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Khalsa AS, Copeland KA, Kharofa RY, Geraghty SR, Dewitt TG, Woo JG. The Longitudinal Relation between Infant Feeding Styles and Growth Trajectories among Families from Low-Income Households. J Nutr 2022; 152:2015-2022. [PMID: 35641195 DOI: 10.1093/jn/nxac123] [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: 03/01/2022] [Revised: 04/11/2022] [Accepted: 05/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Parental feeding styles, including the emotional environment parents create to modify a child's eating behaviors, have been associated with measures of adiposity in cross-sectional studies. The longitudinal relation between parental feeding styles in early infancy and adiposity in later infancy/toddlerhood are scant and have shown mixed results, particularly in families from low-income households. OBJECTIVES This study examined the relation between parental feeding styles and infant BMI z-score trajectories between 6 and 18 mo in families from low-income households. METHODS Parent-infant dyads were recruited during the infant's 6-, 9-, or 12-mo well-child visit. Feeding styles were assessed using the Infant Feeding Style Questionnaire (IFSQ). Infant anthropometrics from birth through 18 mo were extracted from the electronic medical record. BMI z-score slopes were estimated for each infant between 0-6 mo and 6-18 mo. Associations between feeding styles and BMI z-score slopes were examined using mixed models controlling for demographic, clinical, and feeding covariates. RESULTS The final analytic sample included 198 dyads (69% Black; median infant age: 9.0 mo; IQR: 6.8-10.3 mo). The predominant parent feeding styles included the following: laissez-faire (30%), restrictive (28%), responsive (23%), and pressuring (19%). In adjusted models, the predominant feeding style at enrollment was associated with the BMI z-score slope between 6 and 18 mo, with the responsive feeding style exhibiting a steeper increase in BMI z-score than other feeding styles. Infant feeding style was not associated with BMI z-score slope between birth and 6 mo of age. Infants of parents who exhibited restrictive feeding styles were more likely to have a BMI ≥85th percentile at their last measurement. CONCLUSIONS The predominant parent feeding style during infancy in a low-income population was associated with infant BMI z-score between 6 and 18 mo of age, but not earlier. Further studies are needed to better understand how predictive factors collectively contribute to BMI increase in the first 2 y.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Division of Primary Care Pediatrics and Center for Child Health Equity and Outcomes Research, Nationwide Children's Hospital, Columbus, OH.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH
| | - Kristen A Copeland
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Roohi Y Kharofa
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Sheela R Geraghty
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Thomas G Dewitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jessica G Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Zoghby HB, Sfeir E, Akel M, Malaeb D, Obeid S, Hallit S. Knowledge, attitude and practice of Lebanese parents towards childhood overweight/obesity: the role of parent-physician communication. BMC Pediatr 2022; 22:209. [PMID: 35422028 PMCID: PMC9009025 DOI: 10.1186/s12887-022-03279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background Childhood overweight and obesity is one of the most challenging public health problems facing both developed and developing countries. Several studies carried worldwide assessed predisposing risk factors for childhood obesity, however, few addressed the Middle East region and particularly Lebanon. We aimed in our study to assess factors associated with knowledge, attitude and practice of Lebanese parents regarding childhood overweight, particularly the parent-physician communication. Methods This cross-sectional study conducted between September and December 2019. The questionnaire used was the standardized questionnaire of “Parent Questionnaire Curriculum” from the “We Can program” (Ways to Enhance Children’s Activity and Nutrition). Results A higher parent-physician communication score (Beta = 0.05) was significantly associated with higher knowledge, whereas having a higher intermediate vs low income (Beta = -0.65) was significantly associated with lower knowledge. A higher knowledge global score (Beta = 1.25), a higher parent-physician communication score (Beta = 0.18), and having a university education level compared to illiterate/primary/complementary (Beta = 2.59) were significantly associated with better attitude. A better attitude (Beta = 0.92) and a higher global knowledge score (Beta = 0.6) were significantly associated with a better practice. Conclusion This study found that a better parent-physician communication and higher knowledge were associated with better attitude and practice towards obesity. Given the rise in childhood obesity worldwide, identifying factors that help reduce childhood obesity, is becoming mandatory. Our results can open up to future studies addressing strategies to prevent childhood obesity in Lebanon. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03279-1.
