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Tucker K, Ingram M, Doubleday K, Piper R, Sander A, Flores R, Martinez D, Carvajal S. Results From La Vida Buena (The Good Life): A Quasi-Experimental Intervention of a Community Health Worker-Led Family-Based Childhood Obesity Program for Latino Children 5-8 Years of Age on the U.S.-Mexico Border. Health Promot Pract 2023; 24:1196-1205. [PMID: 36468422 DOI: 10.1177/15248399221112691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of the 8-week, community health worker (CHW)-led La Vida Buena childhood obesity program among Latino children 5 to 8 years old in a rural county along the U.S.-Mexico border. METHODS This quasi-experimental study used a community-based participatory research approach to compare the effectiveness of the La Vida Buena (The Good Life) curriculum as compared with a single educational session. We took anthropomorphic measures and administered parent-reported nutrition and physical activity surveys at baseline, 3 months, and 6 months. The study took place between 2017 and 2020 in Santa Cruz County, Arizona. RESULTS Change in body mass index (BMI) z-score was negligible for both groups. The parent-reported behavior indicated a shift toward healthier family behaviors and environment in the intervention group. IMPLICATIONS FOR PRACTICE This study adds to the growing literature of CHW-led childhood obesity interventions. The engagement of the CHWs in all aspects of the intervention helped to facilitate important behavior changes. Future interventions should emphasize health and wellness rather than BMI z-score and include community, socioeconomic, and systems-level interventions to promote healthy environments.
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Affiliation(s)
- Kathryn Tucker
- The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Maia Ingram
- The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Kevin Doubleday
- The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Rosie Piper
- Mariposa Community Health Center, Nogales, AZ, USA
| | | | | | | | - Scott Carvajal
- The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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Martinez GM, Vega-López S, Ayers S, Gonzalvez A, Bruening M, Luna BV, Marsiglia FF. Associations between parent-adolescent health-related conversations and mealtime media use among Hispanic families. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2023:2024-19514-001. [PMID: 37870808 PMCID: PMC11035490 DOI: 10.1037/fsh0000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Whereas parents play an important role in shaping the home environment, it is unknown whether health-related parent-adolescent conversations may be associated with different health-promoting parenting practices, such as limiting adolescent mealtime media use in Hispanic families. METHOD For this cross-sectional analysis, Hispanic parents (n = 344; 40.4 ± 6.6 years; 89.2% female) of sixth- to eighth-grade adolescents self-reported the frequency of having health- or weight-related conversations with their adolescent child, and the frequency of adolescent mealtime media device use. Spearman's rank correlations were used to assess whether parent-adolescent health-related conversations are associated with mealtime media device use by adolescents. RESULTS Over 75% of parents reported having conversations about healthy eating and being physically active at least a few times per week. Fewer parents reported having frequent weight-related conversations. Frequency of mealtime media use was low, except for television/movie watching (only 30% of parents reported their child rarely/never watching television during family meals). Having conversations related to the adolescent weighing too much was correlated with the mealtime use of television (r = .207; p < .001), cellphones (r = .134; p = .018), and headphones for music listening (r = .145; p = .010). Conversations about exercising to lose weight were correlated with television/movie watching during mealtimes (r = .129; p = .035). DISCUSSION Findings suggest the co-occurrence of less health-promoting parenting behaviors, such as focusing on weight-related conversations and allowing the use of media devices during mealtimes. Focusing on health- rather than weight-related parent-adolescent conversations and implementing mealtime media use rules may have the potential to shape a home food environment which ultimately could improve an adolescent's overall health outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Gabriela M. Martinez
- College of Health Solutions, Arizona State University. 550 N 3rd St, Phoenix, AZ 85004, United States
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University. 550 N 3rd St, Phoenix, AZ 85004, United States
- Southwest Interdisciplinary Research Center, Arizona State University. 400 E. Van Buren St., Suite 800. Phoenix, AZ 85004, United States
| | - Stephanie Ayers
- Southwest Interdisciplinary Research Center, Arizona State University. 400 E. Van Buren St., Suite 800. Phoenix, AZ 85004, United States
| | - Anaid Gonzalvez
- Southwest Interdisciplinary Research Center, Arizona State University. 400 E. Van Buren St., Suite 800. Phoenix, AZ 85004, United States
| | - Meg Bruening
- College of Health Solutions, Arizona State University. 550 N 3rd St, Phoenix, AZ 85004, United States
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University. 110 Chandlee Lab, University Park, PA 16802
| | - Beatriz Vega Luna
- Southwest Interdisciplinary Research Center, Arizona State University. 400 E. Van Buren St., Suite 800. Phoenix, AZ 85004, United States
| | - Flavio F. Marsiglia
- Southwest Interdisciplinary Research Center, Arizona State University. 400 E. Van Buren St., Suite 800. Phoenix, AZ 85004, United States
- Global Center for Applied Health Research, Arizona State University. 411 N Central Ave, Ste 720, Phoenix, AZ 85004, United States
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Schneider-Worthington CR, Lauzon M, Berger PK, Goran MI, Salvy SJ. Complementary Feeding and Child Appetitive Traits in a Sample of Hispanic Mother-Child Dyads. J Acad Nutr Diet 2023; 123:1340-1350. [PMID: 36375769 PMCID: PMC10175514 DOI: 10.1016/j.jand.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Complementary feeding practices may contribute to toddler eating practices that affect weight outcomes. Studies are needed to understand the relationship between complementary feeding practices and toddler dietary self-regulation. OBJECTIVE This study tests the hypothesis that earlier complementary food introduction predicts toddler food responsiveness and emotional overeating (ie, tendency to overeat in response to food cues and emotions, respectively), and considers whether introduction of certain foods better predict toddler dietary self-regulation. DESIGN This study is a secondary analysis of data from a parent longitudinal birth cohort study on early growth/development among Hispanic mother-infant dyads. PARTICIPANTS/SETTING The analytic sample included 174 mother-child dyads recruited from maternity clinics affiliated with the University of Southern California in Los Angeles County. Recruitment and data collection were ongoing from July 2016 to April 2020. At 1-, 6-, 12-, and 24-months postpartum, mothers reported exclusive breastfeeding duration and age of complementary food introduction via questionnaire. MAIN OUTCOME MEASURES Child food responsiveness and emotional overeating scores calculated from the Child Eating Behavior Questionnaire at 12 and 24 months of age. STATISTICAL ANALYSES PERFORMED Separate linear mixed models with repeated measures were used to examine associations between age of complementary food introduction as a predictor of child food responsiveness or emotional overeating, controlling for infant sex, birth body mass index z score, duration of exclusive breastfeeding, and mother's body mass index. RESULTS In separate models, delaying complementary food introduction by 1 month was associated with a 6% reduction in food responsiveness (P = 0.007) and a 5% reduction in emotional overeating scores (P = 0.013). Fifty-eight unique combinations of complementary foods introduced first were found, precluding analyses to examine whether specific combinations were related to eating behavior outcomes due to sample size limitations. CONCLUSIONS Earlier complementary feeding was associated with higher food responsiveness and emotional overeating scores among Hispanic children. Future studies in larger samples are needed to characterize patterns of complementary food introduction and their influence on child self-regulation.
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Affiliation(s)
| | - Marie Lauzon
- Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California
| | - Paige K Berger
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael I Goran
- Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Department of Medicine, Cedars-Sinai Medical Center, West Hollywood, California
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MacKay M, Mathis S. School-Based Versus Family-Based Interventions for the Reversal and Prevention of Obesity Among Hispanic Youth: a Review of the Literature. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01701-7. [PMID: 37440109 DOI: 10.1007/s40615-023-01701-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/30/2023] [Accepted: 06/24/2023] [Indexed: 07/14/2023]
Abstract
Childhood obesity prevalence in the USA continues to rise and the Hispanic American population is disproportionately affected. Obesity prevalence among Hispanic youth is 26.2%, the highest prevalence of any minority or non-minority group of children. Prevalence of related conditions including type 2 diabetes, heart disease, and stroke also are increased among Hispanic Americans. Physicians and other providers commonly utilize body mass index (BMI) to estimate percentage of bodily fat and risk of adverse health outcomes. BMI has been shown to track from childhood to adulthood, demonstrating necessity for early intervention. Interventions targeting the prevention and reversal of obesity among children are categorized as school-based or family-based. Interventions vary but may involve strategies such as meetings to discuss health-related curriculum, augmentation of physical activity, and/or improvement of nutritional quality of food. The aim of this article is to review the current literature to determine whether family-based or school-based interventions are more successful in the prevention and reversal of obesity among Hispanic youth. We reviewed twenty-eight studies describing these interventions and included ten (four school-based and six family-based) in our in-depth analysis. Inclusion criteria required trials were conducted among adequate population sizes of Hispanic youth within the age range of interest, analyzed the primary outcome of interest, and took place after the year 2000. Family-based interventions typically involved small population sizes, were dependent upon parent adherence, and were rarely effective. School-based interventions were more commonly effective and involved larger population sizes, allowing for greater generalizability and greater impact of the intervention. Of five family or school-based interventions which successfully reduced BMI among this population, four included a component involving structured physical activity. School-based interventions involving augmentation of physical activity with minimal limitations of study execution demonstrated efficacy in the prevention and reversal of obesity among Hispanic children.
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Affiliation(s)
- Micaela MacKay
- The University of Texas Medical Branch, Galveston, TX, USA.
| | - Samuel Mathis
- The University of Texas Medical Branch, Galveston, TX, USA
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Berge JM, Fertig AR, Trofholz A, de Brito JN. Real-time predictors of food parenting practices and child eating behaviors in racially/ethnically diverse families. Int J Behav Nutr Phys Act 2023; 20:86. [PMID: 37434195 PMCID: PMC10337081 DOI: 10.1186/s12966-023-01476-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/01/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Prior research has shown associations between controlling food parenting practices (e.g., pressure-to-eat, restriction) and factors that increase risk for cardiovascular disease in children (e.g., low diet quality, obesity). This study aimed to examine associations between real-time parental stress and depressed mood, food parenting practices, and child eating behaviors in a longitudinal cohort study. METHODS Children ages 5-9 years and their families (n = 631) from six racial/ethnic groups (African American, Hispanic, Hmong, Native American, Somali/Ethiopian, White) were recruited for this study through primary care clinics in a large metromolitan area in the US (Minneapolis/St. Paul, MN) in 2016-2019. Ecological momentary assessment was carried out over seven days with parents at two time points, 18 months apart. Adjusted associations between morning stress and depressed mood of parents on food parenting practices and child eating behaviors at the evening meal were examined. Interactions tested whether food security, race/ethnicity and child sex moderated associations. RESULTS High levels of parental stress and depressed mood experienced earlier in the day were associated with controlling food parenting practices and child food fussiness at dinner the same night. Results were dependent on food security status, race/ethnicity, and child sex. CONCLUSIONS Health care professionals may want to consider, or continue, screening parents for stress, depression, and food insecurity during well-child visits and discuss the influence these factors may have on food parenting practices and child eating behaviors. Future research should use real-time interventions such as ecological momentary intervention to reduce parental stress and depressed mood to promote healthy food parenting practices and child eating behaviors.
