1
|
Amin SM, Dreidi M, Ghallab E, Morsy Mohamed SR, Alrimawi I. The Status of Food and Nutrition Literacy and its determinants among Elementary School students in Egypt: community nursing-led design. BMC Nurs 2024; 23:708. [PMID: 39358722 PMCID: PMC11445866 DOI: 10.1186/s12912-024-02342-9] [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: 06/17/2024] [Accepted: 09/13/2024] [Indexed: 10/04/2024] Open
Abstract
AIM To assess food and nutrition literacy status and its determinants among elementary school students in El-Beheira Governorate, Egypt. BACKGROUND Developing strategies to enhance food and nutrition literacy necessitates a deeper understanding of the food and nutrition literacy situation among elementary school students and associated factors. DESIGN A cross-sectional descriptive research design was adopted. METHODS A final sample of 400 primary school students (aged 6-12 years) at Itay El Barud public elementary schools in El-Beheira Governorate were administered (1) a socio-demographic characteristics and anthropometric measurements questionnaire developed by the researchers, and (2) the Food and Nutrition Literacy Scale. The derived data were analyzed using descriptive and non-parametric tests. RESULTS The majority (61%) of students had low food and nutrition literacy scores. The results have shown that overall socio-demographic variables were significant in predicting understanding food and nutrition information, nutritional health knowledge, interactive functional and nutritional literacy, critical food and nutritional literacy, and food labeling. CONCLUSION The study reveals that elementary school students in Egypt have poor knowledge and skills in food and nutrition literacy, largely due to a lack of nutrition education and family awareness. Factors like residential location, income, and education level also contribute to this disparity. IMPLICATIONS FOR THE PROFESSION To improve nutrition literacy among students, a nursing approach involving community stakeholders and school nurses is recommended. This includes integrating nutrition-related topics into the school curriculum, organizing workshops, and conducting age-appropriate health education sessions. Active engagement between community health and school nurses is crucial for raising awareness about healthy nutritional choices. IMPACT These findings hold an important impact on the education system and those designing curricula, emphasizing the need for significant incorporation of knowledge and skills related to food and nutrition within schools. REPORTING METHOD Compliance with the STROBE checklist for cross-sectional studies was maintained throughout the research. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
Collapse
Affiliation(s)
- Shaimaa Mohamed Amin
- Lecturer of Community Health Nursing, Faculty of Nursing, Damanhour University, Damanhour city, Egypt.
| | - Mutaz Dreidi
- Nursing Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, P. O. Box. 14, Palestine
| | - Eman Ghallab
- Nursing Education Department, Alexandria University, Alexandris, Egypt
| | | | - Intima Alrimawi
- School of Nursing, Georgetown University, 3700 Reservoir Road Northwest, Washington, D.C, 20057, USA
| |
Collapse
|
2
|
Orr CJ, Gorecki MC, Woo Baidal JA. Applying an Equity Lens to Pediatric Obesity: Clinical, Environmental, and Policy Considerations for Clinicians. Pediatr Clin North Am 2024; 71:805-818. [PMID: 39343494 DOI: 10.1016/j.pcl.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
The etiology of pediatric obesity is complex and multifactorial. This article encourages pediatric clinicians to consider patient's socioenvironmental context and structural discrimination as drivers of pediatric obesity. Viewing pediatric obesity through an equity lens can inform clinical practice, advocacy, and policy to promote equity.
Collapse
Affiliation(s)
- Colin J Orr
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
| | - Michelle C Gorecki
- Department of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | |
Collapse
|
3
|
Farias L, Hellenius ML, Nyberg G, Andermo S. Building a healthy generation together: parents' experiences and perceived meanings of a family-based program delivered in ethnically diverse neighborhoods in Sweden. Int J Equity Health 2024; 23:180. [PMID: 39261839 PMCID: PMC11389329 DOI: 10.1186/s12939-024-02271-8] [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: 06/07/2024] [Accepted: 09/09/2024] [Indexed: 09/13/2024] Open
Abstract
INTRODUCTION AND AIM Ethnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents' experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden. METHODS Researchers' engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis. RESULTS The analysis resulted in three main themes and seven sub-themes representing different aspects of the program's meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls' physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences. CONCLUSIONS The program's activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives.
Collapse
Affiliation(s)
- Lisette Farias
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden.
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, 141 83, Sweden.
| | - Mai-Lis Hellenius
- Department of Medicine, Karolinska Institutet, Solna, 171 77, Sweden
| | - Gisela Nyberg
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Lidingövägen 1, Stockholm, 114 33, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Susanne Andermo
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Lidingövägen 1, Stockholm, 114 33, Sweden
| |
Collapse
|
4
|
Al-Bkerat M, Martins DC, Schwartz-Barcott D. Nutritional Beliefs and Practices of Arabic-Speaking Middle Eastern Mothers Living in the United States. J Transcult Nurs 2024; 35:333-339. [PMID: 38770862 DOI: 10.1177/10436596241253873] [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] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Culture and acculturation influence nutritional beliefs. Little is known about the Arabic population in the United States. In this study, Arabic-speaking Middle Eastern mothers' perceptions of motherhood and childhood nutritional beliefs and practices are explored. METHOD Semi-structured interviews with 12 mothers from Arabic-speaking Middle Eastern countries. RESULTS Food and family are central to everyday life. Mothers worked hard to maintain traditional nutritional practices with their school-age children. DISCUSSION Findings can enhance school nurses' ability to collaborate with mothers in nutritional education and address any issues in the classroom.
Collapse
|
5
|
Karakitsiou G, Plakias S, Christidi F, Tsiakiri A. Unraveling Childhood Obesity: A Grounded Theory Approach to Psychological, Social, Parental, and Biological Factors. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1048. [PMID: 39334581 PMCID: PMC11429650 DOI: 10.3390/children11091048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/18/2024] [Accepted: 08/26/2024] [Indexed: 09/30/2024]
Abstract
Childhood obesity is a major medical and public health issue of global interest, which is influenced by a diverse array of factors and carries significant medical and psychosocial implications. Despite the extensive studies that have been conducted to explore the specific issue, the impact of several factors that influence, generate, worsen, and make chronic the phenomenon needs further exploration. This study aimed to construct a grounded theory that includes and connects the psychological, social, parental, and biological factors affecting childhood obesity. Key psychological factors include mental health issues such as depression and emotional eating, while social factors encompass socioeconomic status and cultural influences. Parental factors involve parenting styles and feeding practices, and biological factors relate to genetic predispositions and prenatal conditions. These factors interact in complex ways, highlighting the multifactorial nature of childhood obesity. The study employed a qualitative grounded theory approach, using research articles to achieve a thorough understanding. Qualitative analysis of the articles was conducted using Atlas.ti 24.0 software. Twenty-five research articles were required to reach theoretical saturation. The analysis resulted in 336 codes that were grouped into seven broad categories and twenty-four different subcategories. Through the construction of the theoretical framework, it was recognized that obesity in minors is a complex and multifactorial issue and that the network of causes and influencing factors covers a broad spectrum ranging from the individual to the family, and subsequently to society at large, which interact with each other.