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Overt restrictive feeding for weight management: a preliminary retrospective examination of childhood experiences. Eat Weight Disord 2021; 26:2407-2411. [PMID: 33245502 DOI: 10.1007/s40519-020-01036-w] [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: 05/20/2020] [Accepted: 09/28/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Overt restrictive feeding practices (ORFP), aimed at promoting weight loss or preventing weight gain for children, are often implemented by parents with good intentions. Despite findings that indicate unintended weight and behavioral outcomes little is known about how parental ORFP are experienced by those who are subjected to them. Thus, we explored retrospective accounts of meaning making related to experiences of such practices during childhood. METHODS Six young adult females who experienced ORFP were interviewed. Data were analyzed using constructivist grounded theory. RESULTS Participants retrospectively associated experiencing ORFP with a meaning making process that involves: (a) perceiving parental motivation for ORFP and receiving messages about weight, (b) internalizing parental messages about weight, and (c) viewing self-worth as contingent on weight. CONCLUSION Preliminary findings suggest that parents may be reinforcing weight stigma in their children through ORFP. Results add evidence against the use of parental ORFP for childhood weight management. LEVEL OF EVIDENCE Level V, Descriptive study.
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Effectiveness of an Innovative Sensory Approach to Improve Children's Nutritional Choices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126462. [PMID: 34203732 PMCID: PMC8296279 DOI: 10.3390/ijerph18126462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 12/03/2022]
Abstract
A case-control study was conducted to investigate the effectiveness of the Edueat® Method, through experiential workshops focused on the use of all 5 senses. In two different primary schools in the same city, questionnaires were administered in two months with a follow-up one year later. Participants: 119 children (age 8.2–9.0) chosen randomly; control group 66 (55.5%). Seven lessons of 2 h each were held in the schools by experts of the Edueat® method and seven extra lessons by the teachers. The main outcome measures were the children’s changes in their approach and attitude towards their eating habits. The answers were grouped with factor analysis and summarized through scores. Repeated-measures analysis of variance was conducted in order to identify the relationships between scores and treatment over time. At the end of treatment, the intervention group showed a significant appreciation towards healthy foods (+4.15 vs. −0.05, p = 0.02) and a greater capacity in identifying foods which are very good for the health (+15.6 vs. +14.4, p = 0.02). In conclusion, the Edueat® method was found to be particularly promising in transmitting knowledge of those foods which are healthy. Greater involvement of teachers and parents is crucial.
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Liao HE, Deng YM. The Role of Caregiver's Feeding Pattern in the Association between Parents' and Children's Healthy Eating Behavior: Study in Taichung, Taiwan. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8050369. [PMID: 34066688 PMCID: PMC8151811 DOI: 10.3390/children8050369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/21/2022]
Abstract
While parenting style has been linked with parent feeding behavior (FB), little is known about the role FB plays in the relationship between parents’ eating behavior (PEB) and children’s eating behavior (CEB). Based on social learning theory, we hypothesized that children learn to develop healthy CEB by obeying and imitating parents’ healthy eating and feeding behaviors, and that FB is the mediator between PEB and CEB. In total, 257 survey responses from parents of children up to 5 years old were included in the study. Results indicated that CEB did not differ by children’s age, gender, or birth order; for parents, older age and lower educational levels were associated with less healthy unhealthier FB and PEB. Healthy PEB and FB explained 46.8% and 21.7% of the variance in healthy CEB, respectively. The model confirmed that FB reduced the coefficient of healthy PEB from 0.563 to 0.468 and increased the variance explained from 35.0% to 38.5%. FB was a mediator for PEB and CEB. Discussion covers the complexity of ideal parenting styles and child feeding and their associated effects on CEB in varied environments, including different cultures. We concluded that PEB was the main predictor of CEB, and healthy feeding acted as a mediator.