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Affiliation(s)
- Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Room 425, Minneapolis, MN, 55414, USA.
| | - Angela R Fertig
- Humphrey School of Public Affairs, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Room 425, Minneapolis, MN, 55414, USA
| | - Junia N de Brito
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Room 425, Minneapolis, MN, 55414, USA
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Fortes JS, Pinto RM, de Souza RF, Godoy FR, da Cruz RS, de M e Silva D, Filho HPL, da Cruz AD, Minasi LB. The influence of six polymorphisms of uncoupling protein 3 (UCP3) gene and childhood obesity: a case-control study. BMC Pediatr 2023; 23:87. [PMID: 36810017 PMCID: PMC9942342 DOI: 10.1186/s12887-023-03905-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Obesity is defined as a multifactorial disease, marked by excessive accumulation of body fat, responsible for compromising the individual's health over the years. The energy balance is essential for the proper functioning of the body, as the individual needs to earn and spend energy in a compensatory way. Mitochondrial Uncoupling Proteins (UCP) help in energy expenditure through heat release and genetic polymorphisms could be responsible for reducing energy consumption to release heat and consequently generate an excessive accumulation of fat in the body. Thus, this study aimed to investigate the potential association between six UCP3 polymorphisms, that have not yet been represented in ClinVar®, and pediatric obesity susceptibility. METHODS A case-control study was conducted with 225 children from Central Brazil. The groups were subdivided into obese (123) and eutrophic (102) individuals. The polymorphisms rs15763, rs1685354, rs1800849, rs11235972, rs647126, and rs3781907 were determined by real-time Polymerase Chain Reaction (qPCR). RESULTS Biochemical and anthropometric evaluation of obese group showed higher levels of triglycerides, insulin resistance, and LDL-C and low level of HDL-C. Insulin resistance, age, sex, HDL-C, fasting glucose, triglyceride levels, and parents' BMI explained up to 50% of body mass deposition in the studied population. Additionally, obese mothers contribute 2 × more to the Z-BMI of their children than the fathers. The SNP rs647126 contributed to 20% to the risk of obesity in children and the SNP rs3781907 contribute to 10%. Mutant alleles of UCP3 increase the risk for triglycerides, total cholesterol, and HDL-C levels. The polymorphism rs3781907 is the only one that could not be a biomarker for obesity as the risk allele seem to be protective gains the increase in Z-BMI in our pediatric population. Haplotype analysis demonstrated two SNP blocks (rs15763, rs647126, and rs1685534) and (rs11235972 and rs1800849) that showed linkage disequilibrium, with LOD 76.3% and D' = 0.96 and LOD 57.4% and D' = 0.97, respectively. CONCLUSIONS The causality between UCP3 polymorphism and obesity were not detected. On the other hand, the studied polymorphism contributes to Z-BMI, HOMA-IR, triglycerides, total cholesterol, and HDL-C levels. Haplotypes are concordant with the obese phenotype and contribute minimally to the risk of obesity.
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Affiliation(s)
- Jakeline S. Fortes
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
- Genetics and Molecular Biology Graduate Program, Federal University of Goiás, Campus Samambaia, Goiânia, GO 74690-900 Brazil
| | - Renata M. Pinto
- Pediatrics Department, Federal University of Goiás, Câmpus Colemar Natal E Silva (Câmpus I), Rua 235, Setor Leste Universitário, Goiânia, GO Brazil
| | - Raissa F. de Souza
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
| | - Fernanda R. Godoy
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
- Genetics and Molecular Biology Graduate Program, Federal University of Goiás, Campus Samambaia, Goiânia, GO 74690-900 Brazil
| | - Raphael S. da Cruz
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
- Physiotherapy Undergraduate Course, Centro Universitário de Goiânia – UNICEUG, Goiânia, GO Brazil
| | - Daniela de M e Silva
- Genetics and Molecular Biology Graduate Program, Federal University of Goiás, Campus Samambaia, Goiânia, GO 74690-900 Brazil
| | | | - Aparecido D. da Cruz
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
- Genetics and Molecular Biology Graduate Program, Federal University of Goiás, Campus Samambaia, Goiânia, GO 74690-900 Brazil
- Human Cytogenetics and Molecular Genetics Laboratory/CRER, State Health Secretary of Goiás, Goiânia, GO Brazil
| | - Lysa B. Minasi
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
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Alemán JO, Almandoz JP, Frias JP, Galindo RJ. Obesity among Latinx people in the United States: A review. Obesity (Silver Spring) 2023; 31:329-337. [PMID: 36695058 PMCID: PMC9937439 DOI: 10.1002/oby.23638] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/11/2022] [Accepted: 10/27/2022] [Indexed: 01/26/2023]
Abstract
Obesity is a serious, chronic disease that is associated with a range of adiposity-based comorbidities, including cardiovascular disease, type 2 diabetes, and nonalcoholic fatty liver disease. In the United States, obesity is a public health crisis, affecting more than 40% of the population. Obesity disproportionately affects Latinx people, who have a higher prevalence of obesity and related comorbidities (such as cardiovascular disease, type 2 diabetes, and nonalcoholic fatty liver disease) compared with the general population. Many factors, including genetic predisposition, environmental factors, traditional calorie-dense Latinx diets, family dynamics, and differences in socioeconomic status, contribute to the increased prevalence and complexity of treating obesity in the Latinx population. Additionally, significant heterogeneity within the Latinx population and disparities in health care access and utilization between Latinx people and the general population add to the challenge of obesity management. Culturally tailored interventions have been successful for managing obesity and related comorbidities in Latinx people. Antiobesity medications and bariatric surgery are also important options for obesity treatment in Latinx people. As highlighted in this review, when managing obesity in the Latinx population, it is critical to consider the impact of genetic, dietary, cultural, and socioeconomic factors, in order to implement an individualized treatment strategy.
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Díaz Rios LK, Ontai LL, Shilts MK, Lanoue L, Townsend MS. Cross-Cultural Adaptation and Initial Validation of Mi Niño: A Tool to Measure Food-Related Parenting Practices of Spanish-Speaking Parents with Young Children. Curr Dev Nutr 2023; 7:100002. [PMID: 37180080 PMCID: PMC10111596 DOI: 10.1016/j.cdnut.2022.100002] [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: 02/08/2022] [Revised: 09/03/2022] [Accepted: 10/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background Accurate measurement of food-related parenting practices is necessary to inform related interventions and program evaluation. Valid tools reflect cultural attributes that affect household food environments and feeding practices. Simple, unidirectional language adaptation approaches are insufficient to capture these attributes in assessment tools. My Child at Mealtime (MCMT) is a 27-item, validated, visually enhanced self-assessment tool to measure food-related parenting practices of low-income English-speaking parents of preschoolers. Objectives The aim of this study was to describe the cross-cultural adaptation of MCMT into its Spanish version Mi Niño a la Hora the Comer (Mi Niño) and to establish its face validity, factor structure, and internal consistency. Methods MCMT was adapted into its Spanish version after an iterative process that triangulated cognitive interviews with verification of conceptual equivalence by content experts to establish face validity and semantic equivalence. The resulting tool underwent confirmatory factor analysis to determine whether internal consistency was equivalent across the 2 versions. Results Four rounds of cognitive interviews (n = 5, n = 6, n = 2, and n = 4, respectively) with Spanish-speaking women caregivers of children aged 3-5 y recruited from Head Start were conducted. Ten items were modified throughout the adaptation process. Modifications included improved clarity (6 items), comprehension (7 items), appropriateness (4 items), suitability (4 items), and usefulness (2 items) of text and/or accompanying visuals. Confirmatory factor analysis with a sample of Spanish-speaking caregivers (n = 243) resulted in 2 reliable factors representing "child-centered" (α = 0.82) and "parent-centered" (α = 0.87) food-related parenting practices. Conclusions Face validity, semantic equivalence, and internal consistency of Mi Niño were established. This tool can be used in community settings to inform program content and measure changes in food-related parenting practices of Spanish-speaking parents and assist in setting food-related parenting goals. The next steps include exploring the correspondence of Mi Nino with mealtime behaviors observed through video recording.
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Affiliation(s)
- L. Karina Díaz Rios
- Division of Agriculture and Natural Resources, University of California–Merced, Merced, CA, USA
| | - Lenna L. Ontai
- Department of Human Ecology, University of California–Davis, Davis, CA, USA
| | - Mical K. Shilts
- Department of Family and Consumer Sciences, California State University–Sacramento, Sacramento, CA, USA
| | - Louise Lanoue
- Department of Nutrition, University of California–Davis, Davis, CA, USA
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Martin CL, McMorris BJ, Eisenberg ME, Sieving RE, Porta CM, Mathiason MA, Espinoza SM, Cespedes YA, Fulkerson JA. Weight Status Among Minnesota Hispanic or Latino/a Youth: An Exploration of Protective Factors. Am J Health Promot 2023; 37:177-188. [PMID: 35968666 DOI: 10.1177/08901171221120912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Pediatric obesity disproportionately impacts Hispanic or Latino/a adolescents. Culturally appropriate family-based behavioral initiatives to improve weight status are warranted. The purpose of this research was to determine prevalence rates and identify protective factors associated with having overweight/obesity (body mass index ≥ 85th percentile) to inform Hispanic or Latino/a-targeted behavioral intervention development. DESIGN Secondary data analyses of a population-based statewide survey. SETTING Minnesota public high schools. PARTICIPANTS Male (n = 2,644) and female (n = 2,798) Hispanic or Latino/a 9th and 11th graders (N = 5,442). MEASURES Obesity-related behaviors (meeting fruit and vegetable [F&V] and physical activity [PA] recommendations), family caring, family country/region of origin, and weight status. ANALYSIS Stepwise logistic regression models (F&V, PA), stratified by biological sex, were used to identify protective factors of overweight/obesity. RESULTS The overall prevalence of meeting F&V and PA recommendations was 11.0% and 11.8%, respectively. Meeting F&V recommendations was not protective against overweight/obesity in either sex. Yet, males and females who met PA recommendations had significantly lower odds of having overweight/obesity (p < .05). In F&V and PA models, family caring was protective against overweight/obesity in females (p < .05), and family country/region of origin was protective against overweight/obesity in both sexes (p < .05). CONCLUSION Findings illustrate a need for obesity prevention initiatives for Hispanic or Latino/a youth. More research is needed to understand the protective nature of family caring and country/region of origin.
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Affiliation(s)
- Christie L Martin
- School of Nursing, 16123University of Minnesota, Minneapolis, MN, USA
| | | | - Marla E Eisenberg
- Department of Pediatrics, 12269University of Minnesota, Minneapolis, MN, USA
| | - Renee E Sieving
- School of Nursing, 16123University of Minnesota, Minneapolis, MN, USA
| | - Carolyn M Porta
- School of Nursing, 16123University of Minnesota, Minneapolis, MN, USA
| | | | - Sarah M Espinoza
- Department of Pediatrics, 12269University of Minnesota, Minneapolis, MN, USA
| | | | - Jayne A Fulkerson
- School of Nursing, 16123University of Minnesota, Minneapolis, MN, USA
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Leite RO, Pavia V, Kobayashi MA, Kyoung Lee T, Prado G, Messiah SE, St. George SM. The Effects of Parent-Adolescent Acculturation Gaps on Adolescent Lifestyle Behaviors: Moderating Role of Family Communication. JOURNAL OF LATINX PSYCHOLOGY 2023; 11:21-39. [PMID: 37519909 PMCID: PMC10374166 DOI: 10.1037/lat0000215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Objectives This study examined 1) associations between parent-adolescent acculturation gaps in Americanism and Hispanicism and adolescents' lifestyle behaviors (fruit and vegetable intake and physical activity), and 2) the moderating roles of adolescent- and parent-reported family communication on these associations. Methods Hispanic adolescents who have overweight or obesity (n=280; 52% female, 13.0±0.8 years old) and their parents (88% female, 44.9±6.5 years old) completed baseline measures on acculturation, family communication, weekly physical activity, and daily fruit and vegetable intake as part of their participation in a family-based health promotion efficacy trial. Acculturation gaps were calculated by taking the product of adolescent and parent scores for each subscale (Americanism and Hispanicism). We conducted multiple linear regression analyses with three-way interaction terms (e.g., parent Americanism x adolescent Americanism x family communication) to assess for moderation. Results Family communication significantly moderated the association between parent-adolescent acculturation gaps in Americanism and adolescent fruit and vegetable intake. For families with low adolescent-reported family communication, parent-adolescent discrepancies in Americanism were associated with lower adolescent fruit and vegetable intake whereas there were no significant associations for families with high family communication. There were no effects on weekly minutes of physical activity. Acculturation gaps in Hispanicism were not significantly associated with either outcome. Conclusions Findings highlight the importance of parent-adolescent acculturation gaps and family communication on fruit and vegetable intake for Hispanic adolescents. Targeting parent-adolescent acculturation gaps for families with low levels of communication may be important to improve dietary behaviors in Hispanic adolescents, who are already disproportionately affected by obesity.
