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Liu M, Sun Y. Understanding Blame in the Context of Childhood Obesity. HEALTH COMMUNICATION 2024; 39:1684-1704. [PMID: 37489249 DOI: 10.1080/10410236.2023.2229987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
This paper explicates blame as a psychological construct in communication processes, with a focus on its underlying structure and its mediating role between message characteristics and the public's issue engagement. Data were collected from Amazon Mechanical Turk (N = 373) via a Web-based experiment, where we manipulated a news story about a child suffering an obesity-related health risk (asthma attack vs. heart attack) with different levels of preventability (high vs. low) and severity (high vs. low). Findings showed that blame should best be conceptualized and operationalized as a latent construct comprising both cognitive and affective components. Blame mediated message effects on social responses related to obesity prevention, including punitive attitudes, policy support, and intentions toward interpersonal communication and civic participatory behaviors.
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Affiliation(s)
- Miao Liu
- School of Journalism and Communication, Beijing Normal University
| | - Ye Sun
- Department of Media and Communication, City University of Hong Kong
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Gupta M, Phan TLT, Lê-Scherban F, Eckrich D, Bunnell HT, Beheshti R. Associations of longitudinal BMI percentile classification patterns in early childhood with neighborhood-level social determinants of health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.06.08.23291145. [PMID: 37398451 PMCID: PMC10312866 DOI: 10.1101/2023.06.08.23291145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background Understanding social determinants of health (SDOH) that may be risk factors for childhood obesity is important to developing targeted interventions to prevent obesity. Prior studies have examined these risk factors, mostly examining obesity as a static outcome variable. Methods We extracted EHR data from 2012-2019 for a children's health system that includes 2 hospitals and wide network of outpatient clinics spanning 5 East Coast states in the US. Using data-driven and algorithmic clustering, we have identified distinct BMI-percentile classification groups in children from 0 to 7 years of age. We used two separate algorithmic clustering methods to confirm the robustness of the identified clusters. We used multinomial logistic regression to examine the associations between clusters and 27 neighborhood SDOHs and compared positive and negative SDOH characteristics separately. Results From the cohort of 36,910 children, five BMI-percentile classification groups emerged: always having obesity (n=429; 1.16%), overweight most of the time (n=15,006; 40.65%), increasing BMI-percentile (n=9,060; 24.54%), decreasing BMI-percentile (n=5,058; 13.70%), and always normal weight (n=7,357; 19.89%). Compared to children in the decreasing BMI-percentile and always normal weight groups, children in the other three groups were more likely to live in neighborhoods with higher poverty, unemployment, crowded households, single-parent households, and lower preschool enrollment. Conclusions Neighborhood-level SDOH factors have significant associations with children's BMI-percentile classification and changes in classification. This highlights the need to develop tailored obesity interventions for different groups to address the barriers faced by communities that can impact the weight and health of children living within them. Impact Statement This study demonstrates the association between longitudinal BMI-percentile patterns and SDOH in early childhood. Five distinct clusters with different BMI-percentile trajectories are found and a strong association between these clusters and SDOH is observed. Our findings highlight the importance of targeted prevention and treatment interventions based on children's SDOH.
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Janda D, Gába A, Hron K, Arundell L, Contardo Ayala AM. Movement behaviour typologies and their associations with adiposity indicators in children and adolescents: a latent profile analysis of 24-h compositional data. BMC Public Health 2024; 24:1553. [PMID: 38858675 PMCID: PMC11163703 DOI: 10.1186/s12889-024-19075-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 06/06/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES Growing evidence supports the important role of 24-hour movement behaviours (MB) in preventing childhood obesity. However, research to understand the heterogeneity and variability of MB among individuals and what kind of typologies of individuals are at risk of developing obesity is lacking. To bridge this gap, this study identified typologies of 24-hour MB in children and adolescents and investigated their associations with adiposity indicators. METHODS In this cross-sectional study, 374 children and 317 adolescents from the Czech Republic wore wrist-worn accelerometers for seven consecutive days. Time spent in moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behaviour (SB), and sleep was quantified using raw accelerometery data. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), fat mass index (FMI), and visceral adipose tissue (VAT). Bias-adjusted latent profile analysis was used on the 24-hour MB data to identify MB typologies and their associations with adiposity indicators. The models were adjusted for potential confounders. The identified typologies were labelled to reflect the behavioural profiles of bees to aid interpretability for the general public. RESULTS Two typologies were identified in children: highly active Workers characterised by high levels of MVPA and LPA, and inactive Queens characterised by low levels of MVPA and LPA, high levels of SB and longer sleep duration compared to Workers. In adolescents, an additional typology labelled as Drones was characterised by median levels of MVPA, LPA, SB and longest sleep duration. After controlling for covariates, we found that children labelled as Queens were associated with 1.38 times higher FM%, 1.43 times higher FMI, and 1.67 times higher VAT than Workers. In adolescents, Drones had 1.14 times higher FM% and Queens had 1.36 higher VAT in comparison with Workers, respectively. CONCLUSION Our study highlights the importance of promoting active lifestyles in children and adolescents to potentially reduce adiposity. These findings can provide insights for interventions aimed at promoting healthy MB and preventing childhood obesity.
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Affiliation(s)
- David Janda
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, Olomouc, 779 00, Czech Republic
| | - Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, Olomouc, 779 00, Czech Republic.
| | - Karel Hron
- Department of Mathematical Analysis and Applications of Mathematics, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lauren Arundell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Ana Maria Contardo Ayala
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Sun Y, Zhang H, Qi G, Tian W. Nutrient deficiency patterns and all-cause and cardiovascular mortality in older adults with hypertension: a latent class analysis. BMC Public Health 2024; 24:1551. [PMID: 38853236 PMCID: PMC11163810 DOI: 10.1186/s12889-024-19003-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 05/30/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Previous researches examining the impact of dietary nutrition on mortality risk have mainly focused on individual nutrients, however the interaction of these nutrients has not been considered. The purpose of this study was to identify of nutrient deficiencies patterns and analyze their potential impact on mortality risk in older adults with hypertension. METHODS We included participants from the National Health and Nutrition Examination Survey (NHANES) study. The latent class analysis (LCA) was applied to uncover specific malnutrition profiles within the sample. Risk of the end points across the phenogroups was compared using Kaplan-Meier analysis and Cox proportional hazard regression model. Multinomial logistic regression was used to determine the influencing factors of specific malnutrition profiles. RESULTS A total of 6924 participants aged 60 years or older with hypertension from NHANES 2003-2014 was followed until December 31, 2019 with a median follow-up of 8.7 years. Various nutrients included vitamin A, vitamin B1, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K, fiber, folate, calcium, magnesium, zinc, copper, iron, and selenium, and LCA revealed 4 classes of malnutrition. Regarding all-cause mortality, "Nutrient Deprived" group showed the strongest hazard ratio (1.42 from 1.19 to 1.70) compared with "Adequate Nutrient" group, followed by "Inadequate Nutrient" group (1.29 from 1.10 to 1.50), and "Low Fiber, Magnesium, and Vit E" group (1.17 from 1.02 to 1.35). For cardiovascular mortality, "Nutrient Deprived" group showed the strongest hazard ratio (1.61 from 1.19 to 2.16) compared with "Adequate Nutrient" group, followed by "Low Fiber, Magnesium, and Vit E" group (1.51 from 1.04 to 2.20), and "Inadequate Nutrient" group (1.37 from 1.03 to 1.83). CONCLUSIONS The study revealed a significant association between nutrients deficiency patterns and the risk of all-cause and cardiovascular mortality in older adults with hypertension. The findings suggested that nutrients deficiency pattern may be an important risk factor for mortality in older adults with hypertension.
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Affiliation(s)
- YuJiao Sun
- Department of Geriatric, The First Hospital of China Medical University, 155 Nanjing North Street, Heping Ward, Shenyang, 110001, NO, China
| | - HuanRui Zhang
- Department of Geriatric, The First Hospital of China Medical University, 155 Nanjing North Street, Heping Ward, Shenyang, 110001, NO, China
| | - GuoXian Qi
- Department of Geriatric, The First Hospital of China Medical University, 155 Nanjing North Street, Heping Ward, Shenyang, 110001, NO, China
| | - Wen Tian
- Department of Geriatric, The First Hospital of China Medical University, 155 Nanjing North Street, Heping Ward, Shenyang, 110001, NO, China.
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Pederson HJ, Al-Hilli Z, Kurian AW. Racial disparities in breast cancer risk factors and risk management. Maturitas 2024; 184:107949. [PMID: 38652937 DOI: 10.1016/j.maturitas.2024.107949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/03/2024] [Accepted: 02/19/2024] [Indexed: 04/25/2024]
Abstract
Racial disparities in breast cancer outcomes are well described across the spectrum of screening, diagnosis, treatment, and survivorship. Breast cancer mortality is markedly elevated for Non-Hispanic Black women compared with other racial and ethnic groups, with multifactorial causes. Here, we aim to reduce this burden by identifying disparities in breast cancer risk factors, risk assessment, and risk management before breast cancer is diagnosed. We describe a reproductive profile and modifiable risk factors specific to the development of triple-negative breast cancer. We also propose that screening strategies should be both risk- and race-based, given the prevalence of early-onset triple-negative breast cancer in young Black women. We emphasize the importance of early risk assessment and identification of patients at hereditary and familial risk and discuss indications for a high-risk referral. We discuss the subtleties following genetic testing and highlight "uncertain" genetic testing results and risk estimation challenges in women who test negative. We trace aspects of the obesity epidemic in the Black community to infant feeding patterns and emphasize healthy eating and activity. Finally, we discuss building an environment of trust to foster adherence to recommendations, follow-up care, and participation in clinical trials. Addressing relevant social determinants of health; educating patients and clinicians on factors impacting disparities in outcomes; and encouraging participation in targeted, culturally sensitive research are essential to best serve all communities.
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Affiliation(s)
- Holly J Pederson
- Breast Center, Integrated Surgical Institute, Cleveland Clinic, 9500 Euclid Avenue, A80, OH 44195, United States of America.
| | - Zahraa Al-Hilli
- Breast Center, Integrated Surgical Institute, Cleveland Clinic, 9500 Euclid Avenue, A80, OH 44195, United States of America.
| | - Allison W Kurian
- Department of Medicine and Epidemiology and Population Health, Stanford University, 900 Blake Wilbur Drive, 1st Floor, Palo Alto, CA 94304, United States of America.
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Fenton T, Bastida E. Beliefs and Perceptions of Physical Activity Among Black Adolescents in South Florida: A Qualitative Study. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02016-x. [PMID: 38713371 DOI: 10.1007/s40615-024-02016-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION In the United States, non-Hispanic Black adolescents have a significantly higher prevalence of obesity than their peers. Though physical activity (PA) has many benefits, many adolescents fail to engage in adequate amounts of PA. Black adolescents are also more sedentary than those from other races and ethnicities. This study aimed to describe the perceptions, beliefs, and barriers to PA in South Florida Black adolescents. METHODS Five focus groups were conducted with self-identified non-Hispanic Black adolescents (n = 38) in South Florida. A semi-structured question guide based on the Theory of Planned Behavior was used for group discussions. The open-ended questions addressed adolescents' (1) attitudes and beliefs toward PA, (2) current PA-related behaviors, and (3) environmental, social, cultural, and racial influences on health behaviors. RESULTS The desire to be healthy, thoughts of the future, and self-image were among the reasons participants engaged in PA. Engagement in PA was associated with a positive social environment, including encouragement from family and friends. Race, culture, and social media were also cited as influences on PA. Perceived control beliefs, such as parental pressures and self-discipline, also impacted PA. CONCLUSION Adolescents recognize the importance of PA; however, their behaviors do not reflect this. Barriers and motivators for Black adolescents are multifaceted. It is critical for Public Health practitioners and local legislators to understand the complexities to serve this population. This study's findings can guide the development of tailored PA and education programs for Black adolescent populations.