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Abstract
Eating behaviors may be expressions of genetic risk for obesity and are potential antecedents of later eating disorders. However, childhood eating behaviors are heterogeneous and transient. Here we show associations between polygenic scores for body mass index (BMI-PGS) and anorexia nervosa (AN-PGS) with eating behavior trajectories during the first ten years of life using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), N=7,825. Results indicated that one standard deviation (SD) increase in the BMI-PGS was associated with a 30-37% increased risk for early- and mid-childhood overeating. In contrast, one SD increase in BMI-PGS was associated with a 20% decrease in risk of persistent high levels of undereating and a 15% decrease in risk of persistent fussy eating. There was no evidence for a significant association between AN-PGS and eating behavior trajectories. Our results support the notion that child eating behavior share common genetic variants associated with BMI.
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Vaughn AE, Bartlett R, Luecking CT, Hennink-Kaminski H, Ward DS. Using a social marketing approach to develop Healthy Me, Healthy We: a nutrition and physical activity intervention in early care and education. Transl Behav Med 2020; 9:669-681. [PMID: 30107586 DOI: 10.1093/tbm/iby082] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Although social marketing principles have been successfully employed in school-based interventions to prevent obesity, use in early care and education (ECE) settings has been limited. This paper describes the use of the social marketing approach to develop an ECE-based intervention that encourages an ECE provider-parent partnership to improve the quality of preschool children's diets and their level of physical activity. A six-step social marketing approach for public health interventions guided the development of this ECE-based intervention. These steps were as follows: (i) initial planning, (ii) formative research, (iii) strategy development, (iv) program development, (v) implementation, and (vi) monitoring and evaluation. During this process, we reviewed current literature, conducted focus groups with ECE providers and parents, developed a detailed conceptual model and content map, created and tested the campaign concept, and developed final campaign materials along with strategies for its implementation. The final intervention resulting from this process was an 8-month campaign known as Healthy Me, Healthy We. The campaign is delivered by the child care center and includes branded materials for use in the classroom and at home. The final campaign is being evaluated in a cluster-randomized trial. Healthy Me, Healthy We offers an innovative approach to promoting healthy eating and physical activity during early childhood, a key developmental period, that leverages partnership between ECE providers and parents to affect behavior change.
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Affiliation(s)
- Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rachel Bartlett
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney T Luecking
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Heidi Hennink-Kaminski
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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8
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Gold JM, Vander Weg MW. Investigating the relationship between parental weight stigma and feeding practices. Appetite 2020; 149:104635. [PMID: 32087281 DOI: 10.1016/j.appet.2020.104635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/21/2020] [Accepted: 02/18/2020] [Indexed: 01/15/2023]
Abstract
Promoting a healthy diet in children remains a prominent public health priority. Parents have been shown to be a major influence on their children's eating behaviors, but limited research has been devoted to exploring the factors that lead parents to select certain feeding practices over others. Past research has demonstrated a link between weight stigma (i.e., prejudicial attitudes or discriminatory behavior targeted at individuals who carry excess weight) and an individual's own weight-related behaviors and outcomes, but no study has examined how parental levels of weight stigma maybe associated with a parent's preferred feeding practices. The primary objective of this study was to examine the cross-sectional associations between parental levels of weight-based stigmatization with parental feeding practices. Responses were collected on Amazon's Mechanical Turk website for n = 406 parents who 1) had at least one child aged 5-10 and 2) perceived themselves to be overweight or obese. After adjusting for relevant covariates, parental weight stigma was shown to be significantly associated with restrictive feeding practices, and verbal modeling of eating behaviors (all ps < .05). A priori exploratory mediation analysis identified concern about child weight as a significant mediator between weight stigma and parental feeding practices. A discussion of the potential limitations of this study, future directions of research, and implications of these findings are included.
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Affiliation(s)
- Joshua M Gold
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52245, USA.
| | - Mark W Vander Weg
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52245, USA; Department of Internal Medicine, University of Iowa, Iowa City, IA, 52245, USA; Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, 52241, USA
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Mojica CM, Liang Y, Foster BA, Parra-Medina D. The Association Between Acculturation and Parental Feeding Practices in Families With Overweight and Obese Hispanic/Latino Children. FAMILY & COMMUNITY HEALTH 2019; 42:180-188. [PMID: 31107728 PMCID: PMC6581037 DOI: 10.1097/fch.0000000000000226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study examines the association between acculturation and parental feeding practices in low-income Latinos. Overweight/obese children (N = 117), aged 5 to 14 years, and their parents were recruited from a rural health clinic. Findings show that more acculturated parents have greater control over their child's eating behavior (P = .04). Parents who perceive their child as having a weight problem also have more control over their child's eating behavior (P = .02). Control measured from regulation of how much and when the child should eat to offering sweets and screen time for good behavior. Results underscore the need for interventions to consider parental acculturation and perceptions of child weight.
