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Renda A, Reilly K, Yoong S, Lum M, Lecathelinais C, Hodder R, Grady A. Assessing the implementation of healthy eating and physical activity policies and practices in Early Childhood Education and Care in New South Wales, Australia: A cross-sectional study. Health Promot J Austr 2024. [PMID: 39187294 DOI: 10.1002/hpja.917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 07/17/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024] Open
Abstract
ISSUE ADDRESSED Australian children are not meeting the recommended physical activity (PA) and healthy eating (HE) guidelines. Health behaviour practices implemented in community settings such as early education services can improve child's health outcomes and are therefore key to help meet guidelines. This study aimed to measure the implementation of HE and PA policies and practices in Early Childhood Education and Care (ECEC) services in New South Wales (NSW), Australia, and to examine their association with service characteristics. METHODS A random sample of 1122 centre-based ECEC services were invited to a cross-sectional survey measuring HE and PA policy and practice implementation. Regression analyses were conducted to assess the relationship between the service characteristics and implementation of policies/practices. RESULTS In total, 565 ECEC services completed the survey. Results show that while some practices are implemented, the implementation of practices promoting HE and PA education is low. Practices related to educator training for HE (18%) and PA (13%) were poorly implemented. The implementation of practices such as 'providing educator training around child PA', 'engaging families in activities to increase child PA' and 'encouraging supportive feeding practices' were significantly higher in services located in major cities than regional/remote services. 'Having a PA policy' and the practice of 'limiting the use of screen time' was significantly higher in long day care services than in preschools. The implementation of 'providing educator-led PA', 'providing free play opportunities' and 'having a PA policy' was significantly lower in private not-for-profit community managed services than in private for-profit services. CONCLUSIONS Implementation of various HE and PA policies and practices in regional/remote services, private not-for-profit services and preschools across NSW could be improved. SO WHAT?: Future research should be prioritised towards identifying factors influencing the implementation of these policies and practices to best tailor implementation support efforts for those who need it the most.
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Affiliation(s)
- Ana Renda
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Sydney Local Health District, Population Health, Sydney, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kathryn Reilly
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Serene Yoong
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Melanie Lum
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Christophe Lecathelinais
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Rebecca Hodder
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Alice Grady
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
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Jongenelis MI, Budden T, Christian H, Coall DA, Jackson B, Nathan A, Glassenbury E. The Role of Grandparents in Facilitating Children's Physical Activity. J Phys Act Health 2024:1-9. [PMID: 39187252 DOI: 10.1123/jpah.2024-0066] [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: 01/23/2024] [Revised: 06/21/2024] [Accepted: 06/29/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Research suggests there is considerable opportunity to improve children's movement behaviors while they are being cared for by their grandparents. An understanding of the extent to which grandparent practices facilitate children's engagement in physical activity is critical to the development of health interventions targeting grandparent caregivers. This study examined the activity-related beliefs and practices of grandparents and their association with grandchildren's engagement in various movement behaviors while in grandparental care. METHODS Australian grandparents (N = 1190; 60% women) who provided regular care to a grandchild aged 3-14 years were recruited via a web panel provider to complete an online survey. The survey assessed grandparents' physical activity-related beliefs (eg, perceived importance) and practices (eg, support and social control) and their grandchildren's engagement in physical activity (unstructured, structured, and outdoor play) and screen-based activities while in grandparental care. RESULTS The importance of grandchildren's physical activity was rated highly by grandparents. Grandparents' support for their grandchildren's physical activity was positively associated with their grandchildren's engagement in structured physical activity, unstructured physical activity, and outdoor play. Negative social control was associated with greater engagement in screen-based activities. Other correlates of grandchildren's physical activity and screen-based activities included grandparents' own engagement in these activities. CONCLUSIONS Findings highlight the importance of reinforcing the beliefs and practices that positively influence children's movement behaviors and addressing those that have unintended consequences. Encouraging grandparents to support their grandchildren's physical activity and discouraging forms of negative social control are likely to be important in efforts to promote physical activity in children.
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Affiliation(s)
- Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Timothy Budden
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia
| | - Hayley Christian
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
- School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia
| | - David A Coall
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ben Jackson
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia
| | - Andrea Nathan
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
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Kerkeni M, Trabelsi K, Kerkeni M, Ammar A, Aziz AR, Glenn JM, Moalla W, Chtourou H, Jahrami H. Impact of Soccer-Based Training Interventions on Anthropometric Measures Among Children and Adolescents With Overweight/Obesity: A Systematic Review, Meta-Analysis, and Assessment of Certainty of Evidence. Pediatr Exerc Sci 2024:1-10. [PMID: 39168460 DOI: 10.1123/pes.2024-0028] [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: 02/12/2024] [Revised: 05/27/2024] [Accepted: 06/19/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE This systematic review and meta-analysis aimed to systematically examine and summarize recent evidence on the effects of soccer-based training (SBT) on anthropometric measures in children and adolescents with overweight/obesity. METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines, a thorough literature search across 7 electronic databases was conducted on October 11, 2023. The studies' methodological quality was evaluated using the QualSyst tool, followed by conducting a meta-analysis with a random-effects model, and the certainty of evidence was assessed. RESULTS Six studies were included, with 4 studies of strong methodological quality and 2 studies of moderate methodological quality. The results of the meta-analysis revealed SBT decreases fat mass percentage (effect size [ES] = 0.47 [small]; P = .002), with no significant effect of SBT on body mass index (ES = 0.180 [small]; P = .275), body mass (ES = 0.183 [trivial]; P = .212), fat-free mass (ES = 0.074 [trivial]; P = .635), or waist circumference (ES = 0.358 [small]; P = .053). The certainty of evidence was moderate for all outcomes. CONCLUSIONS SBT appears to decrease fat mass percentage, without affecting body mass, body mass index, fat-free mass, or waist circumference in obese/overweight children and adolescents. These findings require further investigation given the moderate certainty of evidence. REGISTRATION The protocol of this review was registered in the Open Science Framework database (https://doi.org/10.17605/OSF.IO/8P4V2).
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Affiliation(s)
- Manel Kerkeni
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
- Research laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
- Research laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
| | - Mohamed Kerkeni
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
- Research laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
| | - Achraf Ammar
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
- Research laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg University Mainz, Mainz,Germany
| | - Abdul Rashid Aziz
- Sport Physiology, Sport Science and Sport Medicine, Singapore Sport Institute, Singapore,Singapore
| | - Jordan M Glenn
- Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR,USA
- Neurotrack Technologies, Redwood City, CA,USA
| | - Wassim Moalla
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
- Research laboratory, Education, Motricity, Sport and Health (EM2S), LR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax,Tunisia
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis,Tunisia
| | - Haitham Jahrami
- Department of Psychiatry, Ministry of Health, Manama,Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama,Bahrain
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Norman Å, Malek ME, Nyberg G, Patterson E, Elinder LS. Effects of Universal School-Based Parental Support for Children's Healthy Diet and Physical Activity-the Healthy School Start Plus Cluster-Randomised Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01697-4. [PMID: 38987407 DOI: 10.1007/s11121-024-01697-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2024] [Indexed: 07/12/2024]
Abstract
Health promotion from an early age is key to preventing unhealthy weight development in childhood, and parental involvement is essential. The school-based Healthy School Start intervention aims to promote healthy dietary and activity habits in the home environment and prevent child obesity through parental support. This study evaluated the effectiveness of the third iteration of the programme on children's dietary and activity behaviours, and body composition through a cluster-randomised controlled trial. The trial included 17 schools (8 intervention) in disadvantaged areas in mid-Sweden with 353 families with 5- to 7-year-old children. The primary outcomes were intake of selected healthy and unhealthy foods and beverages measured using photography. Secondary outcomes were physical activity and sedentary time measured by accelerometry, and measured weight and height. All outcomes were assessed at baseline and post-intervention (8 months). Linear multi-level regression showed significant favourable effects of the intervention for intake of sweet beverages (b = - 0.17, p = 0.04), intake of healthy foods (b = 0.11, p = 0.04), and more time in moderate to vigorous physical activity during weekdays (b = 5.68, p = 0.02). An unfavourable sub-group effect of the intervention was found for children from families with low education regarding sedentary time on weekends (b = 23.04, p = 0.05). The results align with the previous two trials of the programme, indicating that school-based parental support is a useful approach for health promotion in young children in disadvantaged areas. Trial registration: ClinicalTrials.gov: No. NCT03390725, retrospectively registered on January 4, 2018, https://clinicaltrials.gov/ct2/show/NCT03390725 .
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Affiliation(s)
- Åsa Norman
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
- Department of Clinical Neurosciences, Karolinska Institutet, Nobels Väg 9, 171 65, Solna, Sweden.
| | | | - Gisela Nyberg
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- The Swedish School of Sport and Health Sciences, Lidingövägen 1, 114 33, Stockholm, Sweden
| | - Emma Patterson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Section for Risk and Benefit Assessment, Swedish Food Agency, Box 622, 751 26, Uppsala, Sweden
| | - Liselotte Schäfer Elinder
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, 104 31, Stockholm, Sweden
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Budden T, Coall DA, Jackson B, Christian H, Nathan A, Jongenelis MI. Barriers and enablers to promoting grandchildren's physical activity and reducing screen time: a qualitative study with Australian grandparents. BMC Public Health 2024; 24:1670. [PMID: 38909205 PMCID: PMC11193900 DOI: 10.1186/s12889-024-19178-2] [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: 02/20/2024] [Accepted: 06/18/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND With an increasing number of grandparents providing care to their grandchildren, calls have been made for these caregivers to be considered important stakeholders in encouraging children's engagement in health-promoting behaviors, such as physical activity. Understanding the perspectives of grandparents who provide care is crucial to informing efforts that aim to increase children's physical activity, yet little is understood about their perceptions of specific barriers and enablers to promoting children's physical activity and reducing screen time. The present study sought to explore these perceptions. METHODS Semi-structured focus groups and individual interviews were conducted with grandparents who reported providing care to a grandchild aged 3 to 14 years. A total of 20 grandparents were sampled (mean age = 67.8 years). Data were subjected to reflexive thematic analysis. RESULTS Key reported barriers to physical activity included (i) the effort (physical and logistical) and financial cost associated with organizing physical activities, (ii) grandparents' age and mobility issues (e.g., due to injury or illness), (iii) caring for children of different ages (e.g., older children having different physical activity interests than younger children), and (iv) a local environment that is not conducive to physical activity (e.g., lack of appropriate facilities). Barriers to reducing screen time included (i) parents sending children to care with electronic devices and (ii) children's fear of missing out on social connection that occurs electronically. Strategies and enablers of physical activity included (i) integrating activity into caregiving routines (e.g., walking the dog), (ii) involving grandchildren in decision making (e.g., asking them in which physical activities they wish to engage), (iii) encouraging grandchildren to engage in activity with other children, and (iv) creating a physical and social environment that supports activity (e.g., owning play equipment). A common strategy for reducing screen time was the creation of a home environment that is not conducive to this activity (e.g., removing electronic devices from view). CONCLUSIONS Findings suggest that grandparents may benefit from resources that assist them to identify activities that are inexpensive and require minimal effort to organize. Activities that account for grandparents' age and health status, as well as any environmental barriers, are likely to be well-received.
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Affiliation(s)
- Timothy Budden
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, 35 Stirling Highway, Nedlands, WA, 6009, Australia
- Telethon Kids Institute, The University of Western Australia, 15 Hospital Avenue, Nedlands, WA, 6009, Australia
| | - David A Coall
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, 35 Stirling Highway, Nedlands, WA, 6009, Australia
- Telethon Kids Institute, The University of Western Australia, 15 Hospital Avenue, Nedlands, WA, 6009, Australia
| | - Hayley Christian
- Telethon Kids Institute, The University of Western Australia, 15 Hospital Avenue, Nedlands, WA, 6009, Australia
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Nedlands, WA, 6009, Australia
| | - Andrea Nathan
- Telethon Kids Institute, The University of Western Australia, 15 Hospital Avenue, Nedlands, WA, 6009, Australia
| | - Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Grattan St, Melbourne, VIC, 3010, Australia.
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Vorage L, Vincze L, Tudehope L, Harris N. Effectiveness of Interventions Promoting Dietary Intake, Physical Activity, and Healthy Weight Status of Children in Family Child Care: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:242-255. [PMID: 38340129 DOI: 10.1016/j.jneb.2023.12.011] [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: 05/07/2023] [Revised: 12/28/2023] [Accepted: 12/28/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION This systematic review examines the effectiveness of interventions in family child care (FCC) on (1) children's dietary intake, physical activity levels and weight, and (2) FCC health-promoting environments, policies, and practices. Quasi-experimental studies measuring these outcomes were included. METHODS All available articles up to July 2023 were searched using MEDLINE, ERIC, CINAHL, Embase, Scopus, and A+ Education, and 15 interventions were included. Methodological quality was assessed with the Effective Public Health Practice Project Assessment tool. RESULTS Thirteen studies were weak, and 2 strong in quality. Four interventions included children's dietary intake as an outcome measure, 2 included physical activity, and 3 weight status. Twelve interventions assessed nutrition and 7 physical activity environmental outcomes. DISCUSSION Interventions in FCC improved children's dietary intake, but their impact on physical activity and weight status was inconclusive. Furthermore, positive impacts were observed in environmental outcomes related to nutrition, whereas research on physical activity environmental outcomes was limited. IMPLICATIONS FOR RESEARCH AND PRACTICE Future research could replicate interventions to validate effectiveness and understand positive outcome mechanisms. Future interventions might use FCC stakeholders' input, incorporate innovative physical activity components, enhance FCC providers' position as role models, involve parents, and target those groups that are at a high risk of being obese.
