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Supporting parents and healthy behaviours through parent-child meetings - a qualitative study in the Netherlands. BMC Public Health 2021; 21:1169. [PMID: 34144699 PMCID: PMC8211718 DOI: 10.1186/s12889-021-11248-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/07/2021] [Indexed: 01/12/2023] Open
Abstract
Background The first 2 years of a child’s life have been found to be crucial to healthy growth and development. Parent support groups can help parents to promote health-related behaviours during this crucial period. The aim of this study was to explore the experiences of parents who participated in a parent support group (Parent-Child Meetings) which promoted health-related behaviours of their children, and to determine whether and how these meetings supported them in promoting these behaviours. Methods We used a qualitative study design. The parent support group consisted of weekly Parent-Child Meetings organized in a multi-ethnic, relatively low-income neighbourhood in Amsterdam, the Netherlands. Data on the experiences of parents was collected through participatory observations, informal conversations (n = 30 sessions) and semi-structured interviews (n = 13) between April 2019 and March 2020. The data was analysed using thematic content analysis. Results Parents indicated that they experienced the parent-child meetings as enjoyable and as providing them with socio-emotional support. They reported that the meetings increased their parenting knowledge, skills and practices regarding healthy behaviours of their children and that they used this knowledge in their daily lives. They also appreciated the practical information and advice provided by experts in the meetings. Parents indicated that the positive attitude of the experts was crucial in accepting and adopting their advice. Additionally, parents valued the interactive and hands-on workshops, which integrated health-related behaviours and active play with children, as it enabled them to learn while they played with their children. Conclusion This study indicated that parent-child meetings contributed to enhancing parental knowledge, skills and practices regarding healthy behaviours of their children. This could potentially benefit the health of children during the first 2 years of their lives. In particular, the peer support of other parents, the hands-on workshops, and the concrete advice and information provided in an informal setting were highly valued by parents. Future parent support groups could use these findings to improve their meetings or to start meetings that better suit the needs of parents with young children. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11248-z.
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da Costa Peres CM, Gardone DS, Costa BVDL, Duarte CK, Pessoa MC, Mendes LL. Retail food environment around schools and overweight: a systematic review. Nutr Rev 2021; 78:841-856. [PMID: 31968100 DOI: 10.1093/nutrit/nuz110] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
CONTEXT The presence of retail food establishments around schools can be a potentiating or protective factor for overweight in students, depending on access to these places as well as types of foods available therein. The hypothesis for this study was that a greater density and proximity of retail food establishments around schools influence the weight of students. OBJECTIVE To systematically review the available observational literature on the association between retail food establishments around schools and the occurrence of overweight and obesity in schoolchildren and adolescents. DATA SOURCES Observational studies were searched in the MEDLINE, EMBASE, and SCOPUS databases published until May 2019. DATA EXTRACTION Two independent reviewers extracted relevant data. DATA ANALYSIS Data on the 31 included studies were summarized with narrative synthesis according to meta-analyses of observational studies in epidemiology, exploring the type of food establishments around schools and analyzing qualitatively the impact of proximity or density on overweight and obesity rates. CONCLUSION Of the 31 articles, a direct association between proximity or density of establishments (mainly fast food restaurants, convenience stores, grocery stores) around schools and overweight and obesity in children and adolescents were found in 14 studies. However, authors of 13 papers found no association and inverse association was presented in 4 papers. The studies presented different methods of classification, location, and analysis of retail food establishments, making it difficult to conclude the real influence that the presence of these establishments near schools have on the nutritional status of children and adolescents. Therefore, future studies should consider the use of longitudinal designs and standardized analysis of the food environment around schools to better understand this food environment and its influence on health-related behaviors.
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Affiliation(s)
- Carla Marien da Costa Peres
- Post-Graduate Program in Nutrition and Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Danielle Soares Gardone
- Post-Graduate Program in Nutrition and Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruna Vieira de Lima Costa
- Post-Graduate Program in Nutrition and Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila Kümmel Duarte
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Milene Cristine Pessoa
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Loures Mendes
- Post-Graduate Program in Nutrition and Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Gelius P, Messing S, Goodwin L, Schow D, Abu-Omar K. What are effective policies for promoting physical activity? A systematic review of reviews. Prev Med Rep 2020; 18:101095. [PMID: 32346500 PMCID: PMC7182760 DOI: 10.1016/j.pmedr.2020.101095] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/14/2020] [Accepted: 04/04/2020] [Indexed: 11/25/2022] Open
Abstract
There is a growing need for evidence on the effectiveness of different policies to promote physical activity. We conducted a systematic literature review to collate the available evidence. We identified 57 reviews with evidence on 53 types of physical activity policies from 7 areas. There is a solid evidence base for the effectiveness of school-based and some infrastructural policies. The evidence for other (e.g. economic) policies remains insufficient.
The importance of policy for promoting physical activity (PA) is increasingly recognized by academics, and there is a push by national governments and international institutions for PA policy development and monitoring. However, our knowledge about which policies are actually effective to promote PA remains limited. This article summarizes the currently available evidence by reviewing existing reviews on the subject. Building on results from a previous scoping review on different types of PA-related evidence, we ran searches for combinations of the terms “physical activity”, “evidence”, “effect”, “review”, and “policy” in six different databases (PubMed, Scopus, SportDiscus, PsycInfo, ERIC, and IBSS). We used EPPI Reviewer 4 to further process the results and conduct an in-depth analysis. We identified 57 reviews providing evidence on 53 types of policies and seven broader groups of policies. Reviews fell into four main categories: 1) setting- and target group-specific; 2) urban design, environment and transport; 3) economic instruments; and 4) broad-range perspective. Results indicate that there is solid evidence for policy effectiveness in some areas (esp. school-based and infrastructural policies) but that the evidence in other areas is insufficient (esp. for economic policies). The available evidence provides some guidance for policy-makers regarding which policies can currently be recommended as effective. However, results also highlight some broader epistemological issues deriving from the current research. This includes the conflation of PA policies and PA interventions, the lack of appropriate tools for benchmarking individual policies, and the need to critically revisit research methodologies for collating evidence on policies.
