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Burton ET, Choquette AE, Gray E, Odulana A, Kim A, Smith WA. Household chaos and childhood obesity-related health outcomes. J Pediatr Psychol 2024:jsae053. [PMID: 38960723 DOI: 10.1093/jpepsy/jsae053] [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: 05/13/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE Household chaos, defined as a lack of organization, structure, and predictability, has been linked to deleterious childhood health outcomes and may hinder attempts to initiate and maintain healthy lifestyle changes. This study examined the associations of household chaos and obesity-related health conditions in a sample of youth being treated for obesity. METHODS Participants were 715 patients (61.8% girls; Mage = 12.3 years; 68.7% non-Hispanic Black; M% of 95th BMI %-ile = 146.9%) enrolled in a pediatric weight management clinic. Caregiver report of household chaos was measured using the Confusion, Hubbub and Order Scale (CHAOS). Physiological obesity-related comorbidities (e.g., insulin resistance, hypertension, dyslipidemia) were assessed by a medical clinician and abstracted from electronic medical records; health conditions were dichotomized as present or not present. Psychological functioning was measured with the Pediatric Symptom Checklist, a caregiver-completed mental health screen that assesses internalizing, externalizing, and attention concerns. RESULTS The Wilcoxon rank-sum test was used to test differences in household chaos scores for each obesity-related health condition. Caregivers of youth diagnosed with hypertension and obstructive sleep apnea reported significantly lower levels of household chaos, while caregivers who reported clinical levels of psychological dysfunction reported higher levels of chaos. CONCLUSIONS Traditional management of childhood obesity requires changes across multiple health domains (e.g., dietary, exercise, sleep), and such change may be facilitated by structure and consistency. Present findings suggest that psychological resources within pediatric weight management settings should address individual patient-level factors associated with physiological and mental health as well as household functioning.
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Affiliation(s)
- E Thomaseo Burton
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Adora E Choquette
- Department of Psychology, The University of Memphis, Memphis, TN, United States
| | - Emily Gray
- Department of Health Promotion and Disease Prevention, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Adebowale Odulana
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Ahlee Kim
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Webb A Smith
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
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Krupsky KL, Zvara BJ, Khalsa AS, Andridge R, Keim SA, Anderson SE. Household chaos, child temperament, and structure-related feeding practices in toddlerhood: A moderation analysis. Eat Behav 2024; 52:101838. [PMID: 38048650 PMCID: PMC11037389 DOI: 10.1016/j.eatbeh.2023.101838] [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: 08/07/2023] [Revised: 10/30/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Abstract
Structure-related feeding practices may promote intuitive child eating behaviors and foster responsiveness to internal cues of hunger and satiety. Caregivers' ability to engage in structure-related feeding practices likely depends on a complex ecology of factors, including household- and child-characteristics. This study examined associations between household chaos and structure-related feeding practices, and the moderating effect of child temperament. Data were from 275 caregiver-toddler dyads from central Ohio. Child temperament was reported by caregivers when children were 18 months of age, whereas household chaos and structure-related feeding practices were reported by caregivers when children were 36 months of age. Multivariable linear regression models were constructed to assess the relationship between chaos and structure-related feeding practices. Interaction terms between household chaos and three dimensions of child temperament were tested to determine whether temperament moderated the relationship between chaos and structure-related feeding practices. Household chaos was not independently associated with structure-related feeding practices, but higher levels of child effortful control were associated with greater mealtime structure. There was a statistically significant interaction between household chaos and child temperamental surgency, such that greater levels of chaos were associated with less structured mealtimes, but only when children had low-surgency. Findings suggest household chaos and child temperament inform caregiver feeding practices, but the influence of chaos may depend on more proximal factors, like child temperament. Recommendations to improve caregiver-child feeding interactions should be sensitive to characteristics of the broader family home environment.
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Affiliation(s)
- Kathryn L Krupsky
- Division of Epidemiology, College of Public Health, The Ohio State University, 336 Cunz Hall, 1841 Neil Ave, Columbus, OH 43210, USA.
| | - Bharathi J Zvara
- Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr., Chapel Hill, NC 27599, USA.
| | - Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Center for Child Health Equity and Outcomes Research, Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH, USA; Department of Pediatrics, College of Medicine, Ohio State University, Columbus, OH, USA.
| | - Rebecca Andridge
- Division of Biostatistics, College of Public Health, The Ohio State University, 1841 Neil Ave, Columbus, OH 43210, USA.
| | - Sarah A Keim
- Division of Epidemiology, College of Public Health, The Ohio State University, 336 Cunz Hall, 1841 Neil Ave, Columbus, OH 43210, USA; Department of Pediatrics, College of Medicine, Ohio State University, Columbus, OH, USA; Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Dr. NEOB 3rd Floor, Columbus, OH 43205, USA.
| | - Sarah E Anderson
- Division of Epidemiology, College of Public Health, The Ohio State University, 336 Cunz Hall, 1841 Neil Ave, Columbus, OH 43210, USA.