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Affiliation(s)
- Lieke Vorage
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
| | - Lisa Vincze
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Lucy Tudehope
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Neil Harris
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
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Campbell JE, McIsaac JLD, Young M, Dickson E, Caldwell S, Barich R, Rossiter M. Advancing assessment of responsive feeding environments and practices in child care. J Nutr Sci 2024; 13:e14. [PMID: 38572372 PMCID: PMC10988165 DOI: 10.1017/jns.2024.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/03/2024] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
Child care environments offer an ideal setting for feeding interventions. CELEBRATE Feeding is an approach implemented in child care environments in two Maritime Provinces in Canada to support responsive feeding (RF) to foster children's self-efficacy, self-regulation, and healthy relationships with food. This study aimed to describe RF in child care using established and enhanced scoring frameworks. The Environment and Policy Assessment and Observation (EPAO) was modified to reflect RF environments and practices, resulting in our modified EPAO and a CELEBRATE scale. Observations were conducted in 18 child care rooms. Behaviours and environments were scored on both scales, creating 21 RF scores, with a score of '3' indicating the most responsiveness. Descriptive analyses of the scores were conducted. The overall room averages were Mean (M) = 41.00, Standard Deviation (SD) = 7.07 (EPAO), and M = 37.92 SD = 6.50 (CELEBRATE). Most responsive scores among rooms within our EPAO and CELEBRATE scales, respectively, were 'educators not using food to calm or encourage behaviour' (M = 2.94, SD = 0.24; M = 2.98, SD = 0.06) and 'not requiring children to sit at the table until finished' (M = 2.89, SD = 0.47; M = 2.97, SD = 0.12). The least responsive scores within the EPAO were 'educator prompts for children to drink water' (M = 0.78, SD = 0.94) and 'children self-serving' (M = 0.83, SD = 0.38). The least responsive in the CELEBRATE scale were 'enthusiastic role modelling during mealtime' (M = 0.70, SD = 0.68) and 'praise of mealtime behaviour unrelated to food intake' (M = 0.74, SD = 0.55). The CELEBRATE scale captured unique observation information about RF to allow documenting change over time with detailed measurement to inform and support nutrition interventions within child care environments.
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Affiliation(s)
- Julie E. Campbell
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Canada
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
| | - Jessie-Lee D. McIsaac
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Canada
- Faculty of Education and Department of Child and Youth Study, Mount Saint Vincent University, Halifax, Canada
| | - Margaret Young
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Elizabeth Dickson
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Canada
| | - Sarah Caldwell
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Canada
| | - Rachel Barich
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Misty Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
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Lee D, Chung JM, Lee SD. Pediatric obesity and development of the penis and testis. Investig Clin Urol 2024; 65:189-195. [PMID: 38454829 PMCID: PMC10925733 DOI: 10.4111/icu.20230287] [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: 08/25/2023] [Revised: 10/25/2023] [Accepted: 12/29/2023] [Indexed: 03/09/2024] Open
Abstract
PURPOSE Pediatric obesity is increasing in many countries as socioeconomic status improves and the consumption of high calorie food increases. Thus, effect of obesity on genital development is an important topic. This study aimed to determine relationships of body mass index (BMI) with penile parameters and testicular volume in pediatric patients without penile or testicular abnormalities. MATERIALS AND METHODS Data from 1,499 male pediatric patients from our center were analyzed. Patients with penile or testicular abnormalities were excluded. Their age ranged from 2 to 18 years. These patients were divided into two groups based on their BMI: normal BMI (5th-85th percentile) and high BMI (≥85th percentile). Factors used in analysis included age, anthropometric indicators, baseline penile length (BPL), stretched penile length (SPL), penile circumference (PC), and mean testicular volume. These same parameters were analyzed for different age groups. RESULTS Pediatric patients with normal BMI showed longer BPL and SPL than patients with high BMI (p<0.05). However, PC and mean testicular volumes showed no significant difference between the two groups. BPL was significantly longer in the normal BMI group starting at ten years of age. SPL was significantly longer in the normal BMI group starting at eleven years of age. CONCLUSIONS Our study confirms that having a higher BMI during childhood has a negative effect on penile length. However, there was no significant relationship between BMI and PC or testicular volume.
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Affiliation(s)
- Danbee Lee
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
| | - Jae Min Chung
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
| | - Sang Don Lee
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Grady A, Jackson J, Wolfenden L, Lum M, Yoong SL. Assessing the scalability of healthy eating interventions within the early childhood education and care setting: secondary analysis of a Cochrane systematic review. Public Health Nutr 2023; 26:3211-3229. [PMID: 37990443 PMCID: PMC10755435 DOI: 10.1017/s1368980023002550] [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: 12/14/2022] [Revised: 10/05/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE Early childhood education and care (ECEC) is a recommended setting for the delivery of health eating interventions 'at scale' (i.e. to large numbers of childcare services) to improve child public health nutrition. Appraisal of the 'scalability' (suitability for delivery at scale) of interventions is recommended to guide public health decision-making. This study describes the extent to which factors required to assess scalability are reported among ECEC-based healthy eating interventions. DESIGN Studies from a recent Cochrane systematic review assessing the effectiveness of healthy eating interventions delivered in ECEC for improving child dietary intake were included. The reporting of factors of scalability was assessed against domains outlined within the Intervention Scalability Assessment Tool (ISAT). The tool recommends decision makers consider the problem, the intervention, strategic and political context, effectiveness, costs, fidelity and adaptation, reach and acceptability, delivery setting and workforce, implementation infrastructure and sustainability. Data were extracted by one reviewer and checked by a second reviewer. SETTING ECEC. PARTICIPANTS Children 6 months to 6 years. RESULTS Of thirty-eight included studies, none reported all factors within the ISAT. All studies reported the problem, the intervention, effectiveness and the delivery workforce and setting. The lowest reported domains were intervention costs (13 % of studies) and sustainability (16 % of studies). CONCLUSIONS Findings indicate there is a lack of reporting of some key factors of scalability for ECEC-based healthy eating interventions. Future studies should measure and report such factors to support policy and practice decision makers when selecting interventions to be scaled-up.
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Affiliation(s)
- Alice Grady
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
| | - Jacklyn Jackson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
| | - Melanie Lum
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Victoria, Australia
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10
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Lee YTH, Zhang Q, Elmontser M, Stevenson E, Gazmararian JA. Association between early care and education centres policies and practices and children's healthy behaviours. Int J Health Plann Manage 2023; 38:1743-1756. [PMID: 37556382 DOI: 10.1002/hpm.3698] [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: 08/24/2021] [Revised: 04/17/2023] [Accepted: 07/07/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE To examine the impact of nutritional and physical activity (PA) policies and practices at early care and education centres on behavioural changes among children ages 2-5. METHODS The study population included 586 children from 25 education centres throughout the state of Georgia. Policies and practices were measured using the Georgia Nutrition and PA Assessment at the start of school year in Fall 2017. Survey data were collected at the beginning of school year September/October 2017 and at the end of school year April/May 2018 to measure changes in children's nutritional and PA behaviour over the school year. We used generalised estimating equations to estimate odds ratios and 95% confidence intervals. RESULTS Children at centres with a high nutrition assessment score had higher odds of increasing vegetable consumption (OR = 2.1; 95% CI: 1.1, 4.0) while the odds of increasing fruit (OR = 1.4; 95% CI: 0.8, 2.4) and water (OR = 1.2; 95% CI: 0.5, 2.7) consumption increased non-significantly. The odds of improving PA were similar between children at centres with a high versus a low PA assessment score. CONCLUSION The results, though insignificant, indicate that policies and practices could influence children's health behaviours. Further research is warranted to examine whether improvements in policies and practices could explain changes in children's health behaviours, the impact of educator's knowledge on children's health behaviours and the implementation of and adherence to policy and practice improvement plans.
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Affiliation(s)
- Yi-Ting Hana Lee
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Qi Zhang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mohnd Elmontser
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | | | - Julie A Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Mozaffarian RS, Carter S, Bovenzi MC, Kenney EL. Comparison of foods and beverages served and consumed in Child and Adult Care Food Program-participating childcare centres to national guidelines. Public Health Nutr 2023; 26:1862-1870. [PMID: 37288521 PMCID: PMC10478045 DOI: 10.1017/s136898002300109x] [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: 03/08/2022] [Revised: 02/02/2023] [Accepted: 05/22/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The federal Child and Adult Care Food Program (CACFP) sets minimum nutrition and portion size standards for meals served in participating childcare programs. CACFP has been associated with more nutritious meals served. It is unclear, however, whether CACFP results in children's dietary intake being aligned with national recommendations. We assess whether children's dietary intake in CACFP-participating childcare centres meets benchmarks set by the Dietary Guidelines for Americans (DGA). DESIGN This is a cross-sectional study. We used direct observation to estimate quantities of foods/beverages served and consumed per child. Mean amounts served per child per day were compared with CACFP portion size requirements for each component (fruits, vegetables, milk and meat/meat alternate). Mean amounts of foods/beverages consumed were compared with DGA recommendations (energy content, fruits, vegetables, whole/refined grains, dairy, protein and added sugars). One sample t-tests evaluated if quantities served and consumed were different from CACFP and DGA standards, respectively. SETTING Six CACFP-participating childcare centres. PARTICIPANTS 2-5 year-old children attending childcare. RESULTS We observed forty-six children across 166 child meals. Most meals served met CACFP nutrition standards. Compared with CACFP portion size standards, children were served more grains at breakfast and lunch; more fruits/vegetables at lunch but less at breakfast and snack and less dairy at all eating occasions. Compared with DGA recommendations, children under-consumed every food/beverage category except grains during at least one eating occasion. CONCLUSIONS Children were served quantities of foods/beverages mostly consistent with CACFP portion size requirements, but had sub-optimal intake relative to DGA. More research is needed to help children consume healthy diets in childcare.
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Affiliation(s)
- Rebecca S Mozaffarian
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Boston, MA02115, USA
| | - Sonia Carter
- Boston Public Health Commission, Boston, MA02118, USA
| | | | - Erica L Kenney
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Boston, MA02115, USA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA02115, USA
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12
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Yoong SL, Lum M, Wolfenden L, Jackson J, Barnes C, Hall AE, McCrabb S, Pearson N, Lane C, Jones JZ, Nolan E, Dinour L, McDonnell T, Booth D, Grady A. Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Cochrane Database Syst Rev 2023; 8:CD013862. [PMID: 37606067 PMCID: PMC10443896 DOI: 10.1002/14651858.cd013862.pub3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND Dietary intake during early childhood can have implications on child health and developmental trajectories. Early childhood education and care (ECEC) services are recommended settings to deliver healthy eating interventions as they provide access to many children during this important period. Healthy eating interventions delivered in ECEC settings can include strategies targeting the curriculum (e.g. nutrition education), ethos and environment (e.g. menu modification) and partnerships (e.g. workshops for families). Despite guidelines supporting the delivery of healthy eating interventions in this setting, little is known about their impact on child health. OBJECTIVES To assess the effectiveness of healthy eating interventions delivered in ECEC settings for improving dietary intake in children aged six months to six years, relative to usual care, no intervention or an alternative, non-dietary intervention. Secondary objectives were to assess the impact of ECEC-based healthy eating interventions on physical outcomes (e.g. child body mass index (BMI), weight, waist circumference), language and cognitive outcomes, social/emotional and quality-of-life outcomes. We also report on cost and adverse consequences of ECEC-based healthy eating interventions. SEARCH METHODS We searched eight electronic databases including CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Scopus and SportDiscus on 24 February 2022. We searched reference lists of included studies, reference lists of relevant systematic reviews, the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov and Google Scholar, and contacted authors of relevant papers. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, stepped-wedge RCTs, factorial RCTs, multiple baseline RCTs and randomised cross-over trials, of healthy eating interventions targeting children aged six months to six years that were conducted within the ECEC setting. ECEC settings included preschools, nurseries, kindergartens, long day care and family day care. To be included, studies had to include at least one intervention component targeting child diet within the ECEC setting and measure child dietary or physical outcomes, or both. DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened titles and abstracts and extracted study data. We assessed risk of bias for all studies against 12 criteria within RoB 1, which allows for consideration of how selection, performance, attrition, publication and reporting biases impact outcomes. We resolved discrepancies via consensus or by consulting a third review author. Where we identified studies with suitable data and homogeneity, we performed meta-analyses using a random-effects model; otherwise, we described findings using vote-counting approaches and via harvest plots. For measures with similar metrics, we calculated mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. We calculated standardised mean differences (SMDs) for primary and secondary outcomes where studies used different measures. We applied GRADE to assess certainty of evidence for dietary, cost and adverse outcomes. MAIN RESULTS We included 52 studies that investigated 58 interventions (described across 96 articles). All studies were cluster-RCTs. Twenty-nine studies were large (≥ 400 participants) and 23 were small (< 400 participants). Of the 58 interventions, 43 targeted curriculum, 56 targeted ethos and environment, and 50 targeted partnerships. Thirty-eight interventions incorporated all three components. For the primary outcomes (dietary outcomes), we assessed 19 studies as overall high risk of bias, with performance and detection bias being most commonly judged as high risk of bias. ECEC-based healthy eating interventions versus usual practice or no intervention may have a positive effect on child diet quality (SMD 0.34, 95% confidence interval (CI) 0.04 to 0.65; P = 0.03, I2 = 91%; 6 studies, 1973 children) but the evidence is very uncertain. There is moderate-certainty evidence that ECEC-based healthy eating interventions likely increase children's consumption of fruit (SMD 0.11, 95% CI 0.04 to 0.18; P < 0.01, I2 = 0%; 11 studies, 2901 children). The evidence is very uncertain about the effect of ECEC-based healthy eating interventions on children's consumption of vegetables (SMD 0.12, 95% CI -0.01 to 0.25; P =0.08, I2 = 70%; 13 studies, 3335 children). There is moderate-certainty evidence that ECEC-based healthy eating interventions likely result in little to no difference in children's consumption of non-core (i.e. less healthy/discretionary) foods (SMD -0.05, 95% CI -0.17 to 0.08; P = 0.48, I2 = 16%; 7 studies, 1369 children) or consumption of sugar-sweetened beverages (SMD -0.10, 95% CI -0.34 to 0.14; P = 0.41, I2 = 45%; 3 studies, 522 children). Thirty-six studies measured BMI, BMI z-score, weight, overweight and obesity, or waist circumference, or a combination of some or all of these. ECEC-based healthy eating interventions may result in little to no difference in child BMI (MD -0.08, 95% CI -0.23 to 0.07; P = 0.30, I2 = 65%; 15 studies, 3932 children) or in child BMI z-score (MD -0.03, 95% CI -0.09 to 0.03; P = 0.36, I2 = 0%; 17 studies; 4766 children). ECEC-based healthy eating interventions may decrease child weight (MD -0.23, 95% CI -0.49 to 0.03; P = 0.09, I2 = 0%; 9 studies, 2071 children) and risk of overweight and obesity (RR 0.81, 95% CI 0.65 to 1.01; P = 0.07, I2 = 0%; 5 studies, 1070 children). ECEC-based healthy eating interventions may be cost-effective but the evidence is very uncertain (6 studies). ECEC-based healthy eating interventions may have little to no effect on adverse consequences but the evidence is very uncertain (3 studies). Few studies measured language and cognitive skills (n = 2), social/emotional outcomes (n = 2) and quality of life (n = 3). AUTHORS' CONCLUSIONS ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain, and likely increase child fruit consumption slightly. There is uncertainty about the effect of ECEC-based healthy eating interventions on vegetable consumption. ECEC-based healthy eating interventions may result in little to no difference in child consumption of non-core foods and sugar-sweetened beverages. Healthy eating interventions could have favourable effects on child weight and risk of overweight and obesity, although there was little to no difference in BMI and BMI z-scores. Future studies exploring the impact of specific intervention components, and describing cost-effectiveness and adverse outcomes are needed to better understand how to maximise the impact of ECEC-based healthy eating interventions.