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Affiliation(s)
- Cynthia M Mojica
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis (Dr Mojica); Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore (Dr Liang); Division of Hospital Medicine, School of Medicine, Oregon Health & Science University, Portland (Dr Foster); and Director, Latino Research Institute, Mexican American and Latina/o Studies, University of Texas at Austin (Dr Parra-Medina)
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Matvienko-Sikar K, Byrne M, Kelly C, Toomey E, Hennessy M, Devane D, Heary C, Harrington J, McGrath N, Queally M, Kearney PM. Development of an infant feeding core outcome set for childhood obesity interventions: study protocol. Trials 2017; 18:463. [PMID: 29017519 PMCID: PMC5634841 DOI: 10.1186/s13063-017-2180-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 09/11/2017] [Indexed: 11/10/2022] Open
Abstract
Background Childhood obesity is a significant public health challenge that affects approximately one in five children worldwide. Infant feeding practices are implicated in the aetiology of childhood obesity. Infant feeding interventions for childhood obesity are increasingly popular but outcome reporting is inconsistent across trials. Lack of standardisation limits examination of intervention effects and mechanisms of change. The aim of the current project is to develop a core set of infant feeding outcomes for children ≤ 1 year old, to be evaluated in childhood obesity intervention trials. Methods This project will use similar methodology to previous core outcome development research. An infant feeding core outcome set (COS) will be developed in four stages: (1) a systematic review of the literature, (2) discussion and clarification of outcomes in a meeting involving multiple stakeholder perspectives, (3) prioritisation of outcomes using the Delphi technique with an expert panel of stakeholders, and (4) achieving consensus on the COS using the nominal group technique (NGT) consensus meeting. An online Delphi survey will be conducted following the NGT meeting to prioritise outcomes identified in the systematic review. An NGT meeting will be conducted with groups of health professionals, non-clinician researchers, and parents of infants ≤ 1 year old, to achieve final consensus on the infant feeding COS. Discussion This study aims to develop a core outcome set of infant feeding outcomes for randomised infant feeding studies to prevent childhood obesity. This research will improve examination and syntheses of the outcomes of such studies to prevent and reduce childhood obesity. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2180-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Molly Byrne
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Colette Kelly
- Discipline of Health Promotion, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Elaine Toomey
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Marita Hennessy
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | | | - Niamh McGrath
- School of Public Health, University College Cork, Cork, Ireland
| | - Michelle Queally
- Discipline of Economics, National University of Ireland Galway, Galway, Ireland
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11
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Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen JL. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs 2017; 28:616-624. [DOI: 10.1177/1043659617719139] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Angela Sun
- Chinese Community Health Resource Center, San Francisco, CA, USA
| | - Joyce Cheng
- Chinese Community Health Resource Center, San Francisco, CA, USA
| | | | - Yvonne Liang
- Chinese Community Health Resource Center, San Francisco, CA, USA
| | - Terence Ng
- Chinese Community Health Resource Center, San Francisco, CA, USA
| | - Jyu-Lin Chen
- University of California, San Francisco, CA, USA
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12
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Chen JL, Esquivel JH, Guo J, Chesla CA, Tang S. Risk factors for obesity in preschool-aged children in China. Int Nurs Rev 2017; 65:217-224. [DOI: 10.1111/inr.12371] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- J. - L. Chen
- School of Nursing; University of California San Francisco; San Francisco CA USA
| | - J. H. Esquivel
- Department of Cardiology and School of Nursing; University of California San Francisco; San Francisco CA USA
- Department of Family Health Care Nursing; University of California San Francisco; San Francisco CA USA
| | - J. Guo
- Xiangya School of Nursing; Central South University; Changsha China
| | - C. A. Chesla
- School of Nursing; University of California San Francisco; San Francisco CA USA
| | - S. Tang
- Xiangya School of Nursing; Central South University; Changsha China
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13
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White C, Murphy T, Hodges EA, Berry DC. Barriers for Hispanic Caregivers With Obese Preschool Children. HISPANIC HEALTH CARE INTERNATIONAL 2016; 14:141-55. [PMID: 27553227 DOI: 10.1177/1540415316665355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Childhood obesity is a growing epidemic, and the rates are disproportionately higher in minorities. Clinical guidelines have contributed to decreased prevalence overall, but the rates in Hispanic preschoolers have increased. METHOD This review of the literature summarizes the perceptions and beliefs of caregivers of Hispanic preschool children regarding weight status and feeding behaviors, as well as the perceived cultural barriers to guideline adherence. A search of the CINAHL, PubMed, Joanna Briggs, and Global Health databases identified studies performed between January 1, 2008, and April 1, 2016. Search terms included Hispanics, guideline adherence, gap, barriers, obesity, overweight, and attitude to obesity. RESULTS Fifteen studies met the inclusion criteria, including some about Hispanic caregivers of preschool-aged children. Several cultural perceptions and beliefs were identified. CONCLUSION Further study is needed to develop more culturally relevant and sensitive guidelines and to design specific and effective interventions for this population.
