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Baltaci A, Laska MN, Horning M, Hearst M, Lee J, Fulkerson JA. Parent meal self-efficacy and practices in households with healthy home food environments in the face of economic hardship. Appetite 2023; 190:107029. [PMID: 37683896 PMCID: PMC10543555 DOI: 10.1016/j.appet.2023.107029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023]
Abstract
Some families who experience economic hardship demonstrate remarkable strength and resourcefulness to sustain a healthy home food environment. This ability to navigate economic barriers could be associated with parent meal practices that promote children's healthful dietary intake. Therefore, this study aimed to examine 1) whether parent meal self-efficacy and practices were associated with economic assistance status and home fruit and vegetable (FV) availability and 2) how parent meal self-efficacy and practices differed by home FV availability and economic assistance status. Analyses utilized baseline data from 274 parent/child dyads from two childhood obesity prevention trials: HOME Plus (urban) and NU-HOME (rural). Parents in households with high FV availability (regardless of economic assistance) had significantly higher self-efficacy in preparing healthy foods, family dinner routines, frequency of child's plate being half filled with FV, frequency of family dinner and breakfast, and lower frequency of purchasing dinner from fast food restaurants. Economic assistance was not associated with parent meal self-efficacy and practices. Four family groups were created and defined by economic assistance (yes/no) and home FV availability (high/low). About 31% of families that received economic assistance and had high home FV availability were food insecure. Families (n = 39) receiving economic assistance and having high home FV availability had greater frequency of family dinners compared to those in households with economic assistance and low home FV availability (n = 47) (p = 0.001); no other parent meal self-efficacy or practices differed between groups. Our findings suggest some families can maintain healthy home food environments despite economic hardship and frequent family dinners may be an important strength for these families. More research is needed to investigate asset-based models to understand the family strengths that enable them to thrive during difficult times.
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Affiliation(s)
- Aysegul Baltaci
- School of Public Health, Division of Epidemiology and Community Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Melissa N Laska
- School of Public Health, Division of Epidemiology and Community Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Melissa Horning
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
| | - Mary Hearst
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
| | - Jiwoo Lee
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
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Tan WY, Hamzaid NH, Ibrahim N. Parental Perceptions on the Importance of Nutrients for Children with Autism Spectrum Disorder (ASD) and the Coping Strategies: A Qualitative Study. Nutrients 2023; 15:nu15071608. [PMID: 37049449 PMCID: PMC10096955 DOI: 10.3390/nu15071608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is a developmental disorder that comes with co-occurring eating behavior such as limited food varieties, selective food intake, and repetitive eating patterns, contributing to significant challenges for their parents. Many parents find mealtimes difficult and develop anxiety or stress about their child’s nutrition, health, and overall well-being. Hence, parents must equip themselves with the correct awareness and nutrition knowledge. An online open-ended semi-structured interview was conducted among fifteen parents from the community-rehabilitation program center to explore their understanding of nutrition’s importance and the possible coping strategies when facing challenges. The interview sessions were recorded, followed by three researchers’ coding processes. Data were then subjected to thematic analysis. The interview sessions suggested that the parents were aware of the autism trait eating behavior and had a general knowledge about nutrition. However, it was quite challenging when it came to preparation. Nevertheless, the parents are able to manage the challenges with unique kinds of coping strategies. In addition, a complete educational dietary intervention program including psychosocial aspects for parents is recommended for better effectiveness.
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Bastami F, Mardani M, Rezapour P. Development and psychometric analysis of a new tool to assess food literacy in diabetic patients. BMC Nutr 2022; 8:134. [PMCID: PMC9666971 DOI: 10.1186/s40795-022-00626-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/27/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
One of the factors affecting self-care in diabetic patients is food literacy, which helps said patients in following a healthy diet. Thus, it is crucial to analyze food literacy in diabetic patients through suitable and reliable instruments.
Objective
The current study aimed to design a questionnaire for food literacy assessment in diabetic patients and analyze its psychometric features.
Method
The present study was a cross-sectional descriptive analysis carried out in 2021. Firstly, the concepts of food literacy in diabetic patients were identified and the questionnaire was deigned based on them. Secondly, its face and content validities and its reliability were analyzed. Finally, the construct validity was analyzed by exploratory factor analysis. The study was carried out on 300 diabetic participants chosen at random via stratified cluster sampling from Health service centers. The exploratory factor analysis was carried out by extracting the main factors and using varimax rotation with eigenvalue values more than 1.
Results
A five-pronged structure accounted for 52.745% of food literacy variance. This included the ability to read food facts, practical ability to group foods, the ability to identify the caloric content of different foods, the ability to understand the effect of food on health, and the ability to prepare a healthy meal. Items with an impact score below 1.5 were discarded. Additionally, items with CVR scores below 0.62 and CVI scores below 0.79 were deleted too. The Kaiser-Meyer-Okin measurement was 0.836 (p < 0.001). Alpha Cronbach Scale dimension was 0.610–0.951.
Conclusion
The results of this study showed that the exploratory dimensions of the current study were consistent with health literacy measurements, such as functional, interactive, and critical food literacy. This scale has acceptable reliability and validity. Health professionals can use this scale to analyze and improve food literacy in diabetic patients. This is a new instrument and thus far no questionnaire has been made to evaluate food literacy in diabetic patients.
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Spyreli E, McKinley MC, Dean M. An online survey of dietary quality during complementary feeding; associations with maternal feeding self-efficacy and adherence to dietary recommendations. BMC Nutr 2022; 8:100. [PMID: 36085052 PMCID: PMC9461111 DOI: 10.1186/s40795-022-00595-8] [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: 04/19/2021] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Parents are the gatekeepers of nutrition in early life and their feeding practices form children’s dietary behaviours. Although maternal characteristics have been associated with certain feeding practices, their relationship with overall quality of complementary feeding diets has not been explored. This study aimed to: assess dietary quality in complementary feeding age; explore its association with maternal and child characteristics; and evaluate the association between complementary feeding practices and child weight. Methods An online cross-sectional survey captured data from a self-selected sample of mothers living in the UK with a healthy full-term child in complementary feeding age. A total of 466 mothers completed a questionnaire on their complementary feeding practices, demographics, anthropometrics, rates of maternal food neophobia, feeding self-efficacy, social support, postnatal depression and infant temperament. Dietary quality was assessed using the Complementary Feeding Utility Index (CFUI). Children were classified into underweight, normal weight, overweight and obese. Results Majority of participants reported high levels of dietary quality as determined by a mean CFUI score of 80%. High dietary quality was associated with reliance on the NHS recommendation on timing of complementary feeding and maternal self-efficacy in promoting a healthy diet and limiting non-recommended foods. Responsive feeding, longer breastfeeding duration, frequent exposure to fruits and to a high variety of protein-rich animal foods were significantly associated with lighter child weight status. Consumption of sweetened drinks and delayed introduction of lumpy foods were associated with heavier child weight status. Conclusions This study provided an evaluation of dietary quality in complementary feeding in a UK sample of children and explored its relationship with maternal and child attributes. Increasing understanding of the current complementary feeding recommendations and strengthening maternal feeding self-efficacy may be key for healthcare professionals and researchers to improving complementary feeding practices. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00595-8.
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Affiliation(s)
- Eleni Spyreli
- Centre for Public Health, Institute of Clinical Science Block A, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, United Kingdom. .,Institute for Global Food Security, Queen's University Belfast, Belfast, BT9 5DL, UK.
| | - Michelle C McKinley
- Centre for Public Health, Institute of Clinical Science Block A, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, United Kingdom.,Institute for Global Food Security, Queen's University Belfast, Belfast, BT9 5DL, UK
| | - Moira Dean
- Institute for Global Food Security, Queen's University Belfast, Belfast, BT9 5DL, UK
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Caregiver Nutritional Health Outcomes of the Simple Suppers Study: Results from a 10 Week, Two-Group Quasi-Experimental Family Meals Intervention. Nutrients 2022; 14:nu14020250. [PMID: 35057431 PMCID: PMC8778256 DOI: 10.3390/nu14020250] [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: 11/23/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/04/2022] Open
Abstract
Individuals from racial minority backgrounds, especially those in low income situations, are at increased risk for obesity. Family meals positively impact child nutritional health; however, there is limited evidence examining the impact on caregivers, particularly racial minority and income-restricted individuals. The objective of this intervention study was to determine the effect of Simple Suppers, a 10 week family meals program, on caregiver diet and nutrition outcomes. Intervention versus waitlist control participants were compared from baseline (T0) to post-intervention (T1). In addition, intervention participants were assessed at a 10 week follow-up time point (T2). This study was a two-group quasi-experimental intervention trial. Lessons (10 total) were delivered on a weekly basis for 90 min. Data were collected from intervention and waitlist control participants at T0 and T1, and intervention participants at T2. After baseline (T0) data collection, families enrolled in the immediate upcoming session of Simple Suppers (intervention group) or waited for 10 weeks (waitlist control group) to begin the program. Participants were caregivers of children ages 4–10 years. This study was conducted in a faith-based community center for underserved families in Columbus, Ohio. Primary outcomes were: diet quality assessed by Healthy Eating Index (HEI) total and component scores, and total energy intake (kcal/day); body mass index (BMI) (kg/m2), waist circumference (cm), systolic and diastolic blood pressure (BP) (mmHG); and self-efficacy for having healthy meals and menu planning (both scalar). The impact of the intervention (T0:T1) was assessed using generalized mixed-effects linear regression models. Maintenance of change in study outcomes among intervention participants (T1:T2) was examined with paired t-tests. 109 caregivers enrolled in this study. The retention rate at T1 was 90% (i.e., 98 participants). 56 of 68 intervention participants completed T2, resulting in a retention rate of 82%. Almost all (99%) were female, 61% were Black, and 50% were between 31 and 40 years old. In total, 40% had low income and 37% had low or very low food security. At T1, intervention vs. waitlist controls had a lower daily energy intake (p = 0.04), but an HEI-2010 component score for fatty acids (adequacy) that was lower indicating a lower dietary intake of fatty acids (p = 0.02), and a component score for empty calories (moderation) that was significantly lower indicating a higher intake of empty calorie foods (p = 0.03). At T1, intervention vs. waitlist controls also had a lower BMI (p < 0.001) and systolic BP (p = 0.04), and higher self-efficacy (p = 0.03). There were no group differences in other outcomes. At T2, intervention participants maintained the changes in daily energy intake, BMI, systolic BP, and self-efficacy that improved during the intervention period. There was no change (improvement) in the component score for fatty acids; however, the component score for empty calories significantly improved (p = 0.02). Engagement in the Simple Suppers program led to improvements in caregivers’ daily caloric intake, weight status, systolic blood pressure, and self-efficacy for family meals. Future research should further explore the dietary and nutritional health benefits of family meals among caregivers at the highest risk for obesity.