Collapse
Affiliation(s)
- Georgia Karakitsiou
- Department of Psychiatry, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Spyridon Plakias
- Department of Physical Education and Sport Science, University of Thessaly, 38221 Trikala, Greece;
| | - Foteini Christidi
- Department of Neurology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Anna Tsiakiri
- Department of Neurology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| |
Collapse
|
6
|
Bodepudi S, Hinds M, Northam K, Reilly-Harrington NA, Stanford FC. Barriers to Care for Pediatric Patients with Obesity. Life (Basel) 2024; 14:884. [PMID: 39063637 PMCID: PMC11277597 DOI: 10.3390/life14070884] [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: 05/11/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
This review article emphasizes the challenges pediatric patients face during obesity treatment. Prior research has been compartmentalized, acknowledging that stigma, the ability to implement lifestyle changes, social health determinants, and healthcare accessibility are considerable impediments for obese children. These issues emerge at various levels, including the individual or family, the community and school, and even national policy. This suggests the need for a more comprehensive, team-based approach to tackle pediatric obesity. Understanding these barriers is the first step toward creating effective strategies and solutions to overcome these challenges.
Collapse
Affiliation(s)
- Sreevidya Bodepudi
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
- Harvard Medical School, Boston, MA 02115, USA
| | | | - Kayla Northam
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
| | - Noreen A. Reilly-Harrington
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA 02115, USA
- MGH Weight Center, Massachusetts General Hospital, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Boston, MA 02114, USA
| |
Collapse
|
7
|
Gavryutina I, Bochner R, Chin V, Bargman R. A Cross-Sectional Pilot Study of Parental Outdoor Play Preferences and Association With Child Overweight and Obesity. Clin Pediatr (Phila) 2024; 63:466-473. [PMID: 37246752 DOI: 10.1177/00099228231176350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Childhood obesity is highly prevalent among certain populations of New York. This cross-sectional pilot study examined the associations between parental attitudes about outdoor activities and body mass index (BMI). A questionnaire was distributed among parents of 1 to 13 aged children at ambulatory pediatric clinics. Of 104 children included in the study 57 were of normal weight and 47 were overweight or obese. Most parents of children with BMI <85% reported frequent playground utilization, considered longer hours to spend outside on weekdays, reported a larger total temperature range for outdoor playground utilization and a lower tolerable minimum temperature compared to parents of children with BMI ≥85%, p < .05. Only having a parent born outside of the United States remained a significant predictor of overweight and obesity in the final model. Parents of children with BMI < 85% are more willing to spend time outdoors, regardless of weather. Immigrant parents are protective against overweight.
Collapse
Affiliation(s)
- Irina Gavryutina
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Risa Bochner
- Department of Pediatrics, New York City Health and Hospitals Harlem Hospital, New York, NY, USA
| | - Vivian Chin
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Renee Bargman
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
- Department of Pediatrics, New York City Health and Hospitals Kings County Hospital, Brooklyn, NY, USA
- Department of Pediatrics, New York City Health and Hospital South Brooklyn Health, Brooklyn, NY, USA
| |
Collapse
|
8
|
Jambholkar PC, Joshi A, Choudhari SG. Addressing the Challenge: A Review of Effective Prevention Strategies for Childhood Obesity in India. Cureus 2024; 16:e56257. [PMID: 38623140 PMCID: PMC11017235 DOI: 10.7759/cureus.56257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/16/2024] [Indexed: 04/17/2024] Open
Abstract
Childhood obesity is a growing public health concern in India, with rising prevalence rates and associated health risks. This review examines effective prevention strategies for addressing this issue. Through a comprehensive analysis of research findings, policy initiatives, and community-based interventions, the review identifies critical components of successful prevention efforts. These include multi-sectoral collaborations, tailored interventions addressing socioeconomic and cultural factors, and the involvement of families and healthcare professionals. The importance of addressing childhood obesity in India is underscored, given its significant impact on health outcomes, healthcare costs, and quality of life. The review concludes with a call to action for stakeholders and policymakers to prioritise prevention efforts, allocate resources, and implement evidence-based interventions to combat childhood obesity effectively. By working together, India can mitigate the adverse effects of childhood obesity and promote a healthier future for its children.
Collapse
Affiliation(s)
- Pankaj C Jambholkar
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Abhishek Joshi
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sonali G Choudhari
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
9
|
McCabe EM, Kaskoun J, Bennett S, Meadows-Oliver M, Schroeder K. Addressing School Connectedness, Belonging, and Culturally Appropriate Care for Newly Immigrated Students and Families. J Pediatr Health Care 2024; 38:233-239. [PMID: 38429035 PMCID: PMC10977599 DOI: 10.1016/j.pedhc.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/07/2023] [Accepted: 10/02/2023] [Indexed: 03/03/2024]
Abstract
School connectedness is the degree to which students experience acceptance, inclusion, and care by school personnel and peers. A sense of belonging incorporates an emotional connection to the community. School connectedness and belonging are protective factors that promote student engagement, accomplishment, and community performance. Despite the rise in students from immigrant families in the United States, belonging and connectedness for youth from diverse cultural and linguistic experiences are understudied. School-based nurses, our term, is inclusive of advanced practice pediatric, family, and psychiatric nurse practitioners, are well-positioned to support school connectedness for youth who may encounter hurdles to health care because of cultural and linguistic differences. We present practice suggestions for language, culture, and inclusion using three health conditions experienced by youth: anxiety, asthma, and obesity. School-based nurses and other school personnel who provide linguistic and culturally appropriate care can support students in feeling connected and included in their school communities.