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Affiliation(s)
- Sze Lin Yoong
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Melanie Lum
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jacklyn Jackson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Nicole Pearson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jannah Z Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Erin Nolan
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Lauren Dinour
- College of Education and Human Services, Montclair State University, Montclair, New Jersey, USA
| | - Therese McDonnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Debbie Booth
- Auchmuty Library, University of Newcastle, Callaghan, Australia
| | - Alice Grady
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
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Song Y, Kong Y, Xie X, Wang Y, Wang N. Association between precocious puberty and obesity risk in children: a systematic review and meta-analysis. Front Pediatr 2023; 11:1226933. [PMID: 37635793 PMCID: PMC10456873 DOI: 10.3389/fped.2023.1226933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Objectives The aim of this study was to evaluate the potential association between early onset puberty and the risk of different forms of obesity in children. Methods The databases PubMed, EMBASE, Web of Science and Cochrane Library were systematically searched for relevant studies. The odds ratio (OR) and 95% confidence interval (CI) of obesity in precocious puberty were calculated using Stata software 14.0. A fixed-effects model was used if P > 0.1 and I2 ≤ 50%. Otherwise, a random-effects model was used. Publication bias was assessed using funnel plots and Egger's test. Result The pooling analysis showed that precocious puberty in girls was associated with a higher risk of obesity (OR = 1.98; 95% CI: 1.76-2.24; I2 = 0.00%, P < 0.001). Girls with a history of precocious puberty were found to have an increased risk of general obesity (OR = 2.03; 95% CI: 1.62-2.55; I2 = 22.2%, P < 0.001), central obesity (OR = 1.96; 95% CI: 1.70-2.26; I2 = 0.00%, P < 0.001), and overweight (OR = 2.03; 95% CI: 1.68-2.46; I2 = 5.1%, P < 0.001). The pooled analysis showed that precocious puberty in boys was not associated with an increased risk of obesity (OR = 1.14; 95% CI: 0.86-1.51; I2 = 50.6%, P = 0.369). In boys, the occurrence of precocious puberty was not associated with an elevated risk of general obesity (OR = 0.96; 95% CI: 0.40-2.27; I2 = 79.6%, P = 0.922), central obesity (OR = 1.17; 95% CI: 0.96-1.43; I2 = 0.00%, P = 0.125), or overweight (OR = 1.03; 95% CI: 0.56-1.88; I2 = 74.4%, P = 0.930). Conclusion This meta-analysis suggests that the onset of puberty at an early age in girls is associated with an increased risk of obesity, however precocious puberty in boy was not associated with an increased risk of obesity. These findings highlight that precocious puberty should be considered an independent risk factor for obesity in girls. Systematic Review Registration CRD42023404479.
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Affiliation(s)
| | | | | | - Yongji Wang
- Department of Pediatrics, Hospital Affiliated to Changchun Traditional Chinese Medicine University, Changchun, China
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14
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Li Y, Liu T, Qin L, Wu L. Effects of probiotic administration on overweight or obese children: a meta-analysis and systematic review. J Transl Med 2023; 21:525. [PMID: 37542325 PMCID: PMC10401801 DOI: 10.1186/s12967-023-04319-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/01/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND This paper aimed to examine the effects of probiotics on eight factors in overweight or obese children by meta-analysis, namely, body mass index (BMI), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), adiponectin, leptin and tumor necrosis factor-α (TNF-α) and summarize the mechanisms of action of probiotics based on the existing researches. METHODS Six databases (PubMed, Web of Science, Embase, Cochrane Library, SinoMed and CNKI) were searched until March 2023. Review Manager 5.4 was used for meta-analysis. The data were analysed using weighted mean differences (WMDs) or standardized mean differences (SMDs) under a fixed effect model or random effect model to observe the effects of probiotic administration on the included indicators. RESULTS Four publications with a total of 206 overweight or obesity children were included. According to the meta-analysis, probiotics were able to significantly decrease the levels of HDL-C (MD, 0.06; 95% CI 0.03, 0.09; P = 0.0001), LDL-C (MD, - 0.06; 95% CI - 0.12, - 0.00; P = 0.04), adiponectin (MD, 1.39; 95% CI 1.19, 1.59; P < 0.00001), leptin (MD, - 2.72; 95% CI - 2.9, - 2.54; P < 0.00001) and TNF-α (MD, - 4.91; 95% CI - 7.15, - 2.67; P < 0.0001) compared to those in the placebo group. Still, for BMI, the palcebo group seemed to be better than the probiotic group (MD, 0.85; 95% CI 0.04, 1.66; P = 0.04). TC (MD, - 0.05; 95% CI - 0.12, 0.02; P = 0.14) and TG (MD, - 0.16; 95% CI - 0.36, 0.05; P = 0.14) were not different between two groups. CONCLUSIONS This review drew that probiotics might act as a role in regulating HDL-C, LDL-C, adiponectin, leptin and TNF-α in overweight or obesity children. Additionally, our systematic review yielded that probiotics might regulate lipid metabolism and improve obese associated symptoms by some paths. This meta-analysis has been registered at PROSPERO with ID: CRD42023408359.
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Affiliation(s)
- Ya Li
- Key Laboratory of Health Cultivation of Traditional Chinese Medicine, the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Tonghua Liu
- Key Laboratory of Health Cultivation of Traditional Chinese Medicine, the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Lingling Qin
- Key Laboratory of Health Cultivation of Traditional Chinese Medicine, the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Lili Wu
- Key Laboratory of Health Cultivation of Traditional Chinese Medicine, the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 102488, China.
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15
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Jiang Q, Risica PM, Tovar A, Cooksey Stowers K, Schwartz MB, Lombardi C, Gans K. Nutrition Practices of Family Child Care Home Providers and Children's Diet Quality. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:480-492. [PMID: 37245146 PMCID: PMC10426435 DOI: 10.1016/j.jneb.2023.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To examine the relationship between the diet quality of children aged 2-5 years cared for in family child care homes (FCCHs) with provider adherence to nutrition best practices. DESIGN Cross-sectional analysis. PARTICIPANTS Family child care home providers (n = 120, 100% female, 67.5% Latinx) and children (n = 370, 51% female, 58% Latinx) enrolled in a cluster-randomized trial. MAIN OUTCOME MEASURES Data were collected over 2 days at each FCCH. The Environment and Policy Assessment and Observation tool was used to document whether providers exhibited nutrition practices on the basis of the Nutrition and Physical Activity Self-Assessment for Child Care. Each practice was scored as either present or absent. Children's food intake was observed using Diet Observation at Child Care and analyzed with the Healthy Eating Index-2015. ANALYSIS Multilevel linear regression models assessed the association between providers exhibiting best practices regarding nutrition and children's diet quality. The model accounted for clustering by FCCH and controlled for provider ethnicity, income level, and multiple comparisons. RESULTS Children in FCCHs in which more of the best practices were implemented had higher diet quality (B = 1.05; 95% confidence interval [CI], 0.12-1.99; P = 0.03). Specifically, children whose providers promoted autonomous feeding (B = 27.52; 95% CI, 21.02-34.02; P < 0.001) and provided nutrition education (B = 7.76; 95% CI, 3.29-12.23; P = 0.001) had higher total Healthy Eating Index scores. CONCLUSIONS AND IMPLICATIONS Future interventions and policies could support FCCH providers in implementing important practices such as autonomy feeding practices, talking informally to children about nutrition, and providing healthful foods and beverages.
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Affiliation(s)
- Qianxia Jiang
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO.
| | - Patricia Markham Risica
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI; Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI
| | - Alison Tovar
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI; Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI
| | | | - Marlene B Schwartz
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT; Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT
| | - Caitlin Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT
| | - Kim Gans
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI; Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI; Department of Allied Health Sciences, University of Connecticut, Storrs, CT
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16
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Yoong SL, Lum M, Wolfenden L, Jackson J, Barnes C, Hall AE, McCrabb S, Pearson N, Lane C, Jones JZ, Dinour L, McDonnell T, Booth D, Grady A. Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Cochrane Database Syst Rev 2023; 6:CD013862. [PMID: 37306513 PMCID: PMC10259732 DOI: 10.1002/14651858.cd013862.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Dietary intake during early childhood can have implications on child health and developmental trajectories. Early childhood education and care (ECEC) services are recommended settings to deliver healthy eating interventions as they provide access to many children during this important period. Healthy eating interventions delivered in ECEC settings can include strategies targeting the curriculum (e.g. nutrition education), ethos and environment (e.g. menu modification) and partnerships (e.g. workshops for families). Despite guidelines supporting the delivery of healthy eating interventions in this setting, little is known about their impact on child health. OBJECTIVES To assess the effectiveness of healthy eating interventions delivered in ECEC settings for improving dietary intake in children aged six months to six years, relative to usual care, no intervention or an alternative, non-dietary intervention. Secondary objectives were to assess the impact of ECEC-based healthy eating interventions on physical outcomes (e.g. child body mass index (BMI), weight, waist circumference), language and cognitive outcomes, social/emotional and quality-of-life outcomes. We also report on cost and adverse consequences of ECEC-based healthy eating interventions. SEARCH METHODS We searched eight electronic databases including CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Scopus and SportDiscus on 24 February 2022. We searched reference lists of included studies, reference lists of relevant systematic reviews, the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov and Google Scholar, and contacted authors of relevant papers. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, stepped-wedge RCTs, factorial RCTs, multiple baseline RCTs and randomised cross-over trials, of healthy eating interventions targeting children aged six months to six years that were conducted within the ECEC setting. ECEC settings included preschools, nurseries, kindergartens, long day care and family day care. To be included, studies had to include at least one intervention component targeting child diet within the ECEC setting and measure child dietary or physical outcomes, or both. DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened titles and abstracts and extracted study data. We assessed risk of bias for all studies against 12 criteria within RoB 1, which allows for consideration of how selection, performance, attrition, publication and reporting biases impact outcomes. We resolved discrepancies via consensus or by consulting a third review author. Where we identified studies with suitable data and homogeneity, we performed meta-analyses using a random-effects model; otherwise, we described findings using vote-counting approaches and via harvest plots. For measures with similar metrics, we calculated mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. We calculated standardised mean differences (SMDs) for primary and secondary outcomes where studies used different measures. We applied GRADE to assess certainty of evidence for dietary, cost and adverse outcomes. MAIN RESULTS: We included 52 studies that investigated 58 interventions (described across 96 articles). All studies were cluster-RCTs. Twenty-nine studies were large (≥ 400 participants) and 23 were small (< 400 participants). Of the 58 interventions, 43 targeted curriculum, 56 targeted ethos and environment, and 50 targeted partnerships. Thirty-eight interventions incorporated all three components. For the primary outcomes (dietary outcomes), we assessed 19 studies as overall high risk of bias, with performance and detection bias being most commonly judged as high risk of bias. ECEC-based healthy eating interventions versus usual practice or no intervention may have a positive effect on child diet quality (SMD 0.34, 95% confidence interval (CI) 0.04 to 0.65; P = 0.03, I2 = 91%; 6 studies, 1973 children) but the evidence is very uncertain. There is moderate-certainty evidence that ECEC-based healthy eating interventions likely increase children's consumption of fruit (SMD 0.11, 95% CI 0.04 to 0.18; P < 0.01, I2 = 0%; 11 studies, 2901 children). The evidence is very uncertain about the effect of ECEC-based healthy eating interventions on children's consumption of vegetables (SMD 0.12, 95% CI -0.01 to 0.25; P =0.08, I2 = 70%; 13 studies, 3335 children). There is moderate-certainty evidence that ECEC-based healthy eating interventions likely result in little to no difference in children's consumption of non-core (i.e. less healthy/discretionary) foods (SMD -0.05, 95% CI -0.17 to 0.08; P = 0.48, I2 = 16%; 7 studies, 1369 children) or consumption of sugar-sweetened beverages (SMD -0.10, 95% CI -0.34 to 0.14; P = 0.41, I2 = 45%; 3 studies, 522 children). Thirty-six studies measured BMI, BMI z-score, weight, overweight and obesity, or waist circumference, or a combination of some or all of these. ECEC-based healthy eating interventions may result in little to no difference in child BMI (MD -0.08, 95% CI -0.23 to 0.07; P = 0.30, I2 = 65%; 15 studies, 3932 children) or in child BMI z-score (MD -0.03, 95% CI -0.09 to 0.03; P = 0.36, I2 = 0%; 17 studies; 4766 children). ECEC-based healthy eating interventions may decrease child weight (MD -0.23, 95% CI -0.49 to 0.03; P = 0.09, I2 = 0%; 9 studies, 2071 children) and risk of overweight and obesity (RR 0.81, 95% CI 0.65 to 1.01; P = 0.07, I2 = 0%; 5 studies, 1070 children). ECEC-based healthy eating interventions may be cost-effective but the evidence is very uncertain (6 studies). ECEC-based healthy eating interventions may have little to no effect on adverse consequences but the evidence is very uncertain (3 studies). Few studies measured language and cognitive skills (n = 2), social/emotional outcomes (n = 2) and quality of life (n = 3). AUTHORS' CONCLUSIONS ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain, and likely increase child fruit consumption slightly. There is uncertainty about the effect of ECEC-based healthy eating interventions on vegetable consumption. ECEC-based healthy eating interventions may result in little to no difference in child consumption of non-core foods and sugar-sweetened beverages. Healthy eating interventions could have favourable effects on child weight and risk of overweight and obesity, although there was little to no difference in BMI and BMI z-scores. Future studies exploring the impact of specific intervention components, and describing cost-effectiveness and adverse outcomes are needed to better understand how to maximise the impact of ECEC-based healthy eating interventions.