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Lohse B, Cunningham-Sabo L. Quantifying parent engagement in the randomized Fuel for Fun impact study identified design considerations and BMI relationships. BMC Med Res Methodol 2021; 21:205. [PMID: 34627162 PMCID: PMC8502317 DOI: 10.1186/s12874-021-01398-4] [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: 04/26/2021] [Accepted: 09/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parent participation in children's health interventions is insufficiently defined and measured. This project quantified parent participation to enable future examination with outcomes in an intervention focused on 4th graders, aged 9-11 years, and their families living in northern Colorado. METHODS Indices were developed to measure type (Parent Participation Profile; PPP) and intensity (Parent Engagement Intensity; PEI) of engagement in Fuel for Fun (FFF), an asymmetric school-and family-based intervention for 4th graders. Study arm-specific participation opportunities were catalogued and summed to calculate the PPP. An algorithm considered frequency, effort, convenience, and invasiveness of each activity to calculate PEI. Indices were standardized (0-100%) using study arm-specific divisors to address asymmetric engagement opportunities. Parents who completed ≥75% of the PPP were defined as Positive Deviants. Youth height and weight were measured. Youth BMI percentile change was compared with parent Positive Deviant status using general linear modeling with repeated measures that included the participation indices. RESULTS Of 1435 youth, 777 (54%) had parent participation in at least one activity. Standardized means were 41.5 ± 25.4% for PPP and 27.6 ± 20.9% for PEI. Demographics, behaviors or baseline FFF outcomes did not differ between the Positive Deviant parent (n = 105) and non-Positive Deviant parents (n = 672); but more Positive Deviant parents followed an indulgent feeding style (p = 0.015). Standardized intensity was greater for Positive Deviant parents; 66.9 ± 20.6% vs 21.5 ± 12.7% (p < 0.001) and differences with non-Positive Deviant parents were related to activity type (p ≤0.01 for six of eight activities). Standardized participation intensity was associated with engagement in a greater number of standardized activity types. Among participating parents, standardized intensity and breadth of activity were inversely related to the youth BMI percentile (n = 739; PEI r = -0.39, p < 0.001; PPP r = -0.34, p < 0.001). Parent engagement was not associated with parent BMI change. CONCLUSIONS An activity-specific intensity schema operationalized measurement of parent engagement in a complex, unbalanced research design and can serve as a template for more sensitive assessment of parent engagement. Positive deviance in parent engagement was not a function of personal, but rather activity characteristics. PPP and PEI increased with fewer requirements and convenient, novel, and personalized activities. Parent engagement indices affirmed lower engagement by parents of overweight/obese youth and concerns about target reach.
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Affiliation(s)
- Barbara Lohse
- Rochester Institute of Technology, Wegmans School of Health and Nutrition, 180 Lomb Memorial Drive 78-A622, Rochester, NY 14623 USA
| | - Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, 106 Gifford Building, Fort Collins, CO 80523-1571 USA
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Verdonschot A, de Vet E, van Seeters N, Warmer J, Collins CE, Bucher T, Haveman-Nies A. Caregivers' Role in the Effectiveness of Two Dutch School-Based Nutrition Education Programmes for Children Aged 7-12 Years Old. Nutrients 2021; 13:nu13010140. [PMID: 33401470 PMCID: PMC7824262 DOI: 10.3390/nu13010140] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 11/24/2022] Open
Abstract
Childhood eating behaviours can track into adulthood. Therefore, programmes that support early healthy eating, including school-based nutrition education programmes, are important. Although school-based programmes may be beneficial in improving nutrition knowledge, impact on actual fruit and vegetable (FV) intake is generally limited as FV intake is also influenced by the home environment. The current study includes secondary analyses of data from an evaluation study on Dutch nutrition education and examined the role of caregivers’ health promotion behaviours (HPB) in influencing healthy eating behaviours in primary school children (n = 1460, aged 7–12 years) and whether caregivers’ HPB contribute to programme effectiveness. Children’s nutrition knowledge, FV intake and caregivers’ HPB (FV/sugar-sweetened beverages/sweets provision to take to school, cooking together and talking about healthy food at home) were measured by child-reported questionnaires at baseline, during, and 6 months post-programme. Results indicated that caregivers’ HPB was positively associated with children’s healthy eating behaviours and that programme effectiveness was highest in those in the lower HPB subcategory. In conclusion, children with less encouragement to eat healthily at home potentially benefit more from school-based nutrition education programmes than children receiving more encouragement. This highlights the important role of the home environment in supporting healthy eating behaviour in children.
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Affiliation(s)
- Angeliek Verdonschot
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
- Priority Research Center for Physical Activity and Nutrition (PRCPAN), The University of Newcastle, Callaghan, NSW 2308, Australia; (C.E.C.); (T.B.)
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
- Correspondence: ; Tel.: +31-317-483401
| | - Emely de Vet
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
| | - Natalie van Seeters
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
| | - Jolieke Warmer
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
| | - Clare E. Collins
- Priority Research Center for Physical Activity and Nutrition (PRCPAN), The University of Newcastle, Callaghan, NSW 2308, Australia; (C.E.C.); (T.B.)
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Tamara Bucher
- Priority Research Center for Physical Activity and Nutrition (PRCPAN), The University of Newcastle, Callaghan, NSW 2308, Australia; (C.E.C.); (T.B.)
- School of Environmental and Life Sciences (SELS), Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Annemien Haveman-Nies
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
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Family structure and affluence in adolescent eating behaviour: a cross-national study in forty-one countries. Public Health Nutr 2020; 24:2521-2532. [PMID: 33106205 DOI: 10.1017/s1368980020003584] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the family structure and affluence-related inequality in adolescent eating behaviour. DESIGN Multivariate binary logistic regression and path analyses were employed to evaluate the impact of family structure and affluence on the consumption of fruits, vegetables, sweets and soft drinks among adolescents. SETTING The cross-national Health Behaviour in School-aged Children study in 2013/2014 across forty-one countries. PARTICIPANTS Adolescents aged 11-15 years old (n 192 755). RESULTS Adolescents from a non-intact family were less likely to eat daily fruits (OR 0·82; 95 % CI 0·80, 0·84), vegetables (OR 0·91; 95 % CI 0·89, 0·93) and sweets (OR 0·96; 95 % CI 0·94, 0·99), but were more likely to consume soft drinks (OR 1·14; 95 % CI 1·11, 1·17), compared with their counterparts from an intact family. Adolescents who had the lowest family affluence scores (FAS) were less likely to eat daily fruits (OR 0·51; 95 % CI 0·49, 0·53), vegetables (OR 0·58; 95 % CI 0·56, 0·60) and sweets (OR 0·94; 95 % CI 0·90, 0·97), but were more likely to consume soft drinks (OR 1·25; 95 % CI 1·20, 1·30), compared with their counterparts who had the highest FAS. Across countries, a wide range of social inequality in daily consumption of foods was observed. CONCLUSIONS Among adolescents in Europe, Canada and Israel, there was a high level of family structure and family affluence inequalities in daily food consumption. Different aspects of family socio-economic circumstances should be considered at the national level designing effective interventions to promote healthy eating among adolescents.
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Walch TJ, Rosenkranz RR, Schenkelberg MA, Fees BS, Dzewaltowski DA. Parent adoption and implementation of obesity prevention practices through building children's asking skills at family child care homes. EVALUATION AND PROGRAM PLANNING 2020; 80:101810. [PMID: 32126415 DOI: 10.1016/j.evalprogplan.2020.101810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 01/15/2020] [Accepted: 02/24/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Early childhood education programs provide a setting to reach children and parents to modify home environments to prevent obesity. The Healthy Opportunities for Physical Activity and Nutrition Home (HOP'N) Home project was a novel approach that linked Family Child Care Homes (FCCH) to home environments by developing children's asking skills for healthful home environmental change through curricular activities. OBJECTIVE To evaluate the feasibility of engaging parents in obesity prevention practices through building children's asking skills at FCCH. METHODS FCCHs (n = 5 settings) and children (n = 25; aged 3-5 years; female = 36 %; non-Hispanic white = 91 %; low socioeconomic status = 28 %; overweight/obese = 52 %) and parents (n = 25) participated in a pre-post cohort design. We assessed children's body mass index and self-report variables at three time points. HOP'N Home included continuous staff training, group time, dramatic play, meal prompts, songs, and home activities. RESULTS FCCH providers implemented 83%-100% of intervention activities. All parents (100 %) adopted the program, most (87 %) returned completed homework activities to FCCHs, and over 90 % implemented changes in the home. Percent of overweight/obese children decreased from pre-intervention (50 %) to post-intervention (29 %,p = 0.06) and follow-up (38 %,p = 0.06). CONCLUSIONS It is feasible to build children's asking skills and pair this strategy with home activities to engage parents to prevent obesity.
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Affiliation(s)
- Tanis J Walch
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, 58202, United States.
| | - Richard R Rosenkranz
- Department of Food, Nutrition, Dietetics, & Health, Kansas State University, Manhattan, KS, 66503, United States
| | - Michaela A Schenkelberg
- School of Health and Kinesiology, University of Nebraska Omaha, Omaha, NE 68182 United States
| | - Bronwyn S Fees
- Family Studies and Human Services, Kansas State University, Manhattan, KS, 66503, United States
| | - David A Dzewaltowski
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, 68198, United States; Buffett Early Childhood Institute, University of Nebraska, Omaha, NE, 68106, United States
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Bastami F, Zamani-Alavijeh F, Mostafavi F. The development and psychometric evaluation of a new instrument to market healthy breakfast and snacks among adolescents. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0083/ijamh-2018-0083.xml. [PMID: 31613793 DOI: 10.1515/ijamh-2018-0083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 06/26/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND The consumption of non-nutritious snacks instead of a proper breakfast is becoming more widespread among adolescents. It is expected that using the 4P (product, price, place, promotion) strategies of the social marketing (SM) model can help to better identify factors affecting healthy breakfast and snack consumption. The objective of this study was to develop and evaluate the psychometric properties of the Healthy Breakfast and Snack Consumption Scale (HBSCS) using the SM model. METHODS This was a cross-sectional descriptive study that was conducted in 2017. First, a scale was developed using the results of a qualitative research based on the SM model. Then, its face, content and construct validities as well as its reliability were assessed. Construct validity was evaluated via exploratory factor analysis conducted on a random sample of 300 high school pupils selected from five girls' schools located in Isfahan, Iran, using the multistage cluster sampling method. Exploratory factor analysis was performed using the methods of principle components extraction and varimax rotation with eigenvalues greater than 1. RESULTS A four-factor structure that explained 61.73% of the total variance of the HBSCS included healthy breakfast and snack preferences, readiness to pay the price, place preferences and communication channel preferences. Items with an impact score of less than 1.5 were removed. Additionally, items with content validity ratio values of less than 0.62 and content validity index values of less than 0.79 were deleted. The Kaiser-Meyer-Olkin measure value was 0.74 [chi-squared (χ2) = 2353.622; p-value < 0.001]. The Cronbach's α values of the scale and its four dimensions were 0.71 and 0.56-0.72, respectively. CONCLUSION This scale has acceptable validity and reliability. School authorities and health professionals can use this scale to screen adolescents at risk of consuming unhealthy foods and snacks. Besides, the scale might be used as a framework for assessing, implementing and promoting healthy eating behaviors among pupils.
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Affiliation(s)
- Fatemeh Bastami
- Isfahan University of Medical Sciences, Department of Health Education and Promotion, Isfahan, Iran
| | | | - Firoozeh Mostafavi
- Isfahan University of Medical Sciences, Department of Health Education and Promotion, Isfahan, Iran
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Flujas-Contreras JM, García-Palacios A, Gómez I. Technology-based parenting interventions for children's physical and psychological health: a systematic review and meta-analysis. Psychol Med 2019; 49:1787-1798. [PMID: 30977462 DOI: 10.1017/s0033291719000692] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Parenting interventions have important consequences for the wellbeing and emotional competences of parents and their children. Technology provides an opportunity with advantages for psychological intervention. The aim of this systematic review and meta-analysis is to analyze the characteristics and effectiveness of technology-based interventions for parents to promote children's physical health or psychological issues. METHODS We conducted a systematic review and meta-analysis for articles about parenting skills for prevention or treatment of children's physical or psychological concerns using technology. We explore the aim of the intervention with parents, kind of problem with children, intervention model, instruments, methodological quality, and risk of bias. A random-effects meta-analysis was conducted. RESULTS Twenty-four studies were included in the systematic review and a meta-analysis of 22 studies was performed to find out the effects of intervention depending on the kind of problem, intervention model, follow-up, type of intervention, type of control condition, and type of outcome data. Results show the usefulness of technology-based therapy for parenting interventions with moderate effect sizes for intervention groups with statistically significant differences from control groups. CONCLUSIONS Technology-based parenting programs have positive effects on parenting and emotional wellbeing of parents and children. Attendance and participation level in technology-based treatment increase compared with traditional parenting intervention.