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Affiliation(s)
- Rafael O. Leite
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Vanina Pavia
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | | | - Tae Kyoung Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL
| | - Sarah E. Messiah
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX
- Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX
| | - Sara M. St. George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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Pfister F, Pozas C. The influence of Chile's food labeling and advertising law and other factors on dietary and physical activity behavior of elementary students in a peripheral region: a qualitative study. BMC Nutr 2023; 9:11. [PMID: 36631817 PMCID: PMC9832755 DOI: 10.1186/s40795-023-00671-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In 2016, Chile implemented the Food Labeling and Advertising Law to fight childhood obesity through front-of-package food labelling, marketing restrictions and school activities and programs. Nevertheless, little is known on its influence on key stakeholders in vulnerable peripheral regions of the country. This study aimed at identifying important influencing factors including the Food Labeling and Advertising Law on dietary habits and physical activity patterns of second graders in Chile, as perceived by school representatives and the children themselves. METHODS Semi-structured interviews with four school directors and 17 groups of three second graders, informal interviews with 9 key teachers and 4 food services staff complemented with documented observations were carried out in four primary schools of the Chilean city of Punta Arenas, in the Magallanes Punta Arenas region. The different sources allowed for triangulation of results. RESULTS FLAL seems to have a negligible influence on young children's diet and physical activity in the study region. Barriers are children's deeply rooted dietary habits, excessive screen-time, the parents' lacking problem awareness, limited time for parenting practices and bad role modeling. Environmental barriers are overloaded schools due to insufficient coordination between governmental entities, lacking funds for sound teacher training and unsafe neighborhoods limiting children's play. CONCLUSIONS Policy interventions aimed at reducing childhood obesity need to include and empower schools, families and local communities as active partners and consider their framework conditions for greater influence on dietary habits and physical activity.
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Affiliation(s)
- Franziska Pfister
- grid.424060.40000 0001 0688 6779School of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland
| | - Claudia Pozas
- grid.424060.40000 0001 0688 6779School of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland
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12
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Varela EG, McVay MA, Shelnutt KP, Mobley AR. The Determinants of Food Insecurity Among Hispanic/Latinx Households With Young Children: A Narrative Review. Adv Nutr 2023; 14:190-210. [PMID: 36811589 PMCID: PMC10103006 DOI: 10.1016/j.advnut.2022.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 12/01/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022] Open
Abstract
Food insecurity has disproportionately impacted Hispanic/Latinx households in the United States, specifically those with young children. Although the literature provides evidence of an association between food insecurity and adverse health outcomes in young children, minimal research has addressed the social determinants and related risk factors associated with food insecurity among Hispanic/Latinx households with children under three, a highly vulnerable population. Using the Socio-Ecological Model (SEM) as a framework, this narrative review identified factors associated with food insecurity among Hispanic/Latinx households with children under three. A literature search was conducted using PubMed and four additional search engines. Inclusion criteria consisted of articles published in English from November 1996 to May 2022 that examined food insecurity among Hispanic/Latinx households with children under three. Articles were excluded if conducted in settings other than the US and/or focused on refugees and temporary migrant workers. Data were extracted (i.e., objective, setting, population, study design, measures of food insecurity, results) from the final articles (n = 27). The strength of each article's evidence was also evaluated. Results identified individual factors (i.e., intergenerational poverty, education, acculturation, language, etc.), interpersonal factors (i.e., household composition, social support, cultural customs), organizational factors (i.e., interagency collaboration, organizational rules), community factors (i.e., food environment, stigma, etc.), and public policy/societal factors (i.e., nutrition assistance programs, benefit cliffs, etc.) associated with a food security status of this population. Overall, most articles were classified as "medium" or higher quality for the strength of evidence, and more frequently focused on individual or policy factors. Findings indicate the need for more research to include a focus on public policy/society factors, as well as on multiple levels of the SEM with considerations of how individual and policy levels intersect and to create or adapt nutrition-related and culturally appropriate interventions to improve food security of Hispanic/Latinx households with young children.
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Affiliation(s)
- Elder Garcia Varela
- Graduate Research and Teaching Assistant, Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Megan A McVay
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Karla P Shelnutt
- Department of Family, Youth & Community Sciences, University of Florida, Gainesville, FL, USA
| | - Amy R Mobley
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA.
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13
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Gilmore B, Reveles K, Frei CR. Electronic cigarette or vaping use among adolescents in the United States: A call for research and legislative action. Front Public Health 2022; 10:1088032. [PMID: 36530666 PMCID: PMC9752070 DOI: 10.3389/fpubh.2022.1088032] [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: 11/02/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
Vaping among adolescents is increasingly common and may result in poor health outcomes; however, little research has been conducted evaluating the risks of vaping among adolescents and the knowledge and perceptions that drive use. We must gain a better understanding of vaping outcomes and adolescents' perceptions while identifying potential ways to lessen or eradicate the health burdens associated with vaping. This knowledge could then inform robust educational and public health programs to prevent and mitigate vaping among youths. Health education incorporating a target populations' world view, spheres of influence, readiness, motivation, intention, and determination promotes informed decision making. There are few resources currently being allocated to the problem even though legislators and enforcement agencies are aware. We cannot simply rely on existing laws to serve as a sufficient deterrent to prevent underaged usage. Further efforts are needed in the areas of behavioral science, health education, and public policy to tackle this urgent public health concern.
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Affiliation(s)
- Bretton Gilmore
- Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, United States,Pharmacotherapy Education and Research Center, School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States,*Correspondence: Bretton Gilmore
| | - Kelly Reveles
- Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, United States,Pharmacotherapy Education and Research Center, School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Christopher R. Frei
- Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, United States,Pharmacotherapy Education and Research Center, School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States,Christopher R. Frei
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14
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Piombo SE, Huh J, Valente TW. Adolescent Body Mass Index and Exposure to Peers with Overweight and Obesity: A Structural Equation Model Approach to Longitudinal Network Data. Child Obes 2022; 18:445-453. [PMID: 35108122 PMCID: PMC9529305 DOI: 10.1089/chi.2021.0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: Considerable evidence has shown that social networks influence a wide variety of health behaviors. This study investigates whether having friends with overweight/obesity in one's social network (network exposure) can predict changes in body mass index (BMI) throughout high school in a diverse urban population of students. Methods: Racially and ethnically diverse students from five high schools in Los Angeles County were surveyed at four time points throughout high school from 2010 to 2013 (N = 2091). Surveys included questions on students' social networks, demographics, and health-related information. BMI and weight categories were calculated for all students who provided height and weight information (∼50%). A latent growth curve model was used to assess the growth trajectory of BMI and the time-varying effect of network exposure to friends with overweight/obesity while controlling for demographic covariates. Results: Hispanic students had a significantly higher initial BMI compared with non-Hispanic students (p < 0.01). There was a significant positive slope for time on BMI growth (p < 0.01). Greater personal network exposure to friends with overweight/obesity was associated with a significant 0.65-point average increase in BMI (p < 0.05) at the first follow-up time point (T2) and a significant 0.62-point average increase in BMI (p < 0.01) at the last follow-up (T4) while controlling for covariates. Conclusions: Using structural equation modeling to understand the relationship between BMI and social networks, we found that increased network exposure to peers with overweight/obesity is associated with higher individual BMI, demonstrating that friendships may influence adolescents' weight status over time.
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Affiliation(s)
- Sarah E. Piombo
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Thomas W. Valente
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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15
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Gray MJ, Vazquez CE, Agnihotri O. "Struggle at night - He doesn't let me sleep sometimes": a qualitative analysis of sleeping habits and routines of Hispanic toddlers at risk for obesity. BMC Pediatr 2022; 22:413. [PMID: 35831852 PMCID: PMC9277846 DOI: 10.1186/s12887-022-03434-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/15/2022] [Indexed: 11/21/2022] Open
Abstract
Background Hispanic children face disproportionately higher risks for early life obesity and resultant comorbidities such as Type 2 diabetes and fatty liver disease. Sleep habits are modifiable behaviors that impact early childhood obesity; Hispanic infants have been shown to have less nighttime sleep compared to their white counterparts. Pediatricians often coach families on parents’ nighttime responsive feeding and longer child sleep duration as protective factors against early life obesity, but must understand the family context and potential barriers. This study aimed to discover the sleeping habits and routines of Hispanic toddlers at risk for obesity through the perspective of their mothers. Methods This qualitative study used a phenomenological approach. 14 Hispanic mothers were recruited from a Federally Qualified Health Center in Central Texas for qualitative interviews regarding their experience raising a small child. Children aged 6 to 18 months with child weight-for-length ratio ≥ 85% for age were approached for study involvement and consented during well child visits. Interviews occurred over several months during 2018–2019; NVivo software was used for analysis of qualitative themes. Two reviewers coded and used constant comparative methods to identify common themes. Results Mothers diverged from AAP recommended guidelines for infant and toddler feeding and sleep habits. Mothers shared their intentions and the real-life barriers to implementing recommended habits. Mothers discussed wanting to have their child sleep in a separate bed or room but not having the resources (i.e., financial, space) to do so. Additionally, mothers discussed knowing not to feed to soothe at night but couldn’t bring themselves to let their child cry if they knew feeding would soothe them. Co-sleeping, feeding to sleep, middle of the night feeding, and lack of structured sleep habits were common interview themes and potentially modifiable factors. Conclusions Pediatricians need to be sensitive to culture and the real-world needs of families to determine if best practices are “practical.” Themes from these parent interviews can inform tailored interventions for children at high risk of obesity. Interventions should promote responsive nighttime feeding and structured sleep, working with individual family logistics, to coach families towards optimal healthy environments and healthy child weight.
Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03434-8.
