern, N-0316, Oslo, Norway.
| | - Cristina Vaqué-Crusellas
- Faculty of Health Science and Wellbeing, University of Vic-University Central of Catalonia, Barcelona, Spain
| | - Lene F Andersen
- Department of Nutrition, Faculty of Medicine, University of Oslo, PO Box 1046, Blindern, N-0316, Oslo, Norway
| | - F Marijn Stok
- Department of Psychological Assessment and Health Psychology, University of Konstanz, Konstanz, Germany
| | - Marta Stelmach-Mardas
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Johannes Brug
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, PO Box 1046, Blindern, N-0316, Oslo, Norway
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Stark LJ, Filigno SS, Bolling C, Ratcliff MB, Kichler JC, Robson SL, Simon SL, McCullough MB, Clifford LM, Stough CO, Zion C, Ittenbach RF. Learning about Activity and Understanding Nutrition for Child Health (LAUNCH): Rationale, design, and implementation of a randomized clinical trial of a family-based pediatric weight management program for preschoolers. Contemp Clin Trials 2017; 52:10-19. [PMID: 27777128 PMCID: PMC6309338 DOI: 10.1016/j.cct.2016.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/12/2016] [Accepted: 10/18/2016] [Indexed: 11/22/2022]
Abstract
Obesity affects nearly 2 million preschool age children in the United States and is not abating. However, research on interventions for already obese preschoolers is limited. To address this significant gap in the literature, we developed an intervention targeting obesity reduction in 2 to 5year olds, Learning about Activity and Understanding Nutrition for Child Health (LAUNCH). This paper describes the rationale, design, participant enrollment, and implementation of a 3-arm randomized, parallel-group clinical trial comparing LAUNCH to a motivational-interviewing intervention (MI) and standard care (STC), respectively. Whereas LAUNCH was designed as a skills based intervention, MI focused on addressing the guardian's motivation to make changes in diet and activity and providing tools to do so at the guardian's level of readiness to implement changes. Child body mass index z-score was the primary outcome, assessed at pretreatment, posttreatment (Month 6), and 6 and 12month follow-ups (Months 12 and 18). Mechanisms of weight change (e.g., dietary intake, physical activity) and environmental factors associated with weight (e.g., foods available in the home, caregiver diet) were also assessed. This study is unique because it is one of the few randomized controlled trials to examine a developmentally informed, clinic and home skills based behavioral family intervention for preschoolers who are already obese. Being obese during the preschool years increases the likelihood of remaining obese as an adult and is associated with serious health conditions; if this intervention is successful, it has the potential to change the health trajectories for young children with obesity.
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Affiliation(s)
- Lori J Stark
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States.
| | - Stephanie Spear Filigno
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | | | | | - Jessica C Kichler
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Shannon L Robson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States
| | - Stacey L Simon
- Department of Pediatrics, Division of Pulmonary Medicine, Children's Hospital Colorado, Aurora, CO, United States
| | - Mary Beth McCullough
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Lisa M Clifford
- Department of Clinical and Health Psychology, University of Florida, United States
| | - Cathleen O Stough
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Cynthia Zion
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Richard F Ittenbach
- Department of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Boles RE, Halbower AC, Daniels S, Gunnarsdottir T, Whitesell N, Johnson SL. Family Chaos and Child Functioning in Relation to Sleep Problems Among Children at Risk for Obesity. Behav Sleep Med 2017; 15:114-128. [PMID: 26745822 PMCID: PMC4938783 DOI: 10.1080/15402002.2015.1104687] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study evaluated the influence of child and family functioning on child sleep behaviors in low-income minority families who are at risk for obesity. A cross-sectional study was utilized to measure child and family functioning from 2013 to 2014. Participants were recruited from Head Start classrooms while data were collected during home visits. A convenience sample of 72 low-income Hispanic (65%) and African American (32%) families of preschool-aged children were recruited for this study. We assessed the association of child and family functioning with child sleep behaviors using a multivariate multiple linear regression model. Bootstrap mediation analyses examined the effects of family chaos between child functioning and child sleep problems. Poorer child emotional and behavioral functioning related to total sleep behavior problems. Chaos associated with bedtime resistance significantly mediated the relationship between Behavioral and Emotional Screening System (BESS) and Bedtime Resistance. Families at high risk for obesity showed children with poorer emotional and behavioral functioning were at higher risk for problematic sleep behaviors, although we found no link between obesity and child sleep. Family chaos appears to play a significant role in understanding part of these relationships. Future longitudinal studies are necessary to establish causal relationships between child and family functioning and sleep problems to further guide obesity interventions aimed at improving child sleep routines and increasing sleep duration.
