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Jiang Q, Risica PM, Tovar A, Cooksey Stowers K, Schwartz MB, Lombardi C, Gans KM. Mediation of the association between social environmental characteristics of family childcare home and weight status in children by diet quality. BMC Public Health 2023; 23:2301. [PMID: 37990180 PMCID: PMC10664465 DOI: 10.1186/s12889-023-17179-1] [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: 07/07/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The food and beverages served in family childcare homes (FCCHs) may play an important role in the development of childhood overweight and obesity. This analysis examines whether children's diet quality mediates the relationship between foods and beverages served in FCCHs and preschool-aged children's weight status. METHODS Trained and certified staff conducted observations for two days in each FCCH, using the Environment and Policy Assessment and Observation (EPAO) measure to determine the foods and beverages served to children (N = 370) in FCCHs (N = 120). They also used the Dietary Observation in Child Care (DOCC) protocol to assess children's food and beverage intake during childcare, from which we calculated the Healthy Eating Index-2015 (HEI), a measure of diet quality. Height and weight were measured for each child with parent consent from which the child's body mass index (BMI) z-scores were calculated. A multilevel mediation analysis was conducted to indicate whether children's diet quality mediates the relations between food and beverage served in FCCHs and preschool-aged children's weight status. RESULTS Children's total HEI scores significantly mediated the relationship between the EPAO subscale Food Provided and children's BMI z-scores (B=-0.01, p < .05, 95% CI = [-0.03, - 0.002]). Further, the EPAO subscale Food Provided was positively associated with the total HEI score (B = 0.75, p < .01, 95% CI = [0.32, 1.18]). Total HEI scores were negatively associated with BMI z-score (B=-0.01, p < .05, 95% CI = [-0.02, - 0.001]). CONCLUSION Children's diet quality did significantly mediate the relationship between the food served in FCCHs and children's weight status. More longitudinal studies with longer follow-up periods need to be conducted to confirm these relationships. Further, future studies need to examine the relationships between a broader spectrum of FCCH environmental characteristics and home environment with children's weight status, as well as other mediators including physical activity.
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Affiliation(s)
- Qianxia Jiang
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.
| | - Patricia Markham Risica
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI, USA
- Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI, USA
| | - Alison Tovar
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI, USA
- Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI, USA
| | | | - Marlene B Schwartz
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT, USA
| | - Caitlin Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Kim M Gans
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI, USA
- Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Sleet K, Sisson SB, Dev DA, Love C, Williams MB, Hoffman LA, Jernigan VBB. The Impact of Responsive Feeding Practice Training on Teacher Feeding Behaviors in Tribal Early Care and Education: The Food Resource Equity and Sustainability for Health (FRESH) Study. Curr Dev Nutr 2020; 4:23-32. [PMID: 32258996 PMCID: PMC7101487 DOI: 10.1093/cdn/nzz105] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/10/2019] [Accepted: 09/13/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Establishing healthy eating habits early affects lifelong dietary intake, which has implications for many health outcomes. With children spending time in early care and education (ECE) programs, teachers establish the daytime meal environment through their feeding practices. OBJECTIVE We aimed to determine the effect of a teacher-focused intervention to increase responsive feeding practices in 2 interventions, 1 focused exclusively on the teacher's feeding practices and the other focused on both the teacher's feeding practices and a nutrition classroom curriculum, in ECE teachers in a Native American (NA) community in Oklahoma. METHODS Nine tribally affiliated ECE programs were randomly assigned to 1 of 2 interventions: 1) a 1.5-h teacher-focused responsive feeding practice training (TEACHER; n = 4) and 2) TEACHER plus an additional 3-h training to implement a 15-wk classroom nutrition curriculum (TEACHER + CLASS; n = 5). Feeding practice observations were conducted during lunch at 1 table in 1 classroom for 2- to 5-y-olds at each program before and 1 mo after the intervention. The Mealtime Observation in Child Care (MOCC) organizes teacher behaviors into 8 subsections. Descriptive statistics and the Shapiro-Wilk test for normality were calculated. Paired t tests were calculated to determine change in each group. RESULTS A mean ± SD of 5.2 ± 2.0 (total n = 47) children and 1.7 ± 0.5 (total n = 14) teachers/center were observed at baseline, and 5.6 ± 1.7 (total n = 50) children and 1.7 ± 0.7 teachers (total n = 14) were observed/center postintervention. Total MOCC scores (max possible = 10) improved for TEACHER (6.1 ± 0.9 compared with 7.5 ± 0.3, t = 4.12, P = 0.026) but not for TEACHER + CLASS (6.5 ± 0.8 compared with 6.4 ± 1.0, t = -0.11, P = 0.915). No other changes were observed. CONCLUSIONS Teacher intervention-only programs demonstrated improvements in responsive feeding practices, whereas the programs receiving teacher and classroom training did not. Greater burden likely decreased capacity to make changes in multiple domains. We demonstrated the ability to implement interventions in NA ECE. Further research with larger communities is necessary. This trial was registered at clinicaltrials.gov as NCT03251950.