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Affiliation(s)
- Tienna Fenton
- Department of Health Promotion and Disease Prevention, Florida International University, 11200 SW 8Th Street, AHC5, Miami, FL, USA.
| | - Elena Bastida
- Department of Health Promotion and Disease Prevention, Florida International University, 11200 SW 8Th Street, AHC5, Miami, FL, USA
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Mihov Y, Meyer AH, Kakebeeke TH, Stülb K, Arhab A, Zysset AE, Leeger-Aschmann CS, Schmutz EA, Kriemler S, Jenni OG, Puder JJ, Messerli-Bürgy N, Munsch S. Child eating behavior predicts body mass index after 1 year: results from the Swiss Preschooler's Health Study (SPLASHY). Front Psychol 2024; 15:1292939. [PMID: 38629046 PMCID: PMC11019003 DOI: 10.3389/fpsyg.2024.1292939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/04/2024] [Indexed: 04/19/2024] Open
Abstract
Child obesity is a growing global issue. Preventing early development of overweight and obesity requires identifying reliable risk factors for high body mass index (BMI) in children. Child eating behavior might be an important and malleable risk factor that can be reliably assessed with the parent-report Child Eating Behavior Questionnaire (CEBQ). Using a hierarchical dataset (children nested within child care centers) from a representative cohort of Swiss preschool children, we tested whether eating behavior, assessed with a 7-factor solution of the CEBQ, and BMI at baseline predicted the outcome BMI after 1 year, controlling for socioeconomic status (n = 555; 47% female; mean age = 3.9 years, range: 2.2-6.6; mean BMI = 16 kg/m2, range: 11.2-23; mean age- and sex-corrected z-transformed BMI, zBMI = 0.4, range -4 to +4.7). The statistical model explained 65.2% of zBMI at follow-up. Baseline zBMI was a strong positive predictor, uniquely explaining 48.8% of outcome variance. A linear combination of all CEBQ scales, taken together, explained 10.7% of outcome variance. Due to their intercorrelations, uniquely explained variance by any individual scale was of negligible clinical relevance. Only food responsiveness was a significant predictor, when accounting for all other predictors and covariates in the model, and uniquely explained only 0.4% of outcome variance. Altogether, our results confirm, extend, and refine previous research on eating behavior and zBMI in preschool children, by adjusting for covariates, accounting for intercorrelations between predictors, partitioning explained outcome variance, and providing standardized beta estimates. Our findings show the importance of carefully examining the contribution of predictors in multiple regression models for clinically relevant outcomes.
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Affiliation(s)
- Yoan Mihov
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Freiburg, Switzerland
| | - Andrea H. Meyer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Freiburg, Switzerland
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Tanja H. Kakebeeke
- Child Development Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Kerstin Stülb
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Freiburg, Switzerland
| | - Amar Arhab
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Annina E. Zysset
- Child Development Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | | | - Einat A. Schmutz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Oskar G. Jenni
- Child Development Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Jardena J. Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Simone Munsch
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Freiburg, Switzerland
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Curzon MM, Dick AS, Coccia C, Graziano PA. Exploring Differences in Physical Health in Young Children With and Without ADHD. J Pediatr Psychol 2024; 49:120-130. [PMID: 38078865 PMCID: PMC10874215 DOI: 10.1093/jpepsy/jsad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE To assess differences in child physical health outcomes and metrices associated with obesity in a sample of predominantly Hispanic/Latinx young children with and without attention-deficit/hyperactivity disorder (ADHD). METHODS Participants included 127 children diagnosed with ADHD and 96 typically developing (TD) children between 4 and 7 years of age. Objective measures of children's body composition, fitness, and physical activity were conducted. Parents of children completed food recalls to assess their child's dietary intake, diet quality was calculated based on the Healthy Eating Index-2015, and parents completed a survey about their family's health habits. RESULTS Logistic regression revealed that those with ADHD were more likely to be classified as having an overweight or obese (Ov/O) body mass index (BMI). Linear regression analyses indicated that children with ADHD performed worse on a fitness test and consumed more calories relative to TD children. Moderation analyses indicated that sex differences in steps were prominent in our TD sample, but not among those with ADHD. CONCLUSIONS Young children with ADHD are at greater risk for having an Ov/O BMI, being less fit, and eating a greater intake of calories compared to TD children.
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Affiliation(s)
- Madeline M Curzon
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Anthony S Dick
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Catherine Coccia
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Paulo A Graziano
- Department of Psychology, Center for Children and Families, Florida International University, USA
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Dastgerdizad H, Dombrowski RD, Bode B, Knoff KAG, Kulik N, Mallare J, Kaur R, Dillaway H. Community Solutions to Increase the Healthfulness of Grocery Stores: Perspectives of Immigrant Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6536. [PMID: 37569076 PMCID: PMC10418834 DOI: 10.3390/ijerph20156536] [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: 06/27/2023] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
Grocery store environments are recognized as one of the most crucial community settings for developing and maintaining healthy nutritional behaviors in children. This is especially true for disadvantaged ethnic minority families, such as immigrants, who reside in the Detroit Metropolitan area and have historically experienced inequities that result in poor health outcomes. Rates of obesity and type II diabetes have affected Detroit 38% more than the rest of the state and nationwide. In 2019, almost 54% of children aged 0-17 in Metro Detroit lived in poverty, and 21.6% experienced food insecurity, compared with the state level of 14.2%. Moreover, nearly 50% of ethnic minority children in Metro Detroit consume sports drinks, and 70% consume soda or pop in an average week. The primary purpose of this study was to explore immigrant parents' perspectives on (1) how in-store Sugar-Sweetened Beverage (SSB) marketing impacts the purchasing behaviors of parents and the eating behaviors of toddlers, and the secondary objective was to (2) determine strategies to reduce SSB purchases and consumption within grocery environments from the viewpoints of immigrant parents. A qualitative multiple-case study design was used to achieve the aims of this study. Semi-structured individual interviews were completed with 18 immigrant parents of children aged 2 to 5 years old who were consumers in 30 independently owned full-service grocery stores within the immigrant enclaves of Detroit, Dearborn, Hamtramck, and Warren, Michigan. Three key thematic categories emerged from the parents' narratives. These themes were: (1) non-supportive grocery store environments; (2) acculturation to the American food environment; and (3) strategies to support reduced SSB consumption among young immigrant children. The findings of this study revealed widespread SSB marketing targeting toddlers within the participating independently owned grocery stores. Even if families with young children practiced healthy nutritional behaviors, the prices, placements, and promotion of SSBs were challenges to establishing and sustaining these healthy eating habits. The parents believed that planning and implementing retail-based strategies in collaboration with families and considering families' actual demands would assist in managing children's eating patterns and reducing early childhood obesity.
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Affiliation(s)
- Hadis Dastgerdizad
- Department of Public Health, University of South Carolina, Bluffton, SC 29909, USA
| | - Rachael D. Dombrowski
- Departments of Public Health and Kinesiology, College of Education, Health and Human Services, California State University-San Marcos, San Marcos, CA 92096, USA;
| | - Bree Bode
- Michigan Fitness Foundation, Lansing, MI 48314, USA;
| | - Kathryn A. G. Knoff
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA 22314, USA;
| | - Noel Kulik
- Center for Health and Community Impact, Division of Kinesiology, Health & Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA;
| | - James Mallare
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48202, USA;
| | - Ravneet Kaur
- Division of Health Research and Evaluation, Department of Family and Community Medicine, College of Medicine, University of Illinois, Rockford, IL 61107, USA;
| | - Heather Dillaway
- Department of Sociology and Anthropology, Illinois State University, Normal, IL 61790, USA;
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Cáceres P, Segovia L, Rivera C, Juretić N. Characterization of a sample of Chilean university students in terms of the bitter‐tasting phenotype and genotype and their preferences for basic flavours and associated foods. FLAVOUR FRAG J 2023. [DOI: 10.1002/ffj.3744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Affiliation(s)
- Paola Cáceres
- Nutrition Department, Faculty of Medicine University of Chile Santiago Chile
| | - Luna Segovia
- Nutrition Department, Faculty of Medicine University of Chile Santiago Chile
- Cellular and Molecular Biology Program, Institute of Biomedical Sciences, Faculty of Medicine University of Chile Santiago Chile
| | - Constanza Rivera
- Cellular and Molecular Biology Program, Institute of Biomedical Sciences, Faculty of Medicine University of Chile Santiago Chile
| | - Nevenka Juretić
- Cellular and Molecular Biology Program, Institute of Biomedical Sciences, Faculty of Medicine University of Chile Santiago Chile
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Mohamad MS, Mahadir Naidu B, Virtanen SM, Lehtinen-Jacks S, Abdul Maulud KN. Relationships of Local Food and Physical Activity Environments With Overweight in 5- to 17-Year-Old Malaysian Children. Asia Pac J Public Health 2023; 35:34-41. [PMID: 36321506 DOI: 10.1177/10105395221135407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Evidence on the associations between built environment and overweight in children outside developed countries is scarce. We examined associations between access to local food and physical activity environments and overweight in 5- to 17-year-old Malaysians in two states with differing overweight levels. Information on children was measured in the National Health and Morbidity Survey 2015 and combined with Geographic Information System-derived data on local food and physical activity environments. Access to the built environment was measured by presence and distance from child's residence. Complete data were available for 880 children. Access to local food outlets and parks was higher and associated with higher occurrence of overweight in children living in the state with higher overweight prevalence. When adjusted for sociodemographic factors, higher presence of and shorter distance to convenience stores and parks were associated with overweight. Both built environment and children's sociodemographic backgrounds should be considered when planning interventions to curb the overweight epidemic in Malaysia.
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Affiliation(s)
- Maria Safura Mohamad
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Balkish Mahadir Naidu
- Research and Methodology Unit, Department of Statistics Malaysia, Putrajaya, Malaysia
| | - Suvi M Virtanen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Centre for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland.,The Science Centre of Pirkanmaa Hospital District, Tampere, Finland
| | - Susanna Lehtinen-Jacks
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Khairul Nizam Abdul Maulud
- Earth Observation Centre, Institute of Climate Change, National University of Malaysia, Bangi, Malaysia.,Department of Civil Engineering, Faculty of Engineering and Built Environment, National University of Malaysia, Bangi, Malaysia
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Coleta H, Schincaglia RM, Gubert MB, Pedroso J. Factors associated with infant feeding styles in the Federal District, Brazil. Appetite 2022; 179:106290. [DOI: 10.1016/j.appet.2022.106290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/10/2022] [Accepted: 08/26/2022] [Indexed: 01/21/2023]
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Aceves-Martins M, López-Cruz L, García-Botello M, Godina-Flores NL, Gutierrez-Gómez YY, Moreno-García CF. Cultural factors related to childhood and adolescent obesity in Mexico: A systematic review of qualitative studies. Obes Rev 2022; 23:e13461. [PMID: 35587773 PMCID: PMC9541705 DOI: 10.1111/obr.13461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
Culture and culturally specific beliefs or practices may influence perceptions and decisions, potentially contributing to childhood obesity. The objective of this study is to identify the cultural factors (expressed through decisions, behaviors, individual experiences, perceptions, attitudes, or views) related to childhood and adolescent obesity in Mexico. Ten databases and one search engine were searched from 1995 onwards for qualitative studies. The Sunrise Enabler Model, described within the Cultural Care Theory, guided this review. Sample, the phenomenon of interest, study design, and evaluation data were extracted, and the Critical Appraisals Skills Programme tool was used to assess the quality of the included studies. Twenty-four studies were included. Of these, 12 studies included children or adolescents, 12 included parents, eight included schoolteachers, four included school staff (other than teachers), four included food vendors, and one included policymakers. Cultural values, beliefs, lifeways (especially food and food costumes), kinship, and social factors (particularly immediate and extended family) strongly influenced childhood and adolescent obesity-related lifestyles in Mexico. Most cultural factors related to childhood obesity in Mexico identified in this review may be modifiable and amenable to practical interventions.
