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Cunningham-Sabo L, Lohse B, Nigg CR, Parody RJ. Fourth-Grade Cooking and Physical Activity Intervention Reveals Associations With Cooking Experience and Sex. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:191-204. [PMID: 36707323 DOI: 10.1016/j.jneb.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/14/2022] [Accepted: 10/24/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Examine the impact of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF) on children's culinary self-efficacy, attitude, fruit and vegetable (FV) preferences, physical activity (PA), and body mass index. DESIGN Randomized controlled trial. SETTING Eight elementary schools in 2 Northern Colorado districts. PARTICIPANTS Fourth-grade students; 7-month interventions: school (S.FFF)-theory-based cooking + tasting lessons, active recess, lesson-driven cafeteria promotions; or school + family (S+F.FFF) with added family nights and home activities. MAIN OUTCOME MEASURE(S) Cooking self-efficacy and attitudes, FV preferences, PA, and measured height/weight. ANALYSIS Individual outcomes nested by classroom, school, and district and assessed > 12 months with repeated measures controlled by sex and baseline cooking experience, with a significance level of P < 0.05. RESULTS The sample included 1,428 youth, 38 teachers, 4 cohorts, 50% boys, 75% White, and 15% Hispanic. No intervention effect was observed. Those who cooked retained higher self-efficacy, attitude, and FV preferences (P < 0.001). Girls reported higher self-efficacy and attitude than boys. Moderate-to-vigorous PA and metabolic equivalent minutes increased for all students; boys retained higher levels (P < 0.001). Body mass index percentile remained stable. CONCLUSIONS AND IMPLICATIONS Cooking and sex were associated with all outcome measures and should be considered for intervention tailoring. Treatment impacts were not evident nesting by classroom, school, and district. Accurate assessment of school-based interventions requires rejecting student independence from group assignment assumptions.
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Affiliation(s)
- Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Barbara Lohse
- Wegmans School of Health and Nutrition, Rochester Institute of Technology, Rochester, NY
| | - Claudio R Nigg
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Robert J Parody
- School of Mathematical Sciences, Rochester Institute of Technology, Rochester, NY
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Brown AW, Altman DG, Baranowski T, Bland JM, Dawson JA, Dhurandhar NV, Dowla S, Fontaine KR, Gelman A, Heymsfield SB, Jayawardene W, Keith SW, Kyle TK, Loken E, Oakes JM, Stevens J, Thomas DM, Allison DB. Childhood obesity intervention studies: A narrative review and guide for investigators, authors, editors, reviewers, journalists, and readers to guard against exaggerated effectiveness claims. Obes Rev 2019; 20:1523-1541. [PMID: 31426126 PMCID: PMC7436851 DOI: 10.1111/obr.12923] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/13/2019] [Accepted: 07/14/2019] [Indexed: 12/16/2022]
Abstract
Being able to draw accurate conclusions from childhood obesity trials is important to make advances in reversing the obesity epidemic. However, obesity research sometimes is not conducted or reported to appropriate scientific standards. To constructively draw attention to this issue, we present 10 errors that are commonly committed, illustrate each error with examples from the childhood obesity literature, and follow with suggestions on how to avoid these errors. These errors are as follows: using self-reported outcomes and teaching to the test; foregoing control groups and risking regression to the mean creating differences over time; changing the goal posts; ignoring clustering in studies that randomize groups of children; following the forking paths, subsetting, p-hacking, and data dredging; basing conclusions on tests for significant differences from baseline; equating "no statistically significant difference" with "equally effective"; ignoring intervention study results in favor of observational analyses; using one-sided testing for statistical significance; and stating that effects are clinically significant even though they are not statistically significant. We hope that compiling these errors in one article will serve as the beginning of a checklist to support fidelity in conducting, analyzing, and reporting childhood obesity research.
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Affiliation(s)
- Andrew W Brown
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Douglas G Altman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Tom Baranowski
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, Texas
| | - J Martin Bland
- Department of Health Sciences, University of York, York, UK
| | - John A Dawson
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas
| | | | - Shima Dowla
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kevin R Fontaine
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrew Gelman
- Department of Statistics and Department of Political Science, Columbia University, New York, New York
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Wasantha Jayawardene
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Scott W Keith
- Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Eric Loken
- Neag School of Education, University of Connecticut, Storrs, Connecticut
| | - J Michael Oakes
- Department of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - June Stevens
- Departments of Nutrition and Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy, West Point, New York
| | - David B Allison
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
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Scherr RE, Linnell JD, Dharmar M, Beccarelli LM, Bergman JJ, Briggs M, Brian KM, Feenstra G, Hillhouse JC, Keen CL, Schaefer SE, Smith MH, Spezzano T, Steinberg FM, Young HM, Zidenberg-Cherr S. Response to "Dramatic Decreases in BMI Percentiles, but Valid Conclusions Can Only Come From Valid Analyses". JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:851. [PMID: 30077580 DOI: 10.1016/j.jneb.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 06/28/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Rachel E Scherr
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, Davis, CA
| | - Jessica D Linnell
- Oregon State University, Extension Family and Community Health Program, Tillamook, OR
| | - Madan Dharmar
- Davis Betty Irene Moore School of Nursing, University of California, Sacramento, CA
| | | | - Jacqueline J Bergman
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, Davis, CA
| | - Marilyn Briggs
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, Davis, CA
| | - Kelley M Brian
- University of California Agriculture and Natural Resources, University of California, Davis, CA; Cooperative Extension, Placer and Nevada Counties, Auburn, CA
| | - Gail Feenstra
- University of California Agriculture and Natural Resources, University of California, Davis, CA; UC Sustainable Agriculture Research and Education Program, Agricultural Sustainability Institute, University of California, Davis, Davis, CA
| | - J Carol Hillhouse
- University of California Agriculture and Natural Resources, University of California, Davis, CA; UC Sustainable Agriculture Research and Education Program, Agricultural Sustainability Institute, University of California, Davis, Davis, CA
| | - Carl L Keen
- Department of Nutrition, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, University of California, Davis, CA; Department of Internal Medicine, University of California, Davis, Davis, CA
| | - Sara E Schaefer
- Foods for Health Institute, University of California, Davis, Davis, CA
| | - Martin H Smith
- University of California Agriculture and Natural Resources, University of California, Davis, CA; Department of Human Ecology, University of California, Davis, Davis, CA; Department of Population Health and Reproduction, University of California, Davis, Davis, CA
| | - Theresa Spezzano
- University of California Agriculture and Natural Resources, University of California Cooperative Extension, Merced and Stanislaus Counties, University of California, Modesto, CA
| | - Francene M Steinberg
- Department of Nutrition, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, University of California, Davis, CA
| | - Heather M Young
- Davis Betty Irene Moore School of Nursing, University of California, Sacramento, CA
| | - Sheri Zidenberg-Cherr
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, Davis, CA; University of California Agriculture and Natural Resources, University of California, Davis, CA
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