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Affiliation(s)
- Kaysha Sleet
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Susan B Sisson
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Dipti A Dev
- Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska Lincoln, Lincoln, NE, USA
| | - Charlotte Love
- Center for Indigenous Health Research and Policy, Oklahoma State University, Tulsa, OK, USA
| | - Mary B Williams
- Department of Biostatistics and Epidemiology, College of Public Health—Schusterman Center, University of Oklahoma Health Sciences Center, Tulsa, OK, USA
| | - Leah A Hoffman
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Sisson SB, Sleet K, Rickman R, Love C, Bledsoe A, Williams M, Jernigan VBB. Impact of the 2017 Child and Adult Care Food Program Meal Pattern Requirement Change on Menu Quality in Tribal Early Care Environments: The Food Resource Equity and Sustainability for Health Study. Curr Dev Nutr 2020; 4:12-22. [PMID: 32258995 PMCID: PMC7101482 DOI: 10.1093/cdn/nzz094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/28/2019] [Accepted: 08/06/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Native American (NA) children have a high prevalence of obesity contributing to lifespan health disparities. Dietary intake is important to promote healthy weight gain, growth, and development. In 2017, the USDA enforced changes to the Child and Adult Care Food Program (CACFP). The CACFP provides reimbursement to qualifying Early Care and Education (ECE) programs that serve foods that uphold the program's nutrition requirements. OBJECTIVE This study had the following 2 objectives: 1) Describe a novel index to evaluate ECE menus based on revised CACFP requirements (accounting for food substitutions) and best practices for 3- to-5-y-old children, and 2) analyze CACFP requirement and best practice compliance and nutrient changes in 9 NA ECE programs before and after enforcement of the revised CACFP requirements. METHODS This longitudinal study is within a larger community-based participatory research study. Menus and meals served were evaluated for 1 wk at each of 9 programs before and after enforcement of the revised meal patterns. Nutrient analysis, CACFP requirement and best practice compliance, and substitution quality were evaluated. Differences were determined using a paired t-test or Wilcoxon matched test. This trial was registered at clinicaltrials.gov as NCT03251950. RESULTS Total grams of fiber consumed increased (5.0 ± 1.2 compared with 5.9 ± 0.8 g, P = 0.04) and total grams of sugar consumed decreased (53.8 ± 12.6 compared with 48.4 ± 7.9 g, P = 0.024), although room for further improvement exists. Although total grams of fat remained unchanged, grams of saturated fat significantly increased (7.8 ± 1.4 compared with 10.5 ± 3.4, P = 0.041). Other nutrients remained unchanged. Overall CACFP requirement and best practice compliance scores improved, although this finding was not statistically significant. No significant changes in food quality associated with substitutions occurred. CONCLUSIONS This study provides early evidence to support the beneficial impact of the revised CACFP requirements. Understanding barriers to compliance within rural NA communities would be an important next step in enhancing the health of vulnerable children.