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Affiliation(s)
| | - Lizet López-Cruz
- Universidad Europea del Atlantico, Parque Cientifico y Tecnologico de Cantabria, Santander, Spain
| | | | - Naara L Godina-Flores
- Nutrition Department, School of Medicine and Health Sciences, Tecnológico de Monterrey, Mexico City, Mexico
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Rafei A, Elliott MR, Jones RE, Riosmena F, Cunningham SA, Mehta NK. Obesity Incidence in U.S. Children and Young Adults: A Pooled Analysis. Am J Prev Med 2022; 63:51-59. [PMID: 35256211 PMCID: PMC9232860 DOI: 10.1016/j.amepre.2021.12.021] [Citation(s) in RCA: 4] [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: 08/31/2021] [Revised: 11/24/2021] [Accepted: 12/21/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Obesity prevalence among children and adolescents has risen sharply, yet there is a limited understanding of the age-specific dynamics of obesity as there is no single nationally representative cohort following children into young adulthood. Investigators constructed a pooled data set of 5 nationally representative panels and modeled age-specific obesity incidence from childhood into young adulthood. METHODS This longitudinal prospective follow-up used 718,560 person-years of observation in a pooled data set of 5 high-quality nationally representative panels-National Longitudinal Survey of Youth 1979 and 1997, National Longitudinal Study of Adolescent Health, and Early Childhood Longitudinal Study-Kindergarten cohorts of 1998 and 2011-constructed by the authors, covering 1980-2016. Differences in obesity incidence across birth cohorts and disparities in obesity incidence by sex and race/ethnicity (non-Hispanic Black, Hispanic, and non-Hispanic White) were tested in multivariate models. Data were analyzed from September 2018 to October 2021. RESULTS Obesity incidence increased by approximately 6% for each 1 year of age (hazard ratio=1.06, 95% CI=1.05, 1.07); however, incidence was nonlinear, exhibiting an inverted "U"-shaped pattern before 15 years of age and then rising from adolescence through 30 years. Obesity incidence more than doubled between the cohorts born in 1957-1965 and those born in 1974-1985 during adolescence. There was no significant change among those born in 1991-1994 and 2003-2006 up to age 15 years. Compared with non-Hispanic White children, non-Hispanic Black and Hispanic children had higher obesity incidence in all study cohorts. The magnitude of these disparities on the relative scale remained stable throughout the study period. CONCLUSIONS Although many children become obese before the age of 10, obesity incidence rises from about 15 years into early adulthood, suggesting that interventions are required at multiple developmental stages.
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Affiliation(s)
- Ali Rafei
- Survey Methodology Program, University of Michigan, Ann Arbor, Michigan
| | - Michael R Elliott
- Survey Methodology Program, University of Michigan, Ann Arbor, Michigan; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Rebecca E Jones
- Hubert Department of Global Health, Emory University, Atlanta, Georgia
| | - Fernando Riosmena
- Population Program, University of Colorado at Boulder, Boulder, Colorado; The Geography Department, University of Colorado at Boulder, Boulder, Colorado
| | | | - Neil K Mehta
- Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, Texas.
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15
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Análisis bibliométrico y revision temática de estudios en consumo infantil de 1974 a 2019. ACTA COLOMBIANA DE PSICOLOGIA 2022. [DOI: 10.14718/acp.2022.25.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
El papel de los niños como consumidores ha generado un gran interés en el marketing social, especialmente en los aspectos relacionados con la alimentación; sin embargo, hay campos como la regulación de la publicidad, el comportamiento digital y las actitudes de los niños hacia los productos, que hasta ahora no están completamente estudiados. Para apoyar las futuras investigaciones de la comunidad científica del marketing social sobre este tema, el presente estudio bibliométrico tuvo como objetivo investigar y describir las líneas y áreas de investigación en psicología, comportamiento y marketing social, en relación con el consumo infantil, para responder a la siguiente pregunta de investigación: ¿Cuáles son las publicaciones, autores y tendencias más importantes en la investigación sobre el consumo infantil en los últimos 45 años? Para ello, se analizaron 1375 artículos de 703 revistas con los paquetes Bibliometrix (R Studio), utilizando una metodología exploratoria y descriptiva, analizando 2588 palabras clave de autor y 1265 palabras clave adicionales con 2597 autores en la base de datos Scopus. Los indicadores cienciométricos muestran la existencia de cinco grupos temáticos relacionados con el consumo infantil. Se concluye que la producción científica sobre el consumo de niños y niñas debe abordar cuestiones de protección y regulación orientadas a la responsabilidad social, especialmente en las comunicaciones integradas de marketing y publicidad de las marcas alimentarias, con mayor y especial cuidado en el entorno digital, debido a la actual inmersión de la población infantil mundial y su creciente autonomía en la elección de contenidos, productos y marcas digitales.
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16
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Warnick J, Cardel M, Jones L, Gonzalez-Louis R, Janicke D. Impact of mothers' distress and emotional eating on calories served to themselves and their young children: An experimental study. Pediatr Obes 2022; 17:e12886. [PMID: 34989150 DOI: 10.1111/ijpo.12886] [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: 04/06/2021] [Revised: 11/17/2021] [Accepted: 12/03/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Parents play a significant role in children's eating behaviours and food environment. Emotional eating (i.e., eating due to/to cope with emotions regardless of hunger) can contribute to excess energy consumption and subsequent weight gain. Yet, there is a paucity of research examining mothers' feeding and eating behaviours in the presence of their young children during times of acute distress. OBJECTIVE The current study examined whether manipulated maternal mood impacted subsequent eating and parental-feeding in mothers with overweight or obesity with their preschool aged children in a laboratory-based experiment. METHODS Mothers (n = 47) with overweight or obesity and their preschool aged children were randomized to either an acute distress or control group. After completing a task which manipulated mothers' moods, respectively, dyads were offered a buffet of snack foods. Measures of mothers' reported emotional eating and distress were collected, and calories served and consumed were objectively measured. RESULTS There were no between-group differences regarding calories served or consumed. Mothers across both groups who reported higher emotional eating served themselves (p = 0.014) and their children (p = 0.007) less food, and mothers consumed less food (p = 0.045). Mothers who reported higher emotional eating and increased acute distress fed their children less food (p = 0.02) and both children and mothers ate less food (p < 0.05). CONCLUSIONS Results suggest that mothers who report emotional eating tendencies may feed their children less food during periods of acute distress.
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Affiliation(s)
- Jennifer Warnick
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Michelle Cardel
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Laura Jones
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Rachel Gonzalez-Louis
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - David Janicke
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
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17
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Lo YL, Lee SS, Cheng SH. Inadequate fruits and vegetables consumption among Malaysian adults during the COVID-19 pandemic. Nutr Health 2022; 28:741-750. [PMID: 35522261 PMCID: PMC9082094 DOI: 10.1177/02601060221099782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The COVID-19 pandemic has negatively impacted the eating behaviours of people especially fruits and vegetable intake. No study has addressed the fruits and vegetables intake during the COVID-19 in Malaysia. Aim: to assess the daily intake of fruits and vegetables among Malaysian adults during the COVID-19 outbreak, perceived changes in intake, as well as factors associated with the changes in intake. Methods: A cross-sectional study was conducted through online platforms and a total of 506 participants were recruited. Semi food-frequency questionnaires were used to assess participants’ fruit and vegetable intake. Socio-demographics information, knowledge, attitude and practices (KAP) of fruits and vegetables were collected. All statistical analyses were performed using SPSS. Results: The majority of participants (99.8%) did not achieve the recommended five servings per day, in which they consumed an average of 0.84 servings of fruits and vegetables per day. 46.4% of participants reported no changes in intake compared to before the outbreak. Fruits and vegetables intake was associated with physical activity level, knowledge, and beliefs of foods that may prevent/cure COVID-19. Binary logistic regression identified two significant risk factors of daily fruits and vegetables intake namely, being a non-Chinese (AOR = 1.905, 95% CI = 1.114–3.257) and having good practices scores (AOR = 2.543, 95% CI = 1.611–4.015). Conclusion: The study found a low daily intake of fruits and vegetables. The findings suggested that nutritional interventions are necessary to improve awareness on consuming more fruits and vegetables to improve overall health.
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Affiliation(s)
- Yi Liang Lo
- Faculty of Science and Engineering, School of Biosciences, 69861University of Nottingham Malaysia, Semenyih, Malaysia
| | - Siew Siew Lee
- Faculty of Science and Engineering, School of Biosciences, 69861University of Nottingham Malaysia, Semenyih, Malaysia
| | - Shi-Hui Cheng
- Faculty of Science and Engineering, School of Biosciences, 69861University of Nottingham Malaysia, Semenyih, Malaysia
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18
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Mackey ER, Burton ET, Cadieux A, Getzoff E, Santos M, Ward W, Beck AR. Addressing Structural Racism Is Critical for Ameliorating the Childhood Obesity Epidemic in Black Youth. Child Obes 2022; 18:75-83. [PMID: 34491828 DOI: 10.1089/chi.2021.0153] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Racism and childhood obesity are both pervasive factors adversely affecting the health and wellbeing of children and adolescents in the United States. The association between racism and obesity has been touched upon in the literature; yet most work has focused on a few dimensions of intersectionality of these two domains at one time. The renewed focus on structural racism as the primary contributor to distress of Black individuals in the United States has highlighted the urgency of identifying the contributions of racism to the childhood obesity epidemic. The current article is not a complete review of the literature, rather, it is meant to take a broad narrative review of the myriad ways in which racism contributes to the obesity epidemic in Black youth to serve as a call to action for more research, prevention, and intervention. The current article illustrates how a number of mechanisms for the etiology and maintenance of obesity are heavily influenced by racism and how addressing racism is critical for ameliorating the childhood obesity epidemic.