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Affiliation(s)
- Megan J Gray
- Departments of Pediatrics and Department of Population Health, Dell Medical School, The University of Texas at Austin, 1601 Trinity St., Bldg B, Austin, TX, 78712, USA.
| | - Christian E Vazquez
- School of Social Work, The University of Texas at Arlington, 211 South Cooper Street, Box 19129, Arlington, TX, 76019, USA
| | - Ojasvie Agnihotri
- UT Health San Antonio Joe R. & Teresa Lozano Long School of Medicine, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
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16
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Denis F, Mahalli R, Delpierre A, Romagna C, Selimovic D, Renaud M. Psychobiological Factors in Global Health and Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116728. [PMID: 35682311 PMCID: PMC9180632 DOI: 10.3390/ijerph19116728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 05/28/2022] [Indexed: 02/01/2023]
Abstract
Psychobiological research is a systems approach that aims to integrate the biological, psychological and social systems that may influence health or pathology, particularly in chronic diseases and physical and/or psychiatric disorders. In this approach, we can expect to be able to deduce a ‘biological signature’ associated with particular symptom clusters. Similarly, psychosocial factors such as life events, health attitudes and behaviours, social support, psychological well-being, spirituality and personality are to be considered in terms of their influence on individual vulnerability to disease. At the psychophysiological level, it is important to understand, for example, the pathways that link the effects of chronic stress, social support and health, through the neuroendocrine and autonomic mechanisms that determine stress responses. At the macroscopic level, the role of individual socio-demographic variables such as personality, treatment modalities and health promotion through psycho-educational interventions needs to be explored.
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Affiliation(s)
- Frédéric Denis
- Department of Odontology, Tours University Hospital Center, 37000 Tours, France; (R.M.); (A.D.); (C.R.); (D.S.)
- Faculty of Dentistry, Nantes University, 44000 Nantes, France
- EA 75-05 Education, Ethics, Health, Faculty of Medicine, François-Rabelais University, 37000 Tours, France
- Correspondence:
| | - Rachid Mahalli
- Department of Odontology, Tours University Hospital Center, 37000 Tours, France; (R.M.); (A.D.); (C.R.); (D.S.)
- U1253, iBrain, CIC1415, Inserm, University Hospital Centre, Université de Tours, 37000 Tours, France
| | - Alexis Delpierre
- Department of Odontology, Tours University Hospital Center, 37000 Tours, France; (R.M.); (A.D.); (C.R.); (D.S.)
| | - Christine Romagna
- Department of Odontology, Tours University Hospital Center, 37000 Tours, France; (R.M.); (A.D.); (C.R.); (D.S.)
| | - Denis Selimovic
- Department of Odontology, Tours University Hospital Center, 37000 Tours, France; (R.M.); (A.D.); (C.R.); (D.S.)
| | - Matthieu Renaud
- Laboratory Bioengineering Nanosciences LBN, University of Montpellier, 34193 Montpellier, France;
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17
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Díaz EN, Le Q, Campos D, Reyes JM, Wright JA, Greaney ML, Lindsay AC. Central American Parents' Preferences for Content and Modality for a Family-Centered Intervention to Promote Healthful Energy Balance-Related Behaviors of Their Preschool-Age Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095080. [PMID: 35564475 PMCID: PMC9101972 DOI: 10.3390/ijerph19095080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
This formative research used a cross-sectional survey to assess interest in informational content and intervention modalities for the design of an early childhood obesity prevention intervention for Central American families from the Northern Triangle countries (El Salvador, Guatemala, and Honduras) living in the United States. A total of 74 parents (36 mothers, 38 fathers) with a mean age of 31.6 years (SD = 5.6) completed the survey; 59.5% of whom were born outside of the United States. Although most parents reported being very interested in receiving information related to the seven assessed energy balance-related behaviors, there were significant differences by parents’ gender and nativity. Most parents endorsed remote modalities for content delivery via text/SMS, WhatsApp, and e-mail. However, respondents were also receptive to in-person delivery provided by community health workers. There were also significant differences in parents’ preferences for intervention modalities by parents’ gender and nativity. Future steps should include investigating different intervention modalities and their integration into a linguistic and culturally sensitive family-based intervention to promote healthful energy balance-related behaviors of preschool-age children in Central American families originating from the Northern Triangle countries.
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Affiliation(s)
- Elizabeth N. Díaz
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA; (E.N.D.); (D.C.); (J.M.R.); (J.A.W.)
| | - Qun Le
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Daniel Campos
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA; (E.N.D.); (D.C.); (J.M.R.); (J.A.W.)
| | - Jesnny M. Reyes
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA; (E.N.D.); (D.C.); (J.M.R.); (J.A.W.)
| | - Julie A. Wright
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA; (E.N.D.); (D.C.); (J.M.R.); (J.A.W.)
| | - Mary L. Greaney
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA;
| | - Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA; (E.N.D.); (D.C.); (J.M.R.); (J.A.W.)
- Correspondence:
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18
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Gago CM, Jurkowski J, Beckerman-Hsu JP, Aftosmes-Tobio A, Figueroa R, Oddleifson C, Mattei J, Kenney EL, Haneuse S, Davison KK. Exploring a theory of change: Are increases in parental empowerment associated with healthier weight-related parenting practices? Soc Sci Med 2022; 296:114761. [PMID: 35123371 PMCID: PMC8894077 DOI: 10.1016/j.socscimed.2022.114761] [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: 08/04/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Parent health-related empowerment is defined as the process by which parents realize control over their life situation and take action to promote a healthier lifestyle. For decades, researchers have described the theoretical potential of empowerment in health promotion efforts, though few have empirically examined this hypothesized relationship. This study is one of the first to examine the relationship between parental empowerment and healthy weight parenting practices (i.e., food, physical activity, sleep, and media parenting), as a mechanism for early childhood health promotion in community settings. METHODS Low-income parents of preschool-aged children attending Head Start in Greater Boston between fall 2017 and spring 2019 were invited to complete a survey in the fall and spring of each academic school year (n = 578 with two surveys and n = 45 with four). Parental empowerment and healthy weight parenting practices were assessed using validated surveys. We used a multilevel difference-in-difference approach to estimate changes in healthy weight parenting practices score by changes in parental empowerment score. RESULTS Out of a possible score of four, the unadjusted mean (SD) score in fall was 3.20 (0.40) for empowerment and 3.01 (0.40) for parenting. An increase in parental empowerment was associated with an increase in healthier parenting practices (b = 0.14; 95% CI = 0.08, 0.20; p < 0.0001). CONCLUSIONS Parent empowerment may be an important target in interventions to prevent obesity in low-income children.
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Affiliation(s)
- Cristina M. Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Janine Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York, Albany, NY, 12222, USA
| | | | | | - Roger Figueroa
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, 14853, USA
| | - Carly Oddleifson
- School of Social Work, Boston College, Chestnut Hill, MA, 02467, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Erica L. Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
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19
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Nagata JM, Ganson KT, Iyer P, Chu J, Baker FC, Gabriel KP, Garber AK, Murray SB, Bibbins-Domingo K. Sociodemographic Correlates of Contemporary Screen Time Use among 9- and 10-Year-Old Children. J Pediatr 2022; 240:213-220.e2. [PMID: 34481807 PMCID: PMC9107378 DOI: 10.1016/j.jpeds.2021.08.077] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine sociodemographic correlates of contemporary screen time use among a diverse population-based sample of 9- and 10-year-old children. STUDY DESIGN In 2021, we analyzed cross-sectional baseline (2016-2018) data from the Adolescent Brain Cognitive Development study (n = 10 755). Multiple linear regression analyses were conducted to estimate associations between sociodemographic factors (sex, race/ethnicity, country of birth, household income, parental education) and 6 contemporary forms of screen time (television, videos [eg, YouTube], video games, social networking, texting, and video chat). RESULTS On average, children reported 3.99 hours of screen time per day across 6 modalities, with the most time spent watching/streaming television shows/movies (1.31 hours), playing video games (1.06 hours), and watching/streaming videos (1.05 hours). On average, Black children reported 1.58 more hours of screen time per day and Asian children reported 0.35 less hours of screen time per day compared with White children (mean 3.46 hours per day), and these trends persisted across most modalities. Boys reported higher overall screen time (0.75 hours more) than girls, which was primarily attributed to video games and videos. Girls reported more time texting, social networking, and video chatting than boys. Higher income was associated with lower screen time usage across all modalities except video chat. However, in high-income households, Latinx children reported 0.65 more hours of screen time per day than White children. CONCLUSIONS Given the sociodemographic differences in child screen use, guideline implementation strategies can focus on key populations, encourage targeted counseling by pediatricians, and adapt Family Media Use Plans for diverse backgrounds.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Puja Iyer
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jonathan Chu
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA,Department of Physiology, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrea K. Garber
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Stuart B. Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
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20
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Othman SI, Fertig A, Trofholz A, Berge JM. How time in the US and race/ethnicity shape food parenting practices and child diet quality. Appetite 2021; 171:105870. [PMID: 34973995 DOI: 10.1016/j.appet.2021.105870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 12/07/2021] [Accepted: 12/12/2021] [Indexed: 11/17/2022]
Abstract
Childhood obesity prevalence is high among children from immigrant/refugee households who live in high-income countries. Poor child dietary intake is a critical risk factor for elevated obesity prevalence and food parenting practices have been found to be associated with child dietary intake and eating behaviors. The main aim of this study was to examine the associations between migrants'/refugees' food parenting practices, the length of residence time in the US, race/ethnicity, and child diet quality. The current study included 577 families from three racial/ethnic groups that include mostly foreign-born parents (Latino, Hmong, and Somali/Ethiopian), and a comparison group of 239 non-Hispanic White families. Results showed that for Latino and Hmong parents, some food parenting practices varied by how long they had lived in the US. For example, more recently moved parents engaged in more non-directive (e.g., avoid buying sweets) practices compared with US-born parents. In contrast, Somali/Ethiopian parents engaged in different food parenting practices than White parents, regardless of time in the US. Results also showed that diet quality among Hmong children was lower if their parents were US-born compared to foreign-born. Future researchers may want to consider studying why some food parenting practices change when parents move to the US and explore whether there is a combination of food parenting practices that are most useful in promoting a healthful child's diet and weight among immigrant and refugee families.
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Affiliation(s)
- Sally I Othman
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA.
| | - Angela Fertig
- University of Minnesota, Humphrey School of Public Affairs, USA
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA
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21
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Lindsay AC, Caires T, Le Q, Nogueira DL, Tavares Machado MM, Greaney ML. Where Do Brazilian Immigrant Parents Obtain Information to Support the Healthful Energy Balance-related Behaviors of Their Preschool-age Children?: A Cross-sectional Study. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.2001775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Qun Le
- Rutgers University, the State University of New Jersey
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22
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Domogalla B, Ko LK, Jones R, Ali WB, Rodriguez E, Duggan C, Perry CK. Rural Latino parent and child physical activity patterns: family environment matters. BMC Public Health 2021; 21:2043. [PMID: 34749683 PMCID: PMC8577017 DOI: 10.1186/s12889-021-12085-w] [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: 03/16/2021] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Rural Latino children and adults are less active than urban and non-Latino counterparts. We examined physical activity (PA) patterns of rural Latino children and their parents, and explored parental beliefs about and reported barriers of Latino family physical activity. Latino families in a rural area in eastern Washington state, with children in grades 3–5 were included. Methods We used mixed methods. Children (n = 27) and parents (n = 25) wore an accelerometer for 5 days; parents (n = 31) participated in a semi-structured interview and completed a demographic survey. Parent and child activity levels were compared using paired t-tests; interviews were analyzed with qualitative content analysis. Results Although 100% children and 46% parents met physical activity guidelines, parents and children spent most of the day in sedentary behaviors. Parent-reported PA barriers included their long work hours, lack of transportation, and their child’s screen-time. Conclusion Addressing barriers and reducing sedentary time could increase PA of rural Latino families. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12085-w.