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Affiliation(s)
- Susan B Sisson
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Kaysha Sleet
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Rachel Rickman
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Charlotte Love
- Center for Indigenous Health Research and Policy, Oklahoma State University, Tulsa, OK
| | - Alexandria Bledsoe
- Center for Indigenous Health Research and Policy, Oklahoma State University, Tulsa, OK
| | - Mary Williams
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Tulsa, OK
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Sisson SB, Sleet K, Rickman R, Love C, Williams M, Jernigan VBB. The development of child and adult care food program best-practice menu and training for Native American head start programs: The FRESH study. Prev Med Rep 2019; 14:100880. [PMID: 31080707 PMCID: PMC6503124 DOI: 10.1016/j.pmedr.2019.100880] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/04/2019] [Accepted: 04/22/2019] [Indexed: 02/07/2023] Open
Abstract
New Child and Adult Care Food Program (CACFP) meal patterns and best practices were implemented nationally in 2017 to address the shift in dietary need from ensuring essential nutrient consumption to chronic disease prevention. Young American Indian (AI) children have disproportionately higher risk of chronic disease. Some AI tribes operate early care and education (ECE) programs and have the opportunity to participate in the CACFP. The purpose of this paper is to describe a CACFP best-practice menu and training developed and implemented as part of the Food Resource Equity and Sustainability for Health (FRESH) study, a community-based participatory research (CBPR) intervention implemented within ECE programs in the Osage Nation of Oklahoma. Site managers and cooks from each of the nine ECE programs attended meetings and provided investigators with feedback that shaped the best-practice menu and training. Each site participated in a three-hour training in January 2018 to discuss the best-practice menu and ways to overcome implementation barriers. Goals of the menu aimed to increase intake of fruit and vegetables and whole grains and reduce pre-fried and processed foods without increasing cook burden. Training included application activities individually and in small and large groups. Though the project is still underway, lessons learned, including the need for technical assistance, improved communication between ECE program staff and food supply vendors, and infrastructure barriers (e.g., limited space, lack of supplies) that challenge workflow, have emerged. Efforts to improve menus in rural and low-income ECE programs must consider these issues in developing feasible intervention strategies.
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Affiliation(s)
- Susan B Sisson
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America
| | - Kaysha Sleet
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America
| | - Rachel Rickman
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America
| | - Charlotte Love
- Center for Indigenous Health Research and Policy, Oklahoma State University, Center for Health Sciences, Tulsa, OK, United States of America
| | - Mary Williams
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Tulsa, OK, United States of America
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University, Center for Health Sciences, Tulsa, OK, United States of America
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Arhab A, Messerli-Bürgy N, Kakebeeke TH, Lanzi S, Stülb K, Zysset AE, Leeger-Aschmann CS, Schmutz EA, Meyer AH, Munsch S, Kriemler S, Jenni OG, Puder JJ. Childcare Correlates of Physical Activity, Sedentary Behavior, and Adiposity in Preschool Children: A Cross-Sectional Analysis of the SPLASHY Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:9157194. [PMID: 30651743 PMCID: PMC6311763 DOI: 10.1155/2018/9157194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/25/2018] [Accepted: 10/25/2018] [Indexed: 01/08/2023]
Abstract
Background The childcare (CC) environment can influence young children's physical activity (PA), sedentary behavior (SB), and adiposity. The aim of the study was to identify a broad range of CC correlates of PA, SB, and adiposity in a large sample of preschoolers. Methods 476 preschool children (mean age 3.9 yrs; 47% girls) participated in the Swiss Preschoolers' Health Study (SPLASHY). PA and SB were measured by accelerometry. Outcome measures included total PA (TPA), moderate-to-vigorous PA (MVPA), SB, body mass index (BMI), and skinfold thickness (SF). PA measures consisted of both daily PA during CC attendance days and overall daily PA (CC and non-CC days). Results We identified the following CC correlates for higher TPA and/or higher MVPA or lower SB during CC attendance days: older age, sex (boys), more frequent child-initiated interactions during CC, mixing different ages within a group, and the presence of a written PA policy in the CC (all p ≤ 0.02). The CC correlates for overall TPA and/or MVPA or lower overall SB including both CC and non-CC days were the following: older age, sex (boys), more frequent child-initiated interactions during CC, mixing different ages within a group, less parental PA involvement in the CC, and having a larger surface area in CC (all p ≤ 0.046). Correlates for lower SF were sex (boys) and parental PA involvement in the CC (all p ≤ 0.02), and, for lower BMI, only increased age (p=0.001) was a correlate. Conclusions More frequent child-initiated interactions and mixing different ages in CC, the presence of a written PA policy, and a larger CC surface are correlates of PA and SB during CC attendance days and/or of overall PA. Parental involvement in CC PA projects was a correlate for reduced body fat. These novel factors are mostly modifiable and can be tackled/addressed in future interventions.