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Affiliation(s)
- Sze Lin Yoong
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Melanie Lum
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jacklyn Jackson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Nicole Pearson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jannah Z Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Lauren Dinour
- College of Education and Human Services, Montclair State University, Montclair, New Jersey, USA
| | - Therese McDonnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Debbie Booth
- Auchmuty Library, University of Newcastle, Callaghan, Australia
| | - Alice Grady
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
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Wells NM, Cosco NG, Hales D, Monsur M, Moore RC. Gardening in Childcare Centers: A Randomized Controlled Trial Examining the Effects of a Garden Intervention on Physical Activity among Children Aged 3-5 Years in North Carolina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5939. [PMID: 37297543 PMCID: PMC10252818 DOI: 10.3390/ijerph20115939] [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: 02/17/2023] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 06/12/2023]
Abstract
This study examined the effects of a childcare gardening intervention on children's physical activity (PA). Eligible childcare centers were randomly assigned to: (1) garden intervention (n = 5; year 1); (2) waitlist control (n = 5; control year 1, intervention year 2); or (3) control (n = 5; year 2 only) groups. Across the two-year study, PA was measured for 3 days at four data collection periods using Actigraph GT3X+ accelerometers. The intervention comprised 6 raised fruit and vegetable garden beds and a gardening guide with age-appropriate learning activities. The sample included a total of 321 3-5-year-olds enrolled in childcare centers in Wake County, North Carolina, with n = 293 possessing PA data for at least one time point. The analyses employed repeated measures linear mixed models (SAS v 9.4 PROC MIXED), accounting for clustering of the children within the center and relevant covariates (e.g., cohort, weather, outside days, accelerometer wear). A significant intervention effect was found for MVPA (p < 0.0001) and SED minutes (p = 0.0004), with children at intervention centers acquiring approximately 6 min more MVPA and 14 min less sedentary time each day. The effects were moderated by sex and age, with a stronger impact for boys and the youngest children. The results suggest that childcare gardening has potential as a PA intervention.
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Affiliation(s)
- Nancy M. Wells
- Department of Human Centered Design, College of Human Ecology, Cornell University, 1300F MVR Hall, Ithaca, NY 14853, USA
| | - Nilda Graciela Cosco
- Department of Landscape Architecture and Environmental Planning, College of Design, North Carolina State University, 50 Pullen Road, Raleigh, NC 27695, USA
| | - Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., CB 7426, Chapel Hill, NC 27599, USA
| | - Muntazar Monsur
- Department of Landscape Architecture, Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409, USA
| | - Robin C. Moore
- Department of Landscape Architecture and Environmental Planning, College of Design, North Carolina State University, 50 Pullen Road, Raleigh, NC 27695, USA
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18
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Hernández ED, Cobo EA, Cahalin LP, Seron P. Impact of structural-level environmental interventions on physical activity: a systematic review. Int Arch Occup Environ Health 2023:10.1007/s00420-023-01973-w. [PMID: 37099193 DOI: 10.1007/s00420-023-01973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/30/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVE To determine the effectiveness of structural-level environmental interventions on the changes in PA levels in the populations examined. METHODS Natural experiments that involve environmental intervention with structural modification were included. The primary outcome PA levels with consideration of both objective and subjective measurements. An electronic search was carried out in Medline/Pubmed, SCIENCE DIRECT, WEB OF SCIENCE, and CINAHL up to January 2022. Two reviewers screened titles and abstracts, selected studies, extracted relevant data, and examined study quality. A qualitative synthesis was performed. RESULTS Twenty-six articles were included. The structural-level environmental interventions included 4 fundamental areas: schools, work environments, streets or cities, and neighborhoods or parks. Of the 26 studies, 21 examined outdoor environments like parks, cities, pedestrian walkways, or steps, while 5 examined indoor or closed environments like schools and workplaces revealing that structural-level environmental interventions improve PA levels with the greatest effect in parks and active transportation. A risk of bias is inherent in natural experiments which is a limitation of this study. In schools and work areas, there is evidence of both decrease in sedentary time and an increase in PA related to environmental modifications. CONCLUSION Structural-level environmental modifications in parks and active transportation demonstrated greater effects in promoting PA. Environmental modifications can impact physical activity in the population. Given that the economic and cultural setting is a key variable when considering the effectiveness of structural interventions, and since only 1 of the 26 reviewed articles included such data, more studies examining economic factors are needed especially in low- and middle-income countries like in South America. TRIAL REGISTRATION PROSPERO CRD42021229718.
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Affiliation(s)
- Edgar D Hernández
- Facultad de Medicina, Human Movement Department, Universidad Nacional de Colombia, cra 45 30-00, Bogotá, Colombia.
| | - Elisa A Cobo
- Facultad de Ciencias de la Salud, Universidad de Boyacá, Boyacá, Tunja, Colombia
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami, Miami, Florida, USA
| | - Pamela Seron
- Facultad de Medicina, Universidad de La Frontera, Claro Solar #112, Temuco, Chile
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19
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Malek ME, Andermo S, Nyberg G, Elinder LS, Patterson E, Norman Å. Parents' experiences of participating in the Healthy School Start Plus programme - a qualitative study. BMC Public Health 2023; 23:646. [PMID: 37016372 PMCID: PMC10074815 DOI: 10.1186/s12889-023-15552-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND The rise in overweight and obesity among children is a global problem and effective prevention interventions are urgently required. Parents play an important role in children's lifestyle behaviours and body weight development and therefore there is a great need to investigate how to involve parents effectively in health promotion and prevention programmes. The aim of the study was to describe parents' experiences of barriers and facilitators of participating in the Healthy School Start Plus (HSSP) intervention study. METHODS HSSP is a parental support programme, conducted in Sweden, with the aim to promote a healthy diet, physical activity and preventing obesity in 5-7-year-old children starting school. In total 20 parents from 7 schools participated in semi-structured telephone-based interviews. The data was analysed using qualitative content analysis, with a deductive approach based on the Consolidated Framework for Implementation Research (CFIR). RESULTS Parental experiences of barriers and facilitators informing the implementation of the HSSP intervention were identified within all five domains of the CFIR. Two additional constructs, not included in the CFIR were identified: Social factors and Cooperation. The findings of parental experiences of barriers and facilitators related to the importance of (1) adaptation of the intervention to fit the abilities of the parents with different social and cultural backgrounds; (2) the need for continuous delivery of information related to healthy behaviours; (3) the commitment and efforts of the deliverers of the intervention; (4) the need for repetition of information related to healthy behaviours given by the deliverers of the intervention; (5) encouragement and facilitation of the involvement of the family and key people around them through the intervention activities and by the deliverers of the intervention; (6) awareness of unexpected impacts and social and cultural conditions complicating the execution of the intervention and; (7) cooperation and a well-functioning interaction between parents and school staff. CONCLUSIONS Barriers and facilitators indicated by the parents highlighted that interventions like the HSSP need to be adapted to fit the parents' abilities, with reminders, follow-ups and delivery of relevant information. Variations in social and cultural conditions need to be taken into consideration. The commitment of the school and the interaction between the school staff and the family as well as key people around them appears to be important. TRIAL REGISTRATION The Healthy School Start Plus trial was retrospectively registered in the International Standard Randomised Controlled Trial Number Registry on January 4, 2018 and available online at ClinicalTrials.gov: No. NCT03390725.
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Affiliation(s)
- Mahnoush Etminan Malek
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden.
| | - Susanne Andermo
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- The Swedish School of Sport and Health Sciences (GIH), Lidingövägen 1, Stockholm, 114 33, Sweden
| | - Gisela Nyberg
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- The Swedish School of Sport and Health Sciences (GIH), Lidingövägen 1, Stockholm, 114 33, Sweden
| | - Liselotte Schäfer Elinder
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Solnavägen 1E, Stockholm, 113 65, Sweden
| | - Emma Patterson
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- Section for Risk and Benefit Assessment, Swedish Food Agency, Box 622, Uppsala, 751 26, Sweden
| | - Åsa Norman
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, 171 77, Sweden
- Department of Psychology, Stockholm University, Stockholm, 106 91, Sweden
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20
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Williams BD, Sisson SB, Bhattacharya S, Merchant C, Slawinski M, Hildebrand D, Stoner JA, Fortin-Miller S, Patel SM, Salvatore AL. Process Evaluation of Two Interventions to Improve Health Environments in Family Child Care Homes. HEALTH EDUCATION & BEHAVIOR 2023; 50:211-223. [PMID: 34963346 DOI: 10.1177/10901981211057537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Early care and education (ECE) environments influence children's lifelong health behaviors, growth, and development. Although the number of interventions to improve health in ECE environments is increasing, few have been designed for and tested in family child care homes (FCCHs). This study reports the process evaluation of two interventions to improve FCCH health environments, both part of Happy Healthy Homes, a matched-attention randomized-controlled intervention trial conducted in Oklahoma FCCHs. Participating child care providers received one of two multicomponent interventions: (a) an intervention focused on enhancing the quality of the nutrition environment, self-efficacy, and practices or (b) an intervention focused on improving providers' environmental health literacy, self-efficacy, and practices. Guided by "Implementation" constructs of the RE-AIM framework (i.e., reach, effectiveness, adoption, implementation, maintenance), intervention report forms and participant tracking were used to assess intervention dose delivered and interventionist-perceived challenges and successes to implementation. Interviews were conducted to obtain participant feedback after the intervention. Dose delivered was high for both interventions overall and across individual sessions, and provider feedback was positive. Implementation challenges and strengths identified for both interventions may be useful for further enhancing intervention appropriateness and success, particularly for interventions with FCCHs. Process evaluation findings indicate that the two Happy Healthy Home interventions can be conducted with high delivery and are well attended and considered to be valuable to FCCH providers.
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Affiliation(s)
- Bethany D Williams
- The University of Oklahoma Health Sciences Center, USA.,Washington State University Health Sciences Spokane, USA
| | | | | | - Cady Merchant
- The University of Oklahoma Health Sciences Center, USA
| | | | | | | | | | - Sarah M Patel
- The University of Oklahoma Health Sciences Center, USA
| | - Alicia L Salvatore
- The University of Oklahoma Health Sciences Center, USA.,Christiana Care Health System Value Institute, Newark, DE, USA
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21
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Do B, Lopez NV, Dunton GF, Mason TB. Motivational and self-regulatory processes associated with weight-related parenting behaviors. OBESITY PILLARS (ONLINE) 2023; 5:100049. [PMID: 37990744 PMCID: PMC10662018 DOI: 10.1016/j.obpill.2022.100049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 11/23/2023]
Abstract
Background Parents play an influential role on their child's eating and physical activity. How maternal personality and individual differences, such as motivation and self-regulation, are associated with their weight-related parenting has yet to be studied. The current study examined relationships of mothers' motivational and self-regulatory characteristics with weight-related parenting practices. Methods Mothers (N = 149, MAge = 42.78 years, 49% Hispanic/Latino) of school-aged children (ages 10-14 years, 55.7% female) completed questionnaires assessing behavioral inhibition system/behavioral activation system (BIS/BAS), self-control, and weight-related parenting practices (i.e., role modeling, food restriction, rule enforcement, limiting, discipline, pressure to eat). Structural equation modeling examined associations of BIS, BAS, and self-control with parenting practices. Results Among mothers, higher avoidance motivation was associated with difficulty with rule enforcement. Higher approach motivation was associated with less limiting of unhealthy food and sedentary behavior. Higher self-control predicted more role modeling and less difficulty with rule enforcement. Conclusion Findings support associations of maternal motivational and self-regulatory processes with weight-related parenting behaviors. Results may inform tailored strategies based on individual differences for family-based interventions for parenting.
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Affiliation(s)
- Bridgette Do
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, 90032, USA
| | - Nanette V. Lopez
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - Genevieve F. Dunton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, 90032, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, 90089, USA
| | - Tyler B. Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, 90032, USA
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22
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Patel D, Sisson SB, Sleet K, Rickman R, Love C, Taniguchi T, Sisk M, Jernigan VBB. Changes in Meal and Menu Quality at Early Care and Education Programs after Training with Food Service Staff: the FRESH Study. Curr Dev Nutr 2023; 7:100040. [PMID: 37181935 PMCID: PMC10111590 DOI: 10.1016/j.cdnut.2023.100040] [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: 07/05/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 02/22/2023] Open
Abstract
Background Prevalence of obesity in Native American (NA) children is disproportionately high, indicating a higher risk of health disparities. Many children attend early care and education (ECE) programs, presenting an opportune environment to improve meal and menu quality as the intake of healthy foods is associated with lowered risk of childhood obesity. Objectives We aimed to examine the effectiveness of food service staff training on meals and menu quality across NA ECEs. Methods Food service staff from 9 participating ECE programs attended a 3-h training focused on Child and Adult Care Food Program (CACFP) best practices, and received a tailored, best-practice menu, and healthy recipes. Meals and menus prepared across 1 wk were examined per CACFP serving size assumptions at baseline, 4 mos, 6 mos, and 12 mos for all 9 programs. Healthy Eating Index (HEI), CACFP requirements and best practices achievement, and food substitutions quality (classified into superior, equivalent, and inferior based on the nutritional quality) were calculated. A repeated measures ANOVA model was used to determine the differences across time points. Results The total meal HEI score increased significantly from baseline to 4 mos (71.1 ± 2.1; 78.6 ± 5.0; P = 0.004), but did not differ from baseline to 12 mos. Menu CACFP requirements and best practices achievement did not differ across time points, although achievement with CACFP requirements was already high at baseline. Superior nutrition quality substitutions declined from baseline to 6 mos (32.4 ± 8.9; 19.5 ± 10.9; P = 0.007); however, it did not differ from baseline to 12 mos. Equivalent and inferior quality substitutions did not differ across time points. Conclusions Implementing a best-practice menu with healthy recipes showed immediate improvements in meal quality. Although the change did not sustain, this study showed evidence of an opportunity to educate and train food service staff. Robust efforts are needed for improving both meals and menus.This trial was registered ClinicalTrials.gov as NCT03251950 (https://clinicaltrials.gov/ct2/show/NCT03251950?cond=food+resource+equity&draw=2&rank=1).