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Affiliation(s)
| | - Azucena García-Palacios
- Department of Basic Psychology,Clinical and Psychobiology - Personality, Evaluation and Psychological Treatments,University Jaume I,Castellon,Spain
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Carbert NS, Brussoni M, Geller J, Mâsse LC. Familial Environment and Overweight/Obese Adolescents' Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142558. [PMID: 31319635 PMCID: PMC6679148 DOI: 10.3390/ijerph16142558] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/05/2019] [Accepted: 07/16/2019] [Indexed: 11/17/2022]
Abstract
(1) Background: Family environments can impact obesity risk among adolescents. Little is known about the mechanisms by which parents can influence obesity-related adolescent health behaviours and specifically how parenting practices (e.g., rules or routines) and/or their own health behaviours relate to their adolescent’s behaviours. The primary aim of the study explored, in a sample of overweight/obese adolescents, how parenting practices and/or parental modeling of physical activity (PA) behaviours relate to adolescents’ PA while examining the moderating role of parenting styles and family functioning. (2) Methods: A total of 172 parent-adolescent dyads completed surveys about their PA and wore an accelerometer for eight days to objectively measure PA. Parents completed questionnaires about their family functioning, parenting practices, and styles (authoritative and permissive). Path analysis was used for the analyses. (3) Results: More healthful PA parenting practices and parental modeling of PA were both associated with higher levels of adolescents’ self-reported moderate-vigorous physical activity (MVPA). For accelerometer PA, more healthful PA parenting practices were associated with adolescents’ increased MVPA when parents used a more permissive parenting style. (4) Conclusions: This study suggests that parenting practices and parental modeling play a role in adolescent’s PA. The family’s emotional/relational context also warrants consideration since parenting style moderated these effects. This study emphasizes the importance of incorporating parenting styles into current familial interventions to improve their efficacy.
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Affiliation(s)
- Nicole S Carbert
- School of Population & Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Mariana Brussoni
- School of Population & Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada
| | - Josie Geller
- St Paul's Eating Disorder Program, Vancouver, BC V6Z 1Y6, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 2A1, Canada
| | - Louise C Mâsse
- School of Population & Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
- British Columbia Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada.
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13
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Lohse B, Pflugh Prescott M, Cunningham-Sabo L. Eating Competent Parents of 4th Grade Youth from a Predominantly Non-Hispanic White Sample Demonstrate More Healthful Eating Behaviors than Non-Eating Competent Parents. Nutrients 2019; 11:nu11071501. [PMID: 31262065 PMCID: PMC6682872 DOI: 10.3390/nu11071501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/27/2019] [Accepted: 06/28/2019] [Indexed: 01/09/2023] Open
Abstract
The purpose of this study was to determine if the associations between eating competence (EC) and eating behaviors that were found in a USA sample of predominantly Hispanic parents of 4th grade youth could be replicated in a USA sample of predominantly non-Hispanic white parents of 4th graders. Baseline responses from parents (n = 424; 94% white) of youth participating in a year-long educational intervention were collected using an online survey. Validated measures included the Satter Eating Competence Inventory (ecSI 2.0TM), in-home fruit/vegetable (FV) availability, healthful eating behavior modeling, and FV self-efficacy/outcome expectancies (SE/OE). Data were analyzed with general linear modeling and cluster analyses. The findings replicated those from the primarily Hispanic sample. Of the 408 completing all ecSI 2.0TM items, 86% were female, 65% had a 4-year degree or higher, and 53% were EC (ecSI 2.0TM score ≥ 32). Compared with non-EC parents, EC modeled more healthful eating, higher FV SE/OE, and more in-home FV availability. Behaviors clustered into those striving toward more healthful practices (strivers; n = 151) and those achieving them (thrivers; n = 255). Striver ecSI 2.0TM scores were lower than those of thrivers (29.6 ± 7.8 vs. 33.7 ± 7.6; p < 0.001). More EC parents demonstrated eating behaviors associated with childhood obesity prevention than non-EC parents, encouraging education that fosters parent EC, especially in tandem with youth nutrition education.
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Affiliation(s)
- Barbara Lohse
- Rochester Institute of Technology Wegmans School of Health and Nutrition, Rochester, NY 14623, USA.
| | - Melissa Pflugh Prescott
- Department of Food Science and Human Nutrition, University of Illinois Urbana-Champagne, Urbana, IL 61801, USA
| | - Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523, USA
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14
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Ruder EH, Lohse B, Mitchell DC, Cunningham-Sabo L. Parent Food and Eating Behavior Assessments Predict Targeted Healthy Eating Index Components. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:711-718. [PMID: 31178008 DOI: 10.1016/j.jneb.2019.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To examine the ability of parent response to assessments of in-home availability of 20 fruits and vegetables (FV), self-efficacy/outcome expectancy to prepare FV that their child would eat, modeling of FV eating behavior, and eating competence to predict parents' targeted Healthy Eating Index-2010 (HEI) scores at baseline. DESIGN Cross-sectional survey. SETTING Sixty-one classrooms in 8 northern Colorado elementary schools over 4 years participating in Fuel for Fun (FFF), a school-based culinary and physical activity intervention. PARTICIPANTS Parents and guardians (n = 71) of fourth-grade youths from participating classrooms. MAIN OUTCOME MEASURE(S) Healthy Eating Index-2010 scores as derived from 24-hour recalls administered with the Automated Self-Administered 24-hour dietary assessment tool. ANALYSIS Generalized linear regression models tested the predictive validity of survey assessments for targeted HEI components. Results were considered statistically significant at P ≤ .05. RESULTS In-home FV availability predicted total fruit (P = .01), whole fruit (P = .001), and total vegetable (P = .01) HEI, and parent modeling of FV eating behavior predicted total fruit (P = .01) and whole fruit (P = .02) HEI. However, these survey measures were not associated with other HEI components, including total HEI. Parent self-efficacy/outcome expectancy to prepare FV that their child would eat or like was not associated with total HEI or HEI components. Eating competence did not predict total HEI but was associated with seafood and plant proteins in the anticipated direction (P = .04). CONCLUSIONS AND IMPLICATIONS The results demonstrated construct validation of some parent Fuel for Fun survey assessments with targeted HEI components. Additional assessment in larger and more diverse samples is warranted so that nutrition education and behavior researchers may use these valid and reliable, brief, low-cost, and easy-to-use survey instruments as a proxy for dietary intake.
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Affiliation(s)
- Elizabeth H Ruder
- Wegmans School of Health and Nutrition, Rochester Institute of Technology, Rochester, NY.
| | - Barbara Lohse
- Wegmans School of Health and Nutrition, Rochester Institute of Technology, Rochester, NY
| | - Diane C Mitchell
- Diet Assessment Center, Department of Nutritional Sciences, Pennsylvania State University, University Park, PA
| | - Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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15
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Fallon V, Halford JCG, Bennett KM, Harrold JA. Postpartum-specific anxiety as a predictor of infant-feeding outcomes and perceptions of infant-feeding behaviours: new evidence for childbearing specific measures of mood. Arch Womens Ment Health 2018; 21:181-191. [PMID: 28936752 PMCID: PMC5856861 DOI: 10.1007/s00737-017-0775-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 09/04/2017] [Indexed: 11/29/2022]
Abstract
Studies of pregnancy-specific anxiety suggest that it is a distinct construct which predicts perinatal outcomes more effectively than other general measures of anxiety. In response, a novel measure of postpartum-specific anxiety (PSAS) has been developed and validated, but it is not yet clear whether it possesses the same predictive power as its pregnancy-specific counterparts. The aim of this short-term prospective study was to (a) test the predictive validity of the PSAS in the context of one specific perinatal outcome, infant-feeding, and (b) examine whether the PSAS may be more efficacious at predicting infant-feeding outcomes and behaviours than the more commonly used general measures. Eight hundred mothers of infants aged between 0 and 6 months completed the PSAS alongside general measures of anxiety and depression at baseline. A subsample (n = 261) returned to complete a follow-up questionnaire examining infant-feeding outcomes and behaviours two weeks later. Hierarchical regression models revealed that the PSAS was associated with lower odds of breastfeeding exclusively, and breastfeeding in any quantity in the first 6 months postpartum. PSAS scores were also significantly associated with infant-feeding behaviours including a lower perceived enjoyment of food, and greater perceived food responsiveness and satiety responsiveness in the infant. As hypothesised, the PSAS was a stronger predictor of infant-feeding outcomes and behaviours than general anxiety and depression. The findings provide evidence for the predictive validity of the PSAS and call for the use of childbearing specific measures of mood when attempting to predict perinatal outcomes. Replication of these findings across other indices of maternal and infant health is now necessary.
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Affiliation(s)
- Victoria Fallon
- Institute of Psychology, Health and Society, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Jason Christian Grovenor Halford
- Institute of Psychology, Health and Society, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
| | - Kate Mary Bennett
- Institute of Psychology, Health and Society, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
| | - Joanne Allison Harrold
- Institute of Psychology, Health and Society, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
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16
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Watts AW, Barr SI, Hanning RM, Lovato CY, Mâsse LC. The home food environment and associations with dietary intake among adolescents presenting for a lifestyle modification intervention. BMC Nutr 2018; 4:3. [PMID: 32153867 PMCID: PMC7050879 DOI: 10.1186/s40795-018-0210-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/29/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The home food environment may be an important target for addressing adolescent obesity. The aim of this study was to investigate associations between aspects of the home food environment and the diets of adolescents who present for obesity treatment. METHODS Cross-sectional baseline data were collected from 167 overweight/obese adolescent-parent pairs participating in an e-health lifestyle modification intervention. Adolescent intake of specific foods (fruit and vegetables, total fat, sugar-sweetened beverages, desserts/treats, and snacking occasions) was assessed by three 24-h dietary recalls, while household factors were collected from adolescent and parent questionnaires. Structural Equation Modeling, controlling for relevant covariates, was used to examine the relationship between adolescent diet and the following household factors: parent modeling, parenting style, family meal practices, and home food/beverage availability. RESULTS Findings reveal that few characteristics of the home food environment were associated with adolescent dietary intake. Greater home availability of high-fat foods was moderately associated with adolescent snack intake (β = 0.27, p < .001). Associations with fruit/vegetables and fat intake were small and some were in unexpected directions. Parent modeling of healthful food choices and healthier family meal practices were associated with lower availability of high-fat foods and treats in the home, but were not directly associated with adolescent diets. CONCLUSIONS Parent modeling of healthy foods and positive mealtime routines might contribute to the healthfulness of foods offered in the homes of adolescents who are overweight/obese. Additional research is needed to better characterize the complex aspects of the household environment that influence adolescent diet.