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Affiliation(s)
- Eleanor R Mackey
- Children's National Hospital, Center for Translational Research, Washington, DC, USA
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - E Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Adelle Cadieux
- Department of Behavioral Health, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, Michigan State University, Lansing MI, USA
| | - Elizabeth Getzoff
- Department of Psychology and Neuropsychology, Mt. Washington Pediatric Hospital, Baltimore, MD, USA
| | - Melissa Santos
- Division of Pediatric Psychology, Connecticut Children's, Hartford, CT, USA
| | - Wendy Ward
- Department of Pediatrics, College of Medicine, University of Arkansas Medical Center, Little Rock, AR, USA
| | - Amy R Beck
- Center for Children's Healthy Lifestyles and Nutrition and Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA
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19
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Althoff T, Nilforoshan H, Hua J, Leskovec J. Large-scale diet tracking data reveal disparate associations between food environment and diet. Nat Commun 2022; 13:267. [PMID: 35042849 PMCID: PMC8766578 DOI: 10.1038/s41467-021-27522-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
An unhealthy diet is a major risk factor for chronic diseases including cardiovascular disease, type 2 diabetes, and cancer1-4. Limited access to healthy food options may contribute to unhealthy diets5,6. Studying diets is challenging, typically restricted to small sample sizes, single locations, and non-uniform design across studies, and has led to mixed results on the impact of the food environment7-23. Here we leverage smartphones to track diet health, operationalized through the self-reported consumption of fresh fruits and vegetables, fast food and soda, as well as body-mass index status in a country-wide observational study of 1,164,926 U.S. participants (MyFitnessPal app users) and 2.3 billion food entries to study the independent contributions of fast food and grocery store access, income and education to diet health outcomes. This study constitutes the largest nationwide study examining the relationship between the food environment and diet to date. We find that higher access to grocery stores, lower access to fast food, higher income and college education are independently associated with higher consumption of fresh fruits and vegetables, lower consumption of fast food and soda, and lower likelihood of being affected by overweight and obesity. However, these associations vary significantly across zip codes with predominantly Black, Hispanic or white populations. For instance, high grocery store access has a significantly larger association with higher fruit and vegetable consumption in zip codes with predominantly Hispanic populations (7.4% difference) and Black populations (10.2% difference) in contrast to zip codes with predominantly white populations (1.7% difference). Policy targeted at improving food access, income and education may increase healthy eating, but intervention allocation may need to be optimized for specific subpopulations and locations.
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Affiliation(s)
- Tim Althoff
- Allen School of Computer Science & Engineering, University of Washington, Seattle, WA, USA.
| | - Hamed Nilforoshan
- Department of Computer Science, Stanford University, Stanford, CA, USA
| | - Jenna Hua
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Million Marker Wellness Inc., San Francisco, CA, USA
| | - Jure Leskovec
- Department of Computer Science, Stanford University, Stanford, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
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20
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Tripicchio GL, Kay M, Herring S, Cos T, Bresnahan C, Gartner D, Sosinsky LS, Bass SB. Development and Preliminary Feasibility of iByte4Health: A Mobile Health (mHealth) Pediatric Obesity Prevention Intervention to Engage Parents with Low-Income of Children 2-9 Years. Nutrients 2021; 13:nu13124240. [PMID: 34959792 PMCID: PMC8708273 DOI: 10.3390/nu13124240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 01/22/2023] Open
Abstract
This research describes the development and preliminary feasibility of iByte4Health, a mobile health (mHealth) obesity prevention intervention designed for parents with a low-income of children 2–9 years of age. Study 1 (n = 36) presents findings from formative work used to develop the program. Study 2 (n = 23) presents a 2-week proof-of-concept feasibility testing of iByte4Health, including participant acceptability, utilization, and engagement. Based on Study 1, iByte4Health was designed as a text-messaging program, targeting barriers and challenges identified by parents of young children for six key obesity prevention behaviors: (1) snacking; (2) physical activity; (3) sleep; (4) sugary drinks; (5) fruit and vegetable intake; and (6) healthy cooking at home. In Study 2, participants demonstrated high program retention (95.7% at follow-up) and acceptability (90.9% reported liking or loving the program). Users were engaged with the program; 87.0% responded to at least one self-monitoring text message; 90.9% found the videos and linked content to be helpful or extremely helpful; 86.4% found text messages helpful or extremely helpful. iByte4Health is a community-informed, evidenced-based program that holds promise for obesity prevention efforts, especially for those families at the increased risk of obesity and related disparities. Future work is warranted to test the efficacy of the program.
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Affiliation(s)
- Gina L. Tripicchio
- Center for Obesity Research and Education, Temple University, Philadelphia, 19140 PA, USA;
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, 19122 PA, USA;
- Correspondence: ; Tel.: +1-215-707-8642
| | - Melissa Kay
- Department of Psychology & Neuroscience, Duke University, Durham, 27708 NC, USA;
| | - Sharon Herring
- Center for Obesity Research and Education, Temple University, Philadelphia, 19140 PA, USA;
| | - Travis Cos
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, 19122 PA, USA;
| | - Carolyn Bresnahan
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, 21205 MD, USA;
| | - Danielle Gartner
- Health Science Center at Houston, University of Texas, Houston, 77030 TX, USA;
| | - Laura Stout Sosinsky
- Research and Evaluation Group, Public Health Management Corporation, Philadelphia, 19102 PA, USA;
| | - Sarah B. Bass
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, 19122 PA, USA;
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21
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Factors associated with feeding practices of black immigrant mothers of African and Caribbean origin living in Ottawa, Canada. Appetite 2021; 167:105641. [PMID: 34384808 DOI: 10.1016/j.appet.2021.105641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022]
Abstract
In Canada, Black immigrant women and their children are at higher risk of developing obesity. Factors that could influence children's weight status include parental feeding practices. Feeding practices such as monitoring, restriction and pressure to eat, are well studied among non-Hispanic White and Latinos groups, however, little is known about the feeding practices of Black immigrant parents of African and Caribbean origin. The aim of this study was to identify factors associated with feeding practices of Black immigrant mothers in Ottawa, Canada. The sample includes 188 Black mothers of African and Caribbean origin and their 6-12-year-old children. The Child Feeding Questionnaire was used to assess mothers' feeding practices. Demographic and socioeconomic data were collected using questionnaires. All participants' weight status was determined from measured weight and height. Pearson Chi-square tests and multivariate logistic regressions were performed. Results showed that mothers who felt responsible for feeding their children were more likely to monitor their children's food intake (p < 0.05). While mothers of children with underweight or normal weight were more like to use pressure to eat (p < 0.01), mothers of children with overweight or obesity were more like to use restriction (P < 0.05). Recent immigrant mothers were also more likely to use pressure to eat (P < 0.05). This study also provides evidence for associations between maternal feeding practices and mothers' weight status, household income and food security status. Findings build on previous research suggesting that parental feeding practices vary based on parents' and children's characteristics. Longitudinal studies are needed to assess the directionality of the association between mothers' feeding practices, and children's weight, diet quality and health in this population.
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22
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Perdew M, Liu S, Naylor PJ. Family-based nutrition interventions for obesity prevention among school-aged children: a systematic review. Transl Behav Med 2021; 11:709-723. [PMID: 32893869 DOI: 10.1093/tbm/ibaa082] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Effective evidence-informed family-based nutrition interventions for childhood obesity management are needed. (a) To assess the number and quality of published randomized controlled trials incorporating family-based nutrition interventions for childhood obesity (ages 5-18 years) management and (b) to identify intervention attributes (e.g., contact time, nutrition curricula, and behavior change strategies) used in successful interventions. Studies that met eligibility criteria were randomized controlled trials and family-based childhood obesity management interventions for children and adolescents ages 5-18 years old that included a healthy eating component and measured child dietary behaviors and/or parent dietary feeding practices. Six databases were searched: CINAHL complete, Cochrane Central Register of Controlled Trials, Health Source: Nursing/Academic Edition, MEDLINE with full text (PubMed), PsycINFO, SPORTDiscus, and ERIC (EBSCO Host). The validated Quality Assessment Tool for Quantitative Studies was used to assess study quality. Eight studies met eligibility criteria. Study quality analysis showed that blinding of the research teams (e.g., analysts, and those focused on data collection) and the use of age appropriate, valid, and reliable instruments were areas of concern. Successful nutrition interventions targeting children 5-18 years old, appear to include setting family-based goals, modifying home food environment, hands-on approaches to teaching nutrition (games, group-based activities), and fruit and vegetable vouchers. This review highlighted a limited amount of moderate to high quality evidence to suggest that family-based nutrition interventions can be successful in improving dietary behaviors and that interventions with positive outcomes had some components of nutrition curricula and strategies in common.
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Affiliation(s)
- Megan Perdew
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Sam Liu
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
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23
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Filos D, Lekka I, Kilintzis V, Stefanopoulos L, Karavidopoulou Y, Maramis C, Diou C, Sarafis I, Papapanagiotou V, Alagialoglou L, Ioakeimidis I, Hassapidou M, Charmandari E, Heimeier R, O'Malley G, O'Donnell S, Doyle G, Delopoulos A, Maglaveras N. Exploring Associations Between Children's Obesogenic Behaviors and the Local Environment Using Big Data: Development and Evaluation of the Obesity Prevention Dashboard. JMIR Mhealth Uhealth 2021; 9:e26290. [PMID: 34048353 PMCID: PMC8274675 DOI: 10.2196/26290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/02/2021] [Accepted: 03/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity is a major public health problem globally and in Europe. The prevalence of childhood obesity is also soaring. Several parameters of the living environment are contributing to this increase, such as the density of fast food retailers, and thus, preventive health policies against childhood obesity must focus on the environment to which children are exposed. Currently, there are no systems in place to objectively measure the effect of living environment parameters on obesogenic behaviors and obesity. The H2020 project "BigO: Big Data Against Childhood Obesity" aims to tackle childhood obesity by creating new sources of evidence based on big data. OBJECTIVE This paper introduces the Obesity Prevention dashboard (OPdashboard), implemented in the context of BigO, which offers an interactive data platform for the exploration of objective obesity-related behaviors and local environments based on the data recorded using the BigO mHealth (mobile health) app. METHODS The OPdashboard, which can be accessed on the web, allows for (1) the real-time monitoring of children's obesogenic behaviors in a city area, (2) the extraction of associations between these behaviors and the local environment, and (3) the evaluation of interventions over time. More than 3700 children from 33 schools and 2 clinics in 5 European cities have been monitored using a custom-made mobile app created to extract behavioral patterns by capturing accelerometer and geolocation data. Online databases were assessed in order to obtain a description of the environment. The dashboard's functionality was evaluated during a focus group discussion with public health experts. RESULTS The preliminary association outcomes in 2 European cities, namely Thessaloniki, Greece, and Stockholm, Sweden, indicated a correlation between children's eating and physical activity behaviors and the availability of food-related places or sports facilities close to schools. In addition, the OPdashboard was used to assess changes to children's physical activity levels as a result of the health policies implemented to decelerate the COVID-19 outbreak. The preliminary outcomes of the analysis revealed that in urban areas the decrease in physical activity was statistically significant, while a slight increase was observed in the suburbs. These findings indicate the importance of the availability of open spaces for behavioral change in children. Discussions with public health experts outlined the dashboard's potential to aid in a better understanding of the interplay between children's obesogenic behaviors and the environment, and improvements were suggested. CONCLUSIONS Our analyses serve as an initial investigation using the OPdashboard. Additional factors must be incorporated in order to optimize its use and obtain a clearer understanding of the results. The unique big data that are available through the OPdashboard can lead to the implementation of models that are able to predict population behavior. The OPdashboard can be considered as a tool that will increase our understanding of the underlying factors in childhood obesity and inform the design of regional interventions both for prevention and treatment.