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Affiliation(s)
| | | | - Eric A Hodges
- The University of North Carolina at Chapel Hill, NC, USA
| | - Diane C Berry
- The University of North Carolina at Chapel Hill, NC, USA
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Militello LK, Melnyk BM, Hekler E, Small L, Jacobson D. Correlates of Healthy Lifestyle Beliefs and Behaviors in Parents of Overweight or Obese Preschool Children Before and After a Cognitive Behavioral Therapy Intervention With Text Messaging. J Pediatr Health Care 2016; 30:252-60. [PMID: 26429638 DOI: 10.1016/j.pedhc.2015.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/24/2015] [Accepted: 08/31/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Significant gaps exist in the published literature regarding the treatment of overweight/obesity in preschool-aged children, especially in primary care settings. Parental influence plays an important factor in the development of healthy behaviors in children, yet there is no consensus about why some behavior change intervention strategies for parents of young children are more influential and effective than others. OBJECTIVE The purpose of this secondary data analysis was to assess correlations among the study variables (healthy lifestyle beliefs, perceived difficulty, and healthy lifestyle behaviors) in parents of overweight/obese preschool children. A second aim explored if the parent's level of cognitive beliefs and perceived difficulty of engaging in healthy lifestyle behaviors correlated with text messaging cognitive behavioral support. METHODS Fifteen preschool-parent dyads from primary care clinics completed a 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the intervention content, and Fogg's Behavior Model guided the implementation. The intervention was delivered using a combination of face-to-face clinic visits and ecological momentary interventions using text messaging. RESULTS Supported are the interconnected relationships among the study variables, that is, parental healthy lifestyle beliefs, thoughts, and behaviors. At baseline, parental healthy lifestyle belief scores significantly correlated with perceived difficulty (rs = 0.598, p < .05) and healthy lifestyle behaviors (rs = 0.545, p < .05). These associations strengthened after the intervention. Furthermore, as parental healthy lifestyle beliefs increased and perceived difficulty lessened, their response rate and subsequent feedback lessened to the static text messaging support. DISCUSSION Findings from this study support the interconnections between parents' thoughts, feelings, and actions toward healthy lifestyles. As parental beliefs became stronger through cognitive behavioral skills building and tailored text messaging, the need for general support via text messaging lessened, warranting additional research.
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Bucher Della Torre S, Dudley-Martin F, Kruseman M. 'Croque&bouge': A feasible and acceptable programme for obesity prevention in preschoolers at risk and their parents. SAGE Open Med 2016; 3:2050312115574365. [PMID: 26770769 PMCID: PMC4679228 DOI: 10.1177/2050312115574365] [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: 03/18/2014] [Accepted: 01/27/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To conceptualize and pilot test a programme of three workshops aiming to prevent the development of overweight in susceptible preschool children. METHODS Three workshops were conducted, targeting both parents and children. The curriculum for parents included discussions on feeding responsibilities, healthy eating, taste development, neophobia and physical activity recommendations. Children participated in various play activities with fruits and vegetables and read stories about hunger and satiety feelings. Recruitment was organized through paediatricians and child-care centres. Evaluation of the programme focused on feasibility, adequacy for children's age, parents' perception of impact and, for children, change of the ability to recognize and willingness to taste fruits and vegetables. RESULTS A total of 21 children and one of their parents participated in the programme. The programme was found to be feasible and adequate for the targeted community. Parents reported perceiving a positive impact of the intervention; however, this finding was not statistically significant. The major difficulty was identifying and recruiting families and engaging the parents in a discussion about weight. CONCLUSIONS This short programme aiming to improve parents' ability to offer healthy environment and promote healthy eating behaviour was feasible and acceptable for families with young children. When developing and implementing such programmes, close collaboration with paediatricians and other health providers should be sought in order to identify and reach children at risk of obesity and their family.