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31
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Stanhope KK, Kay C, Stevenson B, Gazmararian JA. Measurement of obesity prevention in childcare settings: A systematic review of current instruments. Obes Res Clin Pract 2016; 11:52-89. [PMID: 27377860 DOI: 10.1016/j.orcp.2016.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/26/2016] [Accepted: 06/11/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The incidence of childhood obesity is highest among children entering kindergarten. Overweight and obesity in early childhood track through adulthood. Programs increasingly target children in early life for obesity prevention. However, the published literature lacks a review on tools available for measuring behaviour and environmental level change in child care. The objective is to describe measurement tools currently in use in evaluating obesity-prevention in preschool-aged children. METHODS Literature searches were conducted in PubMed using the keywords "early childhood obesity," "early childhood measurement," "early childhood nutrition" and "early childhood physical activity." Inclusion criteria included a discussion of: (1) obesity prevention, risk assessment or treatment in children ages 1-5 years; and (2) measurement of nutrition or physical activity. RESULTS One hundred thirty-four publications were selected for analysis. Data on measurement tools, population and outcomes were abstracted into tables. Tables are divided by individual and environmental level measures and further divided into physical activity, diet and physical health outcomes. Recommendations are made for weighing advantages and disadvantages of tools. CONCLUSION Despite rising numbers of interventions targeting obesity-prevention and treatment in preschool-aged children, there is no consensus for which tools represent a gold standard or threshold of accuracy.
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Affiliation(s)
- Kaitlyn K Stanhope
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
| | - Christi Kay
- HealthMPowers, 3200 Pointe Pkwy NW # 400, Norcross, GA 30092, United States
| | - Beth Stevenson
- HealthMPowers, 3200 Pointe Pkwy NW # 400, Norcross, GA 30092, United States
| | - Julie A Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Towner EK, Clifford LM, McCullough MB, Stough CO, Stark LJ. Treating Obesity in Preschoolers: A Review and Recommendations for Addressing Critical Gaps. Pediatr Clin North Am 2016; 63:481-510. [PMID: 27261546 PMCID: PMC6246919 DOI: 10.1016/j.pcl.2016.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Developing interventions targeting obesity reduction in preschoolers is an emergent area. Although intensive, multicomponent interventions seem a promising approach to preschool obesity reduction, this review identifies and discusses approaches to 3 critical gaps (poor reach to families from low-income and minority backgrounds, lack of sufficient evidence to determine the most effective and efficient treatment components and approaches to treating obesity in early childhood, and lack of consensus on how best to discern intervention effectiveness) that need to be addressed to advance the preschool obesity literature.
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Affiliation(s)
- Elizabeth K Towner
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Wayne State University, IBio 6135 Woodward Avenue, H206, Detroit, MI 48202, USA.
