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Serasinghe N, Vepsäläinen H, Lehto R, Abdollahi AM, Erkkola M, Roos E, Ray C. Associations between socioeconomic status, home food availability, parental role-modeling, and children's fruit and vegetable consumption: a mediation analysis. BMC Public Health 2023; 23:1037. [PMID: 37259139 DOI: 10.1186/s12889-023-15879-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children's diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children's diet. This study aimed to determine the associations between family SES and children's fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations. METHODS Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children's FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level ("low", "middle", and "high") and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0. RESULTS The positive association between high parental educational level and children's FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51-4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10-1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35-1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 - -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children's FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06-1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40-1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations. CONCLUSIONS Parental educational level showed more associations with children's FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children's FV consumption. Future interventions to improve children's dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.
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Affiliation(s)
- Nithya Serasinghe
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland.
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Reetta Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, P.O. Box 63, Helsinki, FI-00014, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
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Abstract
Optimal hydration is required for all physiologic functions and cognition. Children, especially younger ones, are particularly susceptible to dehydration, given their physiological specificities, in particular, their renal immaturity and relatively large skin surface in early life, but also their dependence on adults and their greater propensity to develop digestive diseases leading to fluid losses. Mild dehydration consequences are dominated by their impact on cognitive functions, whereas more severe dehydration may endanger the health outcome. Studies on this subject in children are scarce; in particular, the long-term consequence on renal function remains questionable. This review considers how children's water intake including fluid intake and water content of food, are worrying. The findings show that, worldwide, most children do not meet adequate water intake recommendations. The main problems likely to explain insufficient water intake are access to safe water, availability of drinking water at school, and healthy-hydration education, which are all points that need to be improved within health policy.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Paediatric Nutrition and Gastroenterology, Division of Pediatrics, Woman, Mother and Child Department, Pediatric Nutrition and Gastroenterology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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Cardon G, Chastin S, Van Stappen V, Huys N, Stefanova T, Chakarova N, Kivelä J, Alberto Moreno L, Sándor Istvánné R, Androutsos O, Manios Y, De Craemer M. The Feel4Diabetes intervention: effectiveness on 24-hour physical behaviour composition in families at risk for diabetes development. Health Promot Int 2022; 37:6775000. [DOI: 10.1093/heapro/daac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Summary
The Feel4Diabetes project conducted a 2-year intervention aiming to encourage healthy behaviours in families in six European countries. Within this paper, the intervention effect was evaluated after the first intervention year on 24-hour physical behaviour composition in Belgian families at risk for type 2 diabetes. Parents’ and children’s levels of physical activity (PA) and sedentary behaviour (SB) were objectively measured and sleep duration was self-reported. Valid data were obtained in 82 children (mean age: 8.2 ± 0.84; 50.0% boys) and 72 parents (mean age: 40.1 ± 5.5; 27.8% fathers). Data were analysed using a compositional data approach, and mixed models were used to take clustering into account. Results showed that for children, the mean baseline composition of the 24-hour day in sleep, SB, light and moderate-to-vigorous PA for the intervention group was (11 hours 18 minutes; 6 hours 33 minutes; 5 hours 02 minutes, 1 hour 08 minutes) and for the control group (11 hours 18 minutes; 6 hours 35 minutes; 5 hours 04 minutes; 1 hour 06 minutes), respectively. For parents, the mean baseline composition was for the intervention group (8 hours 12 minutes; 9 hours 36 minutes; 5 hours 43 minutes; 27 minutes) and for the control group (8 hours 00 minute; 9 hours 00 minute; 6 hours 27 minutes; 33 minutes). No significant intervention effects were found on 24-hour physical behaviour composition of either parents or children (p = 0.19 and p = 0.21, respectively). A relatively small study population and a poor attendance rate among parents could maybe explain the lack of effectiveness. More effective strategies are needed to retain vulnerable families in interventions. Furthermore, future approaches to improve the 24-hour physical behaviour composition should maybe focus more specifically on PA, SB and sleep, and involve teachers, children and parents in the design of the intervention. Trial registration: NCT02393872 in ClinicalTrials.gov.