Collapse
|
10
|
Dharod JM, Black MM, McElhenny K, Labban JD, DeJesus JM. Es Niño o Niña?: Gender Differences in Feeding Practices and Obesity Risk among Latino Infants. Curr Dev Nutr 2024; 8:102100. [PMID: 38425439 PMCID: PMC10904161 DOI: 10.1016/j.cdnut.2024.102100] [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: 10/30/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
Background Obesity prevalence is significantly higher among Latino boys than girls. Weight status at 12 mo, a significant predictor of childhood obesity, is associated with feeding practices during infancy. Objectives The objectives were to examine breastfeeding and formula-feeding practices overall and by infant gender and to examine relations among infant gender, milk-feeding practices, and obesity risk among Latino infants over the first year of life. Methods Latino mother-infant dyads (n = 90) were recruited from a pediatric clinic. Mothers were interviewed at regular intervals (infants aged 2, 4, 6, and 9 mo), and 24-h feeding recalls were conducted when infants were aged 6 and 9 mo. Infants' lengths and weights were retrieved from clinic records to calculate weight-for-length percentiles. A bivariate analysis was conducted to compare feeding practices by gender and mediation analysis to test whether feeding practices mediated the relation between gender and obesity risk. Results The majority (80%) of mothers were born outside the United States. In early infancy, mixed feeding of formula and breastfeeding was common. At 6 and 9 mo of age, milk-feeding practices differed, with formula feeding more common for boys than girls. At 12 mo, 38% of infants experienced obesity risk (≥85th weight-for-length percentile). Infants' obesity risk increased by 18% per 1 oz increase in powdered formula intake. Formula intake among boys was on average 1.42 oz (in dry weight) higher than that among girls, which, in turn, mediated their increased obesity risk (IERR = 1.27, 95% confidence interval: 1.02, 1.90). Conclusions The increased obesity risk among Latino boys compared with girls at 12 mo was explained by higher rates of formula feeding at 6 and 9 mo of age. Future investigations of cultural values and beliefs in gender-related feeding practices are warranted to understand the differences in obesity risk between Latino boys and girls.
Collapse
Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Maureen M Black
- RTI International, Research Triangle Park, NC, United States
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kristen McElhenny
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jeffrey D Labban
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jasmine M DeJesus
- Department of Psychology, College of Arts and Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| |
Collapse
|
11
|
Palacios-Marin I, Serra D, Jiménez-Chillarón JC, Herrero L, Todorčević M. Childhood obesity: Implications on adipose tissue dynamics and metabolic health. Obes Rev 2023; 24:e13627. [PMID: 37608466 DOI: 10.1111/obr.13627] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/20/2023] [Accepted: 07/23/2023] [Indexed: 08/24/2023]
Abstract
Obesity is the leading risk factor for the development of type 2 diabetes and cardiovascular diseases. Childhood obesity represents an alarming health challenge because children with obesity are prone to remain with obesity throughout their life and have an increased morbidity and mortality risk. The ability of adipose tissue to store lipids and expand in size during excessive calorie intake is its most remarkable characteristic. Cellular and lipid turnovers determine adipose tissue size and are closely related with metabolic status. The mechanisms through which adipose tissue expands and how this affects systemic metabolic homeostasis are still poorly characterized. Furthermore, the mechanism through which increased adiposity extends from childhood to adulthood and its implications in metabolic health are in most part, still unknown. More studies on adipose tissue development in healthy and children with obesity are urgently needed. In the present review, we summarize the dynamics of white adipose tissue, from developmental origins to the mechanisms that allows it to grow and expand throughout lifetime and during obesity in children and in different mouse models used to address this largely unknown field. Specially, highlighting the role that excessive adiposity during the early life has on future's adipose tissue dynamics and individual's health.
Collapse
Affiliation(s)
- Ivonne Palacios-Marin
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Department of Biochemistry and Physiology, School of Pharmacy and Food Sciences, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona (UB), Barcelona, Spain
| | - Dolors Serra
- Department of Biochemistry and Physiology, School of Pharmacy and Food Sciences, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep C Jiménez-Chillarón
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Department of Physiological Sciences, School of Medicine, Universitat de Barcelona, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Laura Herrero
- Department of Biochemistry and Physiology, School of Pharmacy and Food Sciences, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Marijana Todorčević
- Department of Biochemistry and Physiology, School of Pharmacy and Food Sciences, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona (UB), Barcelona, Spain
| |
Collapse
|
12
|
Fields S, Arthur K, Schueler J, Smallman R. Using a counterfactual-based intervention to change eating intentions: Results from Hispanic and non-Hispanic undergraduate and community samples. Appetite 2023; 183:106460. [PMID: 36642115 DOI: 10.1016/j.appet.2023.106460] [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: 07/11/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/14/2023]
Abstract
Finding ways to improve eating behavior has become a major focus of interventions designed to improve health outcomes. Counterfactual thinking (i.e., mental simulations of how a past outcome could have been different) is a cognitive strategy that has been shown to improve behavior regulation and could be a promising intervention to improve eating behavior. The purpose of the current research was to examine the effect of a counterfactual-based intervention to shift contemplation to change eating behavior, motivation towards eating healthier, and intentions to engage in healthier eating behaviors. Participants in both studies were randomly assigned to either a counterfactual-based intervention or a control condition. In Study 1, those in the counterfactual-based intervention condition reported an increase in readiness to change their eating behavior, higher extrinsic motivation towards eating healthy, and higher intentions to eat healthy compared to those in the control condition. Within the counterfactual condition, individuals who self-identified as Hispanic had higher intentions to use their counterfactual strategies than those who identified as non-Hispanic. Study 2 found similar results using a more diverse community sample. Those in the counterfactual-based intervention condition reported an increase in readiness to change, intentions to eat healthy, and intentions to use their counterfactual strategies, with this effect being stronger for self-identified Hispanic participants. These studies provide initial evidence for the use of a counterfactual-based intervention to improve eating behavior in diverse populations.