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Affiliation(s)
- Divya Patel
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Susan B. Sisson
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kaysha Sleet
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- University Medical Center, Lubbock, TX, USA
| | - Rachel Rickman
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin, TX, USA
| | - Charlotte Love
- School of Health Care Administration, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University, Tulsa, OK, USA
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Toussaint N, Streppel MT, Mul S, Gündüz M, van Verseveld MDA, Janssen M, Weijs PJM, Fukkink RG. Effect and process evaluation of a preschool-based intervention to promote an early childhood education and care teacher-parent partnership about healthy behaviours in children: Study protocol for the cluster randomised controlled trial CO-HEALTHY. PLoS One 2023; 18:e0281999. [PMID: 36812263 PMCID: PMC9946211 DOI: 10.1371/journal.pone.0281999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/01/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Early Childhood Education and Care (ECEC) teachers at urban preschools are potential key figures to promote healthy behaviours in disadvantaged young children and to engage parents in lifestyle-related topics. An ECEC teacher-parent partnership regarding healthy behaviours may support parents and stimulate their children's development. However, it is not an easy task to establish such a collaboration and ECEC teachers need tools to communicate with parents about lifestyle-related topics. This paper describes the study protocol of a preschool-based intervention (CO-HEALTHY) to promote an ECEC teacher-parent partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children. METHODS A cluster randomised controlled trial will be performed at preschools in Amsterdam, the Netherlands. Preschools will be randomly allocated to an intervention or control group. The intervention consists of a toolkit with 10 parent-child activities and associated training for ECEC teachers. The activities were composed using the Intervention Mapping protocol. At intervention preschools, ECEC teachers will carry out the activities during standard contact moments. Parents will receive associated intervention materials and will be encouraged to perform similar parent-child activities at home. At control preschools, the toolkit and training will not be implemented. The primary outcome will be the teacher- and parent-reported partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children. The perceived partnership will be assessed by a questionnaire at baseline and at 6 months. In addition, short interviews with ECEC teachers will be held. Secondary outcomes include the knowledge, attitude, food- and activity-related practices of ECEC teachers and parents. Furthermore, children's eating, physical (in)activity and sleeping behaviours, and weight development will be assessed. A process evaluation of the intervention will be made. DISCUSSION The intervention aims to provide a practical tool for ECEC teachers at urban preschools to promote an ECEC teacher-parent partnership regarding a healthy lifestyle in young children. TRIAL REGISTRATION Netherlands Trial Register (NTR): NL8883. Date registered: September 8, 2020.
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Affiliation(s)
- Nicole Toussaint
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Martinette T. Streppel
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- * E-mail:
| | - Sandra Mul
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Meryem Gündüz
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Marloes D. A. van Verseveld
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mirka Janssen
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Peter J. M. Weijs
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Nutrition & Dietetics, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Ruben G. Fukkink
- Faculty of Child Development and Education, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
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Asada Y, Lin S, Siegel L, Kong A. Facilitators and Barriers to Implementation and Sustainability of Nutrition and Physical Activity Interventions in Early Childcare Settings: a Systematic Review. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:64-83. [PMID: 36198924 DOI: 10.1007/s11121-022-01436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 02/01/2023]
Abstract
A stronger understanding of the factors influencing implementation of interventions in community-based early childcare settings is needed. The purpose of this systematic review was to synthesize existing research on facilitators and barriers to implementation and sustainability of nutrition and physical activity interventions in early childcare settings targeting 2-5-year-old children, including considerations for equitable implementation. This review adhered to PRISMA 2020 guidelines. Peer-reviewed literature was searched in PubMed, EMBASE, CINAHL, ERIC, and PsycINFO databases up to September 2020. Primary research studies that examined facilitators and barriers (or related synonyms) to the implementation and sustainability of nutrition and physical activity interventions in early childcare settings were eligible for inclusion. The search yielded 8092 records that were screened by four analysts in Covidence software with a final review of 24 studies. Two independent reviewers conducted study selection, data extraction, and quality appraisal (Mixed Methods Appraisal Tool). A "best fit" framework was applied using the Consolidated Framework for Implementation Research (CFIR) constructs to code barriers and facilitators. The most salient constructs were (1) "Available Resources," which was composed of time, staffing, space, and staff trainings; (2) adaptability; and (3) compatibility, the latter two indicating that easily modifiable interventions facilitated a smoother "fit" and were more likely to be successful, given adequate site-level resources. Only nine (28%) reported the use of a theory, model, or framework to guide evaluation; six studies (24%) included factors related to sustainability; and nine studies (38%) conducted their interventions with low-income or minoritized groups. The findings point to the need for intervention evaluations examining nutrition and physical activity to more consistently consider (a) sustainability factors early on in design and adoption phases; (b) use of theory, model, or framework to guide evaluation; and (c) equity-related frameworks and considerations for how equitable implementation.
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Affiliation(s)
- Yuka Asada
- School of Public Health, Community Health Sciences, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA.
| | - Shuhao Lin
- College of Applied Health Science, Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W Taylor St, Chicago, IL, 60612, USA
| | - Leilah Siegel
- 4-H Youth Development, University of Illinois Extension, 535 S. Randall Road, St., Charles, IL, 60174, USA
| | - Angela Kong
- Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
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Telehealth als Therapieoption in der juvenilen Adipositasprävention. DIE DIABETOLOGIE 2022. [PMCID: PMC9713089 DOI: 10.1007/s11428-022-00977-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Übergewicht und Adipositas im Kindes- und Jugendalter gehen nicht nur mit ausgeprägten medizinischen und psychologischen Begleit- und Folgeerkrankungen einher, sondern stellen auch aus ökonomischer Sicht eine der größten Herausforderungen für das Gesundheitssystem dar. Die Beschränkungen im Rahmen der weltweiten COVID-19-Pandemie (COVID-19: „coronavirus disease 2019“) führten zu einer weiteren Aggravierung der vorbestehend hohen Prävalenz an juvenilem Übergewicht. Da pharmakologische Behandlungsmöglichkeiten im Kindes‑/Jugendalter im Allgemeinen nicht zugelassen sind und daher keine Option darstellen, spielt die Lebensstilveränderung aus therapeutischer Sicht eine gesonderte Rolle. Dabei haben multimodale Beschulungskonzepte mit Beratungen durch Mitarbeitende verschiedener Fachbereiche (beispielsweise Psychologie, Ernährung, Sport, Medizin) aktuell die besten Erfolgsaussichten. Durch den gezielten Transfer dieser Schulungsprogramme in telemedizinische Konzepte könnten deren Wirkungsgrad nachhaltig verbessert und dabei Ressourcen sowohl auf therapeutischer Seite als auch der der Betroffenen geschont werden.
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Cluster-randomised trial of the impact of an obesity prevention intervention on childcare centre nutrition and physical activity environment over 2 years. Public Health Nutr 2022; 25:3172-3181. [PMID: 34593076 PMCID: PMC9991736 DOI: 10.1017/s1368980021004109] [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: 11/06/2022]
Abstract
OBJECTIVE The prevalence of obesity among pre-school-aged children in the USA remains unacceptably high. Here, we examine the impact of Healthy Caregivers-Healthy Children (HC2) Phase 2, a childcare centre (CCC)-based obesity prevention intervention on changes in the CCC nutrition and physical activity environment over 2 school years. DESIGN This was a cluster-randomised trial with twelve CCC receiving the HC2 intervention arm and twelve in the control arm. The primary outcome was change in the Environment and Policy Assessment and Observation (EPAO) tool over 2 school years (Fall 2015, Spring 2016 and Spring 2017). Changes in EPAO physical activity and nutrition score were analysed via a: (1) random effects mixed models and (2) mixed models to determine the effect of HC2 v. control. SETTING The study was conducted in twenty-four CCC serving low-income, ethnically diverse families in Miami-Dade County. PARTICIPANTS Intervention CCC received (1) teachers/parents/children curriculum, (2) snack, beverage, physical activity, and screen time policies, and (3) menu modifications. RESULTS Two-year EPAO nutrition score changes in intervention CCC were almost twice that of control CCC. The EPAO physical activity environment scores only slightly improved in intervention CCC v. control CCC. Intervention CCC showed higher combined EPAO physical activity and nutrition scores compared to control CCC over the 2-year study period (β = 0·09, P = 0·05). CONCLUSIONS Obesity prevention programmes can have a positive impact on the CCC nutrition environment and can promote healthy weight in early childhood. CCC may need consistent support to improve the physical activity environment to ensure the policies remain intact.
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Relationship between teacher fidelity to an early childhood obesity prevention program and the Child care center nutrition and physical activity environment. Prev Med Rep 2022; 30:102024. [PMID: 36262774 PMCID: PMC9574711 DOI: 10.1016/j.pmedr.2022.102024] [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] [Received: 11/11/2021] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
The child care center is an optimal setting for obesity prevention. Yet, little attention has been paid to teacher fidelity to obesity prevention programs. Measuring teacher fidelity may provide guidance for further improvements to sustainability. Teacher fidelity was correlated with the nutrition but not the physical environment. Childcare center teachers may require continued support for obesity prevention.
Background Child care centers (CCC) can be strategic settings to establish healthy lifestyle behaviors through obesity prevention programs. Fidelity to the implementation of such programs is a vital evaluation component, but is often not measured. This study assessed CCC teacher fidelity to the implementation of “Healthy Caregivers, Healthy Children (HC2)”, a CCC-based obesity prevention intervention. Methods CCCs serving low-resource, ethnically diverse families with ≥ 50 children ages 2-to-5 years old that were randomized to the HC2 intervention and that had teacher fidelity data collected (n = 9 CCC) were included in this analysis. The Environment and Policy Assessment and Observation (EPAO) tool assessed the CCC nutrition and physical activity (PA) environment at the beginning/end of the school year. Fidelity assessments were conducted in CCCs randomized to HC2 in Spring 2016 (n = 33 teachers) and 2017 (n = 39 teachers) by a trained observer. The relationship between teacher fidelity and EPAO was assessed via mixed models. Results For every-one unit rise in teacher fidelity, EPAO nutrition increased 0.055 points (p =.006). No significant relationship was shown between teacher fidelity and EPAO PA score (p =.14). Conclusion Teacher fidelity to obesity prevention program implementation may support a healthy CCC obesity prevention and nutrition environment but might require continued support for all components.
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Strączek K, Horodnicka-Józwa A, Szmit-Domagalska J, Jackowski T, Safranow K, Petriczko E, Walczak M. Impact of One-Year Dietary Education on Change in Selected Anthropometric and Biochemical Parameters in Children with Excess Body Weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11686. [PMID: 36141955 PMCID: PMC9517116 DOI: 10.3390/ijerph191811686] [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: 06/17/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Obesity is regarded as a civilization disease that increases mortality and the risk of cardiovascular complications. In Poland, the prevalence of excess body weight in the paediatric population has been steadily increasing. The consequences of excess body weight in the developmental age population affect children's health and destabilize their development. Appropriate dietary interventions are the main non-invasive methods of preventing and treating obesity. They should be aimed at the whole family, optimally with the use of simple tools such as the Healthy Eating Pyramid. Due to the increasing prevalence of excess body weight in the developmental age population and the problems with the treatment of this condition, studies were undertaken in order to determine the impact of a dietary intervention on anthropometric and biochemical parameters in children with excess body weight. A total of 68 (72.3%) children completed the study. Based on BMI SDS, 59 (86.8%) were diagnosed with obesity and 9 (13.2%) with overweight. After the completion of the one-year dietary educational program, a significant improvement in weight loss, waist and hip circumference, as well as the value of the WHtR index was demonstrated. There was also a significant increase in the percentage of muscle tissue and a decrease in the content of adipose tissue in the bodies of examined children. A significant improvement in the parameters of carbohydrate metabolism, and almost all parameters of lipid metabolism, except for total cholesterol. A significant (by 28.0%) reduction in the incidence of fatty liver was also noted. No influence of dietary education on arterial blood pressure was observed.
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Affiliation(s)
- Kamilla Strączek
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Anita Horodnicka-Józwa
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Justyna Szmit-Domagalska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Tomasz Jackowski
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Elżbieta Petriczko
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Mieczysław Walczak
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, 71-252 Szczecin, Poland
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Khatamnejad M, Akhlaghi M. Maternal-child overweight relationship, assessment of maternal perception of child weight status and feeding behaviours. Nutr Health 2022:2601060221124734. [PMID: 36071603 DOI: 10.1177/02601060221124734] [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: 11/15/2022]
Abstract
BACKGROUND Parents play a key role in constructing children' behaviours. We studies maternal-child overweight relationship and compared maternal perception of child weight status and feeding behaviours between groups of normal-weight and overweight children. METHODS The cross-sectional study was conducted on 192 girls aged 10-13 years and their mothers. They were divided to two groups of overweight (n = 94) and normal-weight (n = 98) children. Anthropometric characteristics were measured for children and mothers. Logistic regression analysis was used to examine the association between child overweight and tertiles of maternal body mass index (BMI). Maternal perception of child's weight status and her engagement in promoting child's healthy behaviours was assessed. RESULTS BMI and waist circumference was significantly higher in children (P < 0.001) and mothers (P < 0.01) of overweight compared to normal-weight group. There was a significant relationship between children's overweight and tertiles of maternal BMI, which remained significant after adjusting for potential confounders. Mothers of overweight children were more concerned for their child's overeating and overweight, and for compelling the child to diet to maintain a desirable weight (P < 0.001). In contrast, mothers of normal-weight children restricted sugar-sweetened drinks (P = 0.008), offered fruit and vegetables (P = 0.035), and helped their children to get enough physical activity (P = 0.022) and night sleep (P = 0.001) more than mothers in other group. CONCLUSIONS This study showed a strong relationship between children and mothers' overweight. Despite being more concerned about their child weight status, mothers of overweight children reported behaviours which were less encouraging the children for healthy eating and lifestyle than mothers of normal-weight children.