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Affiliation(s)
- Greet Cardon
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Sebastien Chastin
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
- Center for Living, School of Health and Life Science, Glasgow Caledonian University , Cowcaddens Rd, Glasgow G4 0BA , UK
| | - Vicky Van Stappen
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Nele Huys
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Tanya Stefanova
- Medical University Varna, Clinic of Paediatric Endocrinology , UMHAT “St. Marina” 1 “Hr. Smirnenski” Blvd., Varna 9010 , Bulgaria
| | - Nevena Chakarova
- Medical University of Sofia, Department of Diabetology, Clinical Centre of Endocrinology , Bulgaria bul. “Pencho Slaveykov”, 1431 Sofia Center, Sofia, Bulgarije
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare , Mannerheimintie 166, 00300 Helsinki , Finland
| | - Luis Alberto Moreno
- University of Zaragoza, GENUD (Growth, Exercise, Nutrition and Development) , C/Domingo Miral s/n, 50009 Zaragoza , Spain
| | - Radó Sándor Istvánné
- University of Debrecen, Debreceni Egyetem (UoD) , Egyetem tér 1, Debrecen, 4032 Hungary
| | - Odysseas Androutsos
- Harokopio University, School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University , 70, El Venizelou Ave, 176 71 Kallithea, Athens , Greece
| | - Yannis Manios
- Harokopio University, School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University , 70, El Venizelou Ave, 176 71 Kallithea, Athens , Greece
| | - Marieke De Craemer
- Research Foundation Flanders (FWO) , Egmontstraat 5, 1000 Brussels , Belgium
- Department of Rehabilitation Sciences, Ghent University , Ghent University Hospital B3, C. Heymanslaan 10, 9000 Ghent , Belgium
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Papamichael MM, Karatzi K, Mavrogianni C, Cardon G, De Vylder F, Iotova V, Usheva N, Tankova T, González-Gil EM, Kivelä J, Wikström K, Moreno L, Liatis S, Makrilakis K, Manios Y. Socio-economic vulnerabilities and food intake in European children: The Feel4Diabetes Study. Nutrition 2022; 103-104:111744. [DOI: 10.1016/j.nut.2022.111744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 11/27/2022]
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Flores-Barrantes P, Mavrogianni C, Iglesia I, Mahmood L, Willems R, Cardon G, De Vylder F, Liatis S, Makrilakis K, Martinez R, Schwarz P, Rurik I, Antal E, Iotova V, Tsochev K, Chakarova N, Kivelä J, Wikström K, Manios Y, Moreno LA. Can food parenting practices explain the association between parental education and children's food intake? The Feel4Diabetes-study. Public Health Nutr 2022; 25:1-14. [PMID: 35416142 PMCID: PMC9991856 DOI: 10.1017/s1368980022000891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 03/11/2022] [Accepted: 03/28/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to investigate the mediating role of food parenting practices (FPP), including home availability of different types of foods and drinks, parental modelling of fruit intake, permissiveness and the use of food as a reward in the relationship between parental education and dietary intake in European children. DESIGN Single mediation analyses were conducted to explore whether FPP explain associations between parents' educational level and children's dietary intake measured by a parent-reported FFQ. SETTING Six European countries. PARTICIPANTS Parent-child dyads (n 6705, 50·7 % girls, 88·8 % mothers) from the Feel4Diabetes-study. RESULTS Children aged 8·15 ± 0·96 years were included. Parental education was associated with children's higher intake of water, fruits and vegetables and lower intake of sugar-rich foods and savoury snacks. All FPP explained the associations between parental education and dietary intake to a greater or lesser extent. Specifically, home availability of soft drinks explained 59·3 % of the association between parental education and sugar-rich food intake. Home availability of fruits and vegetables was the strongest mediators in the association between parental education and fruit and vegetable consumption (77·3 % and 51·5 %, respectively). Regarding savoury snacks, home availability of salty snacks and soft drinks was the strongest mediators (27·6 % and 20·8 %, respectively). CONCLUSIONS FPP mediate the associations between parental education and children's dietary intake. This study highlights the importance of addressing FPP in future interventions targeting low-educated populations.
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Affiliation(s)
- Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece
| | - Iris Iglesia
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, C/ Pedro Cerbuna 12, Madrid50009, Spain
| | - Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Flore De Vylder
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | | | - Peter Schwarz
- Department of Prevention and Care of Diabetes, Technical University Dresden, Dresden, Germany
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Violeta Iotova
- Department of Paediatrics, Medical University, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Paediatrics, Medical University, Varna, Bulgaria
| | - Nevena Chakarova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Jemina Kivelä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Wikström
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, C/ Pedro Cerbuna 12, Madrid50009, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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Schneider S, Schilling L, Osenbrügge N. Determinants of soft drink consumption among children and adolescents in developed countries - a systematic review. Cent Eur J Public Health 2022; 29:290-300. [PMID: 35026068 DOI: 10.21101/cejph.a6755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 11/15/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Soft drinks are a major component of daily caloric and sugar intake. This is especially true for children and adolescents. The WHO as well as many other institutions currently recommend to increase research on the determinants of soft drink consumption. We submit a current systematic review on this topic. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we included all quantitative observational studies that comprise samples from developed countries in the age range 0-18 years and are listed in PubMed, Sociological Abstracts and the Social Sciences Citation Index. Publication period was not limited. The second and the last author screened all 10,392 hits independently with both reviewers being blinded. Interrater reliability (agreement and Cohen's kappa) was 97%/0.73 for the selection of titles, 91%/0.83 for abstracts and 91%/0.80 for full texts. RESULTS Results of 43 included studies, published between 2001 and 2017, show that children and adolescents consuming soft drinks tend to be older, male and of lower social status. Important contextual factors promoting consumption include constant availability at home, at schools or elsewhere as well as restrictions by parents and rules concerning drinks during meals or generally at home. The association between media consumption and soft drink consumption is particularly striking. Other factors in the food environment (choice of food and alternative drinks at home, having meals together, motivation, knowledge about nutrition and healthy eating) are of minor importance. CONCLUSIONS When introducing interventions parents should play a major role because they serve as physical and social gatekeepers for this early risk factor of juvenile obesity.