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Affiliation(s)
- Sophie Bucher Della Torre
- Nutrition and Dietetics Department, School of Health Professions - Geneva (HEdS-GE), University of Applied Sciences Western Switzerland (HES-SO), Carouge, Switzerland
| | - Fiona Dudley-Martin
- Nutrition and Dietetics Department, School of Health Professions - Geneva (HEdS-GE), University of Applied Sciences Western Switzerland (HES-SO), Carouge, Switzerland
| | - Maaike Kruseman
- Nutrition and Dietetics Department, School of Health Professions - Geneva (HEdS-GE), University of Applied Sciences Western Switzerland (HES-SO), Carouge, Switzerland
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16
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Rylatt L, Cartwright T. Parental feeding behaviour and motivations regarding pre-school age children: A thematic synthesis of qualitative studies. Appetite 2015; 99:285-297. [PMID: 26719102 DOI: 10.1016/j.appet.2015.12.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 11/19/2022]
Abstract
Poor childhood diet is a major risk factor for disease and obesity, and parents of pre-school children are in a powerful position to influence diet for life. The technique of thematic synthesis (Thomas & Harden, 2008) was used to synthesise recent qualitative research on parental feeding of pre-school age children (18 months-6 years). The aim was to inform development of nutrition advice by gaining a comprehensive picture of parental feeding behaviours and motivations. Six key parental feeding behaviours were identified: modelling, rewards, pressure and encouragement, repeated exposure, creativity, and limiting intake. Four overarching themes regarding motivations were identified: promoting good health (balance and variety, and weight control); building positive relationships (child involvement, and parental engagement and responsiveness); practicalities and constraints (time, cost, and lack of culinary skill, and pressure and flexibility); and emotional motivations (problem avoidance, and emotional investment). Practicalities and constraints, and emotional motivations impacted more significantly on low income parents. In order to be effective, nutrition advice ought to tap into parents' strong desire to build positive relationships and promote good health while remaining sensitive to the significant constraints and practicalities faced.
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Affiliation(s)
- Louise Rylatt
- Department of Psychology, Faculty of Science and Technology, University of Westminster, London, UK.
| | - Tina Cartwright
- Department of Psychology, Faculty of Science and Technology, University of Westminster, London, UK
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Shloim N, Edelson LR, Martin N, Hetherington MM. Parenting Styles, Feeding Styles, Feeding Practices, and Weight Status in 4-12 Year-Old Children: A Systematic Review of the Literature. Front Psychol 2015; 6:1849. [PMID: 26696920 PMCID: PMC4677105 DOI: 10.3389/fpsyg.2015.01849] [Citation(s) in RCA: 347] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/14/2015] [Indexed: 11/13/2022] Open
Abstract
Childhood is a critical period in the development of obesity. Eating patterns established early in life track into later life. Therefore, parental approaches to feeding in their general parenting style, feeding styles, and specific feeding practices will have a profound impact on how children eat and grow. A systematic research review following PRISMA guidelines was conducted to identify, discuss and integrate recent research investigating the relationship between parenting styles, feeding styles, feeding practices, and body mass index (BMI) in children. Medline (Ovid), PsycINFO, Web of Science, and Food Science and Technology Abstracts were systematically searched using sensitive search strategies. Studies were limited to papers published in English between 2010 and February 2015 with participants aged 4–12 years old with outcomes including obesity, change in weight, or BMI. The search yielded 31 relevant quantitative peer-reviewed papers meeting all inclusion criteria: seven longitudinal, 23 cross-sectional, one randomized control trial. Associations between parenting style and child BMI were strongest and most consistent within the longitudinal studies. Uninvolved, indulgent or highly protective parenting was associated with higher child BMI, whereas authoritative parenting was associated with a healthy BMI. Similarly for feeding styles, indulgent feeding was consistently associated with risk of obesity within cross-sectional studies. Specific feeding practices such as restriction and pressure to eat were linked to BMI, especially within cross-sectional studies. Where child traits were measured, the feeding practice appeared to be responsive to the child, therefore restriction was applied to children with a high BMI and pressure to eat applied to children with a lower BMI. Behaviors and styles that are specific to the feeding context are consistently associated with child BMI. However, since obesity emerges over time, it is through longitudinal, carefully measured (through questionnaire and observation) studies which take account of child appetite and temperament that the association between parenting style, feeding style, specific feeding practices, and child obesity will be understood.
