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Dearing G, Latchford GJ, Caterson ID, Hill AJ. Young children's choices and thoughts about pro-social behaviour towards others with overweight. Pediatr Obes 2024:e13129. [PMID: 38764203 DOI: 10.1111/ijpo.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES This study aimed to investigate weight bias within young children's pro-social choices between characters who differed in body size. METHODS Seventy-six children aged 4-6 years read stories asking them to choose who they would first help, share with, comfort, and steal from, between a healthy weight and child with overweight. They also selected the one character they would most like to play with. Children's reasoning for these choices was recorded and analysed. RESULTS The character with overweight was helped first in only a third of the choices made. Children chose the characters with overweight more often as the target for anti-social action. In friendship selections, children overwhelmingly rejected the characters with overweight. However, weight bias was not prominent in the reasons children gave for the choices. Most children were not negative about body shape, weight or appearance. Similarly, in friendship choices, these were mostly expressed positively to the character chosen. Only a small minority of children were explicitly negative about the character with overweight. CONCLUSIONS A better understanding of weight bias acquisition and variation between children will benefit those working in health care and educational settings. Future research should link with developmental theory, such as on social categorization and theory of mind.
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Affiliation(s)
- Gemma Dearing
- Division of Psychological & Social Medicine, University of Leeds, Leeds, UK
| | - Gary J Latchford
- Division of Psychological & Social Medicine, University of Leeds, Leeds, UK
| | - Ian D Caterson
- Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J Hill
- Division of Psychological & Social Medicine, University of Leeds, Leeds, UK
- Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
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Health Literacy in Early Childhood: A Systematic Review of Empirical Studies. CHILDREN 2022; 9:children9081131. [PMID: 36010022 PMCID: PMC9406303 DOI: 10.3390/children9081131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/15/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Early childhood plays a key role in the formation of healthy habits and the establishment of health literacy. Nonetheless, there are only a few research studies focusing on the health literacy level of children under the age of eight. The aim of our systematic review is to explore empirical research on health literacy related to early childhood. The research was conducted in accordance with the PRISMA protocol. This systematic review examines 12 studies published between 2013–2022. Results show that research focuses on different domains of health literacy for children. In relation to children’s food literacy, children understand the relationship between health and nutrition and they realize the health impact of obesity. The habits connected to oral health are strongly associated with parents’ knowledge of and behaviours around oral health. Results related to health care situations show that children are able to be actively involved in decision-making processes in connection with their health. Exploring young children’s health literacy is essential in order to be able to plan health promotion interventions, embedded into early childhood education. Picture-based messages or story-based messages supported by illustrations can help measure health literacy in early childhood and can support the formation of health literacy.
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Faragó F, Savoy S, Sanchez EA, Khaleghi N, Evans L, Adams EL, Palomino E. Gender Typicality, Pressure to Conform to Gender Norms, and Anti-Fat and Appearance Stereotypes in Girls. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2183-2198. [PMID: 35471679 DOI: 10.1007/s10508-021-02252-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Abstract
This mixed-methods study investigated the relation among gender identity (i.e., self-perceived gender similarity to girls and boys; self-perceived parental and peer pressure to conform to gender norms) and stereotyping about weight (i.e., anti-fat stereotypes), weight change, and appearance in 83 girls ages 6-9 (Mage = 7.60 years, SD = .85; 65% White, 16% Mixed/Other, 11% Black, 8% Latina) in the U.S. Stereotypes about weight change were assessed with open-ended responses (i.e., qualitatively), and the rest of the constructs were assessed with closed-ended responses (i.e., quantitatively). There was a positive association between pressure from parents to conform to gender norms and appearance stereotypes, and between pressure from peers and negative stereotypes about the fat and thin figures. Girls who were more gender typical, or more similar to girls, were more likely to endorse appearance stereotypes. There was no significant relation among stereotypes about weight change and gender identity. Many girls deemed the fat figure as unattractive, physically restrained, unhealthy, and likely to be bullied and believed that the fat figure should change back to look like a thinner figure. Most girls were aware that exercising, eating healthy, and dietary restriction can lead to weight loss and that food consumption and lack of exercise can lead to weight gain. Findings suggest that certain aspects of weight (anti-fat) and appearance stereotypes are closely linked to gender identity in girls, whereas other aspects of weight stereotypes (e.g., stereotypes about weight change) are so pervasive that they are common in most girls, regardless of their gender identity.
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Affiliation(s)
- Flóra Faragó
- School of Human Sciences, Human Development and Family Studies, Stephen F. Austin State University, SFA Station, P. O. Box 13014, Nacogdoches, TX, 75962, USA.