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Affiliation(s)
- Sven Schneider
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Laura Schilling
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nina Osenbrügge
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Smirk E, Mazahery H, Conlon CA, Beck KL, Gammon C, Mugridge O, von Hurst PR. Sugar-sweetened beverages consumption among New Zealand children aged 8-12 years: a cross sectional study of sources and associates/correlates of consumption. BMC Public Health 2021; 21:2277. [PMID: 34903202 PMCID: PMC8670206 DOI: 10.1186/s12889-021-12345-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background The benefit of reducing sugar-sweetened beverage (SSB) consumption is widely accepted, but updated and in-depth data on New Zealand (NZ) children’s SSB consumption is lacking. The aims of this study were to describe beverage consumption, focusing on SSBs in primary school age children living in Auckland; to examine the association of selected socio-demographic, home, community and school factors and children’s beverage knowledge/attitudes with regards to beverage consumption; to explore the relationship between SSBs consumption and adiposity in children. Methods A cross-sectional, Auckland-wide survey of 578 school age children (8-12 years) was conducted using questionnaires to collect data on beverage consumption, beverage knowledge/attitudes, and selected socio-demographic and home, community, school factors. Body fat percentage (BF%) was assessed using bioelectrical impedance (BIA). Results Ninety-six percent of children consumed ≥1 serving of SSBs a week; with ≥5 servings reported by 62% of children. Of all SSBs assessed, consumption of ≥1 serving of sugar sweetened milk-based beverages (85%, mainly milk drinks made from powder) was most prevalent, followed by fruit juice (46%) and sugar-containing carbonated drinks (39%, mainly soft/fizzy drinks). Among unsweetened beverages, plain water was reported to be consumed < 2 times a day by 22% of children, and plain milk < 1 serving a day by 53%. Higher consumption of SSBs was associated with socio-economic disadvantage, non-NZ European ethnicities (Māori, Pacific, Asian, others), availability of SSBs in the home, frequent takeaway/convenience shop visits, children’s incorrect perception of adequate SSBs consumption frequency, and higher BF% (females only). School health policy and encouragement of children to consume un-sweetened beverages was not associated with SSBs consumption. Conclusions The consumption of SSBs is prevalent in NZ school age children, with higher consumption rates observed among those from socially disadvantaged areas. This high consumption is associated with higher BF% in females. Multi-contextual interventions to decrease SSBs should target children, and their families/environment, particularly those from socially disadvantaged areas. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12345-9.
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Affiliation(s)
- Emma Smirk
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Hajar Mazahery
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Cheryl Gammon
- School of Health Sciences, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Owen Mugridge
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand.
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Beun RJ, Luiten C, Verbeek C, Poelman MP. A Rationale for a Gamified E-Coach Application to Decrease the Consumption of Sugar Sweetened Beverages. Front Digit Health 2021; 2:564529. [PMID: 34713037 PMCID: PMC8521872 DOI: 10.3389/fdgth.2020.564529] [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: 05/21/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022] Open
Abstract
The design and implementation of applications for behavior change should be preceded by careful analysis of the behavior change process and the target population. We, therefore, present on the basis of a blended research approach a rationale, opportunities and basic requirements for an application that offers a program for reducing intake of sugar sweetened beverages (SSB) by adolescents. This paper discusses the role of e-coaching and gamification as two high-touch design patterns in the behavior change process. Both design patterns aim at supporting the individual in a transformational journey from a current state toward a desired state where the detrimental behavior should be replaced by healthy alternative behavior. First, an elementary behavior scheme is introduced that frames three empirical studies. In the first study (plenary focus groups; n = 13), participants advised to include system recommendations for alternative healthy behavior, stressed the need for personalization of the e-coach and showed strong appreciation for the inclusion of gamification elements. The second study (online survey; n = 249) showed that SSB-intake is highly contextual and that reasons for (limiting) consumption SSB varies greatly between individuals, which the e-coach application should take into account. In a final small-scale pilot study (n = 27), we observed the potential of the inclusion of gamification elements, such as challenges and rewards, to increase compliance to the self-monitoring process of SSB consumption. Building upon these insights and prior studies, we argue that an e-coach mimics the collaborative practice of the program; its main task is to enrich the interaction with cooperative conversational experiences, in particular with respect to the alignment between user and system, motivational encouragement, personalized advice, and feedback about the activities. In addition, we outline that gamification not only has the potential to increase self-monitoring of the target behavior, user engagement, and commitment with the intervention program, but also enables a designer to shift long-term negative outcome of excessive intake in real life to short-term consequences in a virtual environment. In future larger follow-up studies, we advise to integrate the two design patterns within a social network of virtual and human agents that play a variety of competitive, normative and supportive roles.
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Affiliation(s)
- Robbert Jan Beun
- Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
| | - Claire Luiten
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, Netherlands
| | - Chris Verbeek
- Faculty of Science, Informatics Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
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Baranowski T, Thompson D, Hughes SO, O’Connor TM. Precision Food Parenting: A Proposed Conceptual Model and Research Agenda. Nutrients 2021; 13:3650. [PMID: 34684651 PMCID: PMC8538596 DOI: 10.3390/nu13103650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022] Open
Abstract
Precision medicine, nutrition and behavioral interventions are attempting to move beyond the specification of therapies applied to groups, since some people benefit, some do not and some are harmed by the same therapy. Instead, precision therapies are attempting to employ diverse sets of data to individualize or tailor interventions to optimize the benefits for the receiving individuals. The benefits to be achieved are mostly in the distant future, but the research needs to start now. While precision pediatric nutrition will combine diverse demographic, behavioral and biological variables to specify the optimal foods a child should eat to optimize health, precision food parenting will combine diverse parent and child psychosocial and related variables to identify the optimal parenting practices to help a specific child accept and consume the precision nutrition specified foods. This paper presents a conceptual overview and hypothetical model of factors we believe are needed to operationalize precision food parenting and a proposed research agenda to better understand the many specified relationships, how they change over the age of the child, and how to operationalize them to encourage food parenting practices most likely to be effective at promoting healthy child food choices.
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Affiliation(s)
- Tom Baranowski
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (D.T.); (S.O.H.); (T.M.O.)