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Affiliation(s)
- Allison W. Watts
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z9 Canada
- Present address: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55401 USA
| | - Susan I. Barr
- Department of Food, Nutrition & Health, University of British Columbia, 2357 Main Mall, Vancouver, British Columbia V6T 1Z4 Canada
| | - Rhona M. Hanning
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G5 Canada
| | - Chris Y. Lovato
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z9 Canada
| | - Louise C. Mâsse
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z9 Canada
- Child and Family Research Institute, University of British Columbia, 4480 Oak Street, room F512a, Vancouver, BC V6H 3V4 Canada
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17
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Observed differences in child picky eating behavior between home and childcare locations. Appetite 2017; 116:123-131. [DOI: 10.1016/j.appet.2017.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 03/27/2017] [Accepted: 04/18/2017] [Indexed: 01/17/2023]
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18
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Callender C, Liu Y, Moore CE, Thompson D. The baseline characteristics of parents and African American girls in an online obesity prevention program: A feasibility study. Prev Med Rep 2017; 7:110-115. [PMID: 28652960 PMCID: PMC5477066 DOI: 10.1016/j.pmedr.2017.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/15/2017] [Accepted: 05/15/2017] [Indexed: 12/01/2022] Open
Abstract
The objective of this paper was to identify the relationships and associations between child and parent characteristics with child fruit and vegetable (FV) consumption in an online obesity prevention program for 8-10 year old African American girls. Girls and a parent (n = 342 child-parent pairs) in the southwestern US completed baseline data collection from 2012 to 2014. Girls and a parent completed self-report questionnaires online. Girls also completed two unannounced 24 hour telephone-based dietary recalls. The relationships of parent demographic characteristics, child FV intake, and psychosocial variables (child and parent) were examined by analysis of variance. Pearson correlation coefficients were calculated to determine the relationships between psychosocial variables and child FV intake. Child FV intake was significantly greater in the highest household education (p = 0.001) and income groups (p = 0.004). FV home availability was higher with older parents (p = 0.007) and two-parent households (p = 0.033). Child FV intake was positively related to child FV preferences (p < 0.001), FV home availability (p = 0.022), and FV home accessibility (p = 0.002) but was negatively related to family barriers to FV consumption (p = 0.000). The study highlighted significant findings between child FV consumption and parent psychosocial variables and demographic characteristics that may offer insights for the design of effective obesity prevention interventions for 8-10 year old African American girls. ClinicaTrials.gov (NCT01481948).
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Affiliation(s)
- Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
| | - Yan Liu
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
| | - Carolyn E. Moore
- Texas Woman's University, Department of Nutrition and Food Sciences, 6700 Fannin St, Houston, TX 77030, United States
| | - Deborah Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
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19
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Norman Å, Bohman B, Nyberg G, Schäfer Elinder L. Psychometric Properties of a Scale to Assess Parental Self-Efficacy for Influencing Children's Dietary, Physical Activity, Sedentary, and Screen Time Behaviors in Disadvantaged Areas. HEALTH EDUCATION & BEHAVIOR 2017; 45:132-140. [PMID: 28385099 DOI: 10.1177/1090198117699506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND According to social cognitive theory, self-efficacy is central to behavior change. Consequently, parental self-efficacy (PSE) for influencing children's dietary, physical activity (PA), sedentary, and screen time behaviors is important for child obesity prevention. The aim of this study was to evaluate the psychometric properties of an instrument to measure PSE regarding these behaviors in disadvantaged areas. METHOD Parents ( n = 229) of whom 47% had completed secondary school or less, and who participated in the Healthy School Start trial, responded to a 15-item PSE instrument. Children's diet and screen time were measured through parent reports. PA and sedentary behaviors were measured using accelerometers. Construct validity was assessed using exploratory factor analysis (EFA), criterion validity by correlations with child behaviors, and internal consistency by Cronbach's alpha. RESULTS The EFA yielded three factors: (a) PSE for promoting PA; (b) PSE for limiting intake of unhealthy foods, unhealthy drinks, and screen time; and (c) PSE for promoting intake of fruits and vegetables, all with acceptable to good internal consistency (α = .77-.81). Significant correlations ( p < .01) were found between children's dietary ( rs = -.19 to -.29) and screen time ( r = -.29) behaviors and Factor 2, and dietary behaviors and Factor 3 ( rs = .20-.39) but not regarding PA and sedentary behaviors and Factor 1. CONCLUSION The instrument demonstrated good construct validity and acceptable to good internal consistency regarding all but PA behaviors. It may be useful for assessing PSE in child obesity prevention interventions in disadvantaged settings after some refinement.
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Affiliation(s)
- Åsa Norman
- 1 Karolinska Institutet, Stockholm, Sweden
| | - Benjamin Bohman
- 1 Karolinska Institutet, Stockholm, Sweden.,2 Stockholm Health Care Services, Stockholm, Sweden
| | - Gisela Nyberg
- 1 Karolinska Institutet, Stockholm, Sweden.,3 Stockholm County Council, Stockholm, Sweden
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20
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Rogers C, Anderson SE, Dollahite JS, Hill TF, Holloman C, Miller CK, Pratt KJ, Gunther C. Methods and design of a 10-week multi-component family meals intervention: a two group quasi-experimental effectiveness trial. BMC Public Health 2017; 17:50. [PMID: 28069006 PMCID: PMC5223369 DOI: 10.1186/s12889-016-3908-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 12/07/2016] [Indexed: 01/14/2023] Open
Abstract
Background Given the ongoing childhood obesity public health crisis and potential protective effect of family meals, there is need for additional family meals research, specifically experimental studies with expanded health outcomes that focus on the at-risk populations in highest need of intervention. Future research, specifically intervention work, would also benefit from an expansion of the target age range to include younger children, who are laying the foundation of their eating patterns and capable of participating in family meal preparations. The purpose of this paper is to address this research gap by presenting the objectives and research methods of a 10-week multi-component family meals intervention study aimed at eliciting positive changes in child diet and weight status. Methods This will be a group quasi-experimental trial with staggered cohort design. Data will be collected via direct measure and questionnaires at baseline, intervention completion (or waiting period for controls), and 10-weeks post-intervention. Setting will be faith-based community center. Participants will be 60 underserved families with at least 1, 4–10 year old child will be recruited and enrolled in the intervention (n = 30) or waitlist control group (n = 30). The intervention (Simple Suppers) is a 10-week family meals program designed for underserved families from racial/ethnic diverse backgrounds. The 10, 90-min program lessons will be delivered weekly over the dinner hour. Session components include: a) interactive group discussion of strategies to overcome family meal barriers, plus weekly goal setting for caregivers; b) engagement in age-appropriate food preparation activities for children; and c) group family meal for caregivers and children. Main outcome measures are change in: child diet quality; child standardized body mass index; and frequency of family meals. Regression models will be used to compare response variables results of intervention to control group, controlling for confounders. Analyses will account for clustering by family and cohort. Significance will be set at p < 0.05. Discussion This is the first experimentally designed family meals intervention that targets underserved families with elementary school age children and includes an examination of health outcomes beyond weight status. Results will provide researchers and practitioners with insight on evidence-based programming to aid in childhood obesity prevention. Trial registration NCT02923050. Registered 03 October 2016. Retrospectively registered.
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Affiliation(s)
- Catherine Rogers
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, 325 Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA
| | - Sarah E Anderson
- Division of Epidemiology, The Ohio State University, 336 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, USA
| | - Jamie S Dollahite
- Division of Nutritional Sciences, Cornell University, 408 Savage Hall, Ithaca, NY, 14853, USA
| | - Tisa F Hill
- Division of Nutritional Sciences, Cornell University, 342 MVR, Ithaca, NY, 14853, USA
| | - Chris Holloman
- Department of Statistics, The Ohio State University, 404 Cockins Hall, 1958 Neil Avenue, Columbus, OH, 43210, USA
| | - Carla K Miller
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, 347B Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA
| | - Keeley J Pratt
- Department of Human Sciences, Human Development and Family Science Program, The Ohio State University, 130B Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA
| | - Carolyn Gunther
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, 313 Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA.
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Dave JM, Thompson DI, Svendsen-Sanchez A, Cullen KW. Perspectives on Barriers to Eating Healthy Among Food Pantry Clients. Health Equity 2017; 1:28-34. [PMID: 30283833 PMCID: PMC6071878 DOI: 10.1089/heq.2016.0009] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To explore perspectives on barriers of eating healthy among food pantry clients. Methods: Food pantry clients participated in focus groups/interviews. Qualitative data were coded and analyzed using content analyses and grounded theory approach. Themes were then identified. Quantitative data were analyzed for frequencies and descriptives. Results: Fifty-four clients from 10 pantries participated in interviews/focus groups and completed questionnaires. Two major themes emerged: concern over obesity and other chronic diseases, and barriers to healthy eating. Several subthemes for barriers to healthy eating were identified: financial uncertainty, cost of healthy foods, lack of time, rationing food within family, lack of transportation, lack of adequate kitchen equipment, lack of nutrition knowledge and skills, and social support network. Conclusions: Issues identified above and those identified by others working with low-income populations need to be systematically addressed and incorporated into programs and nutrition education interventions for this group.
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Affiliation(s)
- Jayna M. Dave
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Deborah I. Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Ann Svendsen-Sanchez
- Department of Health and Human Performance, College of Liberal Arts and Social Sciences, University of Houston, Houston, Texas
| | - Karen W. Cullen
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
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22
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Dave JM, Thompson DI, Svendsen-Sanchez A, McNeill LH, Jibaja-Weiss M. Development of a Nutrition Education Intervention for Food Bank Clients. Health Promot Pract 2016; 18:221-228. [PMID: 27903768 DOI: 10.1177/1524839916681732] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The focus of this article is the development of a nutrition education intervention for food bank clients. Formative research using mixed-methods (qualitative and quantitative) and community-based participatory research principles was conducted to assess the nutrition education needs of clients obtaining service from the Houston Food Bank (HFB). Participants were HFB and pantry staff and clients. Interview data were coded and analyzed using grounded theory approach. Themes were then identified. Quantitative data were analyzed for frequencies and descriptives. Data were used to tailor the curriculum to the target population. Six HFB staff, 49 pantry staff from 17 pantries, and 54 clients from 10 pantries participated in interviews and focus groups and completed questionnaires. The participants provided opinion on the current nutrition education provided via the food bank and made suggestions on strategies for development of an intervention. Their feedback was used to develop the six-session intervention curriculum to be delivered over 6 months. This research provides evidence that it is critical for members of the target audience be included in formative research to develop behavior change programs that are relevant and appealing and target their needs and interests.