| | - Lisa M Clifford
- Department of Clinical and Health Psychology, College of Public Health & Health Professions, University of Florida, P.O. Box 100165, Gainesville, FL 32610-0165, USA
| | - Mary Beth McCullough
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, MLC 7039, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA
| | - Cathleen Odar Stough
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, MLC 7039, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA
| | - Lori J Stark
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, MLC 3015, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA
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Validity and reliability of the semi-quantitative self-report Home Food Availability Inventory Checklist (HFAI-C) in White and South Asian populations. Int J Behav Nutr Phys Act 2016; 13:56. [PMID: 27146430 PMCID: PMC4857434 DOI: 10.1186/s12966-016-0381-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 04/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite interest in the importance of the home food environment and its potential influence on children's diets and social norms, there remain few self-report checklist methods that have been validated against the gold standard of researcher-conducted inventories. This study aimed to assess the criterion validity and reliability of the 'Home Food Availability Inventory Checklist' (HFAI-C), a 39-item checklist including categories of fruit, vegetables, snacks and drinks. METHODS The HFAI-C was completed by 97 participants of White and Pakistani origin in the UK. Validity was determined by comparing participant-reported HFAI-C responses to data from researcher observations of home food availability using PABAK and weighted kappa statistics. The validity of measuring the amount of items (in addition to presence/absence) available was also determined. Test-retest reliability compared repeated administrations of the HFAI-C using intra-class correlation coefficients. RESULTS Validity and reliability was fair to moderate overall. For validity, the average category-level PABAK ranged from 0.31 (95% CI: 0.25, 0.37) for vegetables to 0.44 (95% CI: 0.40, 0.49) for fruits. Assessment of the presence/absence of items demonstrated higher validity compared to quantity measurements. Reliability was increased when the HFAI-C was repeated close to the time of the first administration. For example, ICCs for reliability of the measurement of fruits were 0.52 (95%CI: 0.47, 0.56) if re-administered within 5 months, 0.58 (95% CI: 0.51, 0.64) within 30 days and 0.97 (95%CI: 0.94, 1.00) if re-administered on the same day. CONCLUSIONS Overall, the HFAI-C demonstrated fair to moderate validity and reliability in a population of White and South Asian participants. This evaluation is consistent with previous work on other checklists in less diverse, more affluent populations. Our research supports the use of the HFAI-C as a useful, albeit imperfect, representation of researcher-conducted inventories. The feasibility of collecting information using the HFAI-C in large, multi-ethnic samples can facilitate examination of home food availability in relation to exposures such as ethnicity and outcomes including behavioural, social and health outcomes. Future work using the HFAI-C could provide important insights into a modifiable influence with potential to impact health.
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Boles RE, Yun L, Hambidge SJ, Davidson A. Influencing the Home Food and Activity Environment of Families of Preschool Children Receiving Home-Based Treatment for Obesity. Clin Pediatr (Phila) 2015; 54:1387-90. [PMID: 25676834 PMCID: PMC4534366 DOI: 10.1177/0009922815570614] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Lourdes Yun
- Denver Public Health, Denver Health, Denver, CO, USA
| | - Simon J. Hambidge
- University of Colorado School of Medicine, Aurora, CO, USA,Denver Community Health Services, Denver Health, Denver, CO, USA
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35
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Amuta AO, Jacobs W, Idoko EE, Barry AE, McKyer ELJ. Influence of the Home Food Environment on Children's Fruit and Vegetable Consumption: A Study of Rural Low-Income Families. Health Promot Pract 2015; 16:689-98. [PMID: 26055463 DOI: 10.1177/1524839915589733] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This investigation sought to identify micro-level built and sociocultural characteristics of a home food environment that have been theoretically linked with fruit and vegetable (F&V) consumption. METHOD We examined rural families (n = 298) from the southeastern United States. Hierarchical multiple regression analyses determined the association between the outcome variable (F&V consumption) and micro-level built and sociocultural characteristics of a home food environment. RESULTS Demographic characteristics were entered at Step 1, explaining 14% of variance in vegetable consumption and 9% in fruit consumption. After entry of sociocultural factors in the home food environment, such as parenting styles and so on, in Block 2, the total variance explained increased by 25% for vegetable consumption and 12% for fruit consumption. Micro-level built environmental factors such as the availability of F&V in the home was entered at Block 3, total variance explained by the model for vegetable consumption was 67%, F(17, 111) = 13.5, p < .001, and for fruit consumption was 57%, F(17, 160) = 12.5, p < .001. CONCLUSION F&V availability was the most important variable influencing a child's consumption of F&V. There are modifiable factors within the rural low-income home that could serve as priorities for intervention to improve F&V consumption.