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Affiliation(s)
- Netalie Shloim
- Biopsychology Group: Human Nutrition, School of Psychology, Institute of Psychological Sciences, University of Leeds Leeds, UK
| | - Lisa R Edelson
- Behavior and Perception, Nestlé Research Center Lausanne, Switzerland
| | - Nathalie Martin
- Behavior and Perception, Nestlé Research Center Lausanne, Switzerland
| | - Marion M Hetherington
- Biopsychology Group: Human Nutrition, School of Psychology, Institute of Psychological Sciences, University of Leeds Leeds, UK
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Promotion and Prevention Focused Feeding Strategies: Exploring the Effects on Healthy and Unhealthy Child Eating. BIOMED RESEARCH INTERNATIONAL 2015; 2015:306306. [PMID: 26380269 PMCID: PMC4561864 DOI: 10.1155/2015/306306] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/10/2015] [Accepted: 02/26/2015] [Indexed: 01/29/2023]
Abstract
There is a general lack of research addressing the motivations behind parental use of various feeding practices. Therefore, the present work aims to extend the current literature on parent-child feeding interactions by integrating the traditional developmental psychological perspective on feeding practices with elements of Regulatory Focus Theory (RFT) derived from the field of motivational psychology. In this paper, we seek to explain associations between parental feeding practices and child (un)healthy eating behaviors by categorizing parental feeding practices into promotion and prevention focused strategies, thus exploring parent-child feeding interactions within the framework of RFT. Our analyses partly supported the idea that (1) child healthy eating is positively associated with feeding practices characterized as promotion focused, and (2) child unhealthy eating is negatively associated with feeding practices characterized as prevention focused. However, a general observation following from our results suggests that parents' major driving forces behind reducing children's consumption of unhealthy food items and increasing their consumption of healthy food items are strategies that motivate rather than restrict. In particular, parents' provision of a healthy home food environment seems to be essential for child eating.
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Duncan DT, Hansen AR, Wang W, Yan F, Zhang J. Change in Misperception of Child's Body Weight among Parents of American Preschool Children. Child Obes 2015; 11:384-93. [PMID: 25928301 DOI: 10.1089/chi.2014.0104] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Little is known about parental recognition of their child's overweight status over time. The aim of this study was to examine the prevalence of parental misperceptions related to preschool children's weight in the last two decades. METHODS Data come from the National Health and Nutrition Examination Survey from 1988 to 1994 (early survey; n=3839) and 2007 to 2012 (recent survey; n=3153). Parents were asked whether they considered their child, ages 2-5 years, to be overweight, underweight, or just about the right weight. We estimated the probability ratio (PR) between the two surveys for parents perceiving their overweight child as overweight. RESULTS Percentages of parents who inappropriately perceived their overweight child as just about the right weight was 96.6% and 94.9% for the early and recent survey, respectively. As high as 78.4% of parents perceived their obese child as just about the right weight in the recent survey. The probability of overweight/obese children being perceived as overweight in the early survey was 0.18 (95% confidence interval [CI]=0.14-0.22) and further lowered to 0.14 (95% CI=0.11-0.17) in the recent survey. After adjustment for sociodemographics and BMI z-scores of directly measured body weight, probability of being appropriately perceived by the parents declined by 30% between surveys (PR=0.70 [0.63, 0.78]). CONCLUSIONS There was a declining tendency among parents to perceive overweight children appropriately. Strategies are needed to explore how to encourage clinician discussions with parents about appropriate weight for their child and strengthen capacity for childhood obesity prevention.