| | - Sarah Savoy
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Emily A Sanchez
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Neusha Khaleghi
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Lauren Evans
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Emily L Adams
- Human Services and Educational Leadership, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Edgar Palomino
- Human Services and Educational Leadership, Stephen F. Austin State University, Nacogdoches, TX, USA
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Cullin JM. Implicit and explicit fat bias among adolescents from two US populations varying by obesity prevalence. Pediatr Obes 2021; 16:e12747. [PMID: 33191643 DOI: 10.1111/ijpo.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research shows that explicit (reported) and implicit (unconscious) bias are distinct constructs varying by socioecological context. Implicit bias better predicts poor health outcomes related to chronic psychosocial stress. OBJECTIVES Variation in fat bias was identified in two populations of adolescents in Indiana counties with relatively high (Lawrence) and low (Monroe) obesity prevalence. METHODS Adolescents (n = 185) aged 14-18 years were recruited October 2017-2018. Explicit fat bias was measured using the Attitudes Towards Obese Persons (ATOP) scale. Implicit fat bias was measured using the obesity attitude implicit association test (IAT). RESULTS Both samples scored high on the ATOP, indicating more positive reported attitudes towards persons with obesity, and scores did not differ between counties (P > .05) after adjusting for age, sex, ethnicity, and BMI-for-age percentile. Both samples demonstrated unconscious anti-fat bias, with Monroe exhibiting significantly higher IAT scores (ie, greater anti-fat bias) than Lawrence after controlling for confounders (P = .039). CONCLUSION Differences between explicit and implicit fat-bias were observed. Both samples reported positive attitudes towards obesity but also demonstrated unconscious anti-fat bias. Unconscious anti-fat bias was significantly higher in the county with lower prevalence of obesity, suggesting epidemiological context may influence implicit fat bias. Higher obesity prevalence may reduce unconscious anti-fat bias in a population or, alternatively, lower obesity prevalence may increase such bias.
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Affiliation(s)
- Jennifer M Cullin
- Department of Anthropology, Indiana University, Bloomington, Indiana, USA
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Tabacchi G, Battaglia G, Messina G, Paoli A, Palma A, Bellafiore M. Validity and Internal Consistency of the Preschool-FLAT, a New Tool for the Assessment of Food Literacy in Young Children from the Training-To-Health Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082759. [PMID: 32316251 PMCID: PMC7215692 DOI: 10.3390/ijerph17082759] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/03/2020] [Accepted: 04/14/2020] [Indexed: 12/02/2022]
Abstract
Background: The importance of assessing “food literacy” since youth has been highlighted and, to this purpose, valid and consistent instruments are needed. This study aimed to assess the validity and internal consistency of the preschool-FLAT (Food Literacy Assessment Tool). Methods. 505 children from 21 kindergartens, recruited within the Training-to-Health Project in Palermo (Italy), underwent oral sessions and activities on food-related aspects. Their knowledge/skills were recorded in the preschool-FLAT. The following scale measures were assessed: Content validity; internal consistency (Chronbach’s alpha coefficients); construct validity (Structural Equation Modeling—SEM); discriminant validity (intervention subgroup of 100 children vs. control group of 27 children). Results. Acceptable content validity of a 16-items scale and overall adequate internal consistency were revealed: Content validity index (CVI) 0.94, content validity ratio (CVR) 0.88, Chronbach’s alpha 0.76. The SEM revealed a 4-factor model fitting the data well (comparative fit index 0.939, root mean square error of approximation 0.033). Discriminant validity was good (intervention group scoring higher than control, p < 0.001, unpaired Student’s t-test). Conclusion. The preschool-FLAT revealed good psychometric properties, adequate validity and internal consistency. This is the only instrument in the literature specifically targeted to 3–6 years old children that could be effectively used to assess food literacy.
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Affiliation(s)
- Garden Tabacchi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (G.B.); (G.M.); (A.P.); (M.B.)
- Correspondence: ; Tel.: +39-0-912-389-9605
| | - Giuseppe Battaglia
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (G.B.); (G.M.); (A.P.); (M.B.)
| | - Giuseppe Messina
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (G.B.); (G.M.); (A.P.); (M.B.)
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, 35121 Padova, Italy;
| | - Antonio Palma
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (G.B.); (G.M.); (A.P.); (M.B.)
| | - Marianna Bellafiore
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (G.B.); (G.M.); (A.P.); (M.B.)
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Kilmurray M, Collins SC, Caterson ID, Hill AJ. Is Weight Bias Evident in Peer Interactions Between Young and Older Children? Obesity (Silver Spring) 2020; 28:333-338. [PMID: 31868313 DOI: 10.1002/oby.22686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/26/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aimed to investigate whether weight bias is apparent in young and older children's interactions during a paired reading activity. METHODS One hundred seventy-two children (57% girls) read a book in which the main character, "Alfie," was portrayed either as average weight or as having obesity. Younger children (mean = 6.1 years) were paired with a same-sex older child (mean = 9.5 years). Questions within and at the end of the story prompted discussion. Children's conversations were analyzed according to valence (emotional tone). Nonverbal behavior was noted via observation. RESULTS Pairs of children reading about the Alfie character with obesity made significantly more negative and fewer positive comments when offering story completions. Just one pair of boys spoke about him being "fat." There was no evidence that older children passed negative attitudes to younger children. Covertly expressed weight bias was more common. There was more frequent laughter while reading about the character with obesity, and two pairs made nonverbal reference to Alfie's appearance. CONCLUSIONS Covert weight bias was apparent in the interactions of some of these children, but overt weight bias was rare. There is a need to establish a better chronology of children's awareness of, and attitudes toward, obesity and how they are acquired.
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Affiliation(s)
- Michelle Kilmurray
- Division of Psychological & Social Medicine, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Sylvie C Collins
- Division of Psychological & Social Medicine, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Ian D Caterson
- Boden Institute, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Andrew J Hill
- Division of Psychological & Social Medicine, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
- Boden Institute, Charles Perkins Centre, University of Sydney, Sydney, Australia
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Patalay P, Hardman CA. Comorbidity, Codevelopment, and Temporal Associations Between Body Mass Index and Internalizing Symptoms From Early Childhood