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Affiliation(s)
- Amar Arhab
- Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Nadine Messerli-Bürgy
- Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Tanja H. Kakebeeke
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Stefano Lanzi
- Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Kerstin Stülb
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Annina E. Zysset
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | | | - Einat A. Schmutz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Andrea H. Meyer
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Simone Munsch
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Oskar G. Jenni
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Jardena J. Puder
- Obstetric Service, Lausanne University Hospital, Lausanne, Switzerland
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6
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Kracht CL, Sisson SB, Kerr K, Walker D, Stephens L, Seward J, Anderson A, Weedn AE, Cheney M, Copeland KA, Tallbear C, Jacob A, Key M, Dennison M, Horm D, Salvatore AL. Health Care Provider's Role in Obesity Prevention and Healthy Development of Young American Indian Children. J Transcult Nurs 2018; 30:231-241. [PMID: 30071776 DOI: 10.1177/1043659618792605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Health care providers (HCPs) serving American Indian (AI) populations are critical stakeholders in promoting healthy weight-related behaviors of young AI children. The purpose of this study is to develop an understanding of how HCP perceive their role in the healthy development of young AI children, and how they envision working with early care and education teachers and parents to enhance children's health. METHOD Twenty HCP that serve young AI children in Oklahoma participated in individual interviews. Thematic analysis was conducted on coded transcripts and three main themes, each with two to four subthemes were identified. RESULTS HCP had limited contact with teachers, felt family health was equal or more important than child health, and parental empowerment and gradual change was essential for success. CONCLUSION Creating ways to involve HCP, early care and education teachers, and parents together in multilevel and multisector interventions has the potential to improve the health of young AI children.
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Affiliation(s)
- Chelsea L Kracht
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Susan B Sisson
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kelly Kerr
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Devon Walker
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lancer Stephens
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,2 Oklahoma Shared Clinical and Translational Resources, Oklahoma City, OK, USA
| | - Julie Seward
- 3 Southern Plains Tribal Health Board, Oklahoma City, OK, USA
| | - Amber Anderson
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ashley E Weedn
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Kristen A Copeland
- 5 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,6 University of Cincinnati, Cincinnati, OH, USA
| | - Chris Tallbear
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Michelle Key
- 8 Chickasaw Nation Department of Community Services, Ada, OK, USA
| | | | - Diane Horm
- 10 University of Oklahoma, Tulsa, OK, USA
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7
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Erinosho T, Vaughn A, Hales D, Mazzucca S, Gizlice Z, Treadway C, Kelly A, Ward D. The quality of nutrition and physical activity environments of child-care centers across three states in the southern U.S. Prev Med 2018; 113:95-101. [PMID: 29719221 DOI: 10.1016/j.ypmed.2018.04.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/16/2018] [Accepted: 04/28/2018] [Indexed: 11/29/2022]
Abstract
This cross-sectional study assessed the quality of nutrition and physical activity environments of child-care centers in three southern states and examined differences by rural versus urban location, participation in the Child and Adult Care Food Program, and Head Start status. The sample included 354 centers that enroll children aged 2-5: 154 centers from Georgia, 103 from Kentucky, and 97 centers from Mississippi. Directors and 1-2 teachers per center completed the Environment and Policy Assessment and Observation Self-Report (EPAO-SR) tool that assesses nutrition and physical activity environments of child-care centers. The EPAO-SR items were scored to capture six nutrition domains and six physical activity domains that were averaged and then summed to create a combined nutrition and physical activity environment score (range = 0-36); higher scores indicated that centers met more best practices, which translated to higher-quality environments. Overall, the centers had an average combined nutrition and physical activity environment score of 20.2 out of 36. The scores did not differ between rural and urban centers (mean = 20.3 versus 20.2, p = 0.98). Centers in the Child and Adult Care Food Program had higher combined nutrition and physical activity environment scores than non-participating centers (mean = 20.6 versus 19.1, p < 0.01). Head Start centers also had higher combined environment scores than non-Head Start centers (mean = 22.3 versus 19.6, p < 0.01). Findings highlight the vital role of federal programs in supporting healthy child-care environments. Providing technical assistance and training to centers that are not enrolled in well-regulated, federally-funded programs might help to enhance the quality of their nutrition and physical activity environments.