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Affiliation(s)
- Peter Gelius
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Lee Goodwin
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Diana Schow
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Karim Abu-Omar
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
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Berdahl T, Biener A, McCormick MC, Guevara JP, Simpson L. Annual Report on Children's Healthcare: Healthcare Access and Utilization by Obesity Status in the United States. Acad Pediatr 2020; 20:175-187. [PMID: 31843708 DOI: 10.1016/j.acap.2019.11.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 11/04/2019] [Accepted: 11/16/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To examine access to care and utilization patterns across a set of healthcare measures by obesity status and socio-demographic characteristics among children. METHODS Nationally representative data from the Medical Expenditure Panel Survey (2010-2015) provides data on obesity status, well-child visits, access to a usual source of care provider, preventive dental visits, and prescription medication fills in the past year. RESULTS Uninsured adolescents with obesity were less likely to have a usual source of care provider relative to children without obesity (73% vs 65%). Among younger children, children with obesity were less likely to report a well-child visit (difference of 8 percentage points). Younger children with obesity who lived in the Northeast were more than twice as likely as those living in the West to have a well-child visit. Children with obesity were less likely to report preventive dental use relative to their nonobese counterparts. Obesity status was associated with more prescription medication fills for adolescents, but not for younger children. CONCLUSIONS Our findings provide a baseline assessment for examining obesity and utilization trends among children in the future, especially as coverage patterns change with potential changes in childhood insurance coverage access through the Child Health Insurance Programs and Medicaid programs. Our findings highlight new directions for future research, particularly regarding the lower rates of preventive dental care among children with obesity.
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Affiliation(s)
- Terceira Berdahl
- Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, Md (T Berdahl).
| | - Adam Biener
- Department of Economics, Lafayette College, Easton, Pa (A Biener)
| | - Marie C McCormick
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Mass (MC McCormick)
| | - James P Guevara
- Division of General Pediatrics, Children's Hospital of Philadelphia (JP Guevara)
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Messing S, Rütten A, Abu-Omar K, Ungerer-Röhrich U, Goodwin L, Burlacu I, Gediga G. How Can Physical Activity Be Promoted Among Children and Adolescents? A Systematic Review of Reviews Across Settings. Front Public Health 2019; 7:55. [PMID: 30941342 PMCID: PMC6433781 DOI: 10.3389/fpubh.2019.00055] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/25/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction: A vast majority of children and adolescents are physically inactive. As a result, high obesity rates and related diseases have made physical activity promotion a politically relevant topic. In order to form the basis for political decision making, evidence is required regarding the efficacy and effectiveness of interventions for physical activity promotion. In contrast to previous research, this systematic review of reviews targets three key settings (family and home, childcare, school), and is among the largest to have been conducted. Methods: A systematic review of reviews was conducted as part of a large-scale project to develop national recommendations for physical activity promotion in Germany. Six electronic databases were searched and inclusion criteria were defined. Two independent reviewers screened the titles and abstracts of potentially relevant literature. 213 reviews were identified and categorised by target group. A total of 74 reviews were identified dealing with children and adolescents. Each review underwent a quality assessment. Results: 39 reviews with the highest quality and relevance were analysed. Three reviews focused on the family and home setting, 4 on the childcare setting, 28 on the school setting and 4 on other settings. Evidence revealed the key role played by parents in promoting physical activity in children within each setting. Furthermore, evidence pointed toward the efficacy of multi-component interventions in the childcare and school setting. Several evidence-based intervention strategies were identified for childcare facilities and schools. Discussion: The review of reviews identified a number of promising strategies for PA promotion among children and adolescents. Among reviews, multi-component interventions in childcare facilities and schools stand out prominently. At the same time, the review of reviews indicated that there is still a lack of studies on the efficacy of interventions that go beyond the individual level. We recommend that future research should also target community and policy level interventions and interventions other than the school setting. In order to make more specific recommendations regarding the scale-up of promising intervention strategies, further knowledge about the effectiveness, health equity and cost effectiveness of interventions is needed.
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Affiliation(s)
- Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Lee Goodwin
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ionuţ Burlacu
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Günther Gediga
- Department of Psychology, University of Münster, Münster, Germany
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Johnson KA, Showell NN, Flessa S, Janssen M, Reid N, Cheskin LJ, Thornton RL. Do Neighborhoods Matter? A Systematic Review of Modifiable Risk Factors for Obesity among Low Socio-Economic Status Black and Hispanic Children. Child Obes 2019; 15:71-86. [PMID: 30565954 PMCID: PMC6386088 DOI: 10.1089/chi.2018.0044] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Childhood obesity increases the risk of obesity and harmful comorbidities later in life. It is influenced by characteristics of a child's neighborhood, particularly among underserved groups. Our objective was to systematically review the evidence relating neighborhood environment and obesity risk among urban, low socioeconomic status (SES) Black and Hispanic children. METHODS We included studies published from 1993 through early 2017 from PubMed, SCOPUS, Web of Science, and Sociological Abstracts databases investigating relationships between empirically measured neighborhood characteristics and obesity risk factors in the populations of interest. Databases were last searched on May 8, 2018. Initial analysis took place during 2014 and was completed during 2017. We extracted data on study population, design, and associations between neighborhood characteristics and obesity risk factors. RESULTS We identified 2011 unique studies; 24 were included. Few studies demonstrated consistent patterns of association. Most neighborhood characteristics were not examined across multiple studies. BMI may be related to living in a lower-income neighborhood or convenience store access. CONCLUSIONS This review found that the body of evidence relating neighborhood exposures and obesity risk factors among urban, low SES Black (also commonly referred to in the literature as "non-Hispanic Black" or African American) and Hispanic children is limited. Given the high risk of obesity and cardiovascular disease among these populations throughout the life course, research on neighborhood determinants of obesity should specifically include these populations, ensuring adequate power and methodological rigor to detect differences.