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Affiliation(s)
- Mozhgan Khatamnejad
- Department of Community Nutrition, School of Nutrition and Food Sciences, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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Dev DA, Padasas I, Hillburn C, Stage VC, Dzewaltowski DA. Ecological Approach to Family-Style, Multilevel Child Care Intervention: Formative Evaluation Using RE-AIM Framework. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:728-744. [PMID: 35768329 DOI: 10.1016/j.jneb.2022.03.005] [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: 07/14/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Conduct formative evaluation of Ecological Approach to Family-Style Dining (EAT) Intervention. DESIGN Qualitative semistructured interviews and demographic surveys. SETTING Early care and education (ECE) centers in Nebraska. PARTICIPANTS Cooperative Extension coaches (n = 9), ECE administrators (n = 8), and teachers (n = 17) caring for children aged 3-5 years. INTERVENTION The EAT intervention (a 16-week, 7-lesson, evidence-based online responsive feeding ECE model) uses a multilevel improvement system of 5 implementation strategies. Early care and education administrators and teachers completed 1 lesson/wk followed by a coaching session. MAIN OUTCOME MEASURES The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework includes 5 evaluative dimensions. ANALYSIS Thematic analysis. RESULTS Overall, 77% of children aged 3-5 years (n = 216) participated from targeted Child and Adult Care Food Program ECEs (Reach). All perceived EAT improved children's nutritional and developmental outcomes and encouraged a positive mealtime environment (Effectiveness). Coaches found professional development incentives important, whereas administrators/teachers valued inservice hours (Adoption). Teachers reported successful implementation of responsive feeding, and administrators supported the teachers (Implementation). All reported they intended to continue using EAT, and administrators and teachers discussed incorporating EAT practices into the handbook/school policy (Maintenance). CONCLUSION AND IMPLICATIONS The EAT was valued by all stakeholders for its perceived effectiveness to positively impact children's nutritional outcomes. Furthermore, stakeholders valued the provided incentives and multilevel design with coaching, ECE administrators, and teachers. Future research is needed on how to use Extension coaches in ECE interventions.
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Affiliation(s)
- Dipti A Dev
- Department of Child Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE.
| | - Irene Padasas
- Department of Child Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE
| | - Carly Hillburn
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE
| | - Virginia C Stage
- Department of Nutrition Science, East Carolina University, Greenville, NC
| | - David A Dzewaltowski
- Buffett Early Childhood Institute, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE
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Gans KM, Jiang Q, Tovar A, Kang A, McCardle M, Risica PM. Physical Activity and Screen Time Practices of Family Child Care Providers: Do They Meet Best Practice Guidelines? Child Obes 2022; 18:281-290. [PMID: 34851731 PMCID: PMC9145567 DOI: 10.1089/chi.2021.0094] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Child care settings significantly influence children's physical activity (PA) and screen time (ST) behaviors, yet less research has been conducted in family child care homes (FCCHs) than in child care centers. While a few studies have measured family child care providers' (FCCPs') PA practices, none have used observation to assess which specific evidence-based, best practice guidelines FCCPs met or did not meet, and no previous studies have included Latinx providers. This article examines FCCPs' adherence to PA and ST best practice guidelines using primarily observational methods with diverse FCCPs (including Latinx). Methods: We examined baseline data from a cluster randomized trial including surveys and observational data collected at the FCCH to assess whether providers met specific PA and ST best practices from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) and the American Academy of Pediatrics. Results: Providers completed a telephone survey and participated in two full-day observations (n = 127; 72% Hispanic). Overall, only 4 of 14 PA and ST best practices were met by >50% of providers including: leading a planned PA class more than once a week; no ST during meal or snack; not modeling sedentary behavior; and providing families with information about children's ST. Best practices least likely to be met (<20% of providers) include: providing children with >60 minutes of outdoor play daily; providing children with >45 minutes of adult-led PA each day; participating in outdoor PA with children; participating in indoor PA with children; prompting and praising children for being active; and talking with children informally about the importance of PA. Conclusions: While FCCPs engage in some positive PA and ST practices, many providers do not meet best practice guidelines. There is a need for more research about how to overcome providers' personal and environmental barriers for meeting these guidelines as well as interventions and supports to overcome these barriers. Clinical Trial Registration Number NCT0245645.
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Affiliation(s)
- Kim M. Gans
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.,University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA.,Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.,Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA.,Address correspondence to: Kim M. Gans, PhD, MPH, Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Qianxia Jiang
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.,University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Augustine Kang
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Meagan McCardle
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Patricia M. Risica
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.,Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA
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Food Desert Status of Family Child Care Homes: Relationship to Young Children's Food Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116393. [PMID: 35681977 PMCID: PMC9180288 DOI: 10.3390/ijerph19116393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
Family child care homes (FCCHs) are a favored child care choice for parents of young children in the U.S. Most FCCH providers purchase and prepare foods for the children in their care. Although FCCH providers can receive monetary support from the Child and Adult Care Food Program (CACFP), a federal subsidy program, to purchase nutritious foods, little is known about FCCH providers' access to nutritious foods, especially among FCCH providers serving children from communities that have been historically disinvested and predominantly Black. This study aims to describe the food desert status of FCCHs in Baltimore City, Maryland, and examine the relationship between food desert status and the quality of foods and beverages purchased and provided to children. A proportionate stratified random sample of 91 FCCH providers by CACFP participation status consented. Geographic information system mapping (GIS) was used to determine the food desert status of each participating FCCH. Participants reported on their access to food and beverages through telephone-based surveys. Nearly three-quarters (66/91) of FCCHs were located in a food desert. FCCH providers working and living in a food desert had lower mean sum scores M (SD) for the quality of beverages provided than FCCH providers outside a food desert (2.53 ± 0.81 vs. 2.92 ± 0.70, p = 0.036, respectively). Although the significant difference in scores for beverages provided is small, FCCH providers working in food deserts may need support in providing healthy beverages to the children in their care. More research is needed to understand food purchases among FCCH providers working in neighborhoods situated in food deserts.
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Thinking inside the box: The future of young children's physical activity and the home environment. Soc Sci Med 2022; 301:114930. [PMID: 35344777 PMCID: PMC9350970 DOI: 10.1016/j.socscimed.2022.114930] [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: 11/15/2021] [Revised: 02/07/2022] [Accepted: 03/15/2022] [Indexed: 11/20/2022]
Abstract
Parrish et al.'s (2021) investigation of caregiver perceptions of preschoolers' physical activity (PA) within the home environment posits important opportunities for public policy to consider space and available opportunities for PA for preschoolers. This study uncovered qualitative themes on preschoolers' PA in the home, referencing the use of indoor and outdoor spaces, adaptations within the home, interplay between space and caregiving, and variability in child's PA. This work sparks a discussion into the current understanding of the home environment for preschooler PA and future research directions. We propose three main areas to bring forward physical activity and public health research, including 1) role of policies and community (e.g., societal norms) on the home environment and child physical activity, 2) reimagination of the home environment beyond the physical components as a complex system, and 3) advanced measurement of child physical activity using modern technology. Merging these new opportunities with past efforts may help design and facilitate healthier PA and movement patterns for preschoolers now and into the future.
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Gans KM, Tovar A, Kang A, Ward DS, Stowers KC, von Ash T, Dionne L, Papandonatos GD, Mena N, Jiang Q, Risica PM. A multi-component tailored intervention in family childcare homes improves diet quality and sedentary behavior of preschool children compared to an attention control: results from the Healthy Start-Comienzos Sanos cluster randomized trial. Int J Behav Nutr Phys Act 2022; 19:45. [PMID: 35428298 PMCID: PMC9013065 DOI: 10.1186/s12966-022-01272-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/09/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Childcare settings are important environments for influencing child eating and physical activity (PA). Family childcare homes (FCCH) care for many children of low-income and diverse racial/ethnic backgrounds who are at greater risk for poor diet quality, low PA, and obesity, but few interventions have targeted this setting. The aim of this study was to assess the efficacy of a multicomponent intervention conducted in FCCH on the diet quality and PA of 2-5 year old children in their care. TRIAL DESIGN Cluster randomized trial. METHODS The cluster-randomized trial, Healthy Start/Comienzos Sanos (2015-2019) evaluated an 8-month nutrition and PA intervention that included four components: (1) monthly telephone calls from a support coach using brief motivational interviewing, (2) tailored reports, newsletters and videos, (3) group support meetings, and (4) active play toys. After completing baseline measurement, FCCH were randomized into intervention or comparison groups in matched pairs. Both groups received the same intervention components but on different topics (intervention: nutrition/PA vs. comparison: reading readiness/literacy). Evaluation staff were blinded to group assignment. Child primary outcome measures collected at baseline and 8-months included: 1) Healthy Eating Index (HEI-2015) scores calculated from diet observation, and 2) accelerometer measurement of PA. Process measures were collected from field data and provider surveys. Generalized Estimating Equation Models assessed changes in HEI-2015 scores and PA over time by experimental condition. RESULTS Ethnically diverse FCCH providers (n = 119) and 2-to-5-year-old children in their care (n = 377) were included in the final analysis. Process evaluation showed high participation in all intervention components except for group meetings. Compared to children in comparison group FCCH, children in intervention FCCH increased total HEI-2015 scores by 7.2 points (p < .001) including improvement in component scores for vegetables (0.84 points, p = .025) and added sugar (0.94 points, p = .025). For PA, compared to children in the comparison group, children in intervention FCCH decreased sedentary time by 5.7% (p = .021). CONCLUSIONS The multicomponent Healthy Start intervention was effective in improving diet quality and sedentary behavior of children in FCCH, which demonstrates the promise of obesity prevention interventions in this setting. Future research could include enhancing the Healthy Start intervention to strengthen the PA component, considering virtual peer support, and determining how to best translate and disseminate the intervention into FCCH nationally. TRIAL REGISTRATION National Institutes of Health, NCT02452645 . Registered 5 May 2015.
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Affiliation(s)
- Kim M. Gans
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT 06269 USA
- Brown University School of Public Health, Box G-121-5, 121 S. Main St, Providence, 02912 USA
| | - Alison Tovar
- Brown University School of Public Health, Box G-121-5, 121 S. Main St, Providence, 02912 USA
- Center for Health Promotion and Health Equity, Brown School of Public Health, Box G-121 8, Providence, RI 02912 USA
| | | | - Dianne Stanton Ward
- Department of Nutrition, Gillings School of Global Public Health, 135 Dauer Drive 245 Rosenau Hall, CB #7461, Chapel Hill, NC 27599 USA
| | - Kristen Cooksey Stowers
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269 USA
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT 06103 USA
| | - Tayla von Ash
- Brown University School of Public Health, Box G-121-5, 121 S. Main St, Providence, 02912 USA
- Center for Health Promotion and Health Equity, Brown School of Public Health, Box G-121 8, Providence, RI 02912 USA
| | - Laura Dionne
- Center for Health Promotion and Health Equity, Brown School of Public Health, Box G-121 8, Providence, RI 02912 USA
| | | | - Noereem Mena
- Division of Nutritional Sciences, Cornell University, Ithaca, NY USA
| | - Qianxia Jiang
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT 06269 USA
| | - Patricia Markham Risica
- Brown University School of Public Health, Box G-121-5, 121 S. Main St, Providence, 02912 USA
- Center for Health Promotion and Health Equity, Brown School of Public Health, Box G-121 8, Providence, RI 02912 USA
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Willis EA, Chang X, Smith F, Clarke E, Ward DS. Predictors of Non-Compliance with a National Early Care and Education-Based Obesity Prevention Initiative: Go NAPSACC. Am J Health Promot 2022; 36:864-868. [PMID: 35152767 DOI: 10.1177/08901171211069550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose is to examine predictors of intervention non-compliance and develop a risk stratification score. DESIGN Prospective cohort. SETTING Early care and education (ECE). SUBJECTS Early care and education programs (n = 3883) randomly allocated (3:1) to a development (n = 2909) or validation (n = 974) sample. INTERVENTION Go NAPSACC provides a structured, web-based process to help improve the health of children around 7 modules (nutrition, physical activity, oral health, breast/infant feeding, farm to ECE, outdoor play, and screen time). MEASURES Program characteristics and participation data are collected via Go NAPSACC tool. ANALYSIS Multivariable Lasso logistic regression was used to identify predictors. Discriminative ability was based on area under the ROC curve (AUC). RESULTS Overall, ECE program non-compliance (lack of valid pre-/post self-assessment) was 65.5%. Six predictors were retained in the final development model: type of program (P = .002), Child and Adult Care Food Program (CACFP) participation (P = .065), acceptance of subsidies (P < .001), past modules attempted (P < .001), past modules completed (P < .001), and action plans created (P < .001). These factors generated a non-compliance risk score which showed good discrimination in the validation sample (AUC: .922, 95% CI: .903-.940). CONCLUSION Lack of qualitative data limits the ability to fully understand the context of non-compliance; however, this study demonstrates readily available data captured by Go NAPSACC are strong predictors of future success. Early identification of high-risk programs will inform targets for future implementation strategies geared toward improving program success.
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Affiliation(s)
- Erik A Willis
- Center for Health Promotion and Disease Prevention, 2331University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.,Department of Nutrition, Gillings School of Global Public Health, 2331University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Xiuya Chang
- Biostatistics, 2331University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Falon Smith
- Center for Health Promotion and Disease Prevention, 2331University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Emily Clarke
- Center for Health Promotion and Disease Prevention, 2331University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, 2331University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.,Department of Nutrition, Gillings School of Global Public Health, 2331University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
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Laws R, Adam M, Esdaile E, Love P, Campbell KJ. What Works to Improve Nutrition and Food Sustainability across the First 2000 Days of Life: A Rapid Review. Nutrients 2022; 14:731. [PMID: 35215381 PMCID: PMC8878998 DOI: 10.3390/nu14040731] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 12/12/2022] Open
Abstract
Informed by the Innocenti framework, this rapid review of systematic reviews (n = 60) and sentinel grey literature (n = 27) synthesises the evidence of what works to improve nutrition and food sustainability across the first 2000 days. Most systematic reviews focused on interventions targeting the behaviour of parents and caregivers (n = 49), with fewer reviews focusing on the personal (n = 7) and external (n = 4) food environments. No reviews focused on food supply-chain activities. Most reviews were rated as critically low (n = 28, 47%) or low (n = 21, 35%) quality using AMSTAR 2. Evidence supports the effectiveness of multi-component breastfeeding interventions, interventions delivered in home and child-care settings, particularly when involving parents, interactive skill building and repeated exposure to vegetables. Food vouchers and access to local farmers markets and community gardens have potential for improving access and availability to healthier foods, while evidence supports interventions improving the external food environment, including fiscal strategies such as the SSB tax, restrictions on marketing and advertising of discretionary products and improved food labelling. Overall, this review highlights the importance of action across a range of settings and sectors at the international, national and local levels to improve young children's diets.
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Affiliation(s)
- Rachel Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC 3220, Australia; (M.A.); (E.E.); (P.L.); (K.J.C.)