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Karssen LT, Vink JM, de Weerth C, Hermans RCJ, de Kort CPM, Kremers SP, Ruiter ELM, Larsen JK. An App-Based Parenting Program to Promote Healthy Energy Balance-Related Parenting Practices to Prevent Childhood Obesity: Protocol Using the Intervention Mapping Framework. JMIR Form Res 2021; 5:e24802. [PMID: 33988510 PMCID: PMC8164123 DOI: 10.2196/24802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/02/2021] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The family environment plays an important role in the development of children's energy balance-related behaviors. As a result, parents' energy balance-related parenting practices are important targets of preventive childhood obesity programs. Families with a lower socioeconomic position (SEP) may benefit from participating in such programs but are generally less well reached than families with a higher SEP. OBJECTIVE This paper describes the application of the Intervention Mapping Protocol (IMP) for the development of an app-based preventive intervention program to promote healthy energy balance-related parenting practices among parents of children (aged 0-4 years) with a lower SEP. METHODS The 6 steps of the IMP were used as a theory- and evidence-based framework to guide the development of an app-based preventive intervention program. RESULTS In step 1, behavioral outcomes for the app-based program (ie, children have a healthy dietary intake, sufficient sleep, and restricted screen time and sufficient physical activity) and sociocognitive (ie, knowledge, attitudes, and self-efficacy) and automatic (ie, habitual behaviors) determinants of energy balance-related parenting were identified through a needs assessment. In step 2, the behavioral outcomes were translated into performance objectives. To influence these objectives, in step 3, theory-based intervention methods were selected for each of the determinants. In step 4, the knowledge derived from the previous steps allowed for the development of the app-based program Samen Happie! through a process of continuous cocreation with parents and health professionals. In step 5, community health services were identified as potential adopters for the app. Finally, in step 6, 2 randomized controlled trials were designed to evaluate the process and effects of the app among Dutch parents of infants (trial 1) and preschoolers (trial 2). These trials were completed in November 2019 (trial 1) and February 2020 (trial 2). CONCLUSIONS The IMP allowed for the effective development of the app-based parenting program Samen Happie! to promote healthy energy balance-related parenting practices among parents of infants and preschoolers. Through the integration of theory, empirical evidence, and data from the target population, as well as the process of continued cocreation, the program specifically addresses parents with a lower SEP. This increases the potential of the program to prevent the development of obesity in early childhood among families with a lower SEP. TRIAL REGISTRATION Netherlands Trial Register NL6727, https://www.trialregister.nl/trial/6727; Netherlands Trial Register NL7371, https://www.trialregister.nl/trial/7371.
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Affiliation(s)
- Levie T Karssen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Jacqueline M Vink
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Carolina de Weerth
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Roel C J Hermans
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
- Netherlands Nutrition Centre, The Hague, Netherlands
| | - Carina P M de Kort
- Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Stef Pj Kremers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
| | - Emilie L M Ruiter
- Academic Collaborative Centre AMPHI, Primary and Community Care, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Junilla K Larsen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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11
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Han JW, Kim DJ. Prediction model study of overweight and obesity in preschool children with allergic diseases from an ecological perspective. BMC Pediatr 2021; 21:53. [PMID: 33494733 PMCID: PMC7831245 DOI: 10.1186/s12887-021-02515-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/20/2021] [Indexed: 11/17/2022] Open
Abstract
Background Allergic diseases have a high incidence in childhood and a high chance to be carried over into adulthood unless appropriately treated during childhood, it is important that healthcare providers actively manage these diseases. This study was to identify multidimensional factors that affect weight gain in preschool children with allergic diseases. Methods The overweight and obesity prediction model for children with allergic diseases was analyzed using multiple logistic regression analysis and a decision tree model and the present study was a secondary data analysis study that used data from the Panel Study on Korean Children conducted by the Korea Institute of Child Care and Education. Results The significance of this study is identify multidimensional factors that affect weight gain in preschool children with allergic diseases, which found that children (gender, sitting time during weekdays, sleeping hours during weekends,), parent (education level, mother’s job, quality of the home environment), local community (convenience of local community facilities, satisfaction level with local community facilities, quality of childcare in the local community) characteristics affected overweight and obesity at multidimensional levels as risk factors. Conclusions The significance of this study is identify multidimensional factors that affect weight gain in preschool children with allergic diseases using the data of the Panel Study on Korean Children, which found that children, parent, local community characteristics affected overweight and obesity at multidimensional levels as risk factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02515-4.
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Affiliation(s)
- Jeong-Won Han
- College of Nursing Science, Kyung Hee University, 26, Kyunghee-daero, Dongdaemun-gu, Seoul, 02453, South Korea.
| | - Da-Jung Kim
- College of Nursing Science, Kyung Hee University, 26, Kyunghee-daero, Dongdaemun-gu, Seoul, 02453, South Korea
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12
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Wang Z, Jansen EC, Miller AL, Peterson KE, Téllez-Rojo MM, Watkins D, Schnaas L, Chavez MDCH, Cantoral A. Childhood emotional and behavioral characteristics are associated with soda intake: A prospective study in Mexico City. Pediatr Obes 2020; 15:e12682. [PMID: 32558284 PMCID: PMC8570088 DOI: 10.1111/ijpo.12682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 04/18/2020] [Accepted: 05/08/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate whether childhood emotional and behavioral characteristics are associated with soda intake. METHODS The study population included 391 Mexico City adolescents enrolled in a birth cohort study. When children were between 6 and 12 years of age, the Behavioral Assessment System for Children (BASC)-2 was administered. Nondiet soda intake was measured concurrently and again when participants were of peripubertal ages via food frequency questionnaire. Linear regression models were run with soda mL/day (cross-sectional and change in soda over time) as the outcome and BASC composite scores as predictors (in separate models), adjusting for confounders. RESULTS At baseline, children were 8.3 (SD 1.3) years (49% males). Three scales out of 18 examined had statistically significant associations. Parent-reported adaptive skills were inversely associated with concurrent soda intake (β = -2.29 with 95% CI -4.27 to -0.31). Parent-reported internalizing problems (higher = more problems) were related to higher change in soda intake from childhood to adolescence (β = 5.83 with 95% CI 0.98-10.68; N = 191). Self-reported school problems were associated with a higher change in soda intake over time (β = 9.46 with 95% CI 2.10-16.82; N = 122). CONCLUSIONS Parent- and self-reported emotional and behavioral difficulties in childhood were associated with soda consumption and changes in soda consumption over time.
