Parenting Advice School-Age Kids Offer to Parents to Promote Healthier Child Weight-Related Behaviors

Effect of School-Based Educational Intervention on Childhood Obesity in Croatian Urban and Rural Settings

BACKGROUND

Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based "PETICA-Play for Health" obesity prevention program in urban and rural areas in Croatia.

METHODS

This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. "PETICA" multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student's t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman's correlation, and heatmaps were used.

RESULTS

The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents' and children's physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models.

CONCLUSION

The study shows that "PETICA" is an efficient school-based educational model that contributes to positive changes in children's knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention.

HomeStyles-2 for SNAP-Ed families with children in middle childhood: Cluster randomized trial protocol

BACKGROUND

Childhood obesity prevention efforts are needed in the United States, especially for families with low income. The purpose of this study is to determine whether HomeStyles-2, a nutrition education and childhood obesity prevention program for families with children in middle childhood (ages 6 to 11 years), motivates parents to re-shape their home environments and weight-related lifestyle practices to be more supportive of meeting national nutrition and physical activity recommendations and weight status of their children more so than those in the control condition.

METHODS

A research-practice partnership with Florida's Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program was formed to conduct a cluster randomized trial to evaluate the HomeStyles-2 intervention. SNAP-Ed-eligible individuals who are parents/caregivers of children aged 6-11 living in the study catchment area will be invited to enroll in the study and participate in a six-lesson series using the HomeStyles-2 program or an attention control program. The primary outcome measures related to parent weight-related behaviors will be assessed on the individual level. Linear mixed models with a hierarchical design will be used to assess outcomes of interest.

DISCUSSION

This study has the potential to demonstrate the effectiveness of a new curriculum implemented in a federal nutrition education program. Because of the COVID-19 pandemic, adjustments were made to the intervention design to allow for virtual delivery of the intervention through SNAP-Ed. This unanticipated change will offer much-needed research on the effectiveness of virtual nutrition education, which may help to expand SNAP-Ed's reach across the country.

TRIAL REGISTRATION

NCT05019339.

Primary Health Care Intervention Reduces Added Sugars Consumption During Childhood

OBJECTIVE

To investigate the effectiveness of a training program for health workers regarding infant feeding practices to reduce sugar consumption in children.

DESIGN

A cluster randomized trial was conducted at 20 health centers in southern Brazil randomly assigned to an intervention (n = 9) or control (n = 11) group.

PARTICIPANTS

The 715 pregnant women enrolled were assessed when their children were aged 6 months, 3 years, and 6 years.

INTERVENTION

A training session for primary care workers based on the Brazilian National Guidelines for Children.

MAIN OUTCOME MEASURE

Mothers were asked when sugar was first offered to children. Added sugars intake was obtained from dietary recalls.

ANALYSIS

The effectiveness of the intervention was modeled using generalized estimation equations and Poisson regression with robust variance.

RESULTS

Children attending intervention health centers had a 27% reduced risk of sugar introduction before 4 months of age (relative risk, 0.73; 95% confidence interval [CI], 0.61-0.87) as well as lower added sugars consumption (difference, -6.36 g/d; 95% CI, -11.49 to -1.23) and total daily energy intake (difference, -116.90 kcal/d; 95% CI, -222.41 to -11.40) at 3 years of age.

CONCLUSIONS AND IMPLICATIONS

Health care worker training in infant feeding guidelines may be an effective intervention to delay the introduction of added sugars and lower the subsequent intake of added sugars in infants and toddlers.

The Application of Systems Science in Nutrition-Related Behaviors and Outcomes Implementation Research: A Scoping Review

Use of systems science can improve the dissemination and implementation (D&I) process. However, little is known about use of systems science in nutrition D&I research. The purpose of this article is to synthesize the ways in which systems science methodology is applied in nutrition D&I research. Scoping review methodology involved searching 6 academic databases for full-text, peer-reviewed, English articles published between 1970 and 2020 that employed systems science within nutrition D&I research. Data extraction included intervention type, population, study aim, methods, theoretical approach, outcomes, and results. Descriptive statistics and qualitative thematic analysis followed. Thirty-four retained articles qualitatively identified benefits (successful planning and organization of complex interventions) and challenges (limited resources, trainings, and lack of knowledge) to utilizing systems science in nutrition D&I research. Future research should work toward building knowledge capacity among nutrition practitioners by increasing available trainings and resources to enhance the utilization of systems science in nutrition D&I research.

Intergenerational Comparison of Food Parenting of Home Eating Behaviors of Schoolchildren

OBJECTIVE

To explore intergenerational differences on key factors of food parenting practices (FPPs) related to home eating behavior of schoolchildren.

DESIGN

In-depth interviews with social recognition theory-based semistructured interviews conducted from December 2016 to January 2017.

PARTICIPANTS

Primary caregivers of elementary schoolchildren from 23 households (16 parents, 14 grandparents) in 4 remote areas of Hualien, Taiwan.

PHENOMENON OF INTEREST

Factors related to FPPs hindering micronutrient-dense food group consumption by schoolchildren in a remote area.

SETTING

In-depth interviews were conducted at participants' houses.

ANALYSIS

Interviews were audiorecorded and transcribed verbatim. Inductive thematic analysis was performed to elicit studied phenomenon.

RESULTS

Routine family meals provided adequate staple, protein, and vegetables but inadequate whole grains, dairy, fruits, and nuts. More parents provided breakfast composed of pan-fried and semiprocessed products made of refined flour and sugary beverages. Both parents and grandparents had ambiguous nutrition concepts and inconsistent FPPs but in different aspects. They both reflected expectations for assistance from local schools for nutrition and FPPs education to shape up healthy eating behavior of children.

CONCLUSIONS AND IMPLICATIONS

Study findings pinpoint the strength and barriers of FPPs for primary caregivers. Implementing integrated nutrition education programs tailored for empowering nutrition literacy and FPPs is suggested to enhance the healthy eating behavior of schoolchildren in a remote area.