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Affiliation(s)
- Benjamin Domogalla
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA.
| | - Linda K Ko
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Health Services, University of Washington, Seattle, WA, USA
| | - Reo Jones
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Wafaa Bin Ali
- College of Nursing-Jeddah, King Saud Bin Abdulaziz University for Health Science, Jeddah, Saudi Arabia
| | - Edgar Rodriguez
- Therapeutic Products Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Catherine Duggan
- Department of Public Health, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Cynthia K Perry
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
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Hayba N, Shi Y, Allman-Farinelli M. Enabling Better Nutrition for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents. Nutrients 2021; 13:3918. [PMID: 34836174 PMCID: PMC8624745 DOI: 10.3390/nu13113918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
The unyielding obesity epidemic in adolescents from Middle Eastern (ME) backgrounds warrants culturally-responsive and co-designed prevention measures. This study aimed to capture the opinions of ME parents residing in Australia on the crisis and their enablers and barriers to healthy eating interventions given their influence on adolescent eating behaviors. Twenty-six semi-structured interviews were conducted with ME mothers, aged 35-59 years, and most residing in low socioeconomic areas (n = 19). A reflexive thematic analysis using the Capability, Opportunity, Motivation-Behaviour model and Theoretical Domain Framework was conducted. Parents expressed confidence in knowledge of importance of healthy eating, but were reluctant to believe behaviours were engaged in outside of parental influence. Time management skills are needed to support working mothers and to minimize reliance on nearby fast-food outlets, which was heightened during COVID-19 with home-delivery. Time constraints also meant breakfast skipping was common. A culture of feeding in light of diet acculturation and intergenerational trauma in this diaspora was also acknowledged. Parents pleaded for upstream policy changes across government and school bodies to support parental efforts in the form of increased regulation of fast-food and subsidization of healthy products. Opportunities for weight-inclusive programs including parenting workshops underpinned by culturally-responsive pedagogy were recommended.
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Affiliation(s)
- Nematullah Hayba
- Discipline of Nutrition and Dietetics, Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; (Y.S.); (M.A.-F.)
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Chatham RE, Mixer SJ. Cultural Influences on Healthy Weight Care in Karen Children. J Pediatr Nurs 2021; 60:207-214. [PMID: 34246068 DOI: 10.1016/j.pedn.2021.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/12/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Although the rates of childhood obesity are disproportionately higher in children of racial and ethnic minorities, research rarely addresses possible cultural factors. The purpose of this study was to discover cultural influences that contribute to or prevent childhood obesity from the perspectives of Burmese-American children and adolescents of Karen ethnicity in the southeast U.S. DESIGN AND METHODS The ethnonursing research method was used to seek perspectives of healthy weight care from Karen children between 8 and 15 years-of-age (n = 10). Karen parents (n = 5) and non-Karen community members (n = 13) were also interviewed. Data sources - interviews, fieldnotes, and observation notes - were analyzed using the four phases of the ethnonursing method. RESULTS Four themes important to healthy weight care in Karen children were discovered: views of a healthy child, food and food preparation, physical activity, and mutual support among family and community. These themes revealed both Karen and non-Karen influences. CONCLUSIONS Most Karen cultural influences promote healthy weight care in Karen children and adolescents which may protect them from childhood obesity. Lack of after-school transportation, limited space to play/exercise, and the sedentary tendencies of girls could limit healthy weight care. PRACTICE IMPLICATIONS Pediatric nurses may use knowledge gained from this study for promotion of healthy weight care in Karen families and to advocate for community changes which could benefit all children.
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Affiliation(s)
- Rebecca E Chatham
- College of Nursing, University of Tennessee-Knoxville, United States of America.
| | - Sandra J Mixer
- College of Nursing, University of Tennessee-Knoxville, United States of America
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Soltero EG, Peña A, Gonzalez V, Hernandez E, Mackey G, Callender C, Dave JM, Thompson D. Family-Based Obesity Prevention Interventions among Hispanic Children and Families: A Scoping Review. Nutrients 2021; 13:nu13082690. [PMID: 34444850 PMCID: PMC8402012 DOI: 10.3390/nu13082690] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 01/02/2023] Open
Abstract
This scoping review examined intervention and sample characteristics of family-based obesity prevention interventions among Hispanic youth. This review also examined the degree to which existing interventions were culturally-adapted, acknowledged social determinants of health (SDoH), and collaborated with community stakeholders. A comprehensive search across Medline Ovid, Embase, Scopus, PsycInfo, and Pubmed was used to identify 13 studies primarily based in the U.S. (92.3%). Data was extracted by two independent reviewers. Most used a randomized control trial design (69.2%), a behavior change theory (84.6%), and reported moderate to high (≥70%) retention (69.2%). Studies targeted improvements in physical activity (69.2%) and fruit and vegetable intake (92.3%) through nutrition education, cooking demonstrations, and tastings. Younger children from low socioeconomic backgrounds (61.5%) were well represented. Most interventions were culturally-adapted (69.2%), all studies reported collaboration with stakeholders, yet only half used strategies that acknowledged SDoH (46.2%). To increase our understanding of the underlying mechanisms by which family-based approaches can reach and engage Hispanic youth and families, future studies should rigorously evaluate theoretical constructs, family processes, and SDoH that influence program participation and health behaviors. This information will guide the design and development of future interventions aimed at reducing obesity disparities among Hispanic youth.
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Affiliation(s)
- Erica G. Soltero
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (E.G.S.); (E.H.); (G.M.); (C.C.); (J.M.D.)
| | - Armando Peña
- Center for Health Promotion and Disease Prevention, Arizona State University, 500 N. 3rd St., Phoenix, AZ 85004, USA;
| | - Veronica Gonzalez
- Health Promotion and Health Education, School of Public Health, University of Texas Health, 1200 Pressler St., Houston, TX 77030, USA;
| | - Edith Hernandez
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (E.G.S.); (E.H.); (G.M.); (C.C.); (J.M.D.)
| | - Guisela Mackey
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (E.G.S.); (E.H.); (G.M.); (C.C.); (J.M.D.)
| | - Chishinga Callender
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (E.G.S.); (E.H.); (G.M.); (C.C.); (J.M.D.)
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (E.G.S.); (E.H.); (G.M.); (C.C.); (J.M.D.)
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (E.G.S.); (E.H.); (G.M.); (C.C.); (J.M.D.)
- Correspondence: ; Tel.: +713-798-7076
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Telomeres: New players in immune-mediated inflammatory diseases? J Autoimmun 2021; 123:102699. [PMID: 34265700 DOI: 10.1016/j.jaut.2021.102699] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 12/21/2022]
Abstract
Telomeres are repetitive DNA sequences located at the ends of linear chromosomes that preserve the integrity and stability of the genome. Telomere dysfunctions due to short telomeres or altered telomere structures can ultimately lead to replicative cellular senescence and chromosomal instability, both mechanisms being hallmarks of ageing. Chronic inflammation, oxidative stress and finally telomere length (TL) dynamics have been shown to be involved in various age-related non-communicable diseases (NCDs). Immune-mediated inflammatory diseases (IMIDs), including affections such as inflammatory bowel disease, psoriasis, rheumatoid arthritis, spondyloarthritis and uveitis belong to this group of age-related NCDs. Although in recent years, we have witnessed the emergence of studies in the literature linking these IMIDs to TL dynamics, the causality between these diseases and telomere attrition is still unclear and controversial. In this review, we provide an overview of available studies on telomere dynamics and discuss the utility of TL measurements in immune-mediated inflammatory diseases.
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Perreira KM, Allen CD. The Health of Hispanic Children from Birth to Emerging Adulthood. THE ANNALS OF THE AMERICAN ACADEMY OF POLITICAL AND SOCIAL SCIENCE 2021; 696:200-222. [PMID: 37123537 PMCID: PMC10138030 DOI: 10.1177/00027162211048805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This article summarizes frameworks for understanding Hispanic children's health, sources of national data available to evaluate their health, and variations in health among Hispanic children. Following ecological and life-course perspectives, we organize our review of the literature on Hispanic children's health and development according to three key stages of child development (zero to three, early to middle childhood, and adolescence to emerging adulthood) with attention to how each stage influences the next. Within each stage, we consider how social position (i.e. skin color, social class, gender, and nativity), social contexts (i.e. family, school, and neighborhood), and political and legal contexts influence Hispanic children's health and development. To improve the health and development of Hispanic children, federal, state, and local policies must address social and economic injustices that lead to declines in health across immigrant generations and persistent racial/ethnic health disparities.
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Affiliation(s)
| | - Chenoa D Allen
- Department of Health Sciences, University of Missouri School of Health Professions
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28
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Sharma NP, Documėt PI, Gibbs BB, Taverno Ross SE. Generational Status, Language Use, Parental Limit Setting, and Screen Time in US Latinx Children. FAMILY & COMMUNITY HEALTH 2021; 44:146-153. [PMID: 32842001 DOI: 10.1097/fch.0000000000000272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Latinx children engage in excessive screen time and are disproportionately affected by obesity. We examined the effect of generational status and language use on screen time in 6- to 11-year-old Latinx children and whether parental limit setting mediated that relationship. Participants included 3127 children (aged 9.2 ± 2.0 years; 54% male) from the 2011-2012 National Survey of Children's Health. Spanish language use was associated with 14.0 more minutes per day of screen time (P = .038); parental limit setting partially mediated this relationship (11.4%). Future research should explore the protective role of parental limit setting in reducing screen time in Latinx children.
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Affiliation(s)
- Neil P Sharma
- Departments of Health and Human Development (Mr Sharma and Drs Gibbs and Taverno Ross) and Behavioral and Community Health Sciences (Dr Documėt), University of Pittsburgh, Pittsburgh, Pennsylvania
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Eanes LS, Huerta C, Fuentes LA, Bautista B. Nurse Practitioner Students' Perceptions on Delivering Culturally Congruent Care to Vulnerable Mexican Immigrants: A Qualitative Study. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:56-65. [PMID: 34132139 DOI: 10.1177/15404153211020417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increasingly, nurse practitioners serve as vanguards in providing primary health care to vulnerable Mexican immigrants. The aims of this study were to explore the lived experiences of nurse practitioner students in caring for Mexican immigrant patients and to capture their meaning of cultural influences deemed essential to the delivery of culturally congruent care. An exploratory descriptive design was employed. Purposive sampling was used to select 17 nurse practitioner students who volunteered to complete a semistructured face-to-face audio-taped interview and follow-up focus group discussion. Constant comparison was utilized to analyze data. From this process, four distinct themes emerged: Culturally congruent care extends beyond race and ethnicity, understands the importance of therapeutic communication, accepts complementary and alternative medical modalities, and recognizes the importance of eating patterns, food choices, and perceptions of ideal weight and health. These findings build on our understanding of key evidence-based cultural beliefs and practices that are important in delivering culturally congruent care to this subgroup.
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Affiliation(s)
- Linda S Eanes
- 12331The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Carolina Huerta
- School of Nursing, 12331The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | | | - Beatriz Bautista
- 12331The University of Texas Rio Grande Valley, Edinburg, TX, USA
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Perceptions of Family-Level Social Factors That Influence Health Behaviors in Latinx Adolescents and Young Adults at High Risk for Type 2 Diabetes. CHILDREN-BASEL 2021; 8:children8050406. [PMID: 34069897 PMCID: PMC8157582 DOI: 10.3390/children8050406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/30/2021] [Accepted: 05/15/2021] [Indexed: 11/29/2022]
Abstract
Given that health behaviors occur within the context of familial social relationships, a deeper understanding of social factors that influence health behaviors in Latinx families is needed to develop more effective diabetes prevention programming. This qualitative study identified perceived family-level social factors that influence health behaviors in Latinx adolescents (12–16 years; N = 16) and young adults (18–24 years; N = 15) with obesity and explored differences in perceptions across sex and age. Participants completed an in-depth interview that was recorded, transcribed, and coded using thematic content analysis. Emergent themes central to health behaviors included: perceived parental roles and responsibilities, perceived family social support for health behaviors, and familial social relationships. Mom’s role as primary caregiver and dad’s role as a hard worker were seen as barriers to engaging in health behaviors among adolescent females and young adults, males and females. Adolescents perceived receiving more support compared to young adults and males perceived receiving more support compared to females. Health behaviors in both age groups were shaped through early familial social interactions around physical activity. These insights suggest that traditional gender roles, social support, and social interaction around health behaviors are critical components for family-based diabetes prevention programs in high-risk Latinx youth and young adults.