Collapse
Affiliation(s)
- Sherecce Fields
- Department of Psychological & Brain Sciences, Texas A&M University, USA.
| | - Kianna Arthur
- Department of Psychological & Brain Sciences, Texas A&M University, USA
| | - Jordan Schueler
- Department of Psychological & Brain Sciences, Texas A&M University, USA
| | - Rachel Smallman
- Department of Psychological & Brain Sciences, Texas A&M University, USA
| |
Collapse
|
13
|
Alsubhi M, Epton T, Goldthorpe J, Peters S. A qualitative investigation of the health behaviours of young children from refugee families using photo elicitation interviews. Health Psychol Behav Med 2022; 10:1086-1109. [PMID: 36388870 PMCID: PMC9645284 DOI: 10.1080/21642850.2022.2141245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives To explore the experiences and perspectives of refugee parents regarding health behaviour changes among their children (i.e. changes in diet, levels of physical activity) and the impact of these changes on the health of their children aged 2–12 years. Design A qualitative approach using semi-structured interviews supported by photo-elicitation. Methods Parents of 2–12 years old children who had relocated to the UK within the past three or more years were recruited from two refugee organisations in the UK. Semi-structured face-to-face interviews and photo-elicitation were used to stimulate face-to-face in-depth discussions with participants. Data were analysed using an inductive and latent thematic analysis approach. Results Twenty-seven parent refugees were recruited. Participants were primarily mothers (85%) and from Syria (70%). Other countries of origin were Sudan, Eritrea, Iraq, Kuwait, Libya and Tunisia. Twenty-six interviews were conducted in Arabic and one in English. The analysis identified three themes: (1) Reflection on acculturation, (2) Changed parental role, and (3) Environmental barriers to being healthy. Participants described facing substantial changes to their lifestyle and personal context, including a restricted living space, restricted neighbourhood/community and inclement weather. These differences in the environment required parents to adjust their roles, and practices around their own and their child’s eating habits. These changes influenced refugee children’s health behaviours. Of particular concern to parents were increased sedentary behaviour and consumption of unhealthy snacks. Conclusions Multiple factors were identified relating to changes in family circumstances and environments that influenced refugee children’s health behaviours. Targeting these behaviours in tailored interventions may help improve refugee children’s health.
Collapse
Affiliation(s)
- Maha Alsubhi
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Tracy Epton
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Joanna Goldthorpe
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| |
Collapse
|
14
|
Significantly different roles of economic affluence in sex-specific obesity prevalence rates: understanding more modifications within female body weight management. Sci Rep 2022; 12:15757. [PMID: 36130963 PMCID: PMC9492695 DOI: 10.1038/s41598-022-19633-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/31/2022] [Indexed: 11/08/2022] Open
Abstract
Socioeconomic status has been associated with obesity prevalence increase in both males and females worldwide. We examined the magnitude of the difference between the two relationships and explored the independence of both relationships. Country specific data on gross domestic product (GDP) per capita, sex-specific obesity prevalence rates, urbanisation, total calories availability and level of obesity, genetic background accumulation (measured by the Biological State Index, Ibs) were obtained for 191 countries. Curvilinear regressions, bivariate and partial correlations, linear mixed models and multivariate linear regression analyses were used to examine the relationship between GDP and obesity prevalence rates in males and females respectively. Fisher’s r-to-z transformation, F-test and R2 increment in multivariate regression were used to compare results for males and females. GDP significantly correlated with sex-specific obesity prevalence rates, but significantly more strongly with male obesity prevalence in bivariate correlation analyses. These relationships remained independent of calories availability, Ibs and urbanization in partial correlation model. Stepwise multiple regression identified that GDP was a significant predictor of obesity prevalence in both sexes. Multivariate stepwise regression showed that, when adding GDP as an obesity prevalence predictor, the absolute increment of R2 in male fit model (0.046) was almost four (4) times greater than the absolute increment in female model fit (0.012). The Stepwise analyses also revealed that 68.0% of male but only 37.4% of female obesity prevalence rates were explained by the total contributing effects of GDP, Ibs, urbanization and calories availability. In both Pearson’s r and nonparametric analyses, GDP contributes significantly more to male obesity than to female obesity in both developed and developing countries. GDP also determined the significant regional variation in male, but not female obesity prevalence. GDP may contribute to obesity prevalence significantly more in males than in females regardless of the confounding effects of Ibs, urbanization and calories. This may suggest that aetiologies for female obesity are much more complex than for males and more confounders should be included in the future studies when data are available.
Collapse
|
15
|
Aceves-Martins M, López-Cruz L, García-Botello M, Godina-Flores NL, Gutierrez-Gómez YY, Moreno-García CF. Cultural factors related to childhood and adolescent obesity in Mexico: A systematic review of qualitative studies. Obes Rev 2022; 23:e13461. [PMID: 35587773 PMCID: PMC9541705 DOI: 10.1111/obr.13461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
Culture and culturally specific beliefs or practices may influence perceptions and decisions, potentially contributing to childhood obesity. The objective of this study is to identify the cultural factors (expressed through decisions, behaviors, individual experiences, perceptions, attitudes, or views) related to childhood and adolescent obesity in Mexico. Ten databases and one search engine were searched from 1995 onwards for qualitative studies. The Sunrise Enabler Model, described within the Cultural Care Theory, guided this review. Sample, the phenomenon of interest, study design, and evaluation data were extracted, and the Critical Appraisals Skills Programme tool was used to assess the quality of the included studies. Twenty-four studies were included. Of these, 12 studies included children or adolescents, 12 included parents, eight included schoolteachers, four included school staff (other than teachers), four included food vendors, and one included policymakers. Cultural values, beliefs, lifeways (especially food and food costumes), kinship, and social factors (particularly immediate and extended family) strongly influenced childhood and adolescent obesity-related lifestyles in Mexico. Most cultural factors related to childhood obesity in Mexico identified in this review may be modifiable and amenable to practical interventions.