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Affiliation(s)
- Katherine Abowd Johnson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Nakiya N. Showell
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Sarah Flessa
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Natalie Reid
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lawrence J. Cheskin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Global Obesity Prevention Center at Johns Hopkins, Baltimore, MD
| | - Rachel L.J. Thornton
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.,Address correspondence to: Rachel L.J. Thornton, MD, PhD, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins Bayview Medical Center, 5200 Eastern Avenue, Suite 4200, Baltimore, MD 21224
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Tripicchio GL, Ammerman AS, Ward DS, Faith MS, Truesdale KP, Burger KS, Dean K, Dumenci L, Davis A. Clinical-Community Collaboration: A Strategy to Improve Retention and Outcomes in Low-Income Minority Youth in Family-Based Obesity Treatment. Child Obes 2018; 14:141-148. [PMID: 29584452 DOI: 10.1089/chi.2017.0266] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Clinical-community collaboration is a promising strategy for pediatric obesity treatment, but current research is limited. This study examined the effect of a family-based treatment program embedded in a primary care clinic on retention and changes in child weight status at 1 year. METHODS Children (2-16 years, BMI ≥85th percentile, 87.0% Hispanic) and their parents were recruited from a single pediatric clinic for Healthy Hawks Primary Plus (HHP+). Children were referred by physicians and enrolled by a bilingual clinic-based recruitment coordinator. Participants received 12 weekly 2-hour sessions focused on lifestyle modification and health behavior change and then received bimonthly follow-up visits with their clinic-based physician through 1-year follow-up. Child body mass index (BMI) percentage of the 95th percentile (%BMIp95) was measured as the primary outcome at baseline, postintervention, and 1-year follow-up. Random effect multilevel models assessed changes in child weight status over time accounting for clustering by family. To further evaluate the impact, HHP+ retention and changes in child weight status were compared to a standard 12-week treatment program only. RESULTS HHP+ participants had significantly better retention at 1 year (73.9%, p ≤ 0.001) compared to the standard treatment program (38.3%). In HHP+, physician visit attendance was significantly correlated with retention at 1 year (r = 0.69, p ≤ 0.001), and HHP+ completers had significant reductions in %BMIp95 between baseline and 1-year follow-up (p = 0.03). CONCLUSION Clinical-community partnerships might be a promising strategy to improve retention and reduce child weight status in populations currently underrepresented in obesity treatment.
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Affiliation(s)
- Gina L Tripicchio
- 1 Center for Obesity Research and Education, Temple University , Philadelphia, PA
| | - Alice S Ammerman
- 2 Department of Nutrition, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, NC.,3 Center for Health Promotion and Disease Prevention, University of North Carolina , Chapel Hill, NC
| | - Dianne S Ward
- 2 Department of Nutrition, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, NC.,3 Center for Health Promotion and Disease Prevention, University of North Carolina , Chapel Hill, NC
| | - Myles S Faith
- 4 Department of Counseling, School, and Educational Psychology, University at Buffalo- SUNY , Buffalo, NY
| | - Kimberly P Truesdale
- 2 Department of Nutrition, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, NC
| | - Kyle S Burger
- 2 Department of Nutrition, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, NC
| | - Kelsey Dean
- 5 Center for Children's Healthy Lifestyles & Nutrition , Kansas City, MO.,6 Children's Mercy Hospital , Kansas City, MO
| | - Levent Dumenci
- 7 Department of Epidemiology and Biostatistics, Temple University , Philadelphia, PA
| | - Ann Davis
- 5 Center for Children's Healthy Lifestyles & Nutrition , Kansas City, MO.,8 Department of Pediatrics, University of Kansas Medical Center , Kansas City, KS
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Wijtzes AI, van de Gaar VM, van Grieken A, de Kroon MLA, Mackenbach JP, van Lenthe FJ, Jansen W, Raat H. Effectiveness of interventions to improve lifestyle behaviors among socially disadvantaged children in Europe. Eur J Public Health 2018; 27:240-247. [PMID: 28375430 DOI: 10.1093/eurpub/ckw136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background Unhealthy lifestyle behaviors and childhood overweight are more common among children from families with a low socioeconomic position and ethnic minority children (referred to as social disadvantaged children). : This systematic review evaluates the effectiveness of interventions aimed to improve lifestyle behaviours and/or prevent overweight among socially disadvantaged children in Europe. : Six major databases were searched for studies reporting intervention effects on adiposity measures, sedentary behaviours, physical activity behaviours or dietary behaviours. Studies were included when the study sample consisted of at least 50% socially disadvantaged children or when results were presented for subgroups of socially disadvantaged children separately. Methodological quality assessment was based on Cochrane criteria. In total, 11 studies reporting on eight interventions (one among infants 0-2 years, one among preschoolers 2-6 years, six among school-aged children 6-12 years) were identified. Of these eight interventions, five interventions primarily aimed to improve at least one adiposity measure and three primarily aimed to improve a specific lifestyle behaviour. In general, modest positive effects were found but interventions were limited by a short follow-up duration. Despite an urgent need for effective interventions to improve lifestyle behaviours and prevent overweight among socially disadvantaged children, research on the effectiveness of interventions in Europe is still scarce. Those interventions that have been evaluated show modest effects on lifestyle behaviours and adiposity measures, but long-term follow-up is needed to establish whether these effects are sustained over a longer period of time.