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Adolescents' reports of chaos within the family home environment: Investigating associations with lifestyle behaviours and obesity. PLoS One 2023; 18:e0280737. [PMID: 36701326 PMCID: PMC9879426 DOI: 10.1371/journal.pone.0280737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Disorganised and chaotic home environments may hinder the adoption of healthy lifestyle behaviours and contribute to excessive weight gain among adolescents. We examined whether self-reported level of chaos within the family home environment is associated with lifestyle behaviours and obesity in adolescent girls and boys. METHODS Cross-sectional data from the 3rd wave of the Québec Adipose and Lifestyle Investigation in Youth (QUALITY) study were analyzed. The sample consisted of n = 377 White adolescents with a history of parental obesity. Home environment chaos was measured using the Confusion, Hubbub, and Order Scale (CHAOS) analyzed both continuously and dichotomized as high vs. low chaos. Body Mass Index z-scores (zBMI) were computed using WHO standards from measured weight and height. Physical activity (7-day accelerometry), vegetable and fruit intake (three 24-hour diet recalls), and leisure screen time and sleep duration (questionnaire) were assessed. Sex-specific linear regression models were used to estimate associations between level of family home environment chaos, lifestyle behaviours and zBMI. RESULTS The overall level of chaos was low in our study sample, with higher reported levels among girls compared to boys. Among girls, high (vs low) chaos was associated with shorter sleep duration (hours/day) (B = - 0.44, 95% CI: -0.75, -0.14). No associations were observed for other lifestyle behaviours or for zBMI. CONCLUSION In this sample of adolescents with a parental history of obesity, higher household chaos was not associated with obesity or lifestyle behaviours, except for sleep duration among girls. Replication of findings in more diverse samples is indicated.
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Duarte MG, Valentini NC, Nobre GC, Benda RN. Contextual Factors and Motor Skills in Indigenous Amazon Forest and Urban Indigenous Children. Front Public Health 2022; 10:858394. [PMID: 35548073 PMCID: PMC9082032 DOI: 10.3389/fpubh.2022.858394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/18/2022] [Indexed: 01/22/2023] Open
Abstract
This study investigated the contextual factors, motor performance, and body mass index across indigenous land children, indigenous urban children, and non-indigenous urban children. A number of 153 children, both sexes (71 girls, 46.4%), from 8 to 10 years were assessed. The Test of Motor Gross Development-3 was utilized. Indigenous land children showed higher motor performance ( η 2 ρ = 0.37 and η 2 ρ = 0.19 locomotor and object control, respectively) than indigenous urban children (p < 0.03) and non-indigenous urban children (p < 0.01); Indigenous urban children showed higher motor performance than non-indigenous urban children (p < 0.01). Body mass index was similar across groups ( η 2 ρ = 0,02; p = 0.15). Motor performance of indigenous land children was explained by the contextual factors that lead to a more active lifestyle, unsupervised free time, and play outside. In urban areas, behavior was similar, and although indigenous urban children kept some play tradition, it was not strong enough to be a protective factor for the motor performance.
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Affiliation(s)
| | - Nadia Cristina Valentini
- School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rodolfo Novellino Benda
- School of Physical Education, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
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McCabe SM, Abbiss CR, Libert JP, Bach V. Functional links between thermoregulation and sleep in children with neurodevelopmental and chronic health conditions. Front Psychiatry 2022; 13:866951. [PMID: 36451768 PMCID: PMC9703054 DOI: 10.3389/fpsyt.2022.866951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
The bi-directional relationship between sleep and wake is recognized as important for all children. It is particularly consequential for children who have neurodevelopmental disorders (NDDs) or health conditions which challenge their sleep and biological rhythms, and their ability to maintain rhythms of participation in everyday activities. There are many studies which report the diverse reasons for disruption to sleep in these populations. Predominantly, there is focus on respiratory, pharmaceutical, and behavioral approaches to management. There is, however, little exploration and explanation of the important effects of body thermoregulation on children's sleep-wake patterns, and associated behaviors. Circadian patterns of sleep-wake are dependent on patterns of body temperature change, large enough to induce sleep preparedness but remaining within a range to avoid sleep disturbances when active thermoregulatory responses against heat or cold are elicited (to maintain thermoneutrality). Additionally, the subjective notion of thermal comfort (which coincides with the objective concept of thermoneutrality) is of interest as part of general comfort and associated behavioral responses for sleep onset and maintenance. Children's thermoregulation and thermal comfort are affected by diverse biological functions, as well as their participation in everyday activities, within their everyday environments. Hence, the aforementioned populations are additionally vulnerable to disruption of their thermoregulatory system and their capacity for balance of sleep and wakefulness. The purpose of this paper is to present hitherto overlooked information, for consideration by researchers and clinicians toward determining assessment and intervention approaches to support children's thermoregulation functions and promote their subjective thermal comfort, for improved regulation of their sleep and wake functions.
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Affiliation(s)
- Susan M McCabe
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Chris R Abbiss
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | | | - Véronique Bach
- PeriTox UMR_I 01, University of Picardie Jules Verne, Amiens, France
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