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31
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Family Social Capital: Links to Weight-Related and Parenting Behaviors of Mothers with Young Children. Nutrients 2021; 13:nu13051428. [PMID: 33922656 PMCID: PMC8145036 DOI: 10.3390/nu13051428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 01/10/2023] Open
Abstract
Family social capital includes the social relationships, values, and norms shared by a family and is positively linked with children’s mental and physical health status. This cross-sectional study addresses a gap in the literature related to family social capital vis-à-vis weight-related behaviors and home environments of 557 mothers and their young children (ages 2 to 9 years). Mothers completed an online survey comprised of valid, reliable questionnaires assessing family relationships and weight-related behavioral and home environment measures. The measures that determined family social capital (i.e., supportive, engaged parenting behaviors; family cohesion; family conflict; and family meal frequency) yielded distinct tertile groups that differed significantly (p < 0.001) on every family social capital measure with large effect sizes. Analysis of variance with Tukey post-hoc test revealed greater family social capital was linked to significantly better maternal health, dietary intake, physical activity, and sleep behavior. Additionally, maternal modeling of healthy eating and physical activity, child feeding practices, and home environments was higher in groups with greater family social capital. Child mental and physical health, physical activity, and sleep quality were better in families with greater family social capital. Findings suggest greater family social capital is linked to healthier weight-related behaviors and home environments. Future intervention studies should incorporate strategies to build family social capital and compare longitudinal outcomes to traditional interventions to determine the relative value of family social capital on health behaviors.
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Lebron CN, Agosto Y, Guzman T, Sutton D, Stoutenberg M, Messiah SE, George SMS. A qualitative study of cognitive, behavioral, and environmental influences on Hispanic mothers' early childhood feeding practices. Appetite 2021; 164:105268. [PMID: 33864860 DOI: 10.1016/j.appet.2021.105268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/12/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
Young children's lifestyle behaviors are largely shaped by their parents. There are socioeconomic risk factors particular to Hispanic populations that influence the way parents feed their children. As obesity continues to be a public health issue with substantial inequities across race and ethnicity, it is critical to understand Hispanic parents' food choices and feeding practices. The objective of this qualitative study is to identify the behavioral, environmental, and cognitive factors that influence the parental food choices and feeding behaviors of Hispanic mothers of children ages 0-5 years. Snowball sampling was used to recruit participants from the community (n = 30) who were 1) female; 2) Hispanic; 3) over the age of 18; and 4) a mother to child(ren) between the ages zero and five. Each interview consisted of a brief demographic survey and a set of open-ended questions based on Social Cognitive Theory constructs. A thematic analysis using a combined deductive and inductive approach was used to analyze transcriptions. Results indicated that mothers' attitudes around breastfeeding were connected with their challenges, while their attitudes around solid foods were expressed in their feeding strategies. Mothers used strategies of modeling, repeated exposure, and practices of "sneaking" in healthy foods and bribing to promote healthy eating. Mothers were most likely to seek out information from (1) pediatricians, (2) female family members, and (3) the internet. Hispanic mothers actively seek out information from many different sources that impact how they feed their young children. Understanding their trusted sources and how it influences the SCT constructs is an important step in preventing early childhood obesity.
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Affiliation(s)
- Cynthia N Lebron
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.
| | - Yaray Agosto
- Florida International University, Robert Stempel College of Public Health & Social Work, Miami, FL, USA
| | - Tamisha Guzman
- Florida International University, Robert Stempel College of Public Health & Social Work, Miami, FL, USA
| | - Danielle Sutton
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mark Stoutenberg
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Sarah E Messiah
- University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas, TX, USA; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, TX, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Lilo EA, West A. "OMG, I Get Like 100 Teaspoons of Sugar a Day!" Rural Teens' Grasp of Their Beverage Consumption Habits. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 42:272684X211004928. [PMID: 33752544 DOI: 10.1177/0272684x211004928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As part of a campaign to encourage healthier beverage consumption in a rural New Mexico high school, we wanted to understand students' perceptions of their habits, and the associated health risks and benefits surrounding water and sugar-sweetened beverage consumption to influence future messaging to change behavior. We conducted a posthoc qualitative analysis of 27 student interviews from the program evaluation with both students who participated in the campaign and those who did not. Pre-campaign, students appeared largely unaware of the health risks posed by their beverage consumption habits, lacking any knowledge of nutritional recommendations, water recommendations, or of the sugar levels in products. When informed of the risks, students expressed concern for themselves, their family members, and friends, indicated a desire to make significant changes, and reported making changes for themselves, and educating others regarding the risks. Given the large amounts of money spent and concentrated efforts focused on marketing SSBs to teens, it is critically important to be educating teens and engaging them in behavior change strategies. These data can inform future strategies to improve teen health behaviors and encourage teens to become family health messengers for obesity and diabetes prevention.
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Affiliation(s)
- Emily A Lilo
- Department of Communication and Journalism, University of New Mexico, Albuquerque, New Mexico, United States
| | - Andrew West
- Department of Communication and Journalism, University of New Mexico, Albuquerque, New Mexico, United States
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Stern M, Soca Lozano S, Lescano C, Rodriguez C, Redwine L. Developing Adaptando Dieta Y Acción Para Todos (ADAPT): An Intervention to Improve Healthy Lifestyle Behaviors Among Latino Parents and Children Living in Rural Communities. J Immigr Minor Health 2021; 23:88-94. [PMID: 32533505 PMCID: PMC10576241 DOI: 10.1007/s10903-020-01037-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Latino migrant farmworkers are at great risk of obesity and its concomitant negative health impacts. Obesity interventions for this underserved, minority population are limited. We expanded upon our prior intervention work in childhood obesity to develop a multi-family, behavioral intervention, ADAPT. We conducted three phases in the development of the ADAPT program: Phase 1, a needs assessment, Phase 2, in-depth focus groups with Latino parents, their children, and stakeholders, and Phase 3, a feasibility and acceptability trial to inform program optimization. Acceptability and feasibility of ADAPT promoting healthier eating and physical activity behaviors was found. Each phase of the project led to implementation changes to ADAPT, resulting in greater intervention optimization. Participants reported key facilitators and barriers to our intervention, expressing great interest in participation. They particularly liked our mindfulness session. We are currently examining the feasibility of integrating mindfulness to optimize ADAPT efficacy.
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Affiliation(s)
- Marilyn Stern
- Department of Child and Family Studies, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 2510, Tampa, FL, 33612, USA.
| | | | - Celia Lescano
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA
| | | | - Laura Redwine
- College of Nursing, University of South Florida, Tampa, FL, USA
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Fernández-Ruiz VE, Solé-Agustí M, Armero-Barranco D, Cauli O. Weight Loss and Improvement of Metabolic Alterations in Overweight and Obese Children Through the I 2AO 2 Family Program: A Randomized Controlled Clinical Trial. Biol Res Nurs 2021; 23:488-503. [PMID: 33517762 DOI: 10.1177/1099800420987303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Childhood obesity is a major public health concern. We wanted to evaluate the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education to achieve weight loss and improve metabolic parameters in overweight and obese children. A randomized, controlled clinical trial with long-term follow-up (24 months) was conducted at a community care center in overweight and obese individuals aged 6-12 years. A sample of 108 children was divided into an experimental and a control group receiving a standard care program. The experimental groups received a 12-month interdisciplinary program; the results were evaluated at 4 months, the end of the intervention, and at follow-up 12 months later. Anthropometric and biological marker measurements related to metabolic alterations, dyslipidemia (based on total cholesterol), hyperglycemia, fasting glycaemia, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in blood were recorded. The intervention had a significant effect (p < 0.001) in terms of decreased body mass index, skinfolds, and waist and arm circumferences. These changes were accompanied by biochemical changes underlying an improvement in metabolic parameters, such as a significant reduction in total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and hyperglycemia and a significant increase in high-density lipoprotein-cholesterol. These effects were still significant for markers of excess weight or obesity in the experimental group 12 months after the end of the intervention, suggesting that an enduring change in healthy lifestyles had been maintained period. This interdisciplinary, nurse-led program helped to reduce childhood and adolescent excess weight and obesity and had long-lasting effects.
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Affiliation(s)
- Virginia E Fernández-Ruiz
- Department of Endocrinology and Nutrition, Virgen de la Arrixaca University Clinic Hospital Murcia, Spain.,Nursing Department, Faculty of Nursing, Calle Campus Universitario, 16751University of Murcia, Spain
| | | | - David Armero-Barranco
- Nursing Department, Faculty of Nursing, Calle Campus Universitario, 16751University of Murcia, Spain
| | - Omar Cauli
- Nursing Department, Faculty of Nursing and Podiatrics, 16781University of Valencia, Spain
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A qualitative study conducted in the United States exploring the perspectives of Brazilian immigrant fathers about their preschool-age children’s physical activity and screen time. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01411-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Shonkoff E, Folta SC, Fitopoulos T, Ramirez CN, Bluthenthal R, Pentz MA, Chou CP, Dunton GF. A positive deviance-based qualitative study of stress, coping, and feeding practices among low-income, Hispanic mothers whose children do versus do not meet guidelines for fruit and vegetable intake. HEALTH EDUCATION RESEARCH 2020; 35:584-604. [PMID: 33367771 PMCID: PMC8463094 DOI: 10.1093/her/cyaa037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 09/04/2020] [Indexed: 06/12/2023]
Abstract
Less than 1% of children in the United States concurrently meet guidelines for fruit/vegetable intake, physical activity, screen time, and sugar-sweetened beverages. Prior evidence suggests that parents of this 1% potentially cope with stress differently. This qualitative study used a positive deviance-based approach to locate mothers whose children avoided negative feeding outcomes despite being 'high-risk' for obesity. Semi-structured interviews were conducted in Spanish for two groups: low-income, Hispanic mothers whose children were normal weight and met recommendations for fruits/vegetables and physical activity (n = 5); and a comparison group whose children had obesity and did not meet guidelines (n = 8). Topics included weight-related parenting practices, attitudes toward health, and stress management. Interviews were transcribed, translated, and coded using NVivo for theoretically driven thematic analysis. Results suggested that mothers viewed stress differently. Mothers of healthy weight children believed stress could be prevented, such as by paying children more attention or directing one's attention away from stressors; comparison group mothers tended to report stress about managing their child's eating and about financial worries. Future research is needed to understand the underlying sources of these differences (e.g. personality traits, coping practices) and test whether stress prevention interventions can promote healthy parental feeding practices.