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Affiliation(s)
- Anne I Wijtzes
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Vivian M van de Gaar
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Amy van Grieken
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marlou L A de Kroon
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Wilma Jansen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Social Development, City of Rotterdam, The Netherlands, Rotterdam
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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Kumanyika S. The Sociocultural Context for Obesity Prevention and Treatment in Children and Adolescents: Influences of Ethnicity and Gender. CONTEMPORARY ENDOCRINOLOGY 2018. [DOI: 10.1007/978-3-319-68192-4_40] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Training early childcare providers in evidence-based nutrition strategies can help improve nutrition policies and practices of early childcare centres serving racially and ethnically diverse children from low-income families. Public Health Nutr 2017; 21:1212-1221. [PMID: 29233208 DOI: 10.1017/s1368980017003573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We evaluated the extent to which providing training and technical assistance to early childcare centre (ECC) directors, faculty and staff in the implementation of evidence-based nutrition strategies improved the nutrition contexts, policies and practices of ECC serving racially and ethnically diverse, low-income children in Broward County, Florida, USA. The nutrition strategies targeted snack and beverage policies and practices, consistent with Caring for Our Children National Standards. DESIGN We used the nutrition observation and document review portions of the Environment and Policy Assessment and Observation (EPAO) instrument to observe ECC as part of a one-group pre-test/post-test evaluation design. SETTING ECC located within areas of high rates of poverty, diabetes, minority representation and unhealthy food index in Broward County, Florida, USA. SUBJECTS Eighteen ECC enrolled, mean 112·9 (sd 53·4) children aged 2-5 years; 12·3 (sd 7·2) staff members; and 10·2 (sd 4·6) children per staff member at each centre. RESULTS We found significant improvements in centres' overall nutrition contexts, as measured by total EPAO nutrition scores (P=0·01). ECC made specific significant gains within written nutrition policies (P=0·03) and nutrition training and education (P=0·01). CONCLUSIONS Our findings support training ECC directors, faculty and staff in evidence-based nutrition strategies to improve the nutrition policies and practices of ECC serving racially and ethnically diverse children from low-income families. The intervention resulted in improvements in some nutrition policies and practices, but not others. There remains a need to further develop the evaluation base involving the effectiveness of policy and practice interventions within ECC serving children in high-need areas.
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Callender C, Liu Y, Moore CE, Thompson D. The baseline characteristics of parents and African American girls in an online obesity prevention program: A feasibility study. Prev Med Rep 2017; 7:110-115. [PMID: 28652960 PMCID: PMC5477066 DOI: 10.1016/j.pmedr.2017.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/15/2017] [Accepted: 05/15/2017] [Indexed: 12/01/2022] Open
Abstract
The objective of this paper was to identify the relationships and associations between child and parent characteristics with child fruit and vegetable (FV) consumption in an online obesity prevention program for 8-10 year old African American girls. Girls and a parent (n = 342 child-parent pairs) in the southwestern US completed baseline data collection from 2012 to 2014. Girls and a parent completed self-report questionnaires online. Girls also completed two unannounced 24 hour telephone-based dietary recalls. The relationships of parent demographic characteristics, child FV intake, and psychosocial variables (child and parent) were examined by analysis of variance. Pearson correlation coefficients were calculated to determine the relationships between psychosocial variables and child FV intake. Child FV intake was significantly greater in the highest household education (p = 0.001) and income groups (p = 0.004). FV home availability was higher with older parents (p = 0.007) and two-parent households (p = 0.033). Child FV intake was positively related to child FV preferences (p < 0.001), FV home availability (p = 0.022), and FV home accessibility (p = 0.002) but was negatively related to family barriers to FV consumption (p = 0.000). The study highlighted significant findings between child FV consumption and parent psychosocial variables and demographic characteristics that may offer insights for the design of effective obesity prevention interventions for 8-10 year old African American girls. ClinicaTrials.gov (NCT01481948).
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Affiliation(s)
- Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
| | - Yan Liu
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
| | - Carolyn E. Moore
- Texas Woman's University, Department of Nutrition and Food Sciences, 6700 Fannin St, Houston, TX 77030, United States
| | - Deborah Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
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Bai Y, Welk GJ. School and County Correlates Associated with Youth Body Mass Index. Med Sci Sports Exerc 2017; 49:1842-1850. [PMID: 28463900 DOI: 10.1249/mss.0000000000001311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of the study was to explore the utility of school- and county-level variables in explaining variability in children and adolescent body mass index (BMI). METHODS BMI data from nearly 2.5 million of children and adolescents were aggregated at the school level from more than 5000 schools in Texas. School-level predictors included enrollment and the percentage of students qualifying for free and reduced lunch. Seven county-level variables were obtained from the County Health Rankings website, including adult obesity, food environment index, adult physical inactivity, access to exercise, college completion, childhood poverty, and income inequality. Multilevel modeling was used to examine school- and county-level predictors that may explain the variability in group level youth BMI. RESULTS School-level socioeconomic status, school enrollment, and age-group were identified as significant predictors in youth BMI for both boy and girls. In girls, county-level adult obesity, food environment index, college completion, and income inequality were also significantly associated with youth BMI. In boys, the significant county-level predictors were food environment index and income inequality. Approximately 11%-16% of the variations in BMI Healthy Fitness Zone achievement were attributable to the differences between counties. The predictors included in the present study collectively explained approximately 50%-60% of between-county variation and 24%-47% of within-county variation. CONCLUSIONS The results of the current study advance research on the correlates that are associated with youth obesity at both school and county levels. These factors should be taken into account by policy makers and researchers interested in childhood obesity research.
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Affiliation(s)
- Yang Bai
- 1Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT; and 2Department of Kinesiology, Iowa State University, Ames, IA
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Gittelsohn J, Jock B, Redmond L, Fleischhacker S, Eckmann T, Bleich SN, Loh H, Ogburn E, Gadhoke P, Swartz J, Pardilla M, Caballero B. OPREVENT2: Design of a multi-institutional intervention for obesity control and prevention for American Indian adults. BMC Public Health 2017; 17:105. [PMID: 28114926 PMCID: PMC5260044 DOI: 10.1186/s12889-017-4018-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/07/2017] [Indexed: 11/25/2022] Open
Abstract
Background Obesity and other nutrition-related chronic disease rates are high in American Indian (AI) populations, and an urgent need exists to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component (MLMC) interventions are needed, but there are significant knowledge gaps on how to deliver these types of interventions in low-income rural AI communities. Methods OPREVENT2 is a MLMC intervention targeting AI adults living in six rural reservations in New Mexico and Wisconsin. Aiming to prevent and reduce obesity in adults by working at multiple levels of the food and physical activity (PA) environments, OPREVENT2 focuses on evidence-based strategies known to increase access to, demand for, and consumption of healthier foods and beverages, and increase worksite and home-based opportunities for PA. OPREVENT2 works to create systems-level change by partnering with tribal stakeholders, multiple levels of the food and PA environment (food stores, worksites, schools), and the social environment (children as change agents, families, social media). Extensive evaluation will be conducted at each level of the intervention to assess effectiveness via process and impact measures. Discussion Novel aspects of OPREVENT2 include: active engagement with stakeholders at many levels (policy, institutional, and at multiple levels of the food and PA system); use of community-based strategies to engage policymakers and other key stakeholders (community workshops, action committees); emphasis on both the built environment (intervening with retail food sources) and the social environment. This paper describes the design of the intervention and the evaluation plan of the OPREVENT2. Trial registration Clinical Trial Registration: NCT02803853 (June 10, 2016)
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Affiliation(s)
- Joel Gittelsohn
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA.