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Affiliation(s)
- Zeyuan Wang
- Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA,Contributed equally to this work
| | - Erica C. Jansen
- Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA,Contributed equally to this work
| | - Alison L. Miller
- Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Karen E. Peterson
- Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Deborah Watkins
- Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Lourdes Schnaas
- Institute of Perinatology, ABC Hospital, Mexico City, Mexico
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13
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[The importance of water consumption in health and disease prevention: the current situation]. NUTR HOSP 2020; 37:1072-1086. [PMID: 32960634 DOI: 10.20960/nh.03160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Water is an essential nutrient for life and the most abundant component in the human body. However, its dietary recommendations or clinical management guidelines do not receive as much attention as they deserve. In addition, there are some obstacles to establishing optimal values, both for the amount of water the body must contain and for water ingestion. Water intake and elimination depend on unsteady factors that are difficult to measure and, at the same time, compensated by the body's ability to regulate homeostasis. Since scientific evidence is lacking for establishing recommendations, "adequate intakes" (to maintain an adequate hydration state) have been estimated using data on water intake from groups of healthy people. The European Food Safety Authority (EFSA) also considers desirable the use of urine osmolarity to estimate the adequacy of water intake in adults. Clinical studies have generally shown the benefits of adequate hydration and the damage caused by water imbalance, whether quantitative (dehydration and overhydration) or qualitative (extracellular and intracellular water). Unfortunately, these studies are few and often have poor cross-sectional, case-control, or prospective designs, and use small samples or indirect methods to assess hydration status. This article presents up-to-date information on subjects such as: 1) compliance with water consumption recommendations and suggestions for improvement; 2) techniques available to measure hydration status and their clinical applications; 3) effects of hydration/dehydration on physical or cognitive activities and chronic diseases; and 4) existing Spanish regulations on the quality and salubrity of water.
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14
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Røed M, Vik FN, Hillesund ER, Lippevelde WV, Øverby NC. Associations between parental food choice motives, health-promoting feeding practices, and infants' fruit and vegetable intakes: the Food4toddlers study. Food Nutr Res 2020; 64:3730. [PMID: 33240032 PMCID: PMC7672479 DOI: 10.29219/fnr.v64.3730] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022] Open
Abstract
Background Parents influence their infants’ diets and are the providers of healthy foods such as fruit and vegetables. Parental motives can influence infant’s diets directly or through parental feeding practices. Objective This study aimed to assess the associations between parental food choice motives and infants’ fruit and vegetable intakes and to examine whether parental feeding practices mediated these associations. Design A total of 298 parents participated in the Norwegian Food4toddlers study. Before the child’s first birthday (mean age = 10.9 months), the parents completed an online baseline questionnaire. Five parental food choice motives were assessed: health, convenience, sensory appeal, price, and familiarity. Infants’ fruit and vegetable intakes and three health-promoting feeding practices were also assessed. For each food choice motive and its relation to fruit or vegetable intake, three single mediation models were conducted. Mediation effects were examined using MacKinnon’s product of coefficients procedure, and bootstrap confidence intervals (CIs) were used for inferential testing. Results Higher scores on the motive of health were positively associated with infants’ vegetable intake (τ = 0.394, P < 0.001). No other significant associations were found between food choice motives and fruit or vegetable intake. The feeding practice of shaping a healthy environment mediated the relationships between health motive and both fruit (αβ = 0.067, CI: 0.001–0.146) and vegetable (αβ = 0.105, CI: 0.042–0.186) intakes. The feeding practice of encouraging balance and variety mediated the relationships between health motive and vegetable (αβ = 0.085, CI: 0.030–0.150) intake and between sensory appeal motive and vegetable intake (αβ = 0.047, CI: 0.005–0.103). Conclusion High levels of parental health motive are associated with higher infant vegetable intake. Our study contributes to understand the structure of parental feeding behaviors that may have implication for nutrition interventions targeting parents.