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Affiliation(s)
- Ann O Amuta
- Texas A&M University, College Station, TX, USA
| | - Wura Jacobs
- Texas A&M University, College Station, TX, USA
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Yun L, Boles RE, Haemer MA, Knierim S, Dickinson LM, Mancinas H, Hambidge SJ, Davidson AJ. A randomized, home-based, childhood obesity intervention delivered by patient navigators. BMC Public Health 2015; 15:506. [PMID: 26002612 PMCID: PMC4492174 DOI: 10.1186/s12889-015-1833-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 05/13/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although Colorado is perceived as a healthy state, in 2010, 14.1 % of children aged 2-5 were overweight and 9.1 % were obese. Despite the high prevalence of obesity in this population, evidence to support particular strategies to treat obese preschoolers is lacking. The efficacy of home-based, childhood obesity interventions to reduce a child's body mass index is inconclusive. However, this model uniquely provides an opportunity to observe and intervene with the home food and activity environment and engage the entire family in promoting changes that fit each family's unique dynamics. METHODS/DESIGN Eligible participants are children aged 2-5 years who attended a well-child care visit at a Denver Health Community Health Service clinic within 12 months prior to recruitment and on that visit had a body mass index (BMI) >85th percentile-for-age. Participants are randomly recruited at study inception and allocated to the intervention in one of five defined 6-month stepped wedge engagements; the delayed intervention groups serves as control groups until the start of the intervention. The program is delivered by a patient navigator at the family' home and consists of a 16-session curriculum focused on 1) parenting styles, 2) nutrition, and 3) physical activity. At each visit, a portion of curriculum is delivered to guide parents and children in selecting one goal for behavior change in each of three work areas to work on during the following week. The primary study outcome measure is change in BMI z-score from baseline to post-intervention period. DISCUSSION This childhood obesity study, innovative for its home-based intervention venue, provides rich data characterizing barriers and facilitators to healthy behavior change within the home. The study population is innovative as it is focused on preschool-aged, Latino children from low-income families; this population has not typically been targeted in obesity management assessments. The home-based intervention is linked to clinical care through update letters and assessment of the program's impact to the child's medical providers. Informing primary care providers about a child's accomplishments and challenges, allows the clinician to support the health weight effort when seeing families during subsequent clinical visits. TRIAL REGISTRATION ClinicalTrials.gov NCT02024360 Registered December 21, 2013.
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Affiliation(s)
- Lourdes Yun
- Denver Public Health, 605 Bannock Street, Denver, CO, 80204, USA.
| | - Richard E Boles
- Department of Pediatrics, University of Colorado Denver School of Medicine, 12631 East 17th Avenue, Aurora, CO, 80045, USA.
| | - Matthew A Haemer
- Department of Pediatrics, University of Colorado Denver School of Medicine, 12631 East 17th Avenue, Aurora, CO, 80045, USA.
| | - Shanna Knierim
- Denver Health Ambulatory Care Services, Department of Pediatrics, 777 Bannock Street, Denver, 80204, USA.
| | - L Miriam Dickinson
- Department of Family Medicine, University of Colorado Denver, 12631 E. 17th Avenue, Aurora, CO, 80045, USA.
| | - Heather Mancinas
- Denver Public Health, 605 Bannock Street, Denver, CO, 80204, USA.
| | - Simon J Hambidge
- Denver Health, Division of Ambulatory Care, 666 Bannock Street, Denver, 80204, USA.