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Affiliation(s)
- Dimitris Filos
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University, Thessaloniki, Greece
| | - Irini Lekka
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University, Thessaloniki, Greece
| | - Vasileios Kilintzis
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University, Thessaloniki, Greece
| | - Leandros Stefanopoulos
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University, Thessaloniki, Greece
| | - Youla Karavidopoulou
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University, Thessaloniki, Greece
| | - Christos Maramis
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University, Thessaloniki, Greece
| | - Christos Diou
- Department of Informatics and Telematics, Harokopio University of Athens, Athens, Greece.,Multimedia Understanding Group, Aristotle University, Thessaloniki, Greece
| | - Ioannis Sarafis
- Multimedia Understanding Group, Aristotle University, Thessaloniki, Greece
| | | | | | - Ioannis Ioakeimidis
- Department of Biosciences and Nutrition, Karolinska University, Stockholm, Sweden
| | | | | | | | - Grace O'Malley
- School of Physiotherapy, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Shane O'Donnell
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Gerardine Doyle
- College of Business, University College Dublin, Dublin, Ireland
| | | | - Nicos Maglaveras
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University, Thessaloniki, Greece
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24
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Genitsaridi SM, Giannios C, Karampatsou S, Papageorgiou I, Papadopoulos G, Farakla I, Koui E, Georgiou A, Romas S, Terzioglou E, Papathanasiou C, Kassari P, Manios Y, Charmandari E. A Comprehensive Multidisciplinary Management Plan Is Effective in Reducing the Prevalence of Overweight and Obesity in Childhood and Adolescence. Horm Res Paediatr 2021; 93:94-107. [PMID: 32580197 DOI: 10.1159/000507760] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/06/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Obesity in childhood and adolescence represents a major health problem of our century. In Greece, 30-35% of children and adolescents are overweight or obese. Objective and Hypotheses: To investigate the effectiveness of a comprehensive multidisciplinary personalized management plan at reducing the prevalence of overweight and obesity in childhood and adolescence. PATIENTS AND METHODS One thousand (n = 1,000) children and adolescents aged 2-18 years (mean age ± SD: 10.09 ± 2.86 years; 520 females, 480 males) were studied prospectively. Subjects were classified as obese (n = 579, 57.9%), overweight (n = 295, 29.5%) or having a normal body mass index (BMI) (n = 126, 12.6%) according to the International Obesity Task Force cutoff points. All subjects were evaluated by a multidisciplinary team at frequent intervals, received personalized advice on diet and exercise and were studied prospectively for 1 year. Detailed clinical evaluation and laboratory investigations were performed at the beginning and at the end of the study. RESULTS At initial evaluation, 57.9% of subjects were obese, 29.5% overweight and 12.6% of normal BMI. Indices of cardiometabolic disease were higher in obese than in overweight and normal-BMI subjects. Following 1 year of multidisciplinary management interventions, the prevalence of obesity decreased by 16.8%, the prevalence of normal BMI increased by 8.2%, and all cardiometabolic indices improved significantly. CONCLUSIONS A personalized multidisciplinary management plan is effective at reducing the prevalence of obesity in childhood and adolescence.
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Affiliation(s)
- Sofia-Maria Genitsaridi
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece,
| | - Christos Giannios
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Sofia Karampatsou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ifigeneia Papageorgiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Georgios Papadopoulos
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ioanna Farakla
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Eleni Koui
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Alexandra Georgiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.,Department of Nutrition, Harokopio University of Athens, Athens, Greece
| | - Stamatis Romas
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Eleni Terzioglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Chryssanthi Papathanasiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Penio Kassari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Yannis Manios
- Department of Nutrition, Harokopio University of Athens, Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Lebron CN, Agosto Y, Guzman T, Sutton D, Stoutenberg M, Messiah SE, George SMS. A qualitative study of cognitive, behavioral, and environmental influences on Hispanic mothers' early childhood feeding practices. Appetite 2021; 164:105268. [PMID: 33864860 DOI: 10.1016/j.appet.2021.105268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/12/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
Young children's lifestyle behaviors are largely shaped by their parents. There are socioeconomic risk factors particular to Hispanic populations that influence the way parents feed their children. As obesity continues to be a public health issue with substantial inequities across race and ethnicity, it is critical to understand Hispanic parents' food choices and feeding practices. The objective of this qualitative study is to identify the behavioral, environmental, and cognitive factors that influence the parental food choices and feeding behaviors of Hispanic mothers of children ages 0-5 years. Snowball sampling was used to recruit participants from the community (n = 30) who were 1) female; 2) Hispanic; 3) over the age of 18; and 4) a mother to child(ren) between the ages zero and five. Each interview consisted of a brief demographic survey and a set of open-ended questions based on Social Cognitive Theory constructs. A thematic analysis using a combined deductive and inductive approach was used to analyze transcriptions. Results indicated that mothers' attitudes around breastfeeding were connected with their challenges, while their attitudes around solid foods were expressed in their feeding strategies. Mothers used strategies of modeling, repeated exposure, and practices of "sneaking" in healthy foods and bribing to promote healthy eating. Mothers were most likely to seek out information from (1) pediatricians, (2) female family members, and (3) the internet. Hispanic mothers actively seek out information from many different sources that impact how they feed their young children. Understanding their trusted sources and how it influences the SCT constructs is an important step in preventing early childhood obesity.
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Affiliation(s)
- Cynthia N Lebron
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.
| | - Yaray Agosto
- Florida International University, Robert Stempel College of Public Health & Social Work, Miami, FL, USA
| | - Tamisha Guzman
- Florida International University, Robert Stempel College of Public Health & Social Work, Miami, FL, USA
| | - Danielle Sutton
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mark Stoutenberg
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Sarah E Messiah
- University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas, TX, USA; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, TX, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Risk and Protective Factors Associated with Adolescent Food Insecurity in Baltimore. J Urban Health 2021; 98:296-307. [PMID: 33094426 PMCID: PMC8079556 DOI: 10.1007/s11524-020-00488-w] [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] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
While emerging evidence is highlighting a growing problem of food insecurity among adolescents in disadvantaged neighborhoods, very little is known about the factors that may either protect or place adolescents at higher risk for food insecurity. The primary objective for this analysis, therefore, was to examine the associations between individual-, family-, and neighborhood-level risks and protective factors and food insecurity among 452 adolescents in Baltimore, Maryland. Results show that nearly 30% of our sample were food insecure (29.4%). Food insecure youth were more likely to be unstably housed (OR 5.17, 1.24-21.62), live in larger households (OR 1.14, 1.08-1.20), and perceive their neighborhoods unsafe (OR 2.37, 1.47-3.83). Protective factors included perceiving both male and female adult support (OR 0.55 and 0.47, respectively), having a higher sense of community belonging (OR 0.91, 0.32-0.95) and having positive perceptions of their neighborhood's physical environment (OR 0.93, 0.88-0.98). These results suggest that strengthening family and neighborhood relations and resources may promote the health of adolescents in disadvantaged urban areas.
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Marshall S, Taki S, Love P, Laird Y, Kearney M, Tam N, Baur LA, Rissel C, Wen LM. The process of culturally adapting the Healthy Beginnings early obesity prevention program for Arabic and Chinese mothers in Australia. BMC Public Health 2021; 21:284. [PMID: 33541310 PMCID: PMC7863271 DOI: 10.1186/s12889-021-10270-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 01/19/2021] [Indexed: 01/25/2023] Open
Abstract
Background Behavioural interventions for the early prevention of childhood obesity mostly focus on English-speaking populations in high-income countries. Cultural adaptation is an emerging strategy for implementing evidence-based interventions among different populations and regions. This paper describes the initial process of culturally adapting Healthy Beginnings, an evidence-based early childhood obesity prevention program, for Arabic and Chinese speaking migrant mothers and infants in Sydney, Australia. Methods The cultural adaptation process followed the Stages of Cultural Adaptation theoretical model and is reported using the Framework for Reporting Adaptations and Modifications-Enhanced. We first established the adaptation rationale, then considered program underpinnings and the core components for effectiveness. To inform adaptations, we reviewed the scientific literature and engaged stakeholders. Consultations included focus groups with 24 Arabic and 22 Chinese speaking migrant mothers and interviews with 20 health professionals. With input from project partners, bi-cultural staff and community organisations, findings informed cultural adaptations to the content and delivery features of the Healthy Beginnings program. Results Program structure and delivery mode were retained to preserve fidelity (i.e. staged nurse calls with key program messages addressing modifiable obesity-related behaviours: infant feeding, active play, sedentary behaviours and sleep). Qualitative analysis of focus group and interview data resulted in descriptive themes concerning cultural practices and beliefs related to infant obesity-related behaviours and perceptions of child weight among Arabic and Chinese speaking mothers. Based on the literature and local study findings, cultural adaptations were made to recruitment approaches, staffing (bi-cultural nurses and project staff) and program content (modified call scripts and culturally adapted written health promotion materials). Conclusions This cultural adaptation of Healthy Beginnings followed an established process model and resulted in a program with enhanced relevance and accessibility among Arabic and Chinese speaking migrant mothers. This work will inform the future cultural adaptation stages: testing, refining, and trialling the culturally adapted Healthy Beginnings program to assess acceptability, feasibility and effectiveness. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10270-5.
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Affiliation(s)
- Sarah Marshall
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia. .,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia. .,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia.
| | - Sarah Taki
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia
| | - Penny Love
- The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Victoria, 3216, Australia
| | - Yvonne Laird
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Marianne Kearney
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Nancy Tam
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Louise A Baur
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Chris Rissel
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia
| | - Li Ming Wen
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia
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28
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Promoting water consumption among children: a three-arm cluster randomised controlled trial testing a social network intervention. Public Health Nutr 2020; 24:2324-2336. [PMID: 33243308 PMCID: PMC8145454 DOI: 10.1017/s1368980020004802] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: To test the effectiveness of a social network intervention (SNI) to improve children’s healthy drinking behaviours. Design: A three-arm cluster randomised control trial design was used. In the SNI, a subset of children were selected and trained as ‘influence agents’ to promote water consumption–as an alternative to sugar-sweetened beverages (SSB)–among their peers. In the active control condition, all children were simultaneously exposed to the benefits of water consumption. The control condition received no intervention. Setting: Eleven schools in the Netherlands. Participants: Four hundred and fifty-one children (Mage = 10·74, SDage = 0·97; 50·8 % girls). Results: Structural path models showed that children exposed to the SNI consumed 0·20 less SSB per day compared to those in the control condition (β = 0·25, P = 0·035). There was a trend showing that children exposed to the SNI consumed 0·17 less SSB per day than those in the active control condition (β = 0·20, P = 0·061). No differences were found between conditions for water consumption. However, the moderation effects of descriptive norms (β = –0·12, P = 0·028) and injunctive norms (β = 0·11–0·14, both P = 0·050) indicated that norms are more strongly linked to water consumption in the SNI condition compared to the active control and control conditions. Conclusions: These findings suggest that a SNI promoting healthy drinking behaviours may prevent children from consuming more SSB. Moreover, for water consumption, the prevailing social norms in the context play an important role in mitigating the effectiveness of the SNI.
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Food Marketing as a Special Ingredient in Consumer Choices: The Main Insights from Existing Literature. Foods 2020; 9:foods9111651. [PMID: 33198136 PMCID: PMC7698179 DOI: 10.3390/foods9111651] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/13/2022] Open
Abstract
The choices and preferences of food consumers are influenced by several factors, from those related to the socioeconomic, cultural, and health dimensions to marketing strategies. In fact, marketing is a determinant ingredient in the choices related to food consumption. Nonetheless, for an effective implementation of any marketing approach, the brands play a crucial role. Creating new brands in the food sector is not always easy, considering the relevant amount of these goods produced within the agricultural sector and in small food industries. The small dimension of the production units in these sectors hinders both brand creation and respective branding. In this context, it would seem important to analyse the relationships between food marketing and consumer choice, highlighting the role of brands in these frameworks. For this purpose, a literature review was carried out considering 147 documents from Scopus database for the topics of search “food marketing” and “choices” (search performed on 16 October 2020). As main insights, it is worth highlighting that the main issues addressed by the literature, concerning food marketing and consumer choices, are the following: economic theory; label and packaging; marketing strategies; agriculture and food industry; market segments; social dimensions; brand and branding. In turn, food marketing heavily conditions consumer choices; however, these related instruments are better manipulated by larger companies. In addition, this review highlights that bigger companies have dominant positions in these markets which are not always beneficial to the consumers’ objectives.