Collapse
Affiliation(s)
| | - Lizet López-Cruz
- Universidad Europea del Atlantico, Parque Cientifico y Tecnologico de Cantabria, Santander, Spain
| | | | - Naara L Godina-Flores
- Nutrition Department, School of Medicine and Health Sciences, Tecnológico de Monterrey, Mexico City, Mexico
| | | | | |
Collapse
|
16
|
Marshall S, Taki S, Laird Y, Love P, Wen LM, Rissel C. Cultural adaptations of obesity-related behavioral prevention interventions in early childhood: A systematic review. Obes Rev 2022; 23:e13402. [PMID: 34866315 PMCID: PMC9286644 DOI: 10.1111/obr.13402] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/06/2021] [Accepted: 11/03/2021] [Indexed: 01/22/2023]
Abstract
Interventions for obesity prevention can effectively reduce obesity-related behaviors in young children. Understanding how to leverage and adapt evidence-based interventions is needed to improve reach among culturally and linguistically diverse families. This systematic review aimed to synthesize the approaches and outcomes of culturally adapted early childhood obesity-related behavioral prevention interventions. Multiple electronic databases were systematically searched in March 2021. All study designs were included if they reported cultural adaptations of an intervention targeting at least one obesity-related behavior (infant feeding, nutrition, physical activity, and/or sleep) among children aged 0-5 years. Studies that only conducted language translations or that developed new interventions were excluded. Two authors independently conducted critical appraisals using the Mixed Method Appraisal Tool. Findings were synthesized narratively, based on the Stages of Cultural Adaptation theoretical model and the Framework for Reporting Adaptations and Modifications-Enhanced. Twelve interventions met the inclusion criteria, with varied study designs. Few reported all aspects of cultural adaptation processes, and the cultural adaptation strategies documented varied. The results suggest that cultural adaptation of obesity-related behavioral prevention interventions targeting young children increases acceptability among target cultural groups, yet effectiveness is inconclusive due to a lack of trials. More detailed reporting of cultural adaptation processes and further effectiveness trials are needed to evaluate future work.
Collapse
Affiliation(s)
- Sarah Marshall
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,The National Health and Medical Research Council, Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, New South Wales, Australia
| | - Sarah Taki
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,The National Health and Medical Research Council, Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, New South Wales, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Yvonne Laird
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Penelope Love
- The National Health and Medical Research Council, Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, New South Wales, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Li Ming Wen
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,The National Health and Medical Research Council, Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, New South Wales, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Chris Rissel
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,The National Health and Medical Research Council, Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, New South Wales, Australia
| |
Collapse
|
17
|
von Ash T, Alikhani A, Lebron C, Risica PM. Racial/ethnic differences in maternal feeding practices and beliefs at 6 months postpartum. Public Health Nutr 2022; 25:1-10. [PMID: 35029142 PMCID: PMC9991812 DOI: 10.1017/s1368980021005073] [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: 03/01/2021] [Revised: 11/04/2021] [Accepted: 12/22/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine racial/ethnic differences in maternal feeding practices and beliefs in a sample of low-income smoke-exposed women. DESIGN Cross-sectional analysis using data collected during a randomised control trial. Maternal feeding practices and beliefs were assessed using the Infant Feeding Questionnaire (IFQ), which was administered at 6 months postpartum. ANOVA was used to examine differences in IFQ items by race/ethnicity, while multivariable linear regression models were used to examine differences in IFQ factor scores by race/ethnicity adjusting for potential confounders. SETTING Participants were recruited from prenatal clinics. PARTICIPANTS 343 women (39 % non-Hispanic White, 28 % Hispanic/Latina, 13 % Black, and 20 % other). RESULTS Racial/ethnic minority mothers were more likely than non-Hispanic White mothers to put cereal in their infant's bottle so that the infant would stay full longer (P = 0·032), state their infant wanted more than just formula or breast milk prior to 4 months (P = 0·019), allow their infant to eat whenever he/she wanted (P = 0·023) and only allow their infant to eat at set times (P < 0·001). Adjusting for potential confounders, racial/ethnic minority mothers had higher scores for factors 1 (concern about infant undereating or becoming underweight), 2 (concern about infant's hunger), 4 (concern about infant overeating or becoming overweight) and 5 (feeding infant on a schedule), and lower scores for factor 7 (social interaction with the infant during feeding) than White mothers. Racial/ethnic differences were not found for the other two factors. CONCLUSIONS Differences in maternal feeding practices and beliefs across race/ethnicity are present at 6 months postpartum.
Collapse
Affiliation(s)
- Tayla von Ash
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-S121-8, Providence, RI02912, USA
- Center for Health Promotion & Health Equity, Brown School of Public Health, Providence, RI, USA
| | - Anna Alikhani
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-S121-8, Providence, RI02912, USA
| | - Cynthia Lebron
- School of Nursing and Health Studies, University of Miami, Miami, FL, USA
| | - Patricia Markham Risica
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-S121-8, Providence, RI02912, USA
- Center for Health Promotion & Health Equity, Brown School of Public Health, Providence, RI, USA
| |
Collapse
|
18
|
Hayba N, Shi Y, Allman-Farinelli M. Enabling Better Nutrition for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents. Nutrients 2021; 13:3918. [PMID: 34836174 PMCID: PMC8624745 DOI: 10.3390/nu13113918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
The unyielding obesity epidemic in adolescents from Middle Eastern (ME) backgrounds warrants culturally-responsive and co-designed prevention measures. This study aimed to capture the opinions of ME parents residing in Australia on the crisis and their enablers and barriers to healthy eating interventions given their influence on adolescent eating behaviors. Twenty-six semi-structured interviews were conducted with ME mothers, aged 35-59 years, and most residing in low socioeconomic areas (n = 19). A reflexive thematic analysis using the Capability, Opportunity, Motivation-Behaviour model and Theoretical Domain Framework was conducted. Parents expressed confidence in knowledge of importance of healthy eating, but were reluctant to believe behaviours were engaged in outside of parental influence. Time management skills are needed to support working mothers and to minimize reliance on nearby fast-food outlets, which was heightened during COVID-19 with home-delivery. Time constraints also meant breakfast skipping was common. A culture of feeding in light of diet acculturation and intergenerational trauma in this diaspora was also acknowledged. Parents pleaded for upstream policy changes across government and school bodies to support parental efforts in the form of increased regulation of fast-food and subsidization of healthy products. Opportunities for weight-inclusive programs including parenting workshops underpinned by culturally-responsive pedagogy were recommended.