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Affiliation(s)
- Temitope Erinosho
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Amber Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Derek Hales
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephanie Mazzucca
- Prevention Research Center, Washington University in St. Louis, St. Louis, MO, USA
| | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cayla Treadway
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexandra Kelly
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dianne Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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8
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Hesketh KR, Benjamin-Neelon SE, van Sluijs EMF. How does the UK childcare energy-balance environment influence anthropometry of children aged 3-4 years? A cross-sectional exploration. BMJ Open 2018; 8:e021520. [PMID: 30002012 PMCID: PMC6082453 DOI: 10.1136/bmjopen-2018-021520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To assess the association between time spent in care, the childcare energy-balance environment, and preschool-aged children's body mass index z-score (z-BMI), waist-to-height ratio (WHR) and sum of skinfold thickness (SST). DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Children aged 3-4 years were recruited from 30 childcare centres in Cambridgeshire (UK) in 2013. MAIN OUTCOME MEASURES Objectively measured height and weight was used to calculate z-BMI; waist circumference and height were used to generate WHR; subscapular and tricep skinfolds were used to calculate SST. Associations between childcare attendance, the nutrition, physical activity, and overall childcare environment, and three anthropometric outcomes were explored using two-level hierarchical regression models, adjusting for demographic and family based confounders. RESULTS Valid data were available for 196 children (49% female). Time spent in care, the nutrition, physical activity and overall childcare environment were not associated with children's z-BMI, WHR and SST. CONCLUSIONS Childcare environment and level of attendance were not associated with UK preschool-aged children's anthropometry. The childcare environment has been central to intervention efforts to prevent/reduce early childhood obesity, yet other factors, including child-level, family level, wider environmental and policy-level factors warrant substantial attention when considering obesity prevention strategies for young children.
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Affiliation(s)
- Kathryn R Hesketh
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sara E Benjamin-Neelon
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Esther M F van Sluijs
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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9
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Kracht CL, Sisson SB, Walker D, Kerr K, Stephens L, Anderson A, Seward J, Weedn AE, Cheney M, Copeland K, Salvatore AL, Jacob A, Key M, Dennison M, Tallbear C, Horm D. Early Care and Education Teacher’s Role in Obesity Prevention and Healthy Development of Young American Indian Children. J Transcult Nurs 2018; 30:75-85. [DOI: 10.1177/1043659618786363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: The purpose of this study was to develop an understanding of how stakeholders, specifically early care and education (ECE) teachers, perceive their role in the development of young American Indian children, and envision working with health care providers and parents in order to enhance children’s health. Methodology: Twenty tribally affiliated ECE teachers from Oklahoma participated in interviews. Thematic analysis was conducted, and three main themes, each with two to three subthemes, emerged. Results: Teachers felt that nutrition and physical activity were important to children’s health. Teachers had little professional interaction with health care providers but desired more. Parental empowerment was conveyed as essential to actualize positive changes in their child’s behavior. Discussion: Teachers of tribally affiliated ECE centers are important stakeholders in promoting the health and well-being of young American Indian children. Additional efforts are needed to more effectively integrate teachers and nurses in order to create effective interventions. We propose a stakeholder partnership to guide the development of future interventions.