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Affiliation(s)
- Eleanor Shonkoff
- School of Health Sciences, Merrimack College, North Andover, MA 01845, USA
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Theodore Fitopoulos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Cynthia N Ramirez
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Ricky Bluthenthal
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Mary Ann Pentz
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Chih-Ping Chou
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
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Brazilian immigrant fathers' perspectives on child's eating and feeding practices: a qualitative study conducted in the United States. Public Health Nutr 2020; 23:3211-3225. [PMID: 32576301 DOI: 10.1017/s1368980020001123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Brazilians comprise a rapidly growing immigrant Latino group in the USA, yet little research has focused on health issues affecting Brazilian children in immigrant families. As increasing evidence is documenting fathers' influential role in their children's eating behaviours and ultimately weight status, the current study sought to explore the Brazilian immigrant fathers' perspectives and practices related to child's feeding practices and their preschool-aged children's eating. DESIGN Qualitative study using in-depth, semi-structured interviews. Interviews were conducted in Portuguese by native Brazilian research staff using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed thematically using a hybrid approach that incorporated deductive and inductive analytical approaches. SETTING Massachusetts. PARTICIPANTS Twenty-one Brazilian immigrant fathers who had at least one child aged 2-5 years. RESULTS Results revealed fathers' awareness of the importance of healthy eating for their children, their influence as role models and their involvement in feeding routines of their preschool-aged children. Moreover, fathers were receptive to participating in family interventions to promote their children's healthy eating. Nearly all fathers reported wanting to learn more and to do 'what's right' for their children. CONCLUSIONS The current study provides new information about Brazilian immigrant fathers' views about factors influencing their children's healthy eating behaviours and paternal feeding practices. Future research should quantify fathers' feeding styles and practices and solicit fathers' input in the design of culturally appropriate family interventions targeting the home environment of preschool-aged children of Brazilian immigrant families.
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Exploring the Provider-Level Socio-Demographic Determinants of Diet Quality of Preschool-Aged Children Attending Family Childcare Homes. Nutrients 2020; 12:nu12051368. [PMID: 32403299 PMCID: PMC7284878 DOI: 10.3390/nu12051368] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 01/12/2023] Open
Abstract
Since food preferences develop during early childhood and contribute to dietary patterns that can track into adulthood, it is critical to support healthy food environments in places where children spend significant amounts of time in, such as childcare. It is important to understand what factors influence the diet quality of children cared for in family childcare homes (FCCH). METHODS This study used baseline data from a cluster-randomized trial in FCCH, Healthy Start/Comienzos Sanos. Surveys capturing providers' socio-demographic characteristics were completed. Food and beverage consumptions were estimated using the Dietary Observation in Childcare protocol, and diet quality was calculated using the Healthy Eating Index (HEI)-2015. Comparison of mean HEI scores by provider socio-demographic variables were completed using ANOVAs, followed by multiple linear regression models for significant variables. Post-hoc ANOVA models compared mean HEI-2015 sub-components by income and ethnicity. RESULTS Significant differences in mean HEI-2015 scores were found for provider income level (less than $25,000, HEI: 64.8 vs. $25,001-$50,000: 62.9 vs. $75,001 or more: 56.2; p = 0.03), ethnicity (Non-Latinx: 56.6 vs. Latinx: 64.4; p = 0.002), language spoken outside of childcare (English: 58.6 vs. Spanish: 64.3, p = 0.005), and language spoken in childcare (English: 59.6 vs. Spanish: 64.4; p = 0.02). In linear regression models, a higher provider income ($75,001 or more) was negatively and significantly associated with the total HEI-2015 scores (β = -9.8, SE = 3.7; p = 0.009) vs. lower income (less than $25,000). When entering provider income and ethnicity to the same model, adjusting for Child and Adult Food Program (CACFP), only ethnicity was significant, with Latinx being positively associated with total HEI-2015 scores vs. non-Latinx (β = 6.5, SE = 2.4; p = 0.007). Statistically significant differences were found by ethnicity and language for greens/beans, total protein, and seafood and plant protein HEI-2015 component scores. DISCUSSION Lower income, and Latinx providers cared-for children had higher diet quality in FCCH compared to the other providers. Future studies should better understand what specific foods contribute to each of the HEI-2015 components in order to better tailor trainings and interventions.
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Vega-López S, Marsiglia FF, Ayers S, Williams LR, Bruening M, Gonzalvez A, Vega-Luna B, Perilla A, Harthun M, Shaibi GQ, Delgado F, Rosario C, Hartmann L. Methods and rationale to assess the efficacy of a parenting intervention targeting diet improvement and substance use prevention among Latinx adolescents. Contemp Clin Trials 2020; 89:105914. [PMID: 31843638 PMCID: PMC7242150 DOI: 10.1016/j.cct.2019.105914] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Abstract
Latinx adolescents are at higher risk for chronic diseases relative to adolescents of other ethnic groups, in part because of their lack of adherence to diet recommendations and their higher rates of substance use. Given the proximal influence of family factors during the developmental stage of adolescence, parenting interventions may be an effective way to promote healthy nutrition and substance use prevention simultaneously. This article describes the design and theoretical rationale of a study assessing the effects of Families Preparing the New Generation Plus (FPNG Plus), a 10-week culturally-tailored nutrition and substance use prevention parenting program, on diet and substance use outcomes among Latinx middle school students (6th-8th grade). The 3-arm cluster randomized controlled trial compares FPNG Plus (substance use prevention and healthy nutrition), FPNG (substance use prevention only), and a comparison condition (focusing on academic success) in 1494 parent-child dyads from 18 schools, randomized at the school level. Adolescents and parents will complete surveys pre- and post-intervention, and 16-weeks after program participation, regarding diet behaviors, substance use, and parenting practices. A random subsample of 126 dyads (42 from each program), will participate in additional data collection to assess the home food environment, detailed dietary intake (via two 24-h recalls), and provide biomarkers of cardiometabolic risk (blood pressure, total cholesterol and HbA1c). If successful, this study will provide evidence contributing to helping Latinx parents assist their adolescent children develop and maintain long-lasting positive lifestyle behaviors in order to prevent concurrent substance use and diet-related chronic diseases.
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Affiliation(s)
- Sonia Vega-López
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, United States of America; Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 201 North Central Avenue, 33rd Floor, Phoenix, AZ 85004, United States of America.
| | - Flavio F Marsiglia
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 201 North Central Avenue, 33rd Floor, Phoenix, AZ 85004, United States of America
| | - Stephanie Ayers
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 201 North Central Avenue, 33rd Floor, Phoenix, AZ 85004, United States of America
| | - Lela Rankin Williams
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 201 North Central Avenue, 33rd Floor, Phoenix, AZ 85004, United States of America
| | - Meg Bruening
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, United States of America
| | - Anaid Gonzalvez
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 201 North Central Avenue, 33rd Floor, Phoenix, AZ 85004, United States of America
| | - Beatriz Vega-Luna
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 201 North Central Avenue, 33rd Floor, Phoenix, AZ 85004, United States of America
| | - Alex Perilla
- American Dream Academy, Arizona State University, 542 E. Monroe Street, Suite D-100, Phoenix, AZ 85004, United States of America
| | - Mary Harthun
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 201 North Central Avenue, 33rd Floor, Phoenix, AZ 85004, United States of America
| | - Gabriel Q Shaibi
- Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, 201 North Central Avenue, 33rd Floor, Phoenix, AZ 85004, United States of America; College of Nursing and Health Innovation, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, United States of America
| | - Freddy Delgado
- American Dream Academy, Arizona State University, 542 E. Monroe Street, Suite D-100, Phoenix, AZ 85004, United States of America
| | - Christian Rosario
- American Dream Academy, Arizona State University, 542 E. Monroe Street, Suite D-100, Phoenix, AZ 85004, United States of America
| | - Leopoldo Hartmann
- College of Nursing and Health Innovation, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, United States of America
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Linville D, Mintz B, Martinez C, Gau JM, Shune S, Stice E. Preliminary Effects of Tailoring an Obesity Prevention Intervention Program for Latino Immigrant Families. FAMILY & COMMUNITY HEALTH 2020; 43:118-130. [PMID: 32079968 DOI: 10.1097/fch.0000000000000252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
An obesity preventive intervention program for preschool families, Healthy Balance, was tested in 2 sequential pilot trials. The first pilot tested the original and translated group intervention in a heterogeneous population (65 families), and the second tested the feasibility of a culturally adapted version for Latinx immigrant families (27 families). No significant study 1 intervention effects were found. However, in study 2, there were significant improvements in parent body mass index, neck circumference, and blood pressure. These studies suggest that targeting family system change and tailoring the intervention for Latinx immigrant populations is feasible and has the potential to improve obesity-related biomarkers.
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Affiliation(s)
- Deanna Linville
- University of Oregon, Eugene (Drs Linville, Martinez, and Shune and Ms Mintz and Mr Gau); and Oregon Research Institute, Eugene (Dr Stice)
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Innella N, Jameson BE. Interventions that impact weight status in Hispanic preschool children. Public Health Nurs 2019; 37:25-38. [PMID: 31633235 DOI: 10.1111/phn.12677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objectives of this systematic review of literature include: (a) describe the intervention strategies; (b) examine the outcomes as they pertain to the child (individual level), families (interpersonal level), and community or culture (organizational level); and (c) develop a foundation of interventional approaches that specifically target obesogenic behaviors in Hispanic preschool-aged children. DESIGN A systematic review of literature was performed. The theoretical framework was the Socioecological Model. SAMPLE Twenty-four total articles were used for this review. MEASUREMENTS The method used was the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Of the 24 studies reviewed, 36% focused on the individual, 56% were interpersonal (focused on parents), and 9% focused on the organizational level. CONCLUSION Interventions that are culturally competent, directed at families, and include healthy dietary intake along with a physical activity component are most effective at lowering obesity in Hispanic preschool children.
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Schuler BR, Fowler B, Rubio D, Kilby S, Wang Y, Hager ER, Black MM. Building Blocks for Healthy Children: Evaluation of a Child Care Center-Based Obesity Prevention Pilot Among Low-Income Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:958-966. [PMID: 31229396 PMCID: PMC6736706 DOI: 10.1016/j.jneb.2019.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To assess the impact of a multilevel nutrition intervention for low-income child care environments, staff, and center-enrolled children. DESIGN A cluster-randomized, controlled trial conducted among eligible centers. Staff and parent self-report surveys and objective field observations at baseline and follow-up were conducted. SETTING A total of 22 low-income child care centers (enrolling ≥ 25 2- to 5-year-old children). PARTICIPANTS Children aged 18-71 months; 408 children and 97 staff were randomized into intervention (208 children and 50 staff) and waitlist-control groups (200 children and 45 staff). Retention rates were high (87% for children and 93% for staff). INTERVENTION(S) A 6-session, 6-month director's child nutrition course with on-site technical support for center teachers. MAIN OUTCOME MEASURE(S) Center nutrition/physical activity environment; staff feeding styles, dietary patterns, and attitudes about food; child food preferences and dietary patterns. ANALYSIS Covariance regression analyses to assess the intervention effect, adjusting for clustering within centers. RESULTS Significant intervention effects were found for the center nutrition training/education environment (b = 3.01; P = .03), nutrition total scores (b = 1.29; P = .04), and staff-level prompting/encouraging feeding styles (b = 0.38; P = .04). No significant intervention effects were found for child-level measures. CONCLUSIONS AND IMPLICATIONS Curriculum-driven training and implementation support improved nutritional policies and practices and staff-child interactions during meals. Future research could extend the intervention to families and the evaluation to children's dietary behaviors and weight changes.