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Stark LJ, Clifford LM, Towner EK, Filigno SS, Zion C, Bolling C, Rausch J. A pilot randomized controlled trial of a behavioral family-based intervention with and without home visits to decrease obesity in preschoolers. J Pediatr Psychol 2014; 39:1001-12. [PMID: 25080605 DOI: 10.1093/jpepsy/jsu059] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Tested two family-based behavioral treatments for obesity in preschool children, one meeting the Expert Committee guidelines for Stage 3 obesity intervention criteria (LAUNCH-clinic) and one exceeding Stage 3 (LAUNCH with home visit [LAUNCH-HV]), compared with a Stage 1 intervention, pediatrician counseling (PC). METHODS In all, 42 children aged 2-5 years with a body mass index (BMI) percentile of ≥95th were randomized. A total of 33 met intent-to-treat criteria. Assessments were conducted at baseline, Month 6 (posttreatment), and Month 12 (6-month follow-up). RESULTS LAUNCH-HV demonstrated a significantly greater decrease on the primary outcome of change in BMI z-score (BMIz) pre- to posttreatment compared with PC (p = .007), whereas LAUNCH-clinic was not significantly different from PC (p = .08). Similar results were found for secondary outcomes. CONCLUSIONS LAUNCH-HV, but not LAUNCH-clinic, significantly reduced BMIz compared with PC by posttreatment, indicating the need for intensive behavioral intervention, including home visitation, to address weight management in obese preschool children.
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Affiliation(s)
- Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Clinical and Health Psychology, University of Florida, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, and Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Hospital
| | - Lisa M Clifford
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Clinical and Health Psychology, University of Florida, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, and Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Hospital
| | - Elizabeth K Towner
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Clinical and Health Psychology, University of Florida, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, and Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Hospital
| | - Stephanie S Filigno
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Clinical and Health Psychology, University of Florida, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, and Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Hospital
| | - Cindy Zion
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Clinical and Health Psychology, University of Florida, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, and Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Hospital
| | - Christopher Bolling
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Clinical and Health Psychology, University of Florida, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, and Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Hospital
| | - Joseph Rausch
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Clinical and Health Psychology, University of Florida, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, and Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Hospital
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Boles RE, Burdell A, Johnson SL, Gavin WJ, Davies PL, Bellows LL. Home food and activity assessment. Development and validation of an instrument for diverse families of young children. Appetite 2014; 80:23-7. [PMID: 24798760 DOI: 10.1016/j.appet.2014.04.026] [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: 01/15/2014] [Revised: 04/20/2014] [Accepted: 04/29/2014] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to refine and psychometrically test an instrument measuring the home food and activity environment of geographically and economically diverse families of preschool aged children. Caregivers of preschool aged children (n = 83) completed a modified self-report questionnaire. Reliably trained researchers conducted independent observations on 25 randomly selected homes. Agreement statistics were conducted at the item level (154 total items) to determine reliability. Frequency counts were calculated to identify item availability. Results showed Kappa statistics were high (.67-1.00) between independent researchers but varied between researchers and parents resulting in 85 items achieving criterion validity (Kappa >.60). Analyses of reliable items revealed the presence in the home of a high frequency of unhealthy snack foods, high fat milk and low frequency of availability of fruits/vegetables and low fat milk. Fifty-two percent of the homes were arranged with a television in the preschool child's bedroom. Physical Activity devices also were found to have high frequency availability. Families reporting lower education reported higher levels of sugar sweetened beverages and less low-fat dairy (p < .05) compared with higher education families. Low-income families (<$27K per year) reported significantly fewer Physical Activity devices (p < .001) compared with higher income families. Hispanic families reported significantly higher numbers of Sedentary Devices (p < .05) compared with non-Hispanic families. There were no significant differences between demographic comparisons on available fruits/vegetables, meats, whole grains, and regular fat dairy. A modified home food and activity instrument was found to reliably identify foods and activity devices with geographically and economically diverse families.