| | - Brittany Jock
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA
| | - Leslie Redmond
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA
| | - Sheila Fleischhacker
- National Institute of Diabetes, Digestive and Kidney Diseases Office of Nutrition Research, Bethesda, USA
| | - Thomas Eckmann
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA
| | - Sara N Bleich
- Harvard T.H. Chan School of Public Health, Boston, USA
| | - Hong Loh
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA
| | - Elizabeth Ogburn
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA
| | | | - Jacqueline Swartz
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA
| | - Marla Pardilla
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA
| | - Benjamin Caballero
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe St. Suite W2041, Baltimore, MD, 21205, USA
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Kim M, Budd N, Batorsky B, Krubiner C, Manchikanti S, Waldrop G, Trude A, Gittelsohn J. Barriers to and Facilitators of Stocking Healthy Food Options: Viewpoints of Baltimore City Small Storeowners. Ecol Food Nutr 2016; 56:17-30. [PMID: 27841664 DOI: 10.1080/03670244.2016.1246361] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Receptivity to strategies to improve the food environment by increasing access to healthier foods in small food stores is underexplored. We conducted 20 in-depth interviews with small storeowners of different ethnic backgrounds as part of a small-store intervention trial. Store owners perceived barriers and facilitators to purchase, stock, and promote healthy foods. Barriers mentioned included customer preferences for higher fat and sweeter taste and for lower prices; lower wholesaler availability of healthy food; and customers' lack of interest in health. Most store owners thought positively of taste tests, free samples, and communication interventions. However, they varied in terms of their expectations of the effect of these strategies on customers' healthy food purchases. The findings reported add to the limited data on motivating and working with small-store owners in low-income urban settings.
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Affiliation(s)
- Mhinjine Kim
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Nadine Budd
- b Division of Nutrition, Physical Activity, and Obesity , Centers for Disease Control and Prevention , Atlanta , Georgia , USA
| | - Benjamin Batorsky
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Carleigh Krubiner
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Swathi Manchikanti
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Greer Waldrop
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Angela Trude
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
| | - Joel Gittelsohn
- a Center for Human Nutrition, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , Maryland , USA
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Jarpe-Ratner E, Folkens S, Sharma S, Daro D, Edens NK. An Experiential Cooking and Nutrition Education Program Increases Cooking Self-Efficacy and Vegetable Consumption in Children in Grades 3-8. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:697-705.e1. [PMID: 27575849 DOI: 10.1016/j.jneb.2016.07.021] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/21/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Evaluate the effect of a community-based, experiential cooking and nutrition education program on consumption of fruits and vegetables and associated intermediate outcomes in students from low-income families. DESIGN Quasi-experimental program evaluation by pre-post survey of participating students and their parents. SETTING Underserved elementary and middle schools in Chicago. PARTICIPANTS Students (n = 271; 65% girls, 44% Hispanic, 32% African American; 94% eligible for free/reduced price lunch) in grades 3-8 selected by school staff to participate by variable inclusion criteria. 59% of students who applied returned both pre- and post-surveys. INTERVENTION(S) Ten-week (2 h/wk) chef-instructor-led program held in cafeteria kitchens after school. MAIN OUTCOME MEASURE(S) Changes in student nutrition knowledge, cooking self-efficacy, fruit and vegetable liking and consumption, and communication to family about healthy eating. ANALYSIS Changes from beginning to end of program were analyzed with paired t test. Results were considered significant at P < .05. RESULTS Increased nutrition knowledge score from 0.6 to 0.8, cooking self-efficacy score from 3.2 to 3.6, and vegetable consumption score from 2.2 to 2.4 (all P < .05). Increased score for communication about healthy eating (4.1 to 4.4; P < .05) 6 months after the end of the course. CONCLUSIONS AND IMPLICATIONS Experiential cooking and nutrition education programs led by chef-instructors may be effective ways to improve nutrition in low-income communities.
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[Settings-based prevention of overweight in childhood and adolescents : Theoretical foundation, determinants and intervention planning]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:1394-1404. [PMID: 27695936 DOI: 10.1007/s00103-016-2439-z] [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: 10/20/2022]
Abstract
BACKGROUND Childhood and adolescent overweight can still be seen as a global public health problem. Based on our socioeconomic understanding, overweight is the result of a complex interplay of a diverse array of factors acting on different levels. Hence, in addition to individual level determinants overweight prevention should also address environmental related factors as part of a holistic and integrated setting approach. OBJECTIVE This paper aims to discuss the setting approach with regard to overweight prevention in childhood and adolescence. In addition to a summary of environmental factors and their empirical influence on the determinants of overweight, theoretical approaches and planning models of settings-based overweight prevention are discussed. RESULTS While settings can be characterized as specific social-spatial subsystems (e. g. kindergarten, schools), living environments relate to complex subject-oriented environments that may include various subsystems. Direct social contexts, educational contexts and community contexts as relevant systems for young people contain different evidence-based influences that need to be taken into account in settings based overweight prevention. To support a theory-driven intervention, numerous planning models exist, which are presented here. DISCUSSION Given the strengthening of environments for health within the prevention law, the underlying settings approach also needs further development with regard to overweigth prevention. This includes the improvement of the theoretical foundation by aligning intervention practice of planning models, which also has a positive influence on the ability to measure its success.