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Haslam A, Love C, Taniguchi T, Williams MB, Wetherill MS, Sisson S, Weedn AE, Jacob T, Jernigan VBB. Development and Implementation of a Hybrid Online and In-Person Food Sovereignty and Nutrition Education Curriculum for Native American Parents: The FRESH Study. HEALTH EDUCATION & BEHAVIOR 2022; 50:430-440. [PMID: 34991400 PMCID: PMC9981305 DOI: 10.1177/10901981211067168] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Food Resource Equity and Sustainability for Health ("FRESH") study is an Indigenous-led intervention to increase vegetable and fruit intake among Native American children. As part of this study, we developed a hybrid (online and in-person) food sovereignty and nutrition education curriculum for the parents of these children. This 16-week curriculum was developed to promote household- and community-level healthy eating and food sovereignty practices to parents of preschool-aged children residing in Osage Nation, Oklahoma. A total of 81 parent/caregivers participated in the curriculum component of the FRESH study, with a median age of 34 years (range: 23-54 years). Most study participants were female (88.9%) and less than half (45.7%) had an annual household income of more than US$50,000. Most were married or had a significant other (76.5%) and worked full-time (65.4%). The median total number of children in the home <18 years of age was three (range: 1-8). Participation among the 94 parents was 56% during the first week and was 12% in the final week. Having some college or technical training (vs. having a college degree) and having an annual household income of US$20,000-US$50,000 (vs. more than US$50,000) were associated with fewer sessions attended (p = 0.004 and 0.02, respectively) Being married (vs. not) was associated with higher attendance (p < .0001). Participation in a hybrid food sovereignty and nutrition education curriculum for parents was generally low, but income, education, and marital status were associated with curriculum participation. Our research adds to the literature by describing the development and implementation of this curriculum and recommendations for future research incorporating Indigenous approaches to health.
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Affiliation(s)
- Alyson Haslam
- University of California, San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Susan Sisson
- The University of Oklahoma—Tulsa, Tulsa, OK, USA
| | | | - Tvli Jacob
- Oklahoma State University, Tulsa, OK, USA
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Strączek K, Horodnicka-Józwa A, Szmit-Domagalska J, Jackowski T, Safranow K, Petriczko E, Walczak M. Familial dietary intervention in children with excess body weight and its impact on eating habits, anthropometric and biochemical parameters. Front Endocrinol (Lausanne) 2022; 13:1034148. [PMID: 36531483 PMCID: PMC9751449 DOI: 10.3389/fendo.2022.1034148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/04/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Obesity is considered a civilisation disease which increases mortality and impairs quality of life, also among children and adolescents. The prevalence of overweight and obesity is steadily increasing in the developmental age population. Environmental factors are responsible for the main reason of excessive adipose tissue accumulation. Among these, poor eating habits and lack of exercise play the largest role. Familial prevalence of obesity and family dietary patterns also receive significant attention. Many specialists believe that the treatment of obesity should be multidirectional, effective and minimally invasive. Therefore, effective and safe methods are being investigated to effectively reduce body weight and improve eating habits. Dietary education programmes are an alternative to improve the health status of obese and overweight children and adolescents. To be fully effective, these programmes should involve the whole family. AIM OF THE STUDY In the face of constantly increasing prevalence of overweight and obesity in the developmental age population and the lack of effective methods to combat its occurrence, it seems appropriate to try to assess the effectiveness of a one-year-long dietary education of children and adolescents with excess body weight on their eating habits and the eating habits of their mothers, as well as selected anthropometric and biochemical parameters in these children using a simple educational tool, the Healthy Food Pyramid. PATIENTS AND METHODS The study group consisted of 68 children with overweight and obesity, patients of the Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age of the Pomeranian Medical University in Szczecin. The study used a proprietary questionnaire to assess dietary habits. Patients participated in six individual educational meetings over a twelve-month period. Eating habits were assessed in children and mothers before and after dietary intervention. Sixty-seven questionnaires before and after the dietary intervention were used for analysis. RESULTS Sixty-eight children completed the study. Those who did not complete the study came from families living in rural areas and their mothers mostly had primary or vocational education. One-year dietary education resulted in significant improvements in body weight, waist and hip circumference, WHtR and selected measured carbohydrate and lipid metabolism parameters with the exception of total cholesterol. The one-year dietary intervention did not have the same effect on the change in dietary habits in children and in their mothers.
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Affiliation(s)
- Kamilla Strączek
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
- *Correspondence: Kamilla Strączek,
| | - Anita Horodnicka-Józwa
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Justyna Szmit-Domagalska
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Jackowski
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Elżbieta Petriczko
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Mieczysław Walczak
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
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OUP accepted manuscript. Nutr Rev 2022; 80:1247-1273. [DOI: 10.1093/nutrit/nuab123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lessons Learned From 10 Years of Preschool Intervention for Health Promotion. J Am Coll Cardiol 2022; 79:283-298. [DOI: 10.1016/j.jacc.2021.10.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/20/2022]
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Luecking CT, Neshteruk CD, Mazzucca S, Ward DS. Efficacy of an Enhanced Implementation Strategy to Increase Parent Engagement with a Health Promotion Program in Childcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:106. [PMID: 35010364 PMCID: PMC8750233 DOI: 10.3390/ijerph19010106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
Previous efforts to involve parents in implementation of childcare-based health promotion interventions have yielded limited success, suggesting a need for different implementation strategies. This study evaluated the efficacy of an enhanced implementation strategy to increase parent engagement with Healthy Me, Healthy We. This quasi-experimental study included childcare centers from the second of two waves of a cluster-randomized trial. The standard approach (giving parents intervention materials, prompting participation at home, inviting participation with classroom events) was delivered in 2016-2017 (29 centers, 116 providers, and 199 parents). The enhanced approach (standard plus seeking feedback, identifying and addressing barriers to parent participation) was delivered in 2017-2018 (13 centers, 57 providers, and 114 parents). Parent engagement was evaluated at two levels. For the center-level, structured interview questions with providers throughout the intervention were systematically scored. For the parent-level, parents completed surveys following the intervention. Differences in parent engagement were evaluated using linear regression (center-level) and mixed effects (parent-level) models. Statistical significance was set at p < 0.025 for two primary outcomes. There was no difference in parent engagement between approaches at the center-level, β = -1.45 (95% confidence interval, -4.76 to 1.87), p = 0.38l. However, the enhanced approach had higher parent-level scores, β = 3.60, (95% confidence interval, 1.49 to 5.75), p < 0.001. In the enhanced approach group, providers consistently reported greater satisfaction with the intervention than parents (p < 0.001), yet their fidelity of implementing the enhanced approach was low (less than 20%). Results show promise that parent engagement with childcare-based health promotion innovations can positively respond to appropriately designed and executed implementation strategies, but strategies need to be feasible and acceptable for all stakeholders.
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Affiliation(s)
- Courtney T. Luecking
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY 40506, USA
| | - Cody D. Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA;
| | - Stephanie Mazzucca
- Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
| | - Dianne S. Ward
- Center for Health Promotion and Disease Prevention, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
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Zarnowiecki D, Kashef S, Poelman AA, Cochet-Broch MO, Arguelles JC, Cox DN, Golley RK. Application of the multiphase optimisation strategy to develop, optimise and evaluate the effectiveness of a multicomponent initiative package to increase 2-to-5-year-old children's vegetable intake in long day care centres: a study protocol. BMJ Open 2021; 11:e047618. [PMID: 34857552 PMCID: PMC8640664 DOI: 10.1136/bmjopen-2020-047618] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 10/21/2021] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Globally, children do not eat enough core foods, with vegetable intakes persistently low. Early life is critical for establishing vegetable acceptance and intake. Increased usage of formal childcare has led to the importance of childcare settings shaping children's food intake. This study will use the multiphase optimisation strategy to develop, optimise and evaluate the effectiveness of a multicomponent initiative package to increase 2-to-5-year-old children's vegetable intake in long day care centres. METHODS AND ANALYSIS The preparation phase will use existing literature and best practice guidelines to develop three initiatives aiming to: (1) increase vegetable provision at mealtimes, (2) deliver a vegetable-focused sensory curriculum and (3) use supportive mealtime practices encouraging children's tasting of vegetables. The optimisation phase (N=32 centres) will use a 12-week, eight-condition factorial experiment to test main and synergistic effects of the initiatives. The optimum combination of initiatives producing the largest increase in vegetable intake will be identified. The evaluation phase (N=20 centres) will test the effectiveness of the optimised package using a 12-week waitlist randomised controlled trial. Primary outcomes are children's vegetable intake and food group intake at long day care. Secondary outcomes are menu guideline compliance, cook and educator knowledge and skills, and reach. Process evaluation will include fidelity, acceptability, barriers and facilitators, and compatibility with practice. Repeated measures ANOVA with interaction effects (optimisation phase) and linear mixed modelling (evaluation phase) will test effects of the initiatives on vegetable intake. ETHICS AND DISSEMINATION This study has received ethics approval from the Flinders University Research Ethics Committee (Project No: 1873) for the optimisation phase. Approval for the evaluation phase will be obtained following completion of optimisation phase. Findings will be disseminated to stakeholders, including long day care centres and childcare organisations; and to researchers via peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBERS ACTRN12620001301954, ACTRN12620001323910p.
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Affiliation(s)
- Dorota Zarnowiecki
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Shabnam Kashef
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Astrid Am Poelman
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health & Biosecurity, North Ryde, New South Wales, Australia
| | - Maeva O Cochet-Broch
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, North Ryde, New South Wales, Australia
| | | | - David N Cox
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health & Biosecurity, Adelaide, South Australia, Australia
| | - Rebecca K Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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Jiang Q, Tovar A, Risica PM, Cooksey Stowers K, Schwartz M, Lombardi C, Kang A, Mena NZ, Gans KM. Ethnic Differences in Family Childcare Providers' Nutrition- and Activity-Related Attitudes and Barriers. J Obes 2021; 2021:6697006. [PMID: 34659829 PMCID: PMC8516587 DOI: 10.1155/2021/6697006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/07/2021] [Accepted: 09/21/2021] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of the study is to examine family childcare providers' (FCCPs) attitudes and perceived barriers related to nutrition, physical activity (PA), and screen time (ST) behaviors of preschool children, exploring differences by provider ethnicity. Design Baseline survey data from a cluster-randomized trial. Participants. Around 168 FCCPs completed a telephone survey, and 126 completed both telephone and in-person surveys. Main Outcome Measures. Phone and in-person surveys include 44 questions to assess FCCPs attitudes and perceived barriers regarding nutrition, PA, and ST in the family childcare home. Analysis. Associations by ethnicity (Latinx vs. non-Latinx) were assessed by ANOVA, adjusting for provider education and Bonferroni correction. Results Some FCCP attitudes were consistent with national obesity prevention guidelines; for example, most FCCPs agreed that they have an important role in shaping children's eating and PA habits. However, many FCCPs agreed with allowing children to watch educational TV and did not agree that children should serve themselves at meals. Adjusting for education, there were statistically significant differences in attitude and perceived barrier scores by provider ethnicity. For example, Latinx FCCPs were more likely to agree that they should eat the same foods as children(p < .001) but less likely to agree that serving the food at meal and snack time is the adult's responsibility (p < .001). Latinx FCCPs were more like to perceive barriers related to children's safety playing outside (p < .001). Conclusions and Implications. While FCCPs hold some nutrition-, PA-, and ST-related attitudes consistent with national guidelines, training opportunities are needed for FCCPs to improve knowledge and skills and overcome perceived barriers related to nutrition and PA. Latinx FCCPs, in particular, may need culturally tailored training and support to overcome misperceptions and barriers.
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Affiliation(s)
- Qianxia Jiang
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Patricia M. Risica
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA
| | - Kristen Cooksey Stowers
- University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- University of Connecticut Rudd Center for Food Policy and Obesity, Hartford, CT, USA
| | - Marlene Schwartz
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA
- University of Connecticut Rudd Center for Food Policy and Obesity, Hartford, CT, USA
| | - Caitlin Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Augustine Kang
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Noereem Z. Mena
- Food Science and Human Nutrition Department, Colorado State University, Fort Collins, CO, USA
| | - Kim M. Gans
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
- University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA
- University of Connecticut Rudd Center for Food Policy and Obesity, Hartford, CT, USA
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Concordance Between the Weight of Spanish Adolescent Soccer Players, Their Self-Perceived Weight, and Their Weight as Perceived by Their Parents. J Pediatr Nurs 2021; 60:e13-e18. [PMID: 33618980 DOI: 10.1016/j.pedn.2021.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE In the context of soccer clubs, to analyze the concordance between players' actual weight, their self-perceived weight, and their weight as perceived by their parents; to determine which variables might explain the presence of concordance between parents' perception of adolescents' weight and their actual weight. Design and study: A cross-sectional study involving 330 soccer players aged between 13 and 16. Data on personal characteristics of adolescents and parents were analyzed, as well as parents' perceptions of adolescents' weight status and their self-perception. A descriptive analysis of the personal characteristics of the sample (adolescents and parents) and an analysis of the variables explaining the presence of concordance between the parents' perception of adolescents' weight and their actual weight were performed. RESULTS 19% of the adolescents were overweight and 3.4% were obese. The concordance between parents' perceptions of players' weight and players' actual weight was weak. The concordance between adolescents' self-perceived weight and their actual weight was moderate. The difference in BMI scores according to presence or absence of concordance was statistically significant: these scores were higher in the absence of concordance. Discordance between adolescents' weight and their parents' perception of their weight was associated with parents having lower levels of education. CONCLUSION A high percentage of parents and players misperceived their actual weight. This discrepancy was associated with higher BMI scores for adolescents. PRACTICE IMPLICATIONS Nurses should include promotion of accurate weight perception in educational interventions on excess weight.