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Affiliation(s)
- Richard E Boles
- Anschutz Medical Campus, University of Colorado Denver, Aurora, CO, USA.
| | | | - Susan L Johnson
- Anschutz Medical Campus, University of Colorado Denver, Aurora, CO, USA
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An exploration and comparison of food and drink availability in homes in a sample of families of White and Pakistani origin within the UK. Public Health Nutr 2014; 18:1197-205. [PMID: 24607149 DOI: 10.1017/s1368980014000147] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Knowledge of the types and quantities of foods and drinks available in family homes supports the development of targeted intervention programmes for obesity prevention or management, or for overall diet improvement. In the UK, contemporary data on foods that are available within family homes are lacking. The present study aimed to explore home food and drink availability in UK homes. DESIGN An exploratory study using researcher-conducted home food availability inventories, measuring all foods and drinks within the categories of fruits, vegetables, snack foods and beverages. SETTING Bradford, a town in the north of the UK. SUBJECTS Opportunistic sample of mixed ethnicity families with infants approximately 18 months old from the Born in Bradford birth cohort. RESULTS All homes had at least one type of fruit, vegetable and snack available. Fresh fruits commonly available were oranges, bananas, apples, satsumas and grapes. Commonly available fresh vegetables included potatoes, cucumber, tomatoes and carrots. The single greatest non-fresh fruit available in homes was raisins. Non-fresh vegetables contributing the most were frozen mixed vegetables, tinned tomatoes and tinned peas. Ethnic differences were found for the availability of fresh fruits and sugar-sweetened beverages, which were both found in higher amounts in Pakistani homes compared with White homes. CONCLUSIONS These data contribute to international data on availability and provide an insight into food availability within family homes in the UK. They have also supported a needs assessment of the development of a culturally specific obesity prevention intervention in which fruits and vegetables and sugar-sweetened beverages are targeted.
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Bellows LL, Johnson SL, Davies PL, Anderson J, Gavin WJ, Boles RE. The Colorado LEAP study: rationale and design of a study to assess the short term longitudinal effectiveness of a preschool nutrition and physical activity program. BMC Public Health 2013; 13:1146. [PMID: 24321701 PMCID: PMC3867674 DOI: 10.1186/1471-2458-13-1146] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 12/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The preschool years are a critical window for obesity prevention efforts; representing a time when children establish healthy eating habits and physical activity patterns. Understanding the context in which these behaviors develop is critical to formulating a model to address childhood obesity. The Colorado LEAP Study, an intervention study designed to prevent early childhood obesity, utilizes a social ecological approach to explore individual, family and environmental factors and their relationship to child weight status over a 3 year timeframe. METHODS The study is located in 5 rural Colorado preschool centers and elementary schools (2 treatment and 3 control). Treatment sites receive The Food Friends nutrition (12 weeks) and physical activity (18 weeks) interventions during preschool. Observational measures assess 3 layers of the social ecological model including individual, family and organizational inputs. Children's food preferences, food intake, gross motor skills, physical activity (pedometers/accelerometers), cognitive, physical and social self-competence and height/weight are collected. Parents provide information on feeding and activity practices, child's diet, oral sensory characteristics, food neophobia, home food and activity environment, height/weight and physical activity (pedometers). School personnel complete a school environment and policy assessment. Measurements are conducted with 3 cohorts at 4 time points - baseline, post-intervention, 1- and 2-year follow-up. DISCUSSION The design of this study allows for longitudinal exploration of relationships among eating habits, physical activity patterns, and weight status within and across spheres of the social ecological model. These methods advance traditional study designs by allowing not only for interaction among spheres but predictively across time. Further, the recruitment strategy includes both boys and girls from ethnic minority populations in rural areas and will provide insights into obesity prevention effects on these at risk populations. TRIAL REGISTRATION ClinicalTrials.gov: NCT01937481.
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Affiliation(s)
- Laura L Bellows
- Colorado State University, Department of Food Science & Human Nutrition, 1571 Campus Delivery, Fort Collins, CO 80523-1571, USA
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado Denver Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Patricia L Davies
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO 80523, USA
| | - Jennifer Anderson
- Colorado State University, Department of Food Science & Human Nutrition, 1571 Campus Delivery, Fort Collins, CO 80523-1571, USA
| | - William J Gavin
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80523, USA
| | - Richard E Boles
- Department of Pediatrics, Section of Nutrition, University of Colorado Denver Anschutz Medical Campus, Aurora, CO 80045, USA
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