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Babitsch B, Geene R, Hassel H, Kliche T, Bacchetta B, Baltes S, Nold S, Rosenfeldt D. [Criteria catalogue to systematize conceptual approaches in universal prevention of childhood overweight : Methodological approach and first results]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:1415-1422. [PMID: 27757511 DOI: 10.1007/s00103-016-2447-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Overweight and obesity are serious health risks for children and adolescents. Hence, various prevention projects have been initiated and implemented. Until now, a systematic overview of interventions in different settings has been lacking. AIM(S)/RESEARCH QUESTION The aim of the "Prevention of child overweight" project (SkAP-project) is to prepare a systematic overview of the conceptual approaches used in universal prevention of overweight among children and adolescents. First of all, a comprehensive criteria catalogue will be developed based on systematic searches. In the next step the criteria catalogue will be applied to identify and characterize conceptual approaches. DATA AND METHODS Criteria to describe conceptual approaches as well as determinants of childhood overweight were determined by systematic searches. The searches included relevant data bases and were further expanded by internet and hand search. Three settings (kindergarten, school and communities) and families are addressed by the systematic searches. Additional non-setting specific searches were conducted. RESULTS A comprehensive criteria catalogue was developed, which allows a detailed analysis of conceptual approaches. This catalogue covers further quality criteria as well as determinants of childhood overweight. DISCUSSION Currently, the criteria catalogue is being employed. Although the detailed analysis of conceptual approaches can be regarded as advantage of the criteria catalogue, there are also some limitations, such as the lack of necessary information provided in publications. Overall, the application will reveal an overview regarding universal prevention in childhood overweight, which is still lacking, and will support development in this field.
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Affiliation(s)
- Birgit Babitsch
- Abteilung New Public Health, Institut für Gesundheitsforschung und Bildung FB 8 - Humanwissenschaften, Universität Osnabrück, Barbarastr. 22c, 49076, Osnabrück, Deutschland.
| | | | | | | | | | - Simon Baltes
- Hochschule Magdeburg-Stendal, Stendal, Deutschland
| | | | - Daniel Rosenfeldt
- Abteilung New Public Health, Institut für Gesundheitsforschung und Bildung FB 8 - Humanwissenschaften, Universität Osnabrück, Barbarastr. 22c, 49076, Osnabrück, Deutschland
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Rütten A, Schow D, Breda J, Galea G, Kahlmeier S, Oppert JM, van der Ploeg H, van Mechelen W. Three types of scientific evidence to inform physical activity policy: results from a comparative scoping review. Int J Public Health 2016; 61:553-63. [PMID: 27113707 PMCID: PMC4947117 DOI: 10.1007/s00038-016-0807-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 01/15/2016] [Accepted: 01/20/2016] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This paper presents a typology of available evidence to inform physical activity policy. It aims to refine the distinction between three types of evidence relating to physical activity and to compare these types for the purpose of clarifying potential research gaps. METHODS A scoping review explored the extent, range and nature of three types of physical activity-related evidence available in reviews: (I) health outcomes/risk factors, (II) interventions and (III) policy-making. A six-step qualitative, iterative process with expert consultation guided data coding and analysis in EPPI Reviewer 4. RESULTS 856 Type I reviews, 350 Type II reviews and 40 Type III reviews were identified. Type I reviews heavily focused on obesity issues (18 %). Reviews of a systematic nature were more prominent in the Type II (>50 %). Type III reviews tended to conflate research about policy intervention effectiveness and research about policymaking processes. The majority of reviews came from the United States, United Kingdom, Australia and Canada. CONCLUSIONS Although evidence gaps exist regarding evidence Types I and II, the most prominent gap regards Type III, i.e. research pertaining to physical activity policymaking. The findings presented herein will be used to inform physical activity policy development and future research.
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Affiliation(s)
- Alfred Rütten
- Institute of Sport Science and Sport, Friedrich Alexander University, Erlangen, Germany.
| | - Diana Schow
- Institute of Sport Science and Sport, Friedrich Alexander University, Erlangen, Germany
| | - João Breda
- Division of Noncommunicable Diseases and Life-course, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Gauden Galea
- Division of Noncommunicable Diseases and Life-course, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Sonja Kahlmeier
- Physical Activity and Health Unit, Epidemiology, Biostatistics, and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Jean-Michel Oppert
- Department of Nutrition, University Pierre et Marie Curie - Paris 6, Pitie-Salpetriere hospital (AP-HP), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Hidde van der Ploeg
- Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands
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19
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Taber DR, Robinson WR, Bleich SN, Wang YC. Deconstructing race and gender differences in adolescent obesity: Oaxaca-blinder decomposition. Obesity (Silver Spring) 2016; 24:719-26. [PMID: 26841122 PMCID: PMC4792537 DOI: 10.1002/oby.21369] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/21/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To analyze sources of racial and gender disparities in adolescent obesity prevalence in the United States using Oaxaca-Blinder decomposition. METHODS Data were obtained from the National Youth Physical Activity and Nutrition Study, a 2010 nationally representative study of 9th-12th grade students. Obesity status was determined from objective height and weight data; weight-related behaviors and school, home, and environmental data were collected via questionnaire. Oaxaca-Blinder decomposition was used to independently analyze racial and gender obesity prevalence differences (PD), i.e., comparing Black girls to White girls, and Black girls to Black boys. RESULTS Overall, measured characteristics accounted for 46.8% of the racial PD but only 11.9% of the gender PD. Racial PD was associated with Black girls having less fruit/vegetable access at home, obtaining lunch at school more often, and playing fewer sports than White girls. Gender PD was associated with differential associations between physical activity (PA) measures-including total activities in the past year and days of moderate to vigorous physical activity (MVPA) in the past week-and obesity. CONCLUSIONS School lunch and home food environmental variables accounted for racial disparities, but not gender disparities, in obesity prevalence. Gender differences in mechanisms between PA and obesity should be explored further.