Collapse
Affiliation(s)
- Nematullah Hayba
- Discipline of Nutrition and Dietetics, Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; (Y.S.); (M.A.-F.)
| | | | | |
Collapse
|
19
|
Methods, Ethics, and Cross-Language Considerations in Research With Ethnic Minority Children. Nurs Res 2021; 70:383-390. [PMID: 34225322 DOI: 10.1097/nnr.0000000000000537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Qualitative research seeking the perspectives of minority children on child health issues such as childhood obesity and healthy weight care is limited, especially in nursing research. OBJECTIVE Our objective is to share methodological, ethical, and cross-language knowledge gained from conducting an ethnonursing research study. This study focused on providing a voice for ethnic minority children in childhood obesity literature. METHODS The purpose of the study was to discover cultural influences on healthy weight care in children of Burmese refugees of Karen ethnicity. Researchers may exclude children of ethnic minorities from studies because of the distinct challenges in conducting cross-language research and research with children. We critically examine these challenges. The challenge of being a stranger was addressed by a period of immersion in the children's activities prior to data collection, in addition to volunteering as an English teacher with Karen adults. The immersion period was crucial for developing the trust needed in child-inclusive research and research in ethnic minority communities. The challenge of designing an inclusive study with families who experience language barriers was addressed with an interpreter who not only spoke Karen but was also a part of the Karen community. The interpreter provided the authentic sociocultural language equivalence needed for the study's rigor. Ensuring the child's voice was clearly heard was addressed with member checking. Methodological changes necessitated by a pandemic were a distinct challenge discussed in detail. RESULTS We described methods useful for nurse researchers seeking transformative knowledge to reduce health disparities in childhood obesity. Nurse researchers may use these methods related to cross-language research and child research for designing research inclusive of minorities with language barriers. DISCUSSION The perspectives of children from ethnic minorities are needed to inform culturally congruent healthy weight care for their communities. The goal in providing transparency of the difficulties, successes, and recommendations for methods in research with children of Burmese refugees is to encourage more nurse researchers to work with marginalized groups. Nurse researchers can inform evidence-based, culturally appropriate interventions to address health inequities of minority communities by including the voice of children from these communities.
Collapse
|
20
|
Murphy M, Boardman F, Robertson W, Johnson R. Children's perspectives and experiences of health, diet, physical activity and weight in an urban, multi-ethnic UK population: A qualitative study. Child Care Health Dev 2021; 47:597-607. [PMID: 33719138 DOI: 10.1111/cch.12867] [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: 07/28/2020] [Revised: 11/23/2020] [Accepted: 03/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children from Black and South Asian ethnic groups are at risk for childhood obesity in the United Kingdom. To inform local action for childhood obesity prevention, it is crucial to explore the basis of ethnic disparities and consider the perspectives of children. This study aimed to understand cultural and contextual factors influencing childhood obesity in an ethnically diverse population using child-centred methodology. METHODS 'Draw, write and tell' interviews were held with children aged 9-10 years in Coventry, an urban, multi-ethnic city in the United Kingdom. Data were analysed thematically using framework analysis. RESULTS Twenty-six children participated (85% from Black or minority ethnic groups). Children's perspectives revealed universal themes around health, diet, physical activity and weight and highlighted issues specific to ethnic groups and those living in deprived areas. An underlying feature was weight-based stigmatization and group stereotyping, and an emphasis on internal factors as the cause of obesity. Children described some experiences of social disadvantage but did not regard these as a barrier to being physically active. Children identified cultural or religious practices or experiences of migration that influenced diet and physical activity. CONCLUSIONS These findings allow a broad range of children's perspectives to inform future intervention design. In addition, the study was able to identify the many similarities and small amount of diversity in children's perspectives across ethnic groups.
Collapse
Affiliation(s)
- Marie Murphy
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | - Rebecca Johnson
- School of Nursing, Midwifery and Health, Coventry University, Coventry, UK
| |
Collapse
|
21
|
Chatham RE, Mixer SJ. Cultural Influences on Healthy Weight Care in Karen Children. J Pediatr Nurs 2021; 60:207-214. [PMID: 34246068 DOI: 10.1016/j.pedn.2021.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/12/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Although the rates of childhood obesity are disproportionately higher in children of racial and ethnic minorities, research rarely addresses possible cultural factors. The purpose of this study was to discover cultural influences that contribute to or prevent childhood obesity from the perspectives of Burmese-American children and adolescents of Karen ethnicity in the southeast U.S. DESIGN AND METHODS The ethnonursing research method was used to seek perspectives of healthy weight care from Karen children between 8 and 15 years-of-age (n = 10). Karen parents (n = 5) and non-Karen community members (n = 13) were also interviewed. Data sources - interviews, fieldnotes, and observation notes - were analyzed using the four phases of the ethnonursing method. RESULTS Four themes important to healthy weight care in Karen children were discovered: views of a healthy child, food and food preparation, physical activity, and mutual support among family and community. These themes revealed both Karen and non-Karen influences. CONCLUSIONS Most Karen cultural influences promote healthy weight care in Karen children and adolescents which may protect them from childhood obesity. Lack of after-school transportation, limited space to play/exercise, and the sedentary tendencies of girls could limit healthy weight care. PRACTICE IMPLICATIONS Pediatric nurses may use knowledge gained from this study for promotion of healthy weight care in Karen families and to advocate for community changes which could benefit all children.
Collapse
Affiliation(s)
- Rebecca E Chatham
- College of Nursing, University of Tennessee-Knoxville, United States of America.
| | - Sandra J Mixer
- College of Nursing, University of Tennessee-Knoxville, United States of America
| |
Collapse
|
22
|
Flores-Peña Y, Avila-Alpirez H. Maternal Perception of the Child’s Weight, Lifestyle Problems and Self-Efficacy to Deal with Them. AQUICHAN 2021. [DOI: 10.5294/aqui.2021.21.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: To associate the maternal perception of the child’s weight (MPCW) and the child’s nutritional status. To describe child’s lifestyle behavior problems (CLBPs) and maternal self-efficacy (SE) to deal with them, as well as to verify differences according to children with and without overweight-obesity (OW-OB) and MPCW.
Material and methods: There was participation of 274 dyads (mother-preschool child). MPCW was assessed through words and images. The mothers answered the Lifestyle Behaviour Checklist. The child’s weight and height were measured.
Results: 18.8 % (n = 13) of the mothers of children with OW-OB and 78.8 % (n = 160) of the mothers of children without OW-OB obtained adequate MPCW values through words (X2 = 77.759; DoF = 1; p < .001). It was identified that the mothers of children with OW-OB reported more CLBPs and less SE. When the child’s OW-OB is perceived through words, there are more CLBPs (F = 17.041; p = .001) and less SE (U = 1,118; p = .015).
Conclusions: Inadequate MPCW was predominant in mothers of children with OW-OB. When OW-OB is perceived, there are more CLBPs and fewer SE. It is recommended to promote adequate MPCW, particularly in mothers of children with OW-OB. Images assist in the identification of the child’s OW-OB more than to classify it into a category.