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Affiliation(s)
- Margrethe Røed
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway
| | - Wendy Van Lippevelde
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway.,Department of Marketing, Innovation and Organisation, Faculty of Economics & Business administration, Ghent University, Tweekerkenstraat 2, 9000 Ghent, Belgium
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway
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Mekonnen T, Havdal HH, Lien N, O'Halloran SA, Arah OA, Papadopoulou E, Gebremariam MK. Mediators of socioeconomic inequalities in dietary behaviours among youth: A systematic review. Obes Rev 2020; 21:e13016. [PMID: 32162413 DOI: 10.1111/obr.13016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 02/02/2023]
Abstract
Children and adolescents with a lower socioeconomic position have poorer dietary behaviours compared to their counterparts with a higher socioeconomic position. A better understanding of the mechanisms behind such socioeconomic inequalities is vital to identify targets for interventions aimed at tackling these inequalities. This systematic review aimed to summarize existing evidence regarding the mediators of socioeconomic differences in dietary behaviours among youth. A systematic literature search of MEDLINE, Embase, PsycINFO, and Web of Science databases yielded 20 eligible studies. The dietary behaviours included in the reviewed studies were the intake of fruit and vegetables, sugar-sweetened beverages, unhealthy snacks/fast food and breakfast. The consistent mediators of the effects of socioeconomic position on dietary behaviours among youth were: self-efficacy, food preferences and knowledge at the intrapersonal level; and availability and accessibility of food items at home, food rules and parental modelling at the interpersonal level. Few studies including mediators at the organisational, community or policy levels were found. Our review found several modifiable factors at the intrapersonal and interpersonal levels that could be targeted in interventions aimed at combating inequalities in dietary behaviours among youth. Rigorous studies exploring organisational, community and policy level mediators are warranted.
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Affiliation(s)
- Teferi Mekonnen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Hanne Hennig Havdal
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Siobhan Anne O'Halloran
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Onyebuchi A Arah
- Department of Epidemiology and Department of Statistics, University of California, Los Angeles (UCLA), California, USA
| | - Eleni Papadopoulou
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Norway
| | - Mekdes Kebede Gebremariam
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
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The association of parenting practices with toddlers' dietary intake and BMI, and the moderating role of general parenting and child temperament. Public Health Nutr 2020; 23:2521-2529. [PMID: 32423508 PMCID: PMC7550897 DOI: 10.1017/s136898002000021x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: The objective was to examine the association between parenting practices, toddler’s dietary intake and BMI. In addition, potential moderation of these associations by general parenting and child temperament was examined. Design: The current cross-sectional study assessed parenting practices using the Comprehensive Feeding Practices Questionnaire, general parenting using the Comprehensive General Parenting Questionnaire, child temperament using the Child Behavior Check List, and children’s dietary intake through parental questionnaires. Children’s weight and length were objectively measured to determine BMI z-scores. Associations were examined using multiple linear regression analyses. Moderation was examined using interaction terms. Setting: Home setting. Participants: 393 Dutch toddlers (age 1–3 years) and their parents recruited through fifty childcare centres and preschools in the Netherlands. Results: Various practices were related to children’s diet and BMI. For instance, the availability of healthy foods is the most important predictor of healthy dietary intake (e.g. β = –0·35 for sweets; β = 0·18 for fruit). The association of availability with a healthier diet was strongest when parents scored low on the positive parenting style dimensions, including nurturance, structure and/or behavioural control. In addition, it seemed that a high availability of healthy foods and low availability of unhealthy foods is especially beneficial for children showing withdrawal/depressive, anxious or overactive behaviour, while encouraging balance and variety is not beneficial for these children. All other practices were related to children’s diet and/or BMI as well. Conclusions: The findings underline the importance of viewing the impact of parenting practices in the context of general parenting and child temperament.
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17
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Kininmonth AR, Smith AD, Llewellyn CH, Fildes A. Socioeconomic status and changes in appetite from toddlerhood to early childhood. Appetite 2020; 146:104517. [DOI: 10.1016/j.appet.2019.104517] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/14/2019] [Accepted: 11/13/2019] [Indexed: 12/12/2022]
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18
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Ray C, Kaukonen R, Lehto E, Vepsäläinen H, Sajaniemi N, Erkkola M, Roos E. Development of the DAGIS intervention study: a preschool-based family-involving study promoting preschoolers' energy balance-related behaviours and self-regulation skills. BMC Public Health 2019; 19:1670. [PMID: 31830926 PMCID: PMC6909522 DOI: 10.1186/s12889-019-7864-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Preschoolers’ energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health. Few preschool-based interventions aiming to promote preschoolers’ EBRBs and self-regulation skills, simultaneously reducing differences in EBRBs, due to children’s socio-economic status (SES) background, have been conducted. This study will present the Increased Health and Wellbeing in Preschools (DAGIS) intervention development process applying the Intervention Mapping (IM) framework. Methods The development of the DAGIS intervention study, a preschool level clustered randomized controlled trial (RCT), was based on the IM framework. The protocol in IM guides the development process of an intervention through six steps: needs assessment and logic model of the problem, programme outcomes and objectives, design of the programme, production, implementation plan, and evaluation plan. Results The needs assessment, part of the step 1 in IM, yielded the base for the DAGIS logic model of change. The model includes objectives related to changes in children’s EBRBs, self-regulation skills, and in psychosocial and physical environment that is determined by parents and early educators. A 22-week programme was developed, and materials for preschools and families were produced. A feasibility study of the recruitment processes, acceptability of the materials and methods, and implementation was conducted. The DAGIS intervention study was conducted September 2017–May 2018 as a clustered RCT including a comprehensive effectiveness and process evaluation. The process evaluation was run throughout the intervention targeting preschools and families. Conclusion A preschool-based family-involving programme was developed in the DAGIS intervention study by applying the IM protocol. It was a time- and resource-consuming process. However, the systematic planning, development, and running of the programme have reinforced a comprehensive evaluation, which is a strength in the intervention. The results from the evaluation will enhance the knowledge of how to promote EBRBs and self-regulation skills among preschoolers, and diminish SES differences in them. Trial registration ISRCTN57165350 (Prospectively registered January the 8th, 2015).