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The Meaning of Physical Activity: A Qualitative Study on the Perspective of South American Immigrant Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207500. [PMID: 33076326 PMCID: PMC7602638 DOI: 10.3390/ijerph17207500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022]
Abstract
Physical activity facilitates the acquisition of healthy habits from childhood to adulthood. There are differences in the practice of physical activity between immigrant children and native Spanish children. The aim was to describe physical activity in children, from the perspective of South American immigrant parents. A qualitative case study was conducted. Parents were recruited using purposeful sampling. Data were collected from 12 participants by means of unstructured interviews together with researcher notes. A thematic analysis was applied. The following topics were identified: (a) physical activity and health, (b) socialization, (c) the need for movement, (d) gender, (e) barriers, (f) educational burden, (g) community living, and (h) reason for immigrating. Parents described how physical activity is fundamental and has benefits for health, and for the relationship between children. They perceived that physical activity should not be limited by gender. The time dedicated to other school activities, the norms related to community living, and financial limitations were especially relevant as barriers for the performance of physical activity. These results can be used to revise the curriculum in schools, promote equal opportunities for physical activity and support family participation.
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Mahmoud AB, Hack-Polay D, Fuxman L, Naquiallah D, Grigoriou N. Trick or treat? - when children with childhood food allergies lead parents into unhealthy food choices. BMC Public Health 2020; 20:1453. [PMID: 32977776 PMCID: PMC7517056 DOI: 10.1186/s12889-020-09556-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/17/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study examines the relationships between childhood food allergy and parental unhealthy food choices for their children across attitudes towards childhood obesity as mediators and parental gender, income and education as potential moderators. METHODS We surveyed parents with at least one child between the ages of 6 and 12 living in Canada and the United States. We received 483 valid responses that were analysed using structural equation modelling approach with bootstrapping to test the hypothetical path model and its invariance across the moderators. RESULTS The analysis revealed that pressure to eat fully mediated the effects of childhood food allergy and restriction on parental unhealthy food choices for their children. Finally, we found that parental gender moderated the relationship between childhood food allergy and the pressure to eat. CONCLUSIONS The paper contributes to the literature on food allergies among children and the marginalisation of families with allergies. Our explorative model is a first of its kind and offers a fresh perspective on complex relationships between variables under consideration. Although our data collection took place prior to Covid-19 outbreak, this paper bears yet particular significance as it casts light on how families with allergies should be part of the priority groups to have access to food supply during crisis periods.
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Affiliation(s)
| | - Dieu Hack-Polay
- Crandall University, Moncton, Canada
- University of Lincoln, Lincoln, UK
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32
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A National e-Health Program for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence in Greece. Nutrients 2020; 12:nu12092858. [PMID: 32961973 PMCID: PMC7551883 DOI: 10.3390/nu12092858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 11/17/2022] Open
Abstract
Obesity in childhood and adolescence represents one of the most challenging public health problems of the 21st century owing to its epidemic proportions worldwide and the associated significant morbidity, mortality and public health costs. In Greece, the prevalence of overweight and obesity in childhood and adolescence exceeds 30-35%. To address the increasing prevalence of overweight and obesity in children and adolescents in our country, we developed the 'National e-Health Program for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence', which provides specific and detailed guidance to all primary health care physicians about the personalized management of children and adolescents with overweight or obesity. In the present study we evaluated 2400 children and adolescents [mean age ± SEM: 10.10 ± 0.09 years.; Males: 1088, Females: 1312; Obesity (n = 1370, 57.1%), Overweight (n = 674, 28.1%), normal BMI (n = 356, 14.8%)], who followed the personalized multi-disciplinary management plan specified by the 'National e-Health Program for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence', and were studied prospectively for 1 year. We demonstrated that at the end of the first year, the prevalence of obesity decreased by 32.1%, the prevalence of overweight decreased by 26.7%, and the cardiometabolic risk factors improved significantly. These findings indicate that our National e-Health Program is effective at reducing the prevalence of overweight and obesity in childhood and adolescence after one year of intervention in the largest sample size reported to date.
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33
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Ochieng BMN. Healthy weight maintenance strategy in early childhood: The views of black African migrant parents and health visitors. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1551-1559. [PMID: 32173948 DOI: 10.1111/hsc.12979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
In Europe and the US, childhood obesity is found to be higher in migrant children from black African communities and other visible minority ethnic groups. However, very little is known about the factors that contribute to the significant rates of obesity in these groups. The material for this study is drawn from a community-based qualitative study that examined the sociocultural, familial and environmental factors that either facilitate or hinder healthy weight in black African children during early childhood. The participants for the study were black African parents (n = 30) and health visitors (n = 32), residing and working in the East Midlands, UK. The participants were purposively selected according to an inclusion/exclusion criterion and invited to participate in seven focus groups (FG-7) conducted for parents (FG-4) and health visitors (FG-3) at a time and place convenient to the participants, between March and June 2018. The focus groups examined a number of issues, including the participants' views on the barriers and facilitators to achieving and maintaining a healthy weight. Thematic analysis was used to identify themes within the data. Although participants were knowledgeable about the need for a healthy weight in early childhood, the parents discussed how immigration status and experiences of discrimination had an impact on their children's diet and well-being, also discussing how structural factors influenced the decisions they made regarding healthy weight in early childhood. While the health visitors in general felt they did not have the skills to advise black African parents about the cultural influences on diet during early childhood, findings highlighted a need for a system-based approach in meeting the nutritional needs of black African children. This study concludes by suggesting the need for broad social-environment and economic changes that address factors such as migration status, deprivation and discrimination, coupled with culturally specific healthy diet messages.
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Affiliation(s)
- Bertha M N Ochieng
- Integrated Health and Social Care, Faculty of Health & Life Sciences, De Montfort University, Leicester, UK
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34
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Khalsa AS, Copeland KA, Misik L, Brown CL, Kharofa RY, Ollberding NJ. Maternal Body Dissatisfaction and Accuracy of Infant Weight Perception in Families From Low-Income Backgrounds. Acad Pediatr 2020; 20:793-800. [PMID: 32247669 DOI: 10.1016/j.acap.2020.03.009] [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: 03/12/2020] [Accepted: 03/22/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the association between maternal body dissatisfaction and mother's (mis)perception of their infant's weight classification among families from low-income households. METHODS Mother-infant dyads were recruited during well-child visits from 2 urban primary care clinics. Maternal body dissatisfaction was measured using the Stunkard Figure Rating Scale. Perception of infant weight was assessed using a 5-point Likert scale. Infant weight-for-length percentiles were calculated using World Health Organization growth charts. Associations between maternal body dissatisfaction score and mother's (mis)perception of their infant's weight classification were examined using logistic regression allowing for nonlinear associations via restricted cubic splines. RESULTS Mothers (n = 180) were 26.6 ± 5.1 years old and 72% Black; infants were 8.8 ± 2.1 months old. Mean infant weight-for-length percentile was 64 ± 26. On average, mothers wanted to be one body figure smaller than their perceived current body size. Most mothers (82%) accurately perceived their infant's weight classification while few overestimated (7%) or underestimated (11%) their child's weight category. The probability of mothers misperceiving their infant's weight classification increased as maternal body dissatisfaction increased in either extreme in unadjusted (P < .05) and adjusted analysis (P = .06). CONCLUSIONS Increased maternal body dissatisfaction may be associated with mother's misperception of infant weight classification. Future studies should examine this relationship in a heterogeneous population.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Nationwide Children's Hospital (AS Khalsa), Columbus, Ohio; Department of Pediatrics, The Ohio State University College of Medicine (AS Khalsa), Columbus, Ohio.
| | - Kristen A Copeland
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (KA Copeland), Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine (KA Copeland, RY Kharofa, and NJ Ollberding), Cincinnati, Ohio
| | - Lauren Misik
- Northeast Ohio Medical University, College of Medicine (L Misik), Rootstown, Ohio
| | - Callie L Brown
- Department of Pediatrics, Wake Forest University School of Medicine (CL Brown), Winston-Salem, NC
| | - Roohi Y Kharofa
- Department of Pediatrics, University of Cincinnati College of Medicine (KA Copeland, RY Kharofa, and NJ Ollberding), Cincinnati, Ohio; The Heart Institute, Cincinnati Children's Hospital Medical Center (RY Kharofa), Cincinnati, Ohio
| | - Nicholas J Ollberding
- Department of Pediatrics, University of Cincinnati College of Medicine (KA Copeland, RY Kharofa, and NJ Ollberding), Cincinnati, Ohio; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center (NJ Ollberding), Cincinnati, Ohio
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Abstract
PURPOSE OF REVIEW This review is an assessment of the state of the science on nutrition disparities and their contribution to disparities in cardiovascular health. RECENT FINDINGS Nutrition disparities remain pervasive by race/ethnicity, sex/gender, socioeconomic status, and geography. They are rooted in differences in social, cultural, and environmental determinants of health, behavioral and lifestyle factors, and the impact of policy interventions. Systematic differences in diet quality, dietary patterns, and nutrient intakes contribute to cardiovascular disparities and are mediated by microbiota, and CVD risk factors including high levels of blood pressure, low density lipoprotein cholesterol (LDL), and glucose; oxidative stress, pro-inflammatory cytokines, and endothelial dysfunction. Despite the progress made in nutrition research, important gaps persist that signal the need for more effective interventions at multiple levels to reduce cardiovascular disparities. Research opportunities include (1) exploring the gene-nutrient-environment interactions in the context of ancestral diversity; (2) investigating the causal link between diet and gut microbiota and impact of social determinants of health; (3) understanding resilience; (4) testing the effectiveness of multi-level interventions that address social and environmental determinants; and (4) supporting intervention research informed by validated implementation science frameworks.
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Affiliation(s)
- George A Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), 6705 Rockledge Drive, Suite 6070, Bethesda, MD, 20892, USA.
| | - Alison G M Brown
- Division of Cardiovascular Sciences, NHLBI, NIH, 6710 Rockledge Drive, Suite 10115, Bethesda, MD, 20892, USA
| | - Charlotte A Pratt
- Division of Cardiovascular Sciences, NHLBI, NIH, 6710 Rockledge Drive, Suite 10115, Bethesda, MD, 20892, USA
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Burton ET, Smith WA. Mindful Eating and Active Living: Development and Implementation of a Multidisciplinary Pediatric Weight Management Intervention. Nutrients 2020; 12:E1425. [PMID: 32423162 PMCID: PMC7284820 DOI: 10.3390/nu12051425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/30/2020] [Accepted: 05/08/2020] [Indexed: 01/22/2023] Open
Abstract
Pediatric overweight and obesity are significant individual and public health issues that require an innovative approach. While evidence suggests that intensive family-based behavioral lifestyle modification can improve weight status, practical and logistical realities limit the ability of primary healthcare providers to intervene effectively. MEALs (Multidisciplinary Engagement and Learning/Mindful Eating and Active Living) is a family-based mindfulness intervention developed to address pediatric overweight and obesity, while improving healthy lifestyle behaviors through cooking classes. The incorporation of mindfulness, a psychological strategy associated with increased awareness of internal experiences, allows for a focus on the importance of healthy eating along with safe and efficacious kitchen practices. The Template for Intervention Description and Replication (TIDieR) checklist and guide is used to describe the intervention with the intention of providing necessary details to implement the intervention in clinical practice or replicate the intervention for further study. Lessons learned from pilot iterations of the intervention are provided.