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23
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Bohman B, Rasmussen F, Ghaderi A. Development and psychometric evaluation of a context-based parental self-efficacy instrument for healthy dietary and physical activity behaviors in preschool children. Int J Behav Nutr Phys Act 2016; 13:110. [PMID: 27765049 PMCID: PMC5072306 DOI: 10.1186/s12966-016-0438-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 10/17/2016] [Indexed: 12/11/2022] Open
Abstract
Background Parental self-efficacy (PSE) refers to beliefs of parents to effectively engage in behaviors that result in desired outcomes for their children. There are several instruments of PSE for promoting healthy dietary or physical activity (PA) behaviors in children. These measures typically assess PSE in relation to some quantity or frequency of behavior, for example, number of servings or times per week. However, measuring PSE in relation to contextual circumstances, for example, psychological states and situational demands, may be a more informative approach. The purpose of the present study was to develop and psychometrically evaluate a context-based PSE instrument. Methods Swedish mothers of five-year-old children (n = 698) responded to the Parental Self-Efficacy for Healthy Dietary and Physical Activity Behaviors in Preschoolers Scale (PDAP) and a questionnaire on dietary and PA behaviors in children. Interviews were conducted to explore participant perceptions of the quality of the PDAP items. Psychometric evaluation was conducted using exploratory and confirmatory factor analyses. Spearman correlations between PSE and child behaviors were examined. Results Twenty-seven interviews were conducted with participants, who perceived the items as highly comprehensible, relevant and acceptable. A four-factor model of a revised 21-item version of the PDAP fitted the data, with different factors of PSE for promoting healthy dietary or PA behaviors in children depending on whether circumstances were facilitating or impeding successful performance. Internal consistency was excellent for total scale (Cronbach’s α = .94), and good for factors (α = .84–.88). Correlations were in the expected direction: positive correlations between PSE and healthy behaviors, and negative correlations between PSE and unhealthy behaviors (all rss ≤ .32). Conclusions Psychometric evaluation of the PDAP provided preliminary support of construct validity and internal consistency.
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Affiliation(s)
- Benjamin Bohman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. .,Centre for Psychiatric Research, Stockholm Health Care Services, Stockholm County Council, Liljeholmstorget 7 B, SE-117 63, Stockholm, Sweden.
| | - Finn Rasmussen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Abstract
This article presents the results of a randomized clinical trial evaluating the eight-session Family Eats web-based intervention promoting healthy home food environments for African American families. African American families ( n = 126) with 8- to 12-year-old children completed online baseline questionnaires and were randomized into intervention or control groups. Data collection occurred at baseline, immediately postintervention (Post 1), and 4 months later (Post 2), for parents and children, separately. There were two group by time intervention effects: Control group parents reported a significantly greater frequency of drinking 100% fruit juice at Post 1 compared with intervention group parents. Parent menu planning skills were significantly higher at Post 2 for the intervention group compared with the control group. Significant positive changes overtime were noted for both groups for home fruit/vegetable availability, food preparation practices, and healthy restaurant selection. Intervention group children reported a significant increase in home juice availability at Post 1 compared with the control group; home fruit availability improved for both groups. There was no difference in log on rates by group: 84% and 86% for those who completed Post 1 and Post 2 measurements, respectively. Sixty-four participants completed the evaluation survey: 17 control (50%) and 47 intervention (51%) participants. All participants reported liking the program components; all but one gave it an A or B grade. An Internet-delivered nutrition intervention for families was successful in achieving change in some mediating variables, with good log on rates. Future research with Family Eats should include larger sample sizes, with longer follow-up and a more objective measure of diet.
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Affiliation(s)
| | | | - Tzu-An Chen
- 1 Baylor College of Medicine, Houston, TX, USA
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Factors within the family environment such as parents' dietary habits and fruit and vegetable availability have the greatest influence on fruit and vegetable consumption by Polish children. Public Health Nutr 2016; 18:2705-11. [PMID: 26416288 DOI: 10.1017/s1368980015000695] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify determinants of fruit and vegetable (F&V) consumption among school-aged children. DESIGN A survey study was conducted in October 2010. The questionnaire contained questions concerning social and demographic data, lifestyle and dietary habits, particularly the frequency of F&V consumption, availability of F&V and knowledge about recommended amounts of F&V intake. SETTING Polish primary schools. SUBJECTS Children (n 1255) aged 9 years from randomly selected primary schools and their parents. RESULTS The children's consumption of fruit and of vegetables was influenced by the fruit consumption and vegetable consumption of their parents (r=0·333 and r=0·273, respectively; P=0·001), parents encouraging their children to eat F&V (r=0·259 and r=0·271, respectively; P=0·001), giving children F&V to take to school (r=0·338 and r=0·321, respectively; P=0·001) and the availability of F&V at home (r=0·200 and r=0·296, respectively; P=0·001). Parental education influenced only the frequency of fruit consumption (r=0·074; P=0·01). A correlation between parents' knowledge of the recommended intakes and the frequency of vegetable and fruit consumption by children was noticed (r=0·258 and r=0·192, respectively, P=0·001). CONCLUSIONS Factors within the family environment such as parents' dietary habits and F&V availability had the greatest influence on the F&V consumption by children. Educational activities aimed at parents are crucial to increase the consumption of F&V among children.
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Shier V, Nicosia N, Datar A. Neighborhood and home food environment and children's diet and obesity: Evidence from military personnel's installation assignment. Soc Sci Med 2016; 158:122-31. [PMID: 27135542 PMCID: PMC5042141 DOI: 10.1016/j.socscimed.2016.03.043] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/24/2016] [Accepted: 03/29/2016] [Indexed: 01/08/2023]
Abstract
Research and policy initiatives are increasingly focused on the role of neighborhood food environment in children's diet and obesity. However, existing evidence relies on observational data that is limited by neighborhood selection bias. The Military Teenagers' Environments, Exercise, and Nutrition Study (M-TEENS) leverages the quasi-random variation in neighborhood environment generated by military personnel's assignment to installations to examine whether neighborhood food environments are associated with children's dietary behaviors and BMI. Our results suggest that neither the actual nor the perceived availability of particular food outlets in the neighborhood is associated with children's diet or BMI. The availability of supermarkets and convenience stores in the neighborhood was not associated with where families shop for food or children's dietary behaviors. Further, the type of store that families shop at was not associated with the healthiness of food available at home. Similarly, availability of fast food and restaurants was unrelated to children's dietary behaviors or how often children eat fast food or restaurant meals. However, the healthiness of food available at home was associated with healthy dietary behaviors while eating at fast food outlets and restaurants were associated with unhealthy dietary behaviors in children. Further, parental supervision, including limits on snack foods and meals eaten as a family, was associated with dietary behaviors. These findings suggest that focusing only on the neighborhood food environment may ignore important factors that influence children's outcomes. Future research should also consider how families make decisions about what foods to purchase, where to shop for foods and eating out, how closely to monitor their children's food intake, and, ultimately how these decisions collectively impact children's outcomes.
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Affiliation(s)
- Victoria Shier
- Pardee RAND Graduate School, 1776 Main St, Santa Monica CA 90401, USA.
| | - Nancy Nicosia
- RAND Corporation, 20 Park Plaza #920, Boston, MA 02116, USA.
| | - Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089, USA.
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Cunningham-Sabo L, Lohse B, Smith S, Browning R, Strutz E, Nigg C, Balgopal M, Kelly K, Ruder E. Fuel for Fun: a cluster-randomized controlled study of cooking skills, eating behaviors, and physical activity of 4th graders and their families. BMC Public Health 2016; 16:444. [PMID: 27230565 PMCID: PMC4882848 DOI: 10.1186/s12889-016-3118-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/14/2016] [Indexed: 02/04/2023] Open
Abstract
Background Childhood obesity remains a serious concern in the United States and in many other countries. Direct experience preparing and tasting healthful foods and increasing activity during the school day are promising prevention approaches. Engaging parents and families remains an important challenge. Fuel for Fun: Cooking with Kids Plus Parents and Play is a multi-component school- and family-based intervention for 4th graders and their families intended to promote positive food and activity environments, policies and behaviors at the individual, family and school levels. This paper describes the design and evaluation plan. Methods/Design Four cohorts of 4th-graders and their parents from 8 schools in 2 districts in the same Northern Colorado region are participating in a 4-arm cluster randomized controlled trial. Theory-based Fuel for Fun consists of 5 components delivered over 1 school year: 1) Cooking with Kids - Colorado; an experiential classroom-based cooking and tasting curriculum, 2) Cafeteria Connections; cafeteria-based reinforcements of classroom food experiences using behavioral economic strategies, 3) SPARK active recess; a playground intervention to engage children in moderate to vigorous activity, 4) Fuel for Fun Family; multi-element supports targeting parents to reinforce the 3 school-based components at home, and 5) About Eating; an online interactive program for parents addressing constructs of eating competence and food resource management. Outcomes include child and parent measures of fruit and vegetable preferences and intake, cooking, physical activity, sedentary behaviors and attitudes. School level data assess lunch plate waste and physical activity at recess. In-depth diet and accelerometry assessments are collected with a subsample of parent-child dyads. Data are collected at baseline, immediately post-intervention at 7 months, and at 12 month follow-up. We anticipate recruiting 1320–1584 children and their parents over the length of the project. Discussion The Fuel for Fun study design allows for impact assessment of school-, family- and online parent-based intervention components separately and in combination. Study strengths include use of theory- and evidence-based programs, valid child and parent self-report instruments, and objective measures of food, cooking, and physical activity behaviors at the individual, family and school levels. Parent involvement and engagement is examined through multiple strategies. Trial registration Clinicaltrials.gov registration number NCT02491294. Registered 7 July, 2015.
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Affiliation(s)
- Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, 234 Gifford Building, Fort Collins, Colorado, 80523-1571, USA.
| | - Barbara Lohse
- Wegmans School of Nutrition and Health, Rochester Institute of Technology, Rochester, New York, 14623, USA
| | - Stephanie Smith
- Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, Colorado, 80523-1571, USA
| | | | - Erin Strutz
- Aims Community College, 5401 W 20th, Greeley, Colorado, 80634, USA
| | - Claudio Nigg
- Department of Public Health Studies, University of Hawaii at Manoa, 1960 East-west Road, Honolulu, Hawaii, 96822, USA
| | - Meena Balgopal
- Department of Biology, Colorado State University, 1878 Campus Delivery, Fort Collins, Colorado, 80523-1878, USA
| | - Kathleen Kelly
- Department of Marketing, Colorado State University, 1278 Campus Delivery, Fort Collins, Colorado, 80523-1278, USA
| | - Elizabeth Ruder
- Wegmans School of Nutrition and Health, Rochester Institute of Technology, Rochester, New York, 14623, USA
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Shriver LH, Buehler C. Promoting Fruit and Vegetables in Young Children: What Advice Can Pediatricians Give to Parents? Clin Pediatr (Phila) 2016; 55:209-13. [PMID: 26260399 DOI: 10.1177/0009922815600441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Mello S, Hornik RC. Media Coverage of Pediatric Environmental Health Risks and its Effects on Mothers' Protective Behaviors. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2016; 36:605-622. [PMID: 26268577 DOI: 10.1111/risa.12467] [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] [Indexed: 06/04/2023]
Abstract
This study explores the relationship between exposure to U.S. media coverage of chemical threats to pediatric environmental health and mothers' behaviors to protect their children. Prior content analytic work revealed that media coverage volume from September 2012 to February 2013 differed significantly by type of chemical (i.e., pesticides = high coverage volume; bisphenol A [BPA] = moderate; and arsenic = low). Survey data collected from new and expecting mothers in March 2013 (n = 822) revealed mothers incidentally encountered-or scanned-this information in the media in the prior six months, and after adjusting for a series of potential confounders, such scanning was positively associated with mothers' self-reported behaviors to reduce chemical exposures. To test the hypothesis that coverage volume moderates the relationship between scanning and behavior, content analysis and survey data were combined in mixed effects regression analyses. Results showed significant differences between the effects of media scanning at different levels of coverage volume, but in a direction not entirely consistent with the study's hypothesis. The relationship between scanning and behavior was strongest for BPA, suggesting that a characteristic of media coverage other than volume may drive maternal responses to environmental health threats. Implications of these findings for risk communication research and practice are discussed.