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Affiliation(s)
- Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland. .,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.
| | - Riikka Kaukonen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Elviira Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Teacher Education, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Nina Sajaniemi
- Department of Teacher Education, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland.,Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, P.O. Box 111, 80101 Joensuu, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.,Department of Public Health, Clinicum, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland
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19
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Van Stappen V, De Lepeleere S, Huys N, Latomme J, Verloigne M, Cardon G, Androutsos O, Manios Y, De Bourdeaudhuij I, De Craemer M. Effect of integrating a video intervention on parenting practices and related parental self-efficacy regarding health behaviours within the Feel4Diabetes-study in Belgian primary schoolchildren from vulnerable families: A cluster randomized trial. PLoS One 2019; 14:e0226131. [PMID: 31826024 PMCID: PMC6905545 DOI: 10.1371/journal.pone.0226131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/19/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study aimed to investigate the effect of integrating a video intervention "Movie Models" within the Feel4Diabetes-study on specific parenting practices and related parental self-efficacy regarding children's physical activity, screen-time and eating behaviour in vulnerable families (i.e. families living in low socioeconomic municipalities and at risk for developing type 2 diabetes). Additionally, there was examination of how the intervention was perceived by the parents. METHODS Within randomly selected low socioeconomic municipalities in Belgium, families were recruited through primary schools. Families at risk for developing type 2 diabetes were identified using the FINDRISC questionnaire (n = 457). Afterwards, the municipalities were randomly assigned to the intervention or control condition. At risk families assigned to the intervention group were invited to participate in six Feel4Diabetes counselling sessions in which families were encouraged to adopt a healthier lifestyle. The "Movie Models" videos were integrated within two sessions by using a face-to-face group discussion approach. Parenting-related factors were assessed before and after the integration of the videos, using a questionnaire. After integrating the videos, some extra evaluation questions were assessed. In total, 126 families were included in a per protocol evaluation and Repeated Measures ANOVAs were conducted to evaluate the potential intervention effects. RESULTS Some favourable intervention effects were found on parenting practices and related parental self-efficacy regarding children's eating behaviours, however almost no effects were found on parenting-related factors regarding children's physical activity and screen-time. In total, 60.0% of the participants indicated that they applied tips regarding parenting practices and 52.0% indicated that discussions with other participants regarding the videos were useful for them. CONCLUSION The integration of "Movie Models" within the Feel4Diabetes-study was effective in improving some parenting-related factors regarding children's health behaviours, however most parenting-related factors could not be improved. The implementation of "Movie Models" as a face-to-face group discussion approach was relatively well received and may be a promising way to improve parenting-related factors in vulnerable families. TRIAL REGISTRATION ClinicalTrials.gov NCT02278809.
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Affiliation(s)
- Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | - Sara De Lepeleere
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Nele Huys
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Maïté Verloigne
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Kallithea, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Kallithea, Athens, Greece
| | | | - Marieke De Craemer
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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20
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Franse CB, Wang L, Constant F, Fries LR, Raat H. Factors associated with water consumption among children: a systematic review. Int J Behav Nutr Phys Act 2019; 16:64. [PMID: 31409359 PMCID: PMC6693220 DOI: 10.1186/s12966-019-0827-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 07/29/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Water is recommended as the main beverage for daily fluid intake. Previous systematic reviews have studied the consumption of sugar-sweetened beverages (SSBs) among children, but none have focused on water consumption. Insight into factors that are associated with children's water intake is needed to inform the development of interventions aimed at the promotion of water consumption. The objective of this review was therefore to summarize the current evidence on factors associated with water consumption among children aged 2 to 12 years. METHODS A systematic literature search in seven electronic databases was conducted in May, 2018 and retrieved 17,850 unique records. Two additional studies were identified by hand-searching references of included articles. Studies were selected if they had a cross-sectional or longitudinal study design, focused on children aged 2-12 years and published in an English language peer-reviewed journal. Participants from clinical populations, studies that included data of < 10 participants and non-human studies were excluded. RESULTS A total of 63 articles met inclusion criteria and were included in the analysis. We identified 76 factors that were investigated in these studies; 17/76 were investigated in a longitudinal study. There was evidence of positive associations between water consumption and child's self-efficacy, parental education level, parental self-efficacy, use of feeding practices such as restriction or encouraging healthy eating and study year. Evidence was inconsistent (< 60% of studies reported an association) for child's age, sex, BMI, consumption of SSBs and ethnic background of the parent. There was no evidence (≤33% of studies reported an association) of associations between consumption of milk or juice, parental emotional-, modelling- or instrumental feeding practices, eating school lunch or outside temperature and water consumption. The remaining 54 factors were investigated in fewer than three studies. CONCLUSIONS There is some evidence for an association between potentially modifiable parental and child-related factors and water consumption. However, most factors identified in this review were only studied by one or two studies and most studies were cross-sectional. More longitudinal research is necessary to investigate environmental, parental and child-related factors associated with water consumption that are currently under-studied and could further inform intervention strategies. TRIAL REGISTRATION PROSPERO ID# CRD42018093362 , registered May 22, 2018.