Collapse
|
23
|
Xu Q, Zhang SS, Wang RR, Weng YJ, Cui X, Wei XT, Ni JJ, Ren HG, Zhang L, Pei YF. Mendelian Randomization Analysis Reveals Causal Effects of the Human Gut Microbiota on Abdominal Obesity. J Nutr 2021; 151:1401-1406. [PMID: 33768223 DOI: 10.1093/jn/nxab025] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/20/2020] [Accepted: 01/26/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although recent studies have revealed an association between the composition of the gut microbiota and obesity, whether specific gut microbiota cause obesity has not been determined. OBJECTIVES The aim of this study is to determine the causal relationship between specific gut microbiota and abdominal obesity. Based on genome-wide association study (GWAS) summary statistics, we performed a 2-sample Mendelian randomization (MR) analysis to evaluate whether the gut microbiota affects abdominal obesity. METHODS Gut microbiota GWAS in 1126 twin pairs (age range, 18-89 years; 89% were females) from the TwinsUK study were used as exposure data. The primary outcome tested was trunk fat mass (TFM) GWAS in 492,805 participants (age range, 40-69 years; 54% were females) from the UK Biobank. The gut microbiota were classified at family, genus, and species levels. A feature was defined as a distinct family, genus, or species. MR analysis was mainly performed by an inverse variance-weighted test or Wald ratio test, depending on the number of instrumental variables (IVs) involved. A sensitivity analysis was performed on significant results by a weighted median test and a weighted genetic risk score (GRS) analysis. RESULTS Results of MR analyses provided evidence of a causal association between 3 microbiota features and TFM, including 1 family [Lachnosiraceae; P = 0.02; β = 0.001 (SEE, 4.28 × 10-4)], 1 genus [Bifidobacterium; P = 5.0 × 10-9; β = -0.08 (SEE, 0.14)], and 1 species [Prausnitzii; P = 0.03; β = -0.007 (SEE, 0.003)]. Both the weighted median test and GRS analysis successfully validated the association of the genetically predicted family, Lachnosiraceae (Pweighted median = 0.03; PGRS = 0.004). CONCLUSIONS Our findings provided evidence of a causal association between gut microbiota and TFM in UK adults and identified specific bacteria taxa that may regulate the fat metabolism, thus offering new direction for the treatment of obesity.
Collapse
Affiliation(s)
- Qian Xu
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 215123, SuZhou, Jiangsu, PR China
| | - Shan-Shan Zhang
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China
| | - Rui-Rui Wang
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China
| | - Yu-Jing Weng
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China
| | - Xun Cui
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China
| | - Xin-Tong Wei
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 215123, SuZhou, Jiangsu, PR China
| | - Jing-Jing Ni
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China.,Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College of Soochow University, 215123, SuZhou, Jiangsu, PR China
| | - Hai-Gang Ren
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China.,Laboratory of Molecular Neuropathology, Department of Pharmacology, School of Pharmaceutical Sciences, Medical College, Soochow University, 215123, SuZhou, PR China
| | - Lei Zhang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 215123, SuZhou, Jiangsu, PR China.,Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College of Soochow University, 215123, SuZhou, Jiangsu, PR China
| | - Yu-Fang Pei
- Center of Translational Medicine, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215400, SuZhou, Jiangsu, PR China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 215123, SuZhou, Jiangsu, PR China
| |
Collapse
|
24
|
Lebron CN, Agosto Y, Guzman T, Sutton D, Stoutenberg M, Messiah SE, George SMS. A qualitative study of cognitive, behavioral, and environmental influences on Hispanic mothers' early childhood feeding practices. Appetite 2021; 164:105268. [PMID: 33864860 DOI: 10.1016/j.appet.2021.105268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/12/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
Young children's lifestyle behaviors are largely shaped by their parents. There are socioeconomic risk factors particular to Hispanic populations that influence the way parents feed their children. As obesity continues to be a public health issue with substantial inequities across race and ethnicity, it is critical to understand Hispanic parents' food choices and feeding practices. The objective of this qualitative study is to identify the behavioral, environmental, and cognitive factors that influence the parental food choices and feeding behaviors of Hispanic mothers of children ages 0-5 years. Snowball sampling was used to recruit participants from the community (n = 30) who were 1) female; 2) Hispanic; 3) over the age of 18; and 4) a mother to child(ren) between the ages zero and five. Each interview consisted of a brief demographic survey and a set of open-ended questions based on Social Cognitive Theory constructs. A thematic analysis using a combined deductive and inductive approach was used to analyze transcriptions. Results indicated that mothers' attitudes around breastfeeding were connected with their challenges, while their attitudes around solid foods were expressed in their feeding strategies. Mothers used strategies of modeling, repeated exposure, and practices of "sneaking" in healthy foods and bribing to promote healthy eating. Mothers were most likely to seek out information from (1) pediatricians, (2) female family members, and (3) the internet. Hispanic mothers actively seek out information from many different sources that impact how they feed their young children. Understanding their trusted sources and how it influences the SCT constructs is an important step in preventing early childhood obesity.
Collapse
Affiliation(s)
- Cynthia N Lebron
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.