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Affiliation(s)
- Daniel R Taber
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston-Austin Regional Campus, Austin, Texas, USA
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sara N Bleich
- Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Y Claire Wang
- Department of Health Policy & Management, Mailman School of Public Health, Columbia University, New York City, New York, USA
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20
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Barnidge EK, Baker EA, Schootman M, Motton F, Sawicki M, Rose F. The effect of education plus access on perceived fruit and vegetable consumption in a rural African American community intervention. HEALTH EDUCATION RESEARCH 2015; 30:773-85. [PMID: 26338985 PMCID: PMC4668755 DOI: 10.1093/her/cyv041] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 08/06/2015] [Indexed: 06/05/2023]
Abstract
African Americans have an increased risk of cardiovascular disease partly due to low fruit and vegetable consumption. This article reports the results of an intervention to provide nutrition education and access to fruits and vegetables through community gardens to change dietary behaviors among African Americans in rural Missouri. Cross-sectional surveys evaluated the intervention effect on blood pressure, body mass index (BMI), and perceived fruit and vegetable consumption in this quasi-experimental study with a comparison group. Hypertension (OR = 0.52, 95% CI: 0.38-0.71) and BMI (OR = 0.73, 95% CI: 0.52-1.02) were lower in the intervention county at mid-intervention. Participation in nutrition education (OR = 2.67, 95% CI: 1.63-4.40) and access to fruits and vegetables from a community garden (OR = 1.95, 95% CI: 1.20-3.15) were independently associated with perceived fruit and vegetable consumption. The strongest effect on perceived fruit and vegetable consumption occurred with high participation in nutrition education and access to community gardens (OR = 2.18, 95% CI: 1.24-3.81). Those with access but without education had a reduced likelihood of consuming recommended servings of fruits and vegetables (OR = 0.57, 95% CI: 0.34-0.95). Education plus access interventions may be best at increasing consumption of fruits and vegetables in a rural African American population.
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Affiliation(s)
- E K Barnidge
- Department of Behavioral Science and Health Education
| | - E A Baker
- Department of Behavioral Science and Health Education,
| | | | - F Motton
- Department of Behavioral Science and Health Education
| | - M Sawicki
- Department of Nutrition and Dietetics, Saint Louis University College for Public Health & Social Justice, 3545 Lafayette Avenue, St. Louis, MO 63104, USA
| | - F Rose
- Department of Behavioral Science and Health Education
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Williams EP, Mesidor M, Winters K, Dubbert PM, Wyatt SB. Overweight and Obesity: Prevalence, Consequences, and Causes of a Growing Public Health Problem. Curr Obes Rep 2015; 4:363-70. [PMID: 26627494 DOI: 10.1007/s13679-015-0169-4] [Citation(s) in RCA: 484] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This review considers a variety of perspectives on overweight and obesity (OW/obesity), including measurement and classification; prevalence and changes in prevalence in recent years; genetic, biological, medical, individual, and social correlates of OW/obesity; and treatment approaches. Despite increased attention, OW/obesity is escalating in prevalence worldwide, and the causes are exceedingly complex. A range of innovative studies, including basic research on gut microflora, dietary composition, pharmacologic interventions, and surgical procedures, is generating findings with potential for future prevention and treatment of OW/obesity. Social system changes such as school programs and the awareness of the roles of personal, family, health provider, and cultural experiences related to OW/obesity have also gained traction for vital prevention and treatment efforts over the past decade.
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Affiliation(s)
- Ellen P Williams
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Marie Mesidor
- Health Promotion & Disease Prevention Program, Central Arkansas Veterans Healthcare System, 4300 West 7th Street, Little Rock, AR, 72205, USA.
| | - Karen Winters
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Patricia M Dubbert
- South Central Veterans Affairs Mental Illness Research, Education & Clinical Center, Little Rock Geriatric Research, Education & Clinical Center, University of Arkansas for Medical Sciences, 2200 Fort Roots Drive, North Little Rock, AR, 72114, USA.
| | - Sharon B Wyatt
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
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Economos CD, Hatfield DP, King AC, Ayala GX, Pentz MA. Food and physical activity environments: an energy balance approach for research and practice. Am J Prev Med 2015; 48:620-9. [PMID: 25891062 DOI: 10.1016/j.amepre.2014.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 11/14/2014] [Accepted: 12/13/2014] [Indexed: 10/23/2022]
Abstract
Increases in the prevalence of overweight and obesity are a function of chronic, population-level energy imbalance, whereby energy intakes exceed energy expenditures. Although sometimes viewed in isolation, energy intakes and expenditures in fact exist in a dynamic interplay: energy intakes may influence energy expenditures and vice versa. Obesogenic environments that promote positive energy balance play a central role in the obesity epidemic, and reducing obesity prevalence will require re-engineering environments to promote both healthy eating and physical activity. There may be untapped synergies in addressing both sides of the energy balance equation in environmentally focused obesity interventions, yet food/beverage and physical activity environments are often addressed separately. The field needs design, evaluation, and analytic methods that support this approach. This paper provides a rationale for an energy balance approach and reviews and describes research and practitioner work that has taken this approach to obesity prevention at the environmental and policy levels. Future directions in research, practice, and policy include moving obesity prevention toward a systems approach that brings both nutrition and physical activity into interdisciplinary training, funding mechanisms, and clinical and policy recommendations/guidelines.