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Affiliation(s)
- Carmen B. Franse
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - L. Wang
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | | | - Lisa R. Fries
- Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
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Associations Between Socio-Economic Status and Child Health: Findings of a Large German Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050677. [PMID: 30813530 PMCID: PMC6427670 DOI: 10.3390/ijerph16050677] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/08/2019] [Accepted: 02/22/2019] [Indexed: 02/07/2023]
Abstract
The familial social background of a child can significantly impact their behavior and health. We investigated associations between socio-economic status (SES) and health parameters and behaviors in German children and adolescents. Data were collected between 2011 and 2018 in the framework of the LIFE Child study. Participants included 2998 children aged 3⁻18 years. SES was represented by an index combining information on parental education, occupation, and income. Associations between SES and health outcomes were estimated using linear and logistic regression analyses. In a moderator analysis, all associations were checked for interactions between SES and age or sex. A higher SES composite score was associated with better health (lower body mass index (β = -0.26), fewer behavioral difficulties (β = -0.18), higher quality of life (β = 0.21), fewer critical life events (odds ratio (OR) = 0.93); all p < 0.05) and a healthier lifestyle (healthier nutrition (β = 0.16), less excessive television use (OR = 0.87), less nicotine consumption (OR = 0.93), and more physical activity (OR = 1.18); all p < 0.05). However, SES was not associated with alcohol consumption (OR = 1.02) or sleep problems (β = -0.04). The strengths of the associations between SES and child health did not differ depending on SES indicator (education, occupation, income). The associations between SES and parent-reported behavioral difficulties and physical activity were stronger in older vs. younger children. In contrast, none of the observed associations were moderated by sex. This study highlights the strong association between socio-economic status and child health, even in modern Western societies.
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Ring-Dimitriou S, Freudenthaler T, Aistleitner V, Horvath G, Stallinger J, Dimitriou M, Ardelt-Gattinger E, Weghuber D. SALTO - Study Protocol and Rationale of a Community-Oriented Obesity Prevention Program in the Kindergarten. Obes Facts 2018; 11:234-246. [PMID: 29961050 PMCID: PMC6103335 DOI: 10.1159/000481139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/24/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The prevalence of early childhood overweight and obesity in Austria has reached average European levels of 20% in boys and 18% in girls. The rationale and study protocol of SALTO, Salzburg Together against Obesity will be presented, which is aimed to assist adults in increasing the rate of 4- to 6-year-old children with a healthy body weight. METHODS A controlled longitudinal sequential study design consisting of 14 intervention (IK) and 8 control (CK) kindergarten was used to investigate the effect of actions tailored for teachers and parents on BMI among 4- to 6-year-old children. The study launched in November 2014 was approved by the ethics committee of the University of Salzburg. RESULTS 681 children, 181 parents (119 mothers, 62 fathers) and 30 teachers were investigated until October 2016. Preliminary analyses revealed that more boys (19%) and fathers (60% IK, 43% CK) were overweight and obese than girls (16%) and mothers (19% IK, 20% CK). CONCLUSION The challenges faced by the SALTO staff in the implementation of health-promoting actions in the kindergarten are manifold. The Community-Oriented Core Setting (COCS) intervention approach will show whether the actions will reduce the percentage of obesity and be sustainable in the long term.
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Affiliation(s)
- Susanne Ring-Dimitriou
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
- *Assoc. Prof. Dr. Dr. Susanne Ring-Dimitriou, Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria, Schlossallee 49, 5400 Hallein, Austria,
| | - Thomas Freudenthaler
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
| | - Verena Aistleitner
- Salzburg Together against Obesity-SALTO, Project Management, Salzburg, Austria
| | - Gertrude Horvath
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
| | - Julia Stallinger
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
| | - Minas Dimitriou
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
| | | | - Daniel Weghuber
- Department of Paediatrics and Obesity Research Unit Salzburg, Paracelsus Medical University, Salzburg, Austria
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Määttä S, Kaukonen R, Vepsäläinen H, Lehto E, Ylönen A, Ray C, Erkkola M, Roos E. The mediating role of the home environment in relation to parental educational level and preschool children's screen time: a cross-sectional study. BMC Public Health 2017; 17:688. [PMID: 28865436 PMCID: PMC5581928 DOI: 10.1186/s12889-017-4694-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/22/2017] [Indexed: 01/24/2023] Open
Abstract
Background Previous studies suggest that preschoolers from low socioeconomic backgrounds engage in more screen time. Still, the factors in the social and physical home environment driving these differences in preschool children’s screen time are poorly understood. This study examines potential home environment mediators in the associations between parental educational level and preschoolers’ screen time. Methods A total of 864 children aged 3–6 years and their parents participated in a cross-sectional DAGIS study in 2015–2016. Parents recorded their children’s screen time in a diary (N = 823). For the analyses, the daily average screen time at home was calculated. Parental questionnaires (N = 808) assessed educational level and eight social and physical environment factors in the home (i.e., descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, parental attitude toward societal pressures for children’s screen time, access to screens at home, parental self-efficacy for limiting children’s screen time, satisfaction of children’s screen time, and rules for limiting children’s screen time). Parental education was grouped into low, middle, and high education. The associations were tested by conducting mediation analyses adjusted by season and children’s sex and age. The significant mediators in the single-mediator models were included in the final multiple-mediator models. Results Of the potential eight mediators, the following four had a significant indirect association: descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, and parental attitude toward societal pressures for children’s screen time. Parents with high education had lower descriptive norm and used fewer screens in front of children compared to parents with middle or low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Parents with high education placed greater importance on limiting children’s screen time and felt less societal pressures about children’s screen time compared to parents with low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Conclusions Our study recognized multiple modifiable mediators in the associations between parental education and preschool children’s screen time. When aiming to diminish socioeconomic status differences in preschool children’s screen time, the focus should be on parental role models, attitudes, and norm related to children’s screen time.
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Affiliation(s)
- Suvi Määttä
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland.
| | - Riikka Kaukonen
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| | - Elviira Lehto
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Anna Ylönen
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| | - Eva Roos
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland.,Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland.,Clinicum, Department of Public Health, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
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