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Affiliation(s)
- Susan Mello
- Department of Communication Studies, Northeastern University, Boston, MA, USA
| | - Robert C Hornik
- Annenberg School of Communication, University of Pennsylvania, Philadelphia, PA, USA
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Davis JN, Martinez LC, Spruijt-Metz D, Gatto NM. LA Sprouts: A 12-Week Gardening, Nutrition, and Cooking Randomized Control Trial Improves Determinants of Dietary Behaviors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:2-11.e1. [PMID: 26453367 PMCID: PMC5266541 DOI: 10.1016/j.jneb.2015.08.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 08/03/2015] [Accepted: 08/13/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the effect of an exploratory 12-week nutrition, cooking, and gardening trial (LA Sprouts) on preference for fruit and vegetables (FV); willingness to try FV; identification of FV; self-efficacy to garden, eat, and cook FV; motivation to garden, eat, and cook FV; attitudes toward FV; nutrition and gardening knowledge; and home gardening habits. DESIGN Randomized controlled trial. SETTING Four elementary schools. PARTICIPANTS Three hundred four predominately Hispanic/Latino third- through fifth-grade students were randomized to either the LA Sprouts group (n = 167 students) or control group (n = 137 students). INTERVENTION Twelve-week after-school nutrition, cooking, and gardening intervention. MAIN OUTCOME MEASURES Determinants of dietary behavior as measured by questionnaire at baseline and postintervention. ANALYSIS Analyses of covariance. RESULTS After the 12-week program, compared with controls, LA Sprouts participants improved scores for identification of vegetables (+11% vs +5%; P = .001) and nutrition and gardening knowledge (+14.5% vs -5.0%; P = .003), and were more likely to garden at home (+7.5% vs -4.4%; P = .003). CONCLUSIONS The LA Sprouts program positively affected a number of determinants of dietary behaviors that suggest possible mechanisms by which gardening and nutrition education act to improve dietary intake and health outcomes.
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Affiliation(s)
- Jaimie N Davis
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX.
| | - Lauren C Martinez
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Nicole M Gatto
- Center for Nutrition, Healthy Lifestyles and Disease Prevention, School of Public Health, Loma Linda University, Linda Loma, CA
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Effectiveness of a universal parental support programme to promote healthy dietary habits and physical activity and to prevent overweight and obesity in 6-year-old children: the Healthy School Start Study, a cluster-randomised controlled trial. PLoS One 2015; 10:e0116876. [PMID: 25680096 PMCID: PMC4332680 DOI: 10.1371/journal.pone.0116876] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To develop and evaluate the effectiveness of a parental support programme to promote healthy dietary and physical activity habits and to prevent overweight and obesity in Swedish children. Methods A cluster-randomised controlled trial was carried out in areas with low to medium socio-economic status. Participants were six-year-old children (n = 243) and their parents. Fourteen pre-school classes were randomly assigned to intervention (n = 7) and control groups (n = 7). The intervention lasted for 6 months and included: 1) Health information for parents, 2) Motivational Interviewing with parents and 3) Teacher-led classroom activities with children. Physical activity was measured by accelerometry, dietary and physical activity habits and parental self-efficacy through a questionnaire. Body weight and height were measured and BMI standard deviation score was calculated. Measurements were conducted at baseline, post-intervention and at 6-months follow-up. Group differences were examined using analysis of covariance and Poisson regression, adjusted for gender and baseline values. Results There was no significant intervention effect in the primary outcome physical activity. Sub-group analyses showed a significant gender-group interaction in total physical activity (TPA), with girls in the intervention group demonstrating higher TPA during weekends (p = 0.04), as well as in sedentary time, with boys showing more sedentary time in the intervention group (p = 0.03). There was a significantly higher vegetable intake (0.26 servings) in the intervention group compared to the control group (p = 0.003). At follow-up, sub-group analyses showed a sustained effect for boys. The intervention did not affect the prevalence of overweight or obesity. Conclusions It is possible to influence vegetable intake in children and girls’ physical activity through a parental support programme. The programme needs to be intensified in order to increase effectiveness and sustain the effects long-term. These findings are an important contribution to the further development of evidence-based parental support programmes to prevent overweight and obesity in children. Trial Registration Controlled-trials.com ISRCTN32750699
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Alsharairi NA, Somerset SM. Associations between Parenting Styles and Children’s Fruit and Vegetable Intake. Ecol Food Nutr 2014; 54:93-113. [DOI: 10.1080/03670244.2014.953248] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bjelland M, Hausken SES, Sleddens EFC, Andersen LF, Lie HC, Finset A, Maes L, Melbye EL, Glavin K, Hanssen-Bauer MW, Lien N. Development of family and dietary habits questionnaires: the assessment of family processes, dietary habits and adolescents' impulsiveness in Norwegian adolescents and their parents. Int J Behav Nutr Phys Act 2014; 11:130. [PMID: 25316270 PMCID: PMC4200224 DOI: 10.1186/s12966-014-0130-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 10/08/2014] [Indexed: 12/27/2022] Open
Abstract
Background There is a need for valid and comprehensive measures of parental influence on children’s energy balance-related behaviours (EBRB). Such measures should be based on a theoretical framework, acknowledging the dynamic and complex nature of interactions occurring within a family. The aim of the Family & Dietary habits (F&D) project was to develop a conceptual framework identifying important and changeable family processes influencing dietary behaviours of 13–15 year olds. A second aim was to develop valid and reliable questionnaires for adolescents and their parents (both mothers and fathers) measuring these processes. Methods A stepwise approach was used; (1) preparation of scope and structure, (2) development of the F&D questionnaires, (3) the conducting of pilot studies and (4) the conducting of validation studies (assessing internal reliability, test-retest reliability and confirmatory factor analysis) using data from a cross-sectional study. Results The conceptual framework includes psychosocial concepts such as family functioning, cohesion, conflicts, communication, work-family stress, parental practices and parental style. The physical characteristics of the home environment include accessibility and availability of different food items, while family meals are the sociocultural setting included. Individual characteristics measured are dietary intake (vegetables and sugar-sweetened beverages) and adolescents’ impulsivity. The F&D questionnaires developed were tested in a test-retest (54 adolescents and 44 of their parents) and in a cross-sectional survey including 440 adolescents (13–15 year olds), 242 mothers and 155 fathers. The samples appear to be relatively representative for Norwegian adolescents and parents. For adolescents, mothers and fathers, the test-retest reliability of the dietary intake, frequencies of (family) meals, work-family stress and communication variables was satisfactory (ICC: 0.53-0.99). Barratt Impulsiveness Scale-Brief (BIS-Brief) was included, assessing adolescent’s impulsivity. The internal reliability (Cronbach’s alphas: 0.77/0.82) and test-retest reliability values (ICC: 0.74/0.77) of BIS-Brief were good. Conclusions The conceptual framework developed may be a useful tool in guiding measurement and assessment of the home food environment and family processes related to adolescents’ dietary habits, in particular and for EBRBs more generally. The results support the use of the F&D questionnaires as psychometrically sound tools to assess family characteristics and adolescent’s impulsivity. Electronic supplementary material The online version of this article (doi:10.1186/s12966-014-0130-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mona Bjelland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Blindern, Oslo, NO-0316, Norway.
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Koh GA, Scott JA, Woodman RJ, Kim SW, Daniels LA, Magarey AM. Maternal feeding self-efficacy and fruit and vegetable intakes in infants. Results from the SAIDI study. Appetite 2014; 81:44-51. [DOI: 10.1016/j.appet.2014.06.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 06/02/2014] [Accepted: 06/04/2014] [Indexed: 10/25/2022]
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Individual and Household Predictors of Adolescents’ Adherence to a Web-Based Intervention. Ann Behav Med 2014; 49:371-83. [DOI: 10.1007/s12160-014-9658-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Predicting use of effective vegetable parenting practices with the Model of Goal Directed Behavior. Public Health Nutr 2014; 18:1389-96. [PMID: 25234656 DOI: 10.1017/s1368980014002079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To model effective vegetable parenting practices using the Model of Goal Directed Vegetable Parenting Practices construct scales. DESIGN An Internet survey was conducted with parents of pre-school children to assess their agreement with effective vegetable parenting practices and Model of Goal Directed Vegetable Parenting Practices items. Block regression modelling was conducted using the composite score of effective vegetable parenting practices scales as the outcome variable and the Model of Goal Directed Vegetable Parenting Practices constructs as predictors in separate and sequential blocks: demographics, intention, desire (intrinsic motivation), perceived barriers, autonomy, relatedness, self-efficacy, habit, anticipated emotions, perceived behavioural control, attitudes and lastly norms. Backward deletion was employed at the end for any variable not significant at P<0·05. SETTING Houston, TX, USA. SUBJECTS Three hundred and seven parents (mostly mothers) of pre-school children. RESULTS Significant predictors in the final model in order of relationship strength included habit of active child involvement in vegetable selection, habit of positive vegetable communications, respondent not liking vegetables, habit of keeping a positive vegetable environment and perceived behavioural control of having a positive influence on child's vegetable consumption. The final model's adjusted R 2 was 0·486. CONCLUSIONS This was the first study to test scales from a behavioural model to predict effective vegetable parenting practices. Further research needs to assess these Model of Goal Directed Vegetable Parenting Practices scales for their (i) predictiveness of child consumption of vegetables in longitudinal samples and (ii) utility in guiding design of vegetable parenting practices interventions.