| | - Yaray Agosto
- Florida International University, Robert Stempel College of Public Health & Social Work, Miami, FL, USA
| | - Tamisha Guzman
- Florida International University, Robert Stempel College of Public Health & Social Work, Miami, FL, USA
| | - Danielle Sutton
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mark Stoutenberg
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Sarah E Messiah
- University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas, TX, USA; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, TX, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
25
|
Marshall S, Taki S, Love P, Laird Y, Kearney M, Tam N, Baur LA, Rissel C, Wen LM. The process of culturally adapting the Healthy Beginnings early obesity prevention program for Arabic and Chinese mothers in Australia. BMC Public Health 2021; 21:284. [PMID: 33541310 PMCID: PMC7863271 DOI: 10.1186/s12889-021-10270-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 01/19/2021] [Indexed: 01/25/2023] Open
Abstract
Background Behavioural interventions for the early prevention of childhood obesity mostly focus on English-speaking populations in high-income countries. Cultural adaptation is an emerging strategy for implementing evidence-based interventions among different populations and regions. This paper describes the initial process of culturally adapting Healthy Beginnings, an evidence-based early childhood obesity prevention program, for Arabic and Chinese speaking migrant mothers and infants in Sydney, Australia. Methods The cultural adaptation process followed the Stages of Cultural Adaptation theoretical model and is reported using the Framework for Reporting Adaptations and Modifications-Enhanced. We first established the adaptation rationale, then considered program underpinnings and the core components for effectiveness. To inform adaptations, we reviewed the scientific literature and engaged stakeholders. Consultations included focus groups with 24 Arabic and 22 Chinese speaking migrant mothers and interviews with 20 health professionals. With input from project partners, bi-cultural staff and community organisations, findings informed cultural adaptations to the content and delivery features of the Healthy Beginnings program. Results Program structure and delivery mode were retained to preserve fidelity (i.e. staged nurse calls with key program messages addressing modifiable obesity-related behaviours: infant feeding, active play, sedentary behaviours and sleep). Qualitative analysis of focus group and interview data resulted in descriptive themes concerning cultural practices and beliefs related to infant obesity-related behaviours and perceptions of child weight among Arabic and Chinese speaking mothers. Based on the literature and local study findings, cultural adaptations were made to recruitment approaches, staffing (bi-cultural nurses and project staff) and program content (modified call scripts and culturally adapted written health promotion materials). Conclusions This cultural adaptation of Healthy Beginnings followed an established process model and resulted in a program with enhanced relevance and accessibility among Arabic and Chinese speaking migrant mothers. This work will inform the future cultural adaptation stages: testing, refining, and trialling the culturally adapted Healthy Beginnings program to assess acceptability, feasibility and effectiveness. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10270-5.
Collapse
Affiliation(s)
- Sarah Marshall
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia. .,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia. .,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia.
| | - Sarah Taki
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia
| | - Penny Love
- The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Victoria, 3216, Australia
| | - Yvonne Laird
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Marianne Kearney
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Nancy Tam
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Louise A Baur
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Chris Rissel
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia
| | - Li Ming Wen
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.,The National Health and Medical Research Council Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, Australia
| |
Collapse
|
26
|
Stern M, Soca Lozano S, Lescano C, Rodriguez C, Redwine L. Developing Adaptando Dieta Y Acción Para Todos (ADAPT): An Intervention to Improve Healthy Lifestyle Behaviors Among Latino Parents and Children Living in Rural Communities. J Immigr Minor Health 2021; 23:88-94. [PMID: 32533505 PMCID: PMC10576241 DOI: 10.1007/s10903-020-01037-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Latino migrant farmworkers are at great risk of obesity and its concomitant negative health impacts. Obesity interventions for this underserved, minority population are limited. We expanded upon our prior intervention work in childhood obesity to develop a multi-family, behavioral intervention, ADAPT. We conducted three phases in the development of the ADAPT program: Phase 1, a needs assessment, Phase 2, in-depth focus groups with Latino parents, their children, and stakeholders, and Phase 3, a feasibility and acceptability trial to inform program optimization. Acceptability and feasibility of ADAPT promoting healthier eating and physical activity behaviors was found. Each phase of the project led to implementation changes to ADAPT, resulting in greater intervention optimization. Participants reported key facilitators and barriers to our intervention, expressing great interest in participation. They particularly liked our mindfulness session. We are currently examining the feasibility of integrating mindfulness to optimize ADAPT efficacy.
Collapse
Affiliation(s)
- Marilyn Stern
- Department of Child and Family Studies, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 2510, Tampa, FL, 33612, USA.
| | | | - Celia Lescano
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA
| | | | - Laura Redwine
- College of Nursing, University of South Florida, Tampa, FL, USA
| |
Collapse
|
27
|
Vazquez CE, Cubbin C. Socioeconomic Status and Childhood Obesity: a Review of Literature from the Past Decade to Inform Intervention Research. Curr Obes Rep 2020; 9:562-570. [PMID: 32785878 DOI: 10.1007/s13679-020-00400-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW This is a review of the patterns, conceptualization, and suggested mechanisms underlying the relationship of socioeconomic status (SES) to obesity in childhood and the implications of these data for interventions going forward. RECENT FINDINGS Adiposity and SES are negatively associated in high-income countries and positively associated in medium to low-income countries. Several mechanisms, such as early introduction of solid food and parental behaviors, which may explain the association of SES and adiposity, have been identified. Parental education and adiposity and early pediatric nutrition appear to be particularly salient SES-related effectors on adiposity. There is a clear association of SES and adiposity which is affected by population affluence. Evaluation of the relationship of SES and obesity in children are complicated by the complexity of SES and lack of common definition. A number of SES-related interventional targets have been identified. Intervention research should ensure they are addressing SES-associated issues in the study population.
Collapse
Affiliation(s)
- Christian E Vazquez
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA.
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA
| |
Collapse
|
28
|
Parents' Perceptions about Salt Consumption in Urban Areas of Peru: Formative Research for a Social Marketing Strategy. Nutrients 2020; 12:nu12010176. [PMID: 31936312 PMCID: PMC7019816 DOI: 10.3390/nu12010176] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/08/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Salt intakes in Latin America currently double the World Health Organization’s recommendation of 5 g/day. Various strategies to reduce the population’s salt consumption, such as raising awareness using social marketing, have been recommended. This study identified parents’ perceptions of salt consumption to inform a social marketing strategy focused on urban areas in Peru. Methods: Using a sequential exploratory methods design, parents of pre-school children, of high and low socioeconomic status, provided qualitative data in the form of interviews and focus groups. Following this, quantitative data was obtained via questionnaires, which were sent to all parents. The information was analyzed jointly. Results: 296 people (mean age 35.4, 82% women) participated, 64 in the qualitative and 232 in the quantitative phase of the study. Qualitative data from the first phase revealed that the majority of mothers were in charge of cooking, and female participants expressed that cooking was “their duty” as housewives. The qualitative phase also revealed that despite the majority of the participants considered their salt intake as adequate, half of them mentioned that they have tried to reduce salt consumption, and the change in the flavor of the food was stated as the most difficult challenge to continue with such practice. Quantitative data showed that 67% of participants would be willing to reduce their salt intake, and 79.7% recognized that high salt intake causes hypertension. In total, 84% of participants reaffirmed that mothers were in charge of cooking. There were no salient differences in terms of responses provided by participants from high versus low socioeconomic groups. Conclusions: The results point towards the identification of women as a potential target-audience of a social marketing strategy to promote reductions in salt intake in their families and, therefore, a gender-responsive social marketing intervention is recommended.
Collapse
|