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Affiliation(s)
- E. Thomaseo Burton
- Pediatric Obesity Program, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
- Children’s Foundation Research Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA
| | - Webb A. Smith
- Pediatric Obesity Program, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
- Children’s Foundation Research Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA
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Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, Momin SR, Welsh JA, Woo JG, Haycraft E. Caregiver Influences on Eating Behaviors in Young Children: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2020; 9:e014520. [PMID: 32389066 PMCID: PMC7660848 DOI: 10.1161/jaha.119.014520] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self‐regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self‐regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self‐regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self‐regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community‐based care providers.
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Eng S, Donoghue C, Khun T, Szmodis W. Critical Consciousness of Food Systems as a Potential Lifestyle Intervention on Health Issues. Am J Lifestyle Med 2020; 14:258-263. [PMID: 32477023 PMCID: PMC7232891 DOI: 10.1177/1559827620907833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
When examining food systems in contemporary, industrialized, and globalized nations such as the United States, there is a quantity over quality cultural mind-set driven by capitalism. This creates an environment in which consumer desires for convenient lifestyles run high, mainly focused on the production of food and individual financial gain rather than the food systems as a whole. This approach neglects the overall outcomes in health, wellness, health disparities, and the sustainability footprint associated with consumption. Food is more than just food. It involves a network of different levels and elements that creates a multidimensional framework in which food systems, and the choices produced within those systems, can either positively or negatively affect consumers' lifestyles and health. This article discusses the importance of food systems and the ways in which they can be incorporated into a lifestyle intervention for general food consumers as well as those suffering from dietary-related diseases. With a critical understanding that structural barriers associated with current food systems are partly responsible for dietary-related diseases, individuals' self-blame and guilt can be alleviated and liberated, thus enhancing overall emotional and physical health. Drawing on social cognitive theory, food systems are conceptualized into triadic, dynamic interaction of environment (eg, food production, processing, packaging, transporting, marketing, disposing), cognition (eg, learned experience, and knowledge of food, nutrition, and wellness), and behavior (eg, food purchasing, preparation, and consumption).
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Affiliation(s)
- Sothy Eng
- Sothy Eng, PhD, University of Hawaii at Manoa, 2515 Campus Road, Honolulu, HI 96822; e-mail:
| | - Carli Donoghue
- University of Hawaii at Manoa, Honolulu, Hawaii (SE, CD, TK)
- Lehigh University, Bethlehem, Pennsylvania (WS)
| | - Tricia Khun
- University of Hawaii at Manoa, Honolulu, Hawaii (SE, CD, TK)
- Lehigh University, Bethlehem, Pennsylvania (WS)
| | - Whitney Szmodis
- University of Hawaii at Manoa, Honolulu, Hawaii (SE, CD, TK)
- Lehigh University, Bethlehem, Pennsylvania (WS)
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Ralston PA, Wickrama KKAS, Coccia CC, Lemacks JL, Young-Clark IM, Ilich JZ. Health for Hearts United Longitudinal Trial: Improving Dietary Behaviors in Older African Americans. Am J Prev Med 2020; 58:361-369. [PMID: 31866211 PMCID: PMC7039745 DOI: 10.1016/j.amepre.2019.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Church-based interventions have been shown to improve the dietary health of underserved populations, yet few studies have examined sustainability of health behavior change over time. This paper examines dietary outcomes over a 24-month period (baseline and 6, 18, and 24 months) for fruit and vegetable and fat consumption behaviors of African-American participants in the Health for Hearts United church-based intervention in North Florida. STUDY DESIGN This quasi-experimental, longitudinal trial was conducted from 2009 to 2012. Data were analyzed in 2018. SETTING/PARTICIPANTS Six churches in a 2-county area (3 treatment, 3 comparison) were selected for the study using community-based participatory research approaches. Participants were African-American adults (aged ≥45 years; n=211 at baseline) randomly selected from the churches, stratified by age and sex. INTERVENTION Health for Hearts United intervention was developed by the 3 treatment churches. The 18-month intervention was implemented in 3 6-month phases, framed around 3 conceptual components, which included 4 types of programs and 4 key messages. MAIN OUTCOME MEASURES Fruit and vegetable consumption was assessed using a single item (fruit and vegetable intake) and the National Cancer Institute Fruit and Vegetable Screener. Fat consumption was determined using a single item (fat intake) and the National Cancer Institute Fat Screener. Background characteristics included age, sex, educational level, and marital status. RESULTS Significant time effects only were found for daily fruit and vegetable intake (p<0.001), fat intake (p<0.001), and the Fat Screener (p<0.001) with dietary improvements in both treatment and comparison groups across the intervention phases. Fruit and Vegetable Screener results showed that time (p<0.001) and the interaction between time and treatment (p<0.01) were significant, with increases in fruit and vegetable consumption over time for both the treatment and comparison groups and with the increase differing between groups. Post hoc analysis revealed that the treatment group had greater increases in fruit and vegetable consumption than the comparison group between Phases 1 and 3 (p=0.03). CONCLUSIONS Dietary behaviors of mid-life and older African Americans can be improved and sustained over 24 months using a church-based heart health intervention, with similar improvements noted for both comparison and treatment participants. TRIAL REGISTRATION This study is registered at www.clinicaltrials.govNCT03339050.
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Affiliation(s)
- Penny A Ralston
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida.
| | | | - Catherine C Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida
| | - Jennifer L Lemacks
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi
| | - Iris M Young-Clark
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida
| | - Jasminka Z Ilich
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida; Institute for Successful Longevity, Florida State University, Tallahassee, Florida
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Zhang Y, Lin L, Liu J, Shi L, Lu J. Dental Caries Status in Autistic Children: A Meta-analysis. J Autism Dev Disord 2020; 50:1249-1257. [PMID: 32008179 DOI: 10.1007/s10803-019-04256-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The objective of this meta-analysis was to assess the dental health status of children with ASD in terms of decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled deciduous teeth (dmft). PubMed, Embase, psycINFO, and Cochrane library were searched for studies published until September 2018. A random-effects model was applied to estimate the pooled results.Nine studies comprising 532 children with ASD and 622 controls were included. No significant differences between children with ASD and controls were observed for DMFT and dmft in the world. Subgroup analyses revealed that children with ASD had a significantly higher dmft index than that of controls in Asia.Children with ASD have a worse dental health status than healthy children in Asia, but caution is necessary given the limited studies available for analysis.
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Affiliation(s)
- Yujian Zhang
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen, 518003, China
| | - Ling Lin
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen, 518003, China
- Shenzhen Kangning Hospital, Shenzhen University, Shenzhen, 518061, China
| | - Jianbo Liu
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen, 518003, China
| | - Ling Shi
- People's Hospital of Longhua, Shenzhen, 518109, China
| | - Jianping Lu
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen, 518003, China.
- Shenzhen Kangning Hospital, Shenzhen University, Shenzhen, 518061, China.
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Bleiweiss-Sande R, Goldberg J, Evans EW, Chui K, Sacheck J. Perceptions of Processed Foods Among Low-Income and Immigrant Parents. HEALTH EDUCATION & BEHAVIOR 2020; 47:101-110. [PMID: 31661981 PMCID: PMC7510496 DOI: 10.1177/1090198119885419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Parent-aimed guidance on the topic of processed foods may help limit highly processed foods in children's diets, but little is known about parent understanding and perceptions of these products. Aims. To determine how parent perceptions of processing align with processing classification systems used in research, and to identify opportunities for future research in communicating information about processed foods. Method. Six focus groups with lower income, racial/ethnic minority and immigrant parents of fourth to sixth graders (n = 37) were conducted. Parents were asked to discuss their views on terminology related to food processing, classification of foods according to their processing level, the healthfulness of select foods, and criteria for choosing snacks for their children. Focus groups were guided by a thematic approach. NVivo 12 (QSR International) was used to facilitate analyses. Results. Thirty mothers and seven fathers participated. Two thirds (62%) were foreign-born; 38% identified as Hispanic. The term "processing" lacked consistent meaning among parents, with variation by immigrant status. Participants associated highly processed foods with convenience, packaging, and added ingredients; "less-processed" versions of foods (e.g., fresh; homemade) were perceived as healthier. Children's preferences were the main criteria for choosing snacks. Foreign-born parents were more likely to associate processed foods with positive characteristics (e.g., properly cooked). Conclusion. The concept of food processing is an area of misconception among parents, providing an opportunity for education that may be extended to larger audiences. A universally accepted definition of food classification by processing level is necessary to effectively communicate the link between processing and healthfulness.
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Garcia ML, Crespo NC, Behar AI, Talavera GA, Campbell N, Shadron LM, Elder JP. Examining Mexican-Heritage Mothers' Perceptions of Their Children's Weight: Comparison of Silhouette and Categorical Survey Methods. Child Obes 2020; 16:44-52. [PMID: 31556701 PMCID: PMC6931916 DOI: 10.1089/chi.2019.0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: Failure to recognize children's overweight status by parents may contribute to children's risk for obesity. We examined two methods of measuring mothers' perceptions of children's weight and factors associated with weight perception inaccuracy. Methods: Cross-sectional analyses of clinical and self-report data from 287 Mexican-heritage mother-child dyads. Mothers identified their child's weight category using a scale (e.g., "normal/overweight/obese") and a visual silhouette scale (11 child gender-specific weight-varying images). Children's height and weight were measured to calculate body mass index (BMI). Chi-square tests examined associations between categorical, silhouette, and BMI percentile categories of children's weight. Bivariate logistic regression analyses examined factors associated with mothers' inaccuracy of their children's weight. Results: Only 13% of mothers accurately classified their child as obese using the categorical scale, while 78% accurately classified their child as obese using the silhouette scale. Mothers were more likely to underestimate their child's weight using BMI categories (62%) compared to using the silhouette scale (23%). Predictors of mothers' underestimation using the categorical method were child sex [female] (adjusted odds ratio [AOR] = 1.99; 95% CI: 1.02-3.86), child age [younger age] (AOR = 10.39; 95% CI: 4.16-25.92 for ages 5-6 years), and mother's weight status (overweight AOR = 2.99; 95% CI: 1.05-8.51; obese AOR = 5.19; 95% CI: 1.89-14.18). Child BMI was the only predictor of mothers' overestimation (AOR = 0.89; 95% CI: 0.85-0.94) using the silhouette method. Conclusions: Using silhouette scales to identify children's body weight may be a more accurate tool for clinicians and interventionists to activate parents' awareness of unhealthy weight in children compared to using traditional categorical weight-labeling methods.