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Affiliation(s)
- Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
| | - Daniel P Hatfield
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Abby C King
- Health Research and Policy Department and the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford
| | - Guadalupe X Ayala
- San Diego State University and the Institute for Behavioral and Community Health, San Diego
| | - Mary Ann Pentz
- Keck School of Medicine, University of Southern California, Los Angeles, California
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Morales KH, Kumanyika SK, Fassbender JE, Good J, Localio AR, Wadden TA. Patterns of weight change in black Americans: pooled analysis from three behavioral weight loss trials. Obesity (Silver Spring) 2014; 22:2632-40. [PMID: 25251464 PMCID: PMC4236267 DOI: 10.1002/oby.20904] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 09/01/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Differentiating trajectories of weight change and identifying associated baseline predictors can provide insights for improving behavioral obesity treatment outcomes. METHODS Secondary, observational analyses using growth mixture models were conducted in pooled data for 604 black American, primarily female adults in three completed clinical trials. Covariates of identified patterns were evaluated. RESULTS The best fitting model identified three patterns over 2 years: 1) mean weight loss of approximately 2 kg (n = 519); 2) mean weight loss of approximately 3 kg at 1 year, followed by ∼4 kg regain (n = 61); and 3) mean weight loss of ∼20 kg at 1 year followed by ∼4 kg regain (n = 24, with 23 from one study). In final multivariate analyses, higher BMI predicted having pattern 2 (OR [95% CI]) 1.10 [1.03, 1.17]) or 3 (OR [95% CI] 1.42 [1.25, 1.63]), and higher dietary fat score was predictive of a lower odds of having patterns 2 (OR [95% CI] 0.37[0.15, 0.94]) or 3 (OR [95% CI] 0.23 [0.07, 0.79]). CONCLUSIONS Findings were consistent with moderate, clinically non-significant weight loss as the predominant pattern across all studies. Results underscore the need to develop novel and more carefully targeted and tailored approaches to facilitating weight loss in black American adults.
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Affiliation(s)
- Knashawn H. Morales
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Shiriki K. Kumanyika
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Jerene Good
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - A. Russell Localio
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Thomas A. Wadden
- Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Robinson LE, Webster EK, Whitt-Glover MC, Ceaser TG, Alhassan S. Effectiveness of pre-school- and school-based interventions to impact weight-related behaviours in African American children and youth: a literature review. Obes Rev 2014; 15 Suppl 4:5-25. [PMID: 25196404 DOI: 10.1111/obr.12208] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 12/17/2022]
Abstract
This review assessed the effectiveness of pre-school- and school-based obesity prevention and/or treatment interventions targeting healthy eating, physical activity or obesity in African American children and adolescents. Systematic searches were conducted for English-printed research articles published between January 1980 and March 2013. Retained articles included experimental studies conducted in the United States that targeted ≥ 80% African American/black children and adolescents and/or studies whose results were stratified by race/ethnicity, and that were conducted in pre-schools/head start or schools (excluding after-school programmes). Of the 12,270 articles identified, 17 met the inclusion criteria (pre-school, n=2; elementary school, n=7; middle and secondary schools, n=8). Thirteen studies found significant improvements in nutrition (pre-school, n=1; elementary, n=7; secondary, n=5) and three found significant improvements in physical activity (pre-school, n=1; elementary, n=2) variables of interest. Two studies (pre-school, n=1; secondary, n=1) reported significant reductions in obesity in African American children. The evidence available suggests school-based interventions are effective in promoting healthy nutrition behaviours in African American children. Conclusions overall and, particularly, about effects on physical activity and obesity are limited due to the small number of studies, differences in assessment approaches and a lack of follow-up assessments.
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Affiliation(s)
- L E Robinson
- School of Kinesiology, Auburn University, Auburn, AL, USA
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Whitt-Glover MC, Kumanyika SK, Haire-Joshu D. Introduction to the special issue on achieving healthy weight in black American communities. Obes Rev 2014; 15 Suppl 4:1-4. [PMID: 25196403 DOI: 10.1111/obr.12210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 12/17/2022]
Abstract
The prevalence of obesity is high in the United States, and highest among racial and ethnic minority groups. This special issue of Obesity Reviews is based upon evidence reviews prepared for and presented at a national invited workshop convened by the African American Collaborative Obesity Research Network (AACORN) in August of 2012. A set of potential topics was developed, a priori, and AACORN network members and colleagues with relevant expertise were invited to lead evidence reviews. The result is 10 articles focused on providing a comprehensive picture of what is known and unknown about interventions to prevent and treat obesity or improve weight-related behaviours in African American adults and children. Evidence reviews included in this special issue focus on children and adolescents (n=2); adults from various perspectives (n=5); eHealth interventions (n=1); interventions within faith organizations (n=1); and environmental and policy change interventions (n=1). Overall, the reviews show a small evidence base for research on African Americans and call for additional prioritization of funding to include studies that can inform action and bring progress in obesity prevention and treatment in African Americans on par with the scope and seriousness of the problem.
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Kumanyika SK, Whitt-Glover MC, Haire-Joshu D. What works for obesity prevention and treatment in black Americans? Research directions. Obes Rev 2014; 15 Suppl 4:204-12. [PMID: 25196414 DOI: 10.1111/obr.12213] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 06/13/2014] [Accepted: 06/14/2014] [Indexed: 12/01/2022]
Abstract
Obesity prevalence in black/African American children and adults of both sexes is high overall and compared with US whites. What we know, and do not know, about how to enhance the effectiveness of obesity prevention and treatment interventions in African Americans is the focus of the 10 articles in this special issue of Obesity Reviews. The evidence base is limited in quantity and quality and insufficient to provide clear guidance. With respect to children, there is relatively consistent, but not definitive support for prioritizing the systematic implementation and evaluation of child-focused interventions in pre-school and school settings and outside of school time. For adults or all ages, developing and refining e-health approaches and faith-based or other culturally and contextually relevant approaches, including translation of the Diabetes Prevention Program intervention to community settings is indicated. Major evidence gaps were identified with respect to interventions with black men and boys, ways to increase participation and retention of black adults in lifestyle behaviour change programmes, and studies of the impact of environmental and policy changes on eating and physical activity in black communities. Bold steps related to research funding priorities, research infrastructure and methodological guidelines are recommended to improve the quantity and quality of research in this domain.
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Affiliation(s)
- S K Kumanyika
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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