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Christian MS, Evans CEL, Cade JE. Does the Royal Horticultural Society Campaign for School Gardening increase intake of fruit and vegetables in children? Results from two randomised controlled trials. PUBLIC HEALTH RESEARCH 2014. [DOI: 10.3310/phr02040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundChildren’s fruit and vegetable intake in the UK is low. Changing intake is challenging. Gardening in schools might be a vehicle for facilitating fruit and vegetable intake.ObjectivesTo undertake the first clustered randomised controlled trials (RCTs) of a gardening intervention. To evaluate the impact of a school gardening programme, the Royal Horticultural Society (RHS) Campaign for School Gardening, on children’s fruit and vegetable intake.MethodsPrimary school children aged 8–11 years from eight London boroughs were included in one of two related RCTs. Trial 1 consisted of 23 schools, randomised to receive either a RHS-led or teacher-led intervention. Trial 2 consisted of 31 schools, randomised to either the teacher-led intervention or a comparison group. A 24-hour food diary [the Child And Diet Evaluation Tool (CADET)] collected baseline and follow-up dietary intake. Questionnaires measured children’s knowledge and attitudes towards fruit and vegetables and assessed intervention implementation. Data were collected by fieldworkers who were blind to the original allocation of the school. The primary outcome was change in fruit and vegetable intake analysed using a random effects model, based on intention to treat.ResultsTotal sample size at baseline for both trials (2529 children) was lower than the original aim of 2900 children. The final sample size was 1557, with 641 children completing trial 1 (RHS-led,n = 312; teacher-led,n = 329) and 916 children completing trial 2 (teacher-led,n = 488; control,n = 428). The response rate at follow-up for the two combined was 62%.Baseline analysis of children’s fruit and vegetable intake showed that eating a family meal together, cutting up fruit and vegetables, and parental modelling of fruit and vegetable intakes were all associated with higher intakes of fruit and vegetables in children.The primary trial outcome, combined fruit and vegetable intake, showed that in trial 1 the teacher-led group had a mean change in intake of 8 g [95% confidence interval (CI) –19 to 36 g], compared with a mean of –32 g (95% CI –60 to –3 g) in the RHS-led group. However, this difference was not significant (intervention effect –43 g, 95% CI –88 to 1 g;p = 0.06). In trial 2, the teacher-led group consumed 15 g (95% CI –36 to 148 g) more fruit and vegetables than the comparison group; this difference was not significant. No change was found in children’s knowledge and attitudes. However, if schools improved their RHS gardening score by three levels, children had a higher intake of 81 g of fruit and vegetables (95% CI 0 to 163 g;p = 0.05) compared with schools with no change in gardening score.ConclusionResults from these trials provide little evidence that school gardening alone can improve children’s fruit and vegetable intake. In both trials, gardening levels increased across all groups from baseline to follow-up, with no statistically significant difference between groups in terms of improvement in gardening level. This lack of differentiation between groups is likely to have influenced the primary outcome. However, when the gardening intervention was implemented at the highest intensities there was a suggestion that it could improve children’s fruit and vegetable intake by a portion. Analysis of the baseline data showed that family support for fruit and vegetable intakes was associated with higher intakes of fruit and vegetables in children. This study highlights the need for more sophisticated and accurate tools to evaluate diet in children. Future intervention designs should include a greater level of parental involvement in school interventions, along with related components such as cooking, to substantially improve children’s fruit and vegetable intake. In addition, the home environment has been demonstrated to be an important focus for intervention.Trial registrationCurrent Controlled Trials ISRCTN11396528.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 2, No. 4. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Meaghan S Christian
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Charlotte EL Evans
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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Predicting use of ineffective vegetable parenting practices with the Model of Goal Directed Behavior. Public Health Nutr 2014; 18:1028-35. [PMID: 24946833 DOI: 10.1017/s1368980014001220] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Increasing a parent's ability to influence a child's vegetable intake may require reducing the parent's use of ineffective vegetable parenting practices. The present study was designed to understand the psychosocial influences on ineffective vegetable parenting practices. DESIGN A cross-sectional web-based survey was conducted to model use of ineffective vegetable parenting practices using validated scales from a Model of Goal Directed Vegetable Parenting Practices. SETTING The dependent variable was a composite ineffective vegetable parenting practices index. The independent variables included validated subscales of intention, habit, perceived barriers, desire, competence, autonomy, relatedness, attitudes, norms, perceived behavioural control and anticipated emotions. Models were analysed using block regression with backward deletion. SUBJECTS Parents of 307 pre-school children (3-5 years old). RESULTS Variables significantly positively related to ineffective vegetable parenting practices in order of relationship strength included habit of controlling vegetable practices (standardized β=0·349, P<0·0001) and desire (standardized β=0·117, P=0·025). Variables significantly negatively related to ineffective vegetable parenting practices in order of relationship strength included perceived behavioural control of negative parenting practices (standardized β=-0·215, P<0000), the habit of active child involvement in vegetable selection (standardized β=-0·142, P=0·008), anticipated negative parent emotional response to child vegetable refusal (standardized β=-0·133, P=0·009), autonomy (standardized β=-0·118, P=0.014), attitude about negative effects of vegetables (standardized β=-0·118, P=0·015) and descriptive norms (standardized β=-0·103, P=0·032). The model accounted for 40·5 % of the variance in use of ineffective vegetable parenting practices. CONCLUSIONS The present study is the first report of psychometrically tested scales to predict use of ineffective vegetable parenting practices. Innovative intervention procedures will need to be designed and tested to reduce ineffective vegetable parenting practices.
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Nickelson J, Lawrence JC, Parton JM, Knowlden AP, McDermott RJ. What proportion of preschool-aged children consume sweetened beverages? THE JOURNAL OF SCHOOL HEALTH 2014; 84:185-194. [PMID: 24443780 DOI: 10.1111/josh.12136] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 08/20/2013] [Accepted: 09/04/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Obesity affects nearly 17% of US children and youth 2-19 years old and 10% of infants and toddlers under the age of 2 years. One strategy for addressing obesity is to discourage sugar-sweetened beverage (SSB) consumption. Compared with their older school-aged counterparts, children ≤ 5 years depend largely on parents for the purchase and serving of SSBs. Therefore, recognizing parental factors associated with children's intake of SSBs is important. METHODS This study used cross-sectional data from parents of children ≤ 5 years old to examine SSB consumption and associated factors. Elements of the Health Belief Model and Theory of Reasoned Action facilitated data analysis and interpretation. RESULTS The most consistent predictor of SSB intake was child age. Nearly 94% of children aged 3-5 years consumed sweetened milk products, 88% consumed fruity drinks, 63% consumed sodas, and 56% consumed sports drinks and sweet tea. Adjusting for all other factors, the only parental psychosocial factor associated with SSB intake was self-efficacy (predicting fruity drinks consumption). CONCLUSIONS More children drink SSBs as they get older. Interventions designed to prevent SSB consumption should occur early, before children reach preschool age. Additional study of parental factors influencing SSB intake in early childhood is recommended.
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Affiliation(s)
- Jen Nickelson
- Assistant Professor, , Department of Health Science, University of Alabama, PO Box 870311,Tuscaloosa, AL 35487-0311
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Bohman B, Nyberg G, Sundblom E, Elinder LS. Validity and Reliability of a Parental Self-Efficacy Instrument in the Healthy School Start Prevention Trial of Childhood Obesity. HEALTH EDUCATION & BEHAVIOR 2013; 41:392-6. [PMID: 24369178 DOI: 10.1177/1090198113515243] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Measures of parental self-efficacy (PSE) for healthy dietary or physical activity (PA) behaviors in children have been used in several studies; however, further psychometric validation of PSE for these behaviors is needed. The purpose of the present study was to evaluate the psychometric properties of a new PSE instrument. METHODS Mothers (n = 162) of 6-year-old children in the Healthy School Start prevention trial of childhood obesity responded to the instrument and a parent-report questionnaire on diet and PA in children. In addition, PA was objectively assessed by accelerometry. RESULTS Exploratory factor analysis yielded a structure composed of three factors of PSE for dietary and PA behaviors in children, and PSE was associated with parent-report of these behaviors. Internal consistency was good. DISCUSSION Preliminary support of the validity and reliability of the PSE instrument was provided. The measure may be useful in prevention and treatment trials of childhood obesity.
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Baranowski T, Beltran A, Chen TA, Thompson D, O'Connor T, Hughes S, Diep C, Baranowski J. Psychometric assessment of scales for a Model of Goal Directed Vegetable Parenting Practices (MGDVPP). Int J Behav Nutr Phys Act 2013; 10:110. [PMID: 24053779 PMCID: PMC3848744 DOI: 10.1186/1479-5868-10-110] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 09/19/2013] [Indexed: 02/06/2023] Open
Abstract
Background Vegetable intake has been related to lower risk of chronic illnesses in the adult years. The habit of vegetable intake should be established early in life, but many parents of preschoolers report not being able to get their child to eat vegetables. The Model of Goal Directed Behavior (MGDB) has been employed to understand vegetable parenting practices (VPP) to encourage a preschool child’s vegetable intake. The Model of Goal Directed Vegetable Parenting Practices (MGDVPP) provides possible determinants and may help explain why parents use effective or ineffective VPP. Scales to measure effective and ineffective vegetable parenting practices have previously been validated. This manuscript presents the psychometric characteristics and factor structures of new scales to measure the constructs in MGDVPP. Methods Participants were 307 parents of preschool (i.e. 3 to 5 year old) children, used for both exploratory (EFA) and confirmatory factor analyses (CFA). Data were collected via an internet survey. First, EFA were conducted using the scree plot criterion for factor extraction. Next, CFA assessed the fit of the exploratory derived factors. Then, classical test theory procedures were employed with all scales. Finally, Pearson correlations were calculated between each scale and composite effective and ineffective VPP as a test of scale predictive validity. Results Twenty-nine subscales (164 items) within 11 scales were extracted. The number of items per subscale ranged from 2 to 13, with three subscales having 10 or more items and 12 subscales having 4 items or less. Cronbach’s alphas varied from 0.13 to 0.92, with 17 being 0.70 or higher. Most alphas <0.70 had only three or four items. Twenty-five of the 29 subscales significantly bivariately correlated with the composite effective or ineffective VPP scales. Discussion This was the initial examination of the factor structure and psychometric assessment of MGDVPP scales. Most of the scales displayed acceptable to desirable psychometric characteristics. Research is warranted to add items to those subscales with small numbers of items, test their validity and reliability, and characterize the model’s influence on child vegetable consumption.
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Affiliation(s)
- Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Department of Pediatrics, 1100 Bates Street, Houston 77030-2600 TX, USA.
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Melbye EL, Øgaard T, Øverby NC, Hansen H. Parental food-related behaviors and family meal frequencies: associations in Norwegian dyads of parents and preadolescent children. BMC Public Health 2013; 13:820. [PMID: 24015833 PMCID: PMC3846792 DOI: 10.1186/1471-2458-13-820] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 09/04/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Frequent family meals are associated with healthy dietary behaviors and other desirable outcomes in children and adolescents. Therefore, increased knowledge about factors that may increase the occurrence of family meals is warranted. The present study has its focus on the home food environment, and aims to explore potential associations between parent-reported feeding behaviors and child-reported family meal frequencies. METHODS Cross-sectional surveys were performed among 10-12-year-olds and their parents recruited from eighteen schools in southwest Norway. The child questionnaire included measures of family meal frequencies (breakfast, dinner and supper). The parent questionnaire included measures of parental feeding behaviors adapted from the Comprehensive Feeding Practices Questionnaire. A series of multiple linear regression analyses were conducted to examine the relationships between parental feeding behaviors and the frequency of family meals. RESULTS The frequency of family breakfasts was associated with three parental feeding variables; home environment (β=.11, p<.05), pressure to eat (β=.11, p<.01), and monitoring (β=.10, p<.05). The frequency of family dinners and suppers was associated with one parental feeding variable; home environment (β=.11, p<.01 and β=.12, p<.01 for dinners and suppers respectively). CONCLUSIONS The home environment variable was the most important correlate of child-reported family meal frequencies in this study. Although further research is needed, our findings support the evident influence of parents and the home food environment on child and adolescent eating behavior, which in the present study was measured as the frequency of shared family meals.
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Thompson D, Mahabir R, Bhatt R, Boutte C, Cantu D, Vazquez I, Callender C, Cullen K, Baranowski T, Liu Y, Walker C, Buday R. Butterfly Girls; promoting healthy diet and physical activity to young African American girls online: rationale and design. BMC Public Health 2013; 13:709. [PMID: 23915235 PMCID: PMC3750459 DOI: 10.1186/1471-2458-13-709] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 05/22/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Young African American girls have a high risk of obesity. Online behavior change programs promoting healthy diet and physical activity are convenient and may be effective for reducing disparities related to obesity. This report presents the protocol guiding the design and evaluation of a culturally and developmental appropriate online obesity prevention program for young African American girls. METHODS/DESIGN The Butterfly Girls and the Quest for Founder's Rock is an 8-episode online program delivered as an animated, interactive comic. The program promotes healthy diet and physical activity and is specifically designed for 8-10 year old African American girls. Girls, parents, and community representatives provided formative feedback on cultural relevance and developmental appropriateness. A three-group (treatment, comparison, wait-list control) randomized design (n=390 parent/child dyads) is employed, with child as the unit of assignment. Change in body mass index is the primary outcome; change in fruit and vegetable consumption, water, and physical activity are secondary outcomes. Data collection occurs at baseline, approximately 3 months after baseline (i.e., completion of the online program), and approximately three months later (i.e., maintenance assessment). Two dietary recalls are collected at each data collection period by trained interviewers using the Nutrient Data System for Research (NDSR 2012) system. Physical activity is objectively measured by seven days of accelerometry. Psychosocial and process data are also collected. Girls in the treatment and comparison groups will be interviewed at post 1 to obtain information on personal reactions to the program. DISCUSSION This research will develop and evaluate the efficacy of an online program for reducing obesity risk among girls at risk of obesity and related diseases. Online programs offer the potential for wide dissemination, thus reducing disparities related to obesity. TRIAL REGISTRATION NCT01481948.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston TX 77030, USA.