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Toussaint N, Streppel MT, Mul S, Balledux M, van Drongelen K, Janssen M, Fukkink RG, Weijs PJM. The effects of a preschool-based intervention for Early Childhood Education and Care teachers in promoting healthy eating and physical activity in young children: A cluster randomised controlled trial. PLoS One 2021; 16:e0255023. [PMID: 34298547 PMCID: PMC8302250 DOI: 10.1371/journal.pone.0255023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
The need for excess weight gain prevention in disadvantaged young children is widely recognised. Early Childhood Education and Care teachers are potential key actors in early interventions to prevent overweight and obesity. This study examines the effects of a preschool-based intervention for teachers in promoting healthy eating and physical activity in young children. A cluster randomised controlled trial was conducted at 41 preschools in a deprived area of Amsterdam, The Netherlands. The intervention consisted of 2 programmes that were applied in succession: A Healthy Start and PLAYgrounds for TODdlers. The study period was 9 months. Primary outcomes were assessed via questionnaires and included teachers' knowledge, attitude, food/activity-related practices, and level of confidence in promoting healthy behaviours. Secondary outcomes in this study were teachers' and children's BMI (z-score), body composition, dietary intake and physical activity level. Intention-to-treat analyses were performed using linear mixed models. In total, 115 teachers and 249 children (mean age 3.0 (0.2) years) were included. A positive effect on teachers' knowledge about the Dutch dietary guidelines was found after the programme A Healthy Start (difference = 1.38; 1-sided 95% CL = 0.29; p = 0.02). This effect was not sustained at 9 months (difference = 0.34; 1-sided 95% CL = -0.76; p = 0.31). The overall intervention had a positive effect on 3 of the 5 attitude statements regarding a healthy lifestyle (difference ranged from 0.34 to 0.55) and on the practice scale Activity-related-Modelling (difference = 0.16; 1-sided 95% CL = 0.06; p = 0.01). No intervention effects were observed on food-related practice scales and the level of confidence in promoting healthy behaviours. At this stage, no effects were seen on teachers' and children's BMI (z-score). This study contributes to the professional development of Early Childhood Education and Care teachers and addresses the call for interventions to prevent overweight/obesity and to minimise health inequalities in young children.
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Affiliation(s)
- Nicole Toussaint
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Martinette T. Streppel
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Sandra Mul
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | | | | | - Mirka Janssen
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Ruben G. Fukkink
- Faculty of Child Development and Education, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter J. M. Weijs
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Nutrition & Dietetics, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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Cheng H, George C, Dunham M, Whitehead L, Denney-Wilson E. Nurse-led interventions in the prevention and treatment of overweight and obesity in infants, children and adolescents: A scoping review. Int J Nurs Stud 2021; 121:104008. [PMID: 34260995 DOI: 10.1016/j.ijnurstu.2021.104008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 06/01/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Nurses are well-placed in primary care, school and community settings to identify and manage paediatric overweight and obesity. This scoping review examined what types of nurse-led interventions have been undertaken for the prevention, treatment and management of obesity and overweight in infants, children and adolescents. DESIGN Scoping review. DATA SOURCES CINAHL, Cochrane Library, Embase, MEDLINE, ProQuest Central, ProQuest Dissertations & Theses Global, and Scopus. Searches were undertaken from inception to 2019. METHODS Database searches and handsearching were used to identify academic and grey literature, such as scientific reports and university theses and dissertations, on nurse-led interventions undertaken in school, primary health care and community settings. Studies focused on addressing overweight and obesity in children and adolescents, for studies published from 1999 onwards. Studies included focused on experimental and quasi-experimental research that implemented interventions, and described new practice or change in practice. RESULTS 117 references encompassing 83 studies or programs were selected for inclusion. 16 trials were analysed descriptively, and 67 trials were analysed descriptively and quantitatively. The analysis structured intervention settings and outcomes using the socioecological model, encompassing intrapersonal, interpersonal, community, organisation and policy factors. Studies included were clinically heterogeneous for intervention setting and multicomponent strategies. Education for nutrition, physical activity and behaviour change was the most common strategy used, and nutrition and physical activity knowledge most consistently improved after intervention. Nursing roles focused on education; counselling and behaviour change in primary care; advocacy in school and community environments; and implementing policy in child care settings. Fifty-four studies received financial or resource funding and support to implement the study. On sustainability, seven programs and two research studies were ongoing at time of writing. CONCLUSIONS While the clinical heterogeneity of studies makes synthesis of outcomes complex, it demonstrates the breadth of nursing interventions to address paediatric overweight and obesity. Incentives that encourage routine health promotion, upskilling of nurses, and embedding food and nutrition education into the school curricula, are suitable strategies that support nurse-led interventions against paediatric obesity. REGISTRATION NUMBER Not applicable. Tweetable abstract: Scoping r/v - what interventions are led by nurses to address paediatric obesity? 83 studies investigate nurses' work in school, primary health, community care.
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Affiliation(s)
- Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Susan Wakil Health Building, Camperdown, NSW, 2006, Australia; Centre of Research Excellence in Early Prevention of Childhood Obesity, The University of Sydney, Australia.
| | - Cobie George
- Australian College of Nursing, 1 Napier Close, Deakin, Australian Capital Territory, 2050, Australia.
| | - Melissa Dunham
- Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia.
| | - Lisa Whitehead
- Australian College of Nursing, 1 Napier Close, Deakin, Australian Capital Territory, 2050, Australia; Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia.
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Susan Wakil Health Building, Camperdown, NSW, 2006, Australia; Centre of Research Excellence in Early Prevention of Childhood Obesity, The University of Sydney, Australia; Sydney Institute for Women, Children and Families, King George V Building, Sydney Local Health District, Missenden Road, Camperdown, New South Wales, 2050, Australia.
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Sanchez-Flack J, Buscemi J, O'Donnell A, Clark Withington MH, Fitzgibbon M. Black American and Latinx Parent/Caregiver Participation in Digital Health Obesity Interventions for Children: A Systematic Review. Front Digit Health 2021; 3:687648. [PMID: 34713158 PMCID: PMC8522024 DOI: 10.3389/fdgth.2021.687648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/18/2021] [Indexed: 11/25/2022] Open
Abstract
Parents/caregivers are consistently described as integral targets given their influential role in supporting and managing behaviors such as diet and physical activity. Identifying effective obesity prevention interventions to enhance and sustain parent participation is needed. Digital obesity prevention interventions are a promising strategy to improve parent/caregiver participation. Digital health interventions demonstrate acceptable participation and retention among parents/caregivers. However, our understanding of digital obesity prevention interventions targeting Black American and Latinx parents/caregivers is limited. This systematic review aims to identify Black American and Latinx parents'/caregivers' level of participation in digital obesity prevention and treatment interventions and determine the relationship between parent/caregiver participation and behavioral and weight status outcomes. This review adheres to PRISMA guidelines and is registered in PROSPERO. Eligibility criteria include: intervention delivered by digital technology, targeted Black American and Latinx parents/caregivers of young children (2-12 years), reported parent/caregiver participation outcomes, targeted diet or physical activity behaviors, and randomized controlled trial study design. Searches were conducted in September 2020 in ERIC, PsychInfo, PubMed, and Web of Science. Initial searches returned 499 results. Four reviewers screened records against eligibility criteria and 12 studies met inclusion criteria. Across all studies, parent/caregiver participation ranged from low to high. Only half of the included studies reported significant improvements in behavioral or weight status outcomes for parents/caregivers and/or children. Of these studies, three reported high parental/caregiver participation rates, and three reported high satisfaction rates. These findings suggest that participation and satisfaction may impact behavior change and weight status. The small number of studies indicates that additional research is needed to determine whether engagement or other factors predict responsiveness to the digital health intervention. Our results lay the groundwork for developing and testing future digital health interventions with the explicit goal of parental/caregiver participation and considers the need to expand our digital health intervention research methodologies to address obesity inequities among diverse families better.
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Affiliation(s)
- Jennifer Sanchez-Flack
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, United States
- University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, United States
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, United States
| | | | | | - Marian Fitzgibbon
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, United States
- University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, United States
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
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Malek ME, Nyberg G, Elinder LS, Patterson E, Norman Å. Children's experiences of participating in a school-based health promotion parental support programme - a qualitative study. BMC Pediatr 2021; 21:228. [PMID: 33975569 PMCID: PMC8111964 DOI: 10.1186/s12887-021-02694-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 04/29/2021] [Indexed: 01/22/2023] Open
Abstract
Background Children’s voices are seldom heard in process evaluations concerning health promotion programmes. A Healthy School Start Plus (HSSP) is a parental support programme, conducted in Sweden, with the aim of promoting healthy diet, physical activity and preventing obesity in preschool class children. The 6-month programme includes: (1) Health information to parents; (2) Motivational Interviewing with parents by school nurses; (3) Classroom activities and home assignments for children; (4) A self-test of type-2 diabetes risk for parents. We aimed to describe children’s experiences of the third component regarding barriers and facilitators of participating in and learning from the classroom activities in the HSSP. Methods In total 36 children from 7 schools in Sweden, mean age 6 years, participated in 7 focus group discussions. Purposeful sampling with maximum variation was used to collect the data. The focus groups were audio-recorded, transcribed and analysed using qualitative content analysis. Results Four categories were identified; (1) Time available to work on intervention activities; (2) Others’ interest; (3) Abilities and interests in intervention activities; and (4) Practicing the concept of health. Conclusions The findings may improve the HSSP and other similar interventions that include classroom-based learning regarding health by highlighting the following points to consider: aiming for homework to be an integrated part of the school-setting to enhance parental involvement; using flexible material, tailored to the children’s abilities and giving children adequate time to finish the intervention activities; and making teachers and parents aware of the importance of verbal and body language regarding intervention activities. Trial registration The Healthy School Start Plus trial was retrospectively registered in the International Standard Randomised Controlled Trial Number Registry on January 4, 2018 and available online at ClinicalTrials.gov: No. NCT03390725. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02694-0.
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Affiliation(s)
- Mahnoush Etminan Malek
- Karolinska Institutet, Department of Global Public Health, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
| | - Gisela Nyberg
- Karolinska Institutet, Department of Global Public Health, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.,The Swedish School of Sport and Health Sciences, Lidingövägen 1, 114 33, Stockholm, Sweden
| | - Liselotte Schäfer Elinder
- Karolinska Institutet, Department of Global Public Health, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Region Stockholm, Solnavägen 1E, 113 65, Stockholm, Sweden
| | - Emma Patterson
- Karolinska Institutet, Department of Global Public Health, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden
| | - Åsa Norman
- Karolinska Institutet, Department of Global Public Health, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden
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Swindle T, McBride NM, Selig JP, Johnson SL, Whiteside-Mansell L, Martin J, Staley A, Curran GM. Stakeholder selected strategies for obesity prevention in childcare: results from a small-scale cluster randomized hybrid type III trial. Implement Sci 2021; 16:48. [PMID: 33933130 PMCID: PMC8088574 DOI: 10.1186/s13012-021-01119-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Together, We Inspire Smart Eating (WISE) is an intervention for the early care and education setting to support children's exposure to and intake of fruits and vegetables. WISE emphasizes 4 evidence-based practices (EBPs): (1) use of a mascot; (2) educators' role modeling; (3) positive feeding practices; and (4) hands-on exposures. The current study reports on a small-scale implementation trial aimed at improving the use of WISE EBPs by teachers. METHODS A Hybrid Type III Cluster Randomized Design compared a Basic and Enhanced implementation strategy. The Basic Strategy included training and reminders only; the Enhanced strategy was a multi-faceted package of stakeholder-selected strategies including a leadership commitment, an implementation blueprint, a local champion, an environmental reminder of the EBPs, facilitation, and tailored educational resources and incentives. All study sites were Head Starts. Sites were randomized using a balancing technique that considered site characteristics; 4 sites (20 classrooms, 39 educators, 305 children) received Enhanced support; 5 sites (18 classrooms, 36 educators, 316 children) received Basic support. RE-AIM guided the evaluation, and implementation fidelity was the primary outcome. Strategies were assessed using examination of data distributions and unadjusted comparisons (t tests) as well as general linear and mixed effects models controlling for covariates. RESULTS For the primary outcome of fidelity, the Enhanced group had significantly higher means for 3 of 4 EBPs. Multivariate models explained a significant portion of variance for both mascot use and hands-on exposure with a significant positive effect observed for treatment condition. The Enhanced group also had higher rates of Appropriateness and Organizational Readiness for Implementing Change (as indicators of implementation and adoption, respectively). There was no significant difference between groups for indicators of Reach, Effectiveness or Maintenance. Formative interviews indicated key targets for iteration and potential mechanisms. Key events were catalogued to provide context for interpretation (e.g., 61% of classrooms with turnover). CONCLUSIONS Findings were mixed but suggested promise for the Enhanced strategy, especially considering key events of the study. Implementation fidelity improvements occurred mainly in the last 3 months of the school year; additional time may be needed to translate to improvements in child outcomes. TRIAL REGISTRATION NCT03075085 Registered 20 February 2017.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Nicole M. McBride
- Embedded Preventive Behavioral Health Capability, Marine Corps Community Services, III MEF, United State Marine Corps, Okinawa, Japan
| | - James P. Selig
- College of Public Health, Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 W. Markham St., #781, Little Rock, AR 72205 USA
| | - Susan L. Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue Box C225, Aurora, CO 80045 USA
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Janna Martin
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Audra Staley
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Geoffrey M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham St, #522-4, Little Rock, AR 72205-7199 USA
- Central Arkansas Veterans Healthcare System, North Little Rock, AR 72114 USA
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50
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Luecking CT, Vaughn AE, Burney R, Hennink-Kaminski H, Hales D, Ward DS. Fidelity and factors influencing implementation of Healthy Me, Healthy: process evaluation of a social marketing campaign for diet and physical activity behaviors of children in childcare. Transl Behav Med 2021; 11:733-744. [PMID: 33538306 PMCID: PMC8034246 DOI: 10.1093/tbm/ibab001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The effectiveness of interventions targeting children's eating and physical activity behaviors through childcare settings is inconsistent. To enhance public health impact, it is imperative to evaluate fidelity of implementing complex interventions in real-world settings. This study evaluated fidelity and contextual factors influencing implementation of Healthy Me, Healthy We (HMHW). HMHW was an 8-month social marketing campaign delivered through childcare to support children's healthy eating and physical activity. HMHW required two levels of implementation support (research team and childcare providers) and two levels of campaign delivery (childcare providers and parents). Process evaluation was conducted among childcare centers in the intervention group (n=48) of the cluster-randomized control trial. Measures included attendance logs, self-report surveys, observation checklists, field notes, and semi-structured interviews. A 35-item fidelity index was created to assess fidelity of implementation support and campaign delivery. The fidelity with which HMHW was implemented by childcare providers and parents was low (mean 17.4 out of 35) and decreased between childcare providers and parents. Childcare providers had high acceptability of the program and individual components (80 - 93%). Only half of parents felt intervention components were acceptable. Frequently cited barriers to implementation by childcare providers included time constraints, parent engagement, staff turnover, and restrictive policies. The lack of observable effect of HMHW on children's dietary or physical activity behaviors may be due to inadequate implementation at multiple levels. Different or additional strategies are necessary to support implementation of multilevel interventions, particularly when individuals are expected to deliver intervention components and support others in doing so.
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Affiliation(s)
- Courtney T Luecking
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Regan Burney
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Heidi Hennink-Kaminski
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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