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Affiliation(s)
- Brittany R Schuler
- School of Social Work, College of Public Health, Temple University, Philadelphia, PA.
| | - Baylie Fowler
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Diana Rubio
- University of Minnesota Medical School, Twin Cities Campus, Twin Cities, MN
| | - Sarah Kilby
- Maryland State Department of Education, Baltimore, MD
| | - Yan Wang
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Erin R Hager
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD; Distinguished Fellow, RTI International, Research Triangle Park, NC
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Kakkad A, Chandler C, Coel M, Spann A, Struhar S, Wilkinson S, Crocker T. Partnering with Panama: Exploring Anthropometrics, Dietary Patterns, and the Built Food Environment of School-aged Children. Ecol Food Nutr 2019; 59:21-34. [PMID: 31430200 DOI: 10.1080/03670244.2019.1652821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Childhood obesity is a global public health concern in developed and developing countries. Approximately 3 in 10 Panamanian children suffer from obesity, and overweight/obesity is responsible for the highest number of premature or avoidable deaths in this country. A formative community assessment and exploration of the built food environment was conducted. Analysis suggests that almost one-third of the children measured were overweight or obese, and the availability of foods recommended for optimal health is limited in this community. Actionable recommendations for intervention and future collaboration were provided, and stakeholders from all groups will continue to explore opportunities.
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Affiliation(s)
- Astha Kakkad
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Chelsea Chandler
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Mikaela Coel
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Adeeba Spann
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Stacey Struhar
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Shannon Wilkinson
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Theresa Crocker
- College of Public Health, University of South Florida, Tampa, FL, USA
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Chatham RE, Mixer SJ. Cultural Influences on Childhood Obesity in Ethnic Minorities: A Qualitative Systematic Review. J Transcult Nurs 2019; 31:87-99. [PMID: 31423926 DOI: 10.1177/1043659619869428] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Introduction: Childhood obesity remains an unrelenting public health problem disproportionately affecting ethnic minorities. Although research has examined ethnicity as a factor of childhood obesity, few studies have examined cultural influences. The purpose of this systematic review was to examine the qualitative evidence of cultural influences on childhood obesity in ethnic minority groups. Methodology: Selective sampling of studies since 2008 yielded 251 articles. Twelve articles that addressed cultural influences on childhood obesity were identified for review. The Culture Care Theory Sunrise Enabler factors were used as an a priori framework for theme coding. Results: Nine themes emerged: child feeding, family, gender roles, food, healthy child appearance, physical activity, sedentary activity, food cost, and obesogenic environment. Discussion: Cultural care practices such as traditional foods and family meals are protective factors in childhood obesity and should be encouraged by nurses caring for and working with ethnic minority populations.
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Tucker KM, Ingram M, Doubleday K, Piper R, Carvajal SC. La Vida Buena (The Good Life) evaluation: a quasi experimental intervention of a community health worker-led family-based childhood obesity program for Latino children 5-8 years of age on the US-Mexico border. BMC Public Health 2019; 19:759. [PMID: 31200685 PMCID: PMC6570830 DOI: 10.1186/s12889-019-7081-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022] Open
Abstract
Background Due to multiple and interacting factors, Latino children are disproportionately at risk for overweight and obesity in the United States. Childhood obesity increases the risk for adverse physical and psychosocial outcomes throughout the lifespan. Intensive behavioral interventions recommended in primary care settings may not conform to current practices, and the most vulnerable populations are often unable to access these services. Community Health Workers (CHWs) offer a promising approach to bridging the gap between vulnerable communities and culturally competent services. La Vida Buena (The Good Life) is an 8-week family-focused intervention for Latino children 5–8 years old and their parents or caregivers who are patients at a Federally-Qualified Community Health Center (FQHC). It is a culturally and linguistically appropriate curriculum, facilitated by CHWs, that targets family behaviors to foster a healthy lifestyle in order to prevent and mitigate childhood overweight and obesity. Methods The primary objective is to test the effectiveness of the La Vida Buena (LVB) childhood obesity program among Latino children 5–8 years old and their families as compared with a single educational session. This study uses a parallel two-arm quasi-experimental design. The intervention group receives the 8-week La Vida Buena intervention and the comparison group receives a single educational session. The primary outcome is the change in the child’s BMI z-score from baseline to 6 months. Discussion The implementation and evaluation of La Vida Buena may inform research and practice for linking Latino patients in FQHCs to culturally responsive community-based childhood obesity interventions. It will also contribute to the literature about CHWs as facilitators of behavior change for families underserved by health services and preventive programs. La Vida Buena can serve as a culturally and linguistically appropriate early intervention curriculum that will foster a healthy home environment for childhood obesity mitigation and prevention. Trial registration The trial was retrospectively registered on December 18, 2018. The ClinicalTrials.gov Identifier is NCT03781856.
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Affiliation(s)
- Kathryn M Tucker
- University of Arizona Prevention Research Center, 1295 N Martin Ave, Tucson, AZ, USA.
| | - Maia Ingram
- University of Arizona Prevention Research Center, 1295 N Martin Ave, Tucson, AZ, USA
| | - Kevin Doubleday
- University of Arizona Prevention Research Center, 1295 N Martin Ave, Tucson, AZ, USA
| | - Rosie Piper
- Mariposa Community Health Center, 1710 N Mastick Way, Nogales, AZ, USA
| | - Scott C Carvajal
- University of Arizona Prevention Research Center, 1295 N Martin Ave, Tucson, AZ, USA
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LeCroy MN, Siega-Riz AM, Albrecht SS, Ward DS, Cai J, Perreira KM, Isasi CR, Mossavar-Rahmani Y, Gallo LC, Castañeda SF, Stevens J. Association of food parenting practice patterns with obesogenic dietary intake in Hispanic/Latino youth: Results from the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth). Appetite 2019; 140:277-287. [PMID: 31063792 DOI: 10.1016/j.appet.2019.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/10/2019] [Accepted: 05/03/2019] [Indexed: 12/26/2022]
Abstract
Some food parenting practices (FPPs) are associated with obesogenic dietary intake in non-Hispanic youth, but studies in Hispanics/Latinos are limited. We examined how FPPs relate to obesogenic dietary intake using cross-sectional data from 1214 Hispanic/Latino 8-16-year-olds and their parents/caregivers in the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth). Diet was assessed with 2 24-h dietary recalls. Obesogenic items were snack foods, sweets, and high-sugar beverages. Three FPPs (Rules and Limits, Monitoring, and Pressure to Eat) derived from the Parenting strategies for Eating and Activity Scale (PEAS) were assessed. K-means cluster analysis identified 5 groups of parents with similar FPP scores. Survey-weighted multiple logistic regression examined associations of cluster membership with diet. Parents in the controlling (high scores for all FPPs) vs. indulgent (low scores for all FPPs) cluster had a 1.75 (95% CI: 1.02, 3.03) times higher odds of having children with high obesogenic dietary intake. Among parents of 12-16-year-olds, membership in the pressuring (high Pressure to Eat, low Rules and Limits and Monitoring scores) vs. indulgent cluster was associated with a 2.96 (95% CI: 1.51, 5.80) times greater odds of high obesogenic dietary intake. All other associations were null. Future longitudinal examinations of FPPs are needed to determine temporal associations with obesogenic dietary intake in Hispanic/Latino youth.
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Affiliation(s)
- Madison N LeCroy
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, CB #7461, Chapel Hill, NC, 27599, USA.
| | - Anna Maria Siega-Riz
- School of Nursing, University of Virginia, 202 Jeanette Lancaster Way, Charlottesville, VA, 22908-0782,, USA
| | - Sandra S Albrecht
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, CB #7461, Chapel Hill, NC, 27599, USA; Carolina Population Center, University of North Carolina at Chapel Hill, 123 West Franklin Street, CB #8120, Chapel Hill, NC, 27599, USA
| | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, CB #7461, Chapel Hill, NC, 27599, USA
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, CB #7420, Chapel Hill, NC, 27599, USA
| | - Krista M Perreira
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 West Franklin Street, CB #8120, Chapel Hill, NC, 27599, USA
| | - Carmen R Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Building, Bronx, NY, 10461, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Building, Bronx, NY, 10461, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, 9245 Sky Park Court, Suite 110, San Diego, CA, 92123, USA
| | - Sheila F Castañeda
- South Bay Latino Research Center, School of Public Health, San Diego State University, 780 Bay Blvd, Suite 200, Chula Vista, CA, 92101, USA
| | - June Stevens
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, CB #7461, Chapel Hill, NC, 27599, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, CB #7435, Chapel Hill, NC, 27599, USA
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Edberg D, Mukhopadhyay S, Wendel J. Incentive design to boost health for juveniles with Medicaid coverage: Evidence from a field experiment. ECONOMICS AND HUMAN BIOLOGY 2019; 33:101-115. [PMID: 30797161 DOI: 10.1016/j.ehb.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/18/2018] [Accepted: 01/10/2019] [Indexed: 06/09/2023]
Abstract
Augmenting incentives for juveniles with separate incentives for parents could boost juvenile efforts to reduce BMI. However, financing a parent incentive by reducing the incentives offered to adolescents could attenuate the juvenile response. In a field experiment, Medicaid-covered juveniles enrolled in a cardiac wellness program were randomly assigned to two groups: juveniles in the focused-incentive group received all earned points; juveniles in the split-incentive group split earned points with a parent. The focused-incentive group was 12.8 percentage points more likely to achieve their stipulated goals compared to the split-incentive group at the end of the 3-month active phase of the program. In contrast, members of the split-incentive group outperformed their peers in the focused-incentive group during the second quarter, and the two incentives structures were equally effective at the year-end session. Additional quasi-experimental data indicates that members of both incentivized groups significantly outperformed (focused-incentive group by 8.48 percentage points and split-incentive group by 11.0 percentage points) a pre-experiment (non-incentivized) set of juveniles enrolled in the same program at year-end.
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Affiliation(s)
- Dana Edberg
- Department of Economics, Mail Stop 0030, College of Business, University of Nevada Reno, Reno, NV 89557, United States
| | - Sankar Mukhopadhyay
- Department of Economics, Mail Stop 0030, College of Business, University of Nevada Reno, Reno, NV 89557, United States; IZA, Bonn.
| | - Jeanne Wendel
- Department of Economics, Mail Stop 0030, College of Business, University of Nevada Reno, Reno, NV 89557, United States
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Case Reports: Multifaceted Experiences Treating Youth with Severe Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060927. [PMID: 30875836 PMCID: PMC6466372 DOI: 10.3390/ijerph16060927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 12/20/2022]
Abstract
The management of youth with severe obesity is strongly impacted by social determinants of health and family dynamics. We present case studies of three patients seen in our tertiary care obesity treatment clinic as examples of the challenges faced by these patients and their families, as well as by the medical team. We discuss how these cases illustrate potential barriers to care, the role of child protective services, and we reflect upon lessons learned through the care of these patients. These cases highlight the need for comprehensive care in the management of youth with severe obesity, which can include: visits to multiple medical specialists, and mental and behavioral health providers; school accommodations; linkage to community resources; and, potentially, child protective services involvement. Through the care of these youth, our medical team gained more experience with using anti-obesity medications and meal replacements. The care of these youth also heightened our appreciation for the integral role of mental health services and community-based resources in the management of youth with severe obesity.
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50
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Power TG, Johnson SL, Beck AD, Martinez AD, Hughes SO. The Food Parenting Inventory: Factor structure, reliability, and validity in a low-income, Latina sample. Appetite 2019; 134:111-119. [DOI: 10.1016/j.appet.2018.11.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/30/2018] [Accepted: 11/29/2018] [Indexed: 01/04/2023]
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