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Affiliation(s)
- Chelsea L. Kracht
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Susan B. Sisson
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Devon Walker
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kelly Kerr
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lancer Stephens
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Shared Clinical and Translational Resources, Oklahoma City, OK, USA
| | - Amber Anderson
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Julie Seward
- Southern Plains Tribal Health Board, Oklahoma City, OK, USA
| | - Ashley E. Weedn
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Kristen Copeland
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati, Cincinnati, OH, USA
| | | | | | - Michelle Key
- Chickasaw Nation Department of Community Services, Ada, OK, USA
| | | | - Chris Tallbear
- Southern Plains Tribal Health Board, Oklahoma City, OK, USA
| | - Diane Horm
- Early Childhood Education Institute, University of Oklahoma, Tulsa, OK, USA
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10
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Zhang Z, Pereira JR, Sousa-Sá E, Okely AD, Feng X, Santos R. Environmental characteristics of early childhood education and care centres and young children's weight status: A systematic review. Prev Med 2018; 106:13-25. [PMID: 29038034 DOI: 10.1016/j.ypmed.2017.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/07/2017] [Accepted: 10/02/2017] [Indexed: 02/04/2023]
Abstract
The aim of this systematic review was to summarize ECEC environmental correlates of weight status in children under the age of 6years. Six databases (PubMed, PsycINFO, CINAHL, SPORTDiscus, Scopus, and Web of Science) were searched until March 2017. Observational studies examining the relationship between ECEC environmental characteristics and weight status in children aged 0-6years were included. Data was extracted using a predesigned form. Eight studies, representing 4862 children, met the inclusion criteria. Twenty-two environmental characteristics were identified and classified into four domains (physical, political, economic, and sociocultural); of these, six correlates were found. 'Active environment' 'sedentary opportunities', 'active play time', 'high sugar and high fat served', 'educators' weight' and 'educators' habitual physical activity level' were associated with weight status in young children. However, for most environmental characteristics examined, strong evidence is not available yet, due to variations across studies on the measures of environmental characteristics and analytical methodologies. Stronger empirical evidence in greater quantity is needed. Future studies in this area are recommended to investigate the environmental influence using an ecological approach and to examine the potential mediators, with a focus on the settings of family-based centres and samples representing toddlers and/or infants.
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Affiliation(s)
- Zhiguang Zhang
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia.
| | - João R Pereira
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Research Unit for Sport and Physical Activity, University of Coimbra, Coimbra, Portugal
| | - Eduarda Sousa-Sá
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - Anthony D Okely
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia
| | - Xiaoqi Feng
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia; Population Wellbeing and Environment Research Lab, University of Wollongong, NSW, Australia
| | - Rute Santos
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia; Research Centre in Physical Activity, Health and Leisure; University of Porto, Porto, Portugal
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Sisson SB, Smith CL, Cheney M. Big impact on small children: child-care providers’ perceptions of their role in early childhood healthy lifestyle behaviours. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/13575279.2017.1299111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Susan B. Sisson
- Behavioral Nutrition and Physical Activity Laboratory, Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Chelsea L. Smith
- Behavioral Nutrition and Physical Activity Laboratory, Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Marshall Cheney
- Department of Health and Exercise Science, College of Arts and Sciences, University of Oklahoma, Norman, OK, USA
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