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Affiliation(s)
- Dustin T Duncan
- 1 Department of Population Health, New York University School of Medicine , New York, NY
| | - Andrew R Hansen
- 2 Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University , Statesboro, GA
| | - Wei Wang
- 3 Department of Social Medicine, School of Public Health, Fudan University , Shanghai, China
| | - Fei Yan
- 3 Department of Social Medicine, School of Public Health, Fudan University , Shanghai, China
| | - Jian Zhang
- 4 Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University , Statesboro, GA
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Mallan KM, Nothard M, Thorpe K, Nicholson JM, Wilson A, Scuffham PA, Daniels LA. The role of fathers in child feeding: perceived responsibility and predictors of participation. Child Care Health Dev 2014; 40:715-22. [PMID: 23902382 DOI: 10.1111/cch.12088] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The role of fathers in shaping their child's eating behaviour and weight status through their involvement in child feeding has rarely been studied. This study aims to describe fathers' perceived responsibility for child feeding, and to identify predictors of how frequently fathers eat meals with their child. METHODS Four hundred and thirty-six Australian fathers (M age = 37 years, SD = 6 years; 34% university educated) of a 2-5-year-old child (M age = 3.5 years, SD = 0.9 years; 53% boys) were recruited via contact with mothers enrolled in existing research projects or a university staff and student email list. Data were collected from fathers via a self-report questionnaire. Descriptive and hierarchical linear regression analyses were conducted. RESULTS The majority of fathers reported that the family often/mostly ate meals together (79%). Many fathers perceived that they were responsible at least half of the time for feeding their child in terms of organizing meals (42%); amount offered (50%) and deciding if their child eats the 'right kind of foods' (60%). Time spent in paid employment was inversely associated with how frequently fathers ate meals with their child (β = -0.23, P < 0.001); however, both higher perceived responsibility for child feeding (β = 0.16, P < 0.004) and a more involved and positive attitude toward their role as a father (β = 0.20, P < 0.001) were positively related to how often they ate meals with their child, adjusting for a range of paternal and child covariates, including time spent in paid employment. CONCLUSIONS Fathers from a broad range of educational backgrounds appear willing to participate in research studies on child feeding. Most fathers were engaged and involved in family meals and child feeding. This suggests that fathers, like mothers, should be viewed as potential agents for the implementation of positive feeding practices within the family.
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Affiliation(s)
- K M Mallan
- Institute of Health and Biomedical Innovation and School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Qld, Australia
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21
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Mallan KM, Daniels LA, Nothard M, Nicholson JM, Wilson A, Cameron CM, Scuffham PA, Thorpe K. Dads at the dinner table. A cross-sectional study of Australian fathers’ child feeding perceptions and practices. Appetite 2014; 73:40-4. [DOI: 10.1016/j.appet.2013.10.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hendy HM, Williams KE. Mother's feeding practices for children 3-10 years of age and their associations with child demographics. Appetite 2012; 58:710-6. [PMID: 22269792 DOI: 10.1016/j.appet.2012.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 01/05/2012] [Accepted: 01/07/2012] [Indexed: 11/18/2022]
Abstract
The present study examined relationships between mothers' feeding practices and child demographics such as gender, age, weight status, and family income. This cross-sectional analysis was conducted using data from 2259 children between 3 and 10 years of age who were sampled for the development of the Parent Mealtime Action Scale. No child gender differences were found in mothers' feeding practices. Older children received more Fat Reduction and Many Food Choices, but less Positive Persuasion, Use of Rewards, Insistence on Eating, and Special Meals, with differences in these feeding practices being most notable from before to after school age. Overweight children received less Insistence on Eating and more Fat Reduction than underweight or normal weight children. Children with the lowest family incomes received less Fat Reduction, less Daily FV Availability, more Use of Rewards. Results suggest that mothers respond to changing conditions, possibly including feedback from school nurses, increases in children's weight status, and availability of financial resources.
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Affiliation(s)
- Helen M Hendy
- Penn State University, Schuylkill Campus, 200 University Drive, Schuylkill Haven, PA 17972, USA.
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