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Patrick H, Hennessy E, McSpadden K, Oh A. Parenting styles and practices in children's obesogenic behaviors: scientific gaps and future research directions. Child Obes 2013; 9 Suppl:S73-86. [PMID: 23944926 PMCID: PMC3746290 DOI: 10.1089/chi.2013.0039] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Given the emerging global childhood obesity epidemic and the specter of a generation of children who will have a shorter life expectancy than that of their parents, recent research has focused on factors that influence children's weight status and obesogenic behaviors (i.e., eating, physical activity, and screen media use). Parents act as primary socializing agents for children, and thus growing evidence supports the role of parenting styles and practices in children's obesity-related behaviors and weight. Studying these processes in children and adolescents is important for several reasons. First, diet and physical activity behaviors and weight status track from childhood and adolescence into adulthood. Furthermore, diet and physical activity behaviors and weight status confer significant risk for cancer, diabetes, cardiovascular disease, and other chronic diseases. The purpose of this article is to describe the scientific gaps that need to be addressed to develop a more informed literature on parenting styles and practices in the domains of weight status and obesogenic behaviors, as identified by an expert panel assembled by the National Cancer Institute.
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Affiliation(s)
- Heather Patrick
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892-9671, USA.
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Vaughn AE, Tabak RG, Bryant MJ, Ward DS. Measuring parent food practices: a systematic review of existing measures and examination of instruments. Int J Behav Nutr Phys Act 2013; 10:61. [PMID: 23688157 PMCID: PMC3681578 DOI: 10.1186/1479-5868-10-61] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 05/08/2013] [Indexed: 11/10/2022] Open
Abstract
During the last decade, there has been a rapid increase in development of instruments to measure parent food practices. Because these instruments often measure different constructs, or define common constructs differently, an evaluation of these instruments is needed. A systematic review of the literature was conducted to identify existing measures of parent food practices and to assess the quality of their development. The initial search used terms capturing home environment, parenting behaviors, feeding practices and eating behaviors, and was performed in October of 2009 using PubMed/Medline, PsychInfo, Web of knowledge (ISI), and ERIC, and updated in July of 2012. A review of titles and abstracts was used to narrow results, after which full articles were retrieved and reviewed. Only articles describing development of measures of parenting food practices designed for families with children 2-12 years old were retained for the current review. For each article, two reviewers extracted data and appraised the quality of processes used for instrument development and evaluation. The initial search yielded 28,378 unique titles; review of titles and abstracts narrowed the pool to 1,352 articles; from which 57 unique instruments were identified. The review update yielded 1,772 new titles from which14 additional instruments were identified. The extraction and appraisal process found that 49% of instruments clearly identified and defined concepts to be measured, and 46% used theory to guide instrument development. Most instruments (80%) had some reliability testing, with internal consistency being the most common (79%). Test-retest or inter-rater reliability was reported for less than half the instruments. Some form of validity evidence was reported for 84% of instruments. Construct validity was most commonly presented (86%), usually with analysis of associations with child diet or weight/BMI. While many measures of food parenting practices have emerged, particularly in recent years, few have demonstrated solid development methods. Substantial variation in items across different scales/constructs makes comparison between instruments extremely difficult. Future efforts should be directed toward consensus development of food parenting practices constructs and measures.
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Affiliation(s)
- Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L, King Jr, Blvd,, CB 7426, Chapel Hill, NC 27599-7426, USA.
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Bohman B, Ghaderi A, Rasmussen F. Psychometric Properties of a New Measure of Parental Self-Efficacy for Promoting Healthy Physical Activity and Dietary Behaviors in Children. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2013. [DOI: 10.1027/1015-5759/a000159] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
There is a lack of validated measures of parental self-efficacy (PSE) covering both physical activity and dietary behaviors in children which can be used to prevent childhood obesity. This study developed a new measure of PSE for promoting healthy physical activity and dietary behaviors in children and assessed its psychometric properties. Participants were mothers (n = 2,232) with 3-year-old first-born children living in Stockholm, Sweden. The mothers responded to questionnaires measuring PSE, locus of control, and self-esteem. Exploratory factor analysis yielded a three-factor structure, interpreted as PSE for promoting healthy dietary behaviors in children (Factor 1), PSE for limit-setting of unhealthy dietary or physical activity behaviors in children (Factor 2), and PSE for promoting healthy physical activity behaviors in children (Factor 3). The factor model was supported by confirmatory factor analysis. The internal consistency and test-retest reliability of the new PSE measure were high; discriminant validity was adequate. The Parental Self-Efficacy for Promoting Healthy Physical Activity and Dietary Behaviors in Children Scale (PSEPAD) shows promise as a valuable instrument in childhood obesity prevention.
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Affiliation(s)
- Benjamin Bohman
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Ata Ghaderi
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Finn Rasmussen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Baranowski T, Diep C, Baranowski J. Influences on Children's Dietary Behavior, and Innovative Attempts to Change It. ANNALS OF NUTRITION AND METABOLISM 2013; 62 Suppl 3:38-46. [DOI: 10.1159/000351539] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Thompson D, Bhatt R, Lazarus M, Cullen K, Baranowski J, Baranowski T. A Serious Video Game to Increase Fruit and Vegetable Consumption Among Elementary Aged Youth (Squire's Quest! II): Rationale, Design, and Methods. JMIR Res Protoc 2012; 1:e19. [PMID: 23612366 PMCID: PMC3626159 DOI: 10.2196/resprot.2348] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 11/02/2012] [Accepted: 11/05/2012] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Youths eat fewer fruits and vegetables than recommended. Effective methods are needed to increase and maintain their fruit and vegetable consumption. Goal setting has been an effective behavior change procedure among adults, but has had limited effectiveness among youths. Implementation intentions are specific plans to facilitate goal attainment. Redefining goal setting to include implementation intentions may be an effective way to increase effectiveness. Video games offer a controlled venue for conducting behavioral research and testing hypotheses to identify mechanisms of effect. OBJECTIVE This report describes the protocol that guided the design and evaluation of Squire's Quest! II, a video game aimed to increase child fruit and vegetable consumption. METHODS Squire's Quest! II is a 10-episode videogame promoting fruit and vegetable consumption to 4th and 5th grade children (approximately 9-11 year old youths). A four group randomized design (n=400 parent/child dyads) was used to systematically test the effect of two types of implementation intentions (action, coping) on fruit and vegetable goal attainment and consumption of 4th and 5th graders. Data collection occurred at baseline, immediately post game-play, and 3 months later. Child was the unit of assignment. Three dietary recalls were collected at each data collection period by trained interviewers using the Nutrient Data System for Research (NDSR 2009). Psychosocial and process data were also collected. RESULTS To our knowledge, this is the first research to explore the effect of implementation intentions on child fruit and vegetable goal attainment and consumption. CONCLUSIONS This intervention will contribute valuable information regarding whether implementation intentions are effective with elementary age children. TRIAL REGISTRATION ClinicalTrials.gov NCT01004094.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.
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Lohse B, Cunningham-Sabo L. Eating competence of Hispanic parents is associated with attitudes and behaviors that may mediate fruit and vegetable-related behaviors of 4th grade youth. J Nutr 2012; 142:1903-9. [PMID: 22933747 DOI: 10.3945/jn.112.164269] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Parent self-efficacy, outcome expectancies, and behaviors toward cooking and fruits and vegetables mediate children's eating. Eating competence, an intra-individual approach to food-related attitudes and behaviors, is associated with healthful outcomes but has not been studied as a moderator of parent food-related behaviors that mediate healthful eating in 4th grade children. Parents (n = 339; 78% Hispanic, 89% female) of 4th graders who participated in an impact study of the Cooking with Kids curriculum in Santa Fe, NM schools eligible for Supplemental Nutrition Assistance Program Education completed the following surveys: Satter eating competence inventory for low-income (ecSI/LI) (16 items, Likert scale, possible score 0-48); modeling behaviors related to food preparation and fruits/vegetables (11 items, Likert scale, possible score 0-33); self-efficacy/outcome expectancies (SE/OE) (12 items, Likert scale, possible score 12-60); and availability of fruits/vegetables (20 items, possible score 0-20). Higher scores indicate more desired behaviors. The mean ecSI/LI score was 33.6 ± 8.5; 59% were eating competent, i.e., ecSI/LI ≥ 32. Eating-competent parents demonstrated more modeling (16.3 ± 5.0 vs. 14.0 ± 4.3; P < 0.001), greater SE/OE (53.7 ± 10.1 vs. 51.2 ± 8.5; P = 0.03), and greater in-home fruit/vegetable availability (12.7 ± 3.0 vs. 11.9 ± 3.2; P = 0.02). Two clusters of modeling behavior were defined: achievers and strivers. Modeling achievers (34.9 ± 6.9) were more eating competent (P < 0.001) than strivers (30.3 ± 8.9). Eating competence moderated parent food-related behaviors. Measuring eating competence may contribute to understanding parent behavior as a mediator in school-based nutrition interventions.
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Affiliation(s)
- Barbara Lohse
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
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Evans CEL, Christian MS, Cleghorn CL, Greenwood DC, Cade JE. Systematic review and meta-analysis of school-based interventions to improve daily fruit and vegetable intake in children aged 5 to 12 y. Am J Clin Nutr 2012; 96:889-901. [PMID: 22952187 DOI: 10.3945/ajcn.111.030270] [Citation(s) in RCA: 305] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To our knowledge, no reviews have assessed the impact of a range of multi- and single-component school-based programs on daily fruit and vegetable intake by using a meta-analysis. OBJECTIVE The aim of this study was to quantify the impact of school-based interventions on fruit and vegetable intake in children aged 5-12 y. DESIGN A systematic literature review was carried out to identify randomized and nonrandomized controlled trials that were based in primary schools and designed to increase portions of daily fruit and vegetable intake. MEDLINE, Cochrane libraries, EMBASE, PsycINFO, and Educational Information Centre were searched from 1985 to 2009. Data were extracted, and mean effect sizes were calculated by using random effects models. RESULTS A total of 27 school-based programs involving 26,361 children were identified that met the inclusion criteria and assessed the daily weight of fruit and vegetable intake combined, fruit intake only, or vegetable intake only, and 21 studies were used in meta-analyses. The results of the meta-analyses indicated an improvement of 0.25 portions (95% CI: 0.06, 0.43 portions) of fruit and vegetable daily intake if fruit juice was excluded and an improvement of 0.32 portions (95% CI: 0.14, 0.50 portions) if fruit juice was included. Improvement was mainly due to increases in fruit consumption but not in vegetable consumption. The results of the meta-analyses for fruit (excluding juice) and vegetables separately indicated an improvement of 0.24 portions (95% CI: 0.05, 0.43 portions) and 0.07 portions (95% CI: -0.03, 0.16 portions), respectively. CONCLUSIONS School-based interventions moderately improve fruit intake but have minimal impact on vegetable intake. Additional studies are needed to address the barriers for success in changing dietary behavior, particularly in relation to vegetables.
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Affiliation(s)
- Charlotte E L Evans
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom.
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