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Affiliation(s)
- Melawhy L. Garcia
- Department of Health Science, Center for Latino Community Health, Evaluation, and Leadership Training, California State University Long Beach, Long Beach, CA.,Address correspondence to: Melawhy L. Garcia, MPH, PhD, Department of Health Science, California State University Long Beach, 1250 Bellflower Boulevard, HHS2-115, Long Beach, CA 90840
| | - Noe C. Crespo
- School of Public Health, Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
| | - Alma I. Behar
- School of Public Health, Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
| | - Gregory A. Talavera
- Department of Psychology, South Bay Latino Research Center, San Diego State University, Chula Vista, CA
| | - Nadia Campbell
- Sponsored Research Administration, San Diego State University Research Foundation, San Diego, CA
| | - Lisa M. Shadron
- Sponsored Research Administration, San Diego State University Research Foundation, San Diego, CA
| | - John P. Elder
- School of Public Health, Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
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Maternal body dissatisfaction in pregnancy, postpartum and early parenting: An overlooked factor implicated in maternal and childhood obesity risk. Appetite 2019; 147:104525. [PMID: 31756411 DOI: 10.1016/j.appet.2019.104525] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Current evidence indicates that to prevent the intergenerational transfer of overweight and obesity from parent to child, interventions are needed across the early life stages, from preconception to early childhood. Maternal body image is an important but often overlooked factor that is potentially implicated in both short- and long-term maternal and child health outcomes, including maternal gestational weight gain, postpartum weight retention, obesity, child feeding practices and early parenting. AIM The aim of this paper is to propose a conceptual model of the relationship between maternal body image (with a specific focus on body dissatisfaction) and maternal and child excess body weight risk across the pregnancy, postpartum and early childhood periods, as well as to highlight opportunities for intervention. CONCLUSION Our conceptual model proposes factors that mediate the associations between antenatal and postpartum maternal body dissatisfaction and maternal and childhood obesity risk. Pregnancy and postpartum present key risk periods for excess weight gain/retention and body dissatisfaction. Psychosocial factors associated with maternal body dissatisfaction, including psychopathology and disordered eating behaviours, may increase maternal and child obesity risk as well as compromise the quality of mother-child interactions underpinning child development outcomes, including physical weight gain. Our conceptual model may be useful for understanding modifiable psychosocial factors for preventing the intergenerational transfer of obesity risk from mothers to their children, from as early as pregnancy, and highlights next steps for multidisciplinary research focused on combatting maternal and child obesity during critical risk periods.
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Aksoy H, Döner Güner P, Kahveci R, Özkara A. WEIGHT LOSS EXPERIENCES OF OBESE INDIVIDUALS; QUALITATIVE STUDY. KONURALP TIP DERGISI 2019. [DOI: 10.18521/ktd.565911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bergmeier H, Paxton SJ, Milgrom J, Anderson SE, Baur L, Hill B, Lim S, Green R, Skouteris H. Early mother-child dyadic pathways to childhood obesity risk: A conceptual model. Appetite 2019; 144:104459. [PMID: 31533059 DOI: 10.1016/j.appet.2019.104459] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/06/2019] [Accepted: 09/14/2019] [Indexed: 01/24/2023]
Abstract
Understanding the emotional quality of the mother-child dyadic relationship and parent-child feeding interactions may further clarify early developmental pathways to eating behaviours and obesity risk. The quality of parent-child relationships fosters all aspects of child development but has not yet been extensively examined in relation to childhood weight gain. The aim of this paper is to propose a conceptual model, which outlines early mother-child dyadic pathways linking parent-child feeding interactions to child body mass index, where parent-child relationships have a central role. It maps out individual and dyadic mother-child factors (i.e., attachment, child temperament and maternal mental health) that influence the nature and quality of parent-child feeding interactions from infancy to toddlerhood. Our model bridges the gap between research fields by bringing together key maternal and child factors implicated in child development. Understanding early parent-child feeding interactional patterns and their influence on child self-regulation and eating behaviours may be relevant to multidisciplinary approaches toward preventing childhood obesity. High quality quantitative and observational data capturing meaningful parent, child and dyadic level interactions around food contexts, attachment security, maternal mental health, child temperament and self-regulation will help to inform new, aetiologically important, targets for preventative intervention.
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Affiliation(s)
- Heidi Bergmeier
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jeannette Milgrom
- School of Psychological Sciences, Melbourne University, Melbourne, Australia; Parent-Infant Research Institute, Department of Clinical and Health, Psychology, Heidelberg Repatriation Hospital, Heidelberg West, Australia
| | - Sarah E Anderson
- Division of Epidemiology, School of Public Health, The Ohio State University, Columbus, OH, USA
| | - Louise Baur
- Discipline of Paediatrics and Child Health and Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Rachael Green
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
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Lebron CN, Lee TK, Prado G, St George SM, Pantin H, Messiah SE. Psychometric properties of an abbreviated Childhood Family Mealtime Questionnaire among overweight and obese Hispanic adolescents. Appetite 2019; 140:169-179. [PMID: 31075325 PMCID: PMC6639035 DOI: 10.1016/j.appet.2019.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022]
Abstract
The current family mealtime literature shows that assessments of the mealtime environment are typically self-report, yet few studies discuss validation techniques or report using validated scales. As such, the current analysis was conducted to validate one of the only published measures to assess the mealtime environment from the adolescent perspective. Specifically, the Childhood Family Mealtime Questionnaire (CFMQ) was evaluated in a sample of 280 overweight and obese Hispanic adolescents to address the need for a validated measure of the family mealtime environment in a demographic that is disproportionately affected by the current obesity epidemic. Results of exploratory and confirmatory factor analyses to evaluate the optimal factor structure, reliability, and validity for a revised, abbreviated CFMQ are presented here. The concurrent validity of the CFMQ was evaluated using correlations between the factor structures and the previously used, culturally appropriate comparable measure of family functioning. Correlations were also computed between factor scores and obesogenic outcomes (fruit and vegetable intake, added sugar intake, and physical activity). Analyses produced a revised, abbreviated version that includes 22 items (reduced from a total of 69 items) and consists of the following 4 factors: family mealtime communication (5 items), family mealtime stress (7 items), appearance weight control (5 items), and mealtime structure (6 items). Cronbach's alphas are reported for reliability. When examining CFMQ concurrent validity with the family functioning latent variable, results showed the family mealtime communication subscale ranked highest. Additionally, the family mealtime communication subscale was associated with all three obesogenic outcomes. This abbreviated CFMQ may be a useful tool for those studying family mealtime environments and their influence on obesity and its associated lifestyle behaviors.
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Affiliation(s)
- Cynthia N Lebron
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Tae K Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hilda Pantin
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sarah E Messiah
- School of Public Health Dallas, University of Texas, Dallas, TX, USA
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Call for action: Addressing obesity in early childhood. Nurse Pract 2019; 44:11-14. [PMID: 31436588 DOI: 10.1097/01.npr.0000577956.19725.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Eichler J, Schmidt R, Poulain T, Hiemisch A, Kiess W, Hilbert A. Stability, Continuity, and Bi-Directional Associations of Parental Feeding Practices and Standardized Child Body Mass Index in Children from 2 to 12 Years of Age. Nutrients 2019; 11:nu11081751. [PMID: 31366059 PMCID: PMC6723946 DOI: 10.3390/nu11081751] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Parental feeding practices are related to child body mass index (BMI, kg/m2) and seem to be a consequence rather than cause of child BMI, but research so far is limited. Stability and continuity of feeding practices, probably explaining changes in food intake and child BMI, remain to be poorly examined. (2) Methods: Feeding practices (i.e., restriction, food as reward, pressure to eat, monitoring) assessed via the Child Feeding Questionnaire, child age, standardized BMI (zBMI), and socio-economic status were measured annually at multiple visits (range 2–8) in a population-based longitudinal cohort study of 1512 parents with their children aged 2 to 12 years. Stability, continuity, and bi-directionality of feeding practices and child zBMI were calculated using correlation coefficients, paired t tests, and cross-lagged panels, respectively. (3) Results: Feeding practices and child zBMI showed moderate to high stability. While continuity was high for restriction, minor temporal changes were observed for other feeding practices and child zBMI. Cross-lags indicated that child zBMI predicted restriction, pressure to eat, and monitoring, while food-rewarding predicted child zBMI only minorly. (4) Conclusions: Parents seem to adapt feeding practices to child zBMI with the exception of food-rewarding.
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Affiliation(s)
- Janina Eichler
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Medical Psychology and Medical Sociology, Psychosomatic Medicine and Psychotherapy, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany.
| | - Ricarda Schmidt
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Medical Psychology and Medical Sociology, Psychosomatic Medicine and Psychotherapy, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany
| | - Tanja Poulain
- LIFE Child Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Andreas Hiemisch
- LIFE Child Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Wieland Kiess
- LIFE Child Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103 Leipzig, Germany
| | - Anja Hilbert
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Medical Psychology and Medical Sociology, Psychosomatic Medicine and Psychotherapy, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany
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Prevalence of Overweight and Obesity among European Preschool Children: A Systematic Review and Meta-Regression by Food Group Consumption. Nutrients 2019; 11:nu11071698. [PMID: 31340602 PMCID: PMC6682909 DOI: 10.3390/nu11071698] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/18/2019] [Accepted: 07/18/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of this review was to estimate the prevalence of overweight and obesity among European children aged 2–7 years from 2006 to 2016 and to analyze these estimations by gender, country, and food group consumption. We searched CINAHL, EMBASE, MEDLINE, and Web of Science databases from their inception until 27 February 2019 including cross-sectional studies and baseline measurements of cohort studies with overweight and obesity defined according to the International Obesity Task Force criteria. Both the inverse-variance fixed-effects method and the DerSimonian and Laird random effects method were used to determinate pooled prevalence estimates and their respective 95% confidence intervals (CIs). A total of 32 studies (n = 197,755 children) with data from 27 European countries were included. Overall, the pooled prevalence estimates of overweight/obesity in European children (aged 2–7 years) during the period 2006–2016 was 17.9% (95% CI: 15.8–20.0), and the pooled prevalence estimate of obesity was 5.3% (95% CI: 4.5–6.1). Southern European countries showed the highest prevalence of excess weight. Additional measures to address the obesity epidemic in early life should be established, especially in European countries where the prevalence of excess weight is very high.
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Luesse HB, Paul R, Gray HL, Koch P, Contento I, Marsick V. Challenges and Facilitators to Promoting a Healthy Food Environment and Communicating Effectively with Parents to Improve Food Behaviors of School Children. Matern Child Health J 2019; 22:958-967. [PMID: 29445980 DOI: 10.1007/s10995-018-2472-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Childhood obesity is a major public health concern and families play an important role. Improving strategies to reach parents and directing tailored nutrition education to them is needed. Purpose To investigate the challenges and facilitators to promoting a healthy environment at home and to identify communication preferences to inform intervention strategies for effectively reaching low-income urban minority families. Procedure Semi-structured focus group interviews were conducted with four groups involving 16 low-income urban parents (94% female; 88% Hispanic/Latino, 12% African American) of elementary school children. Interviews were transcribed and analyzed applying Social Cognitive Theory and using in-vivo coding. Main Findings The most common barriers to parents providing healthy foods to their children were accommodating child preferences and familial opposition. Parents showed intentionality to engage in healthy behaviors, and often shared procedural knowledge for reaching health goals. The analyses of desired communication channels yielded major preferences: tailored information, information provided through multiple mediums, appropriate duration/frequency of messages, and presented from a voice of authority. Conclusion and Implication While parents expressed desires to be healthy, the home food environment presented substantial challenges. Multi-media supports such as workshops, flyers, and text messaging may be useful to facilitate the sharing of information to minimize the tensions between intentionality and reaching desired goals to be healthy. Some parents thought that information received through text messaging could be easily shared and would act as a voice of authority to support child behavior change.
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Affiliation(s)
- Hiershenee B Luesse
- Research, Evaluation, Strategy Consulting, 8RES, LLC, 8 West 87th Street, #7, New York, NY, 10024, USA.
| | - Rachel Paul
- Department of Heath & Behavior, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA
| | - Heewon L Gray
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Pamela Koch
- Department of Heath & Behavior, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA
| | - Isobel Contento
- Department of Heath & Behavior, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA
| | - Victoria Marsick
- Department of Art and Humanities, Teachers College Columbia University, 525 West 120th Street, New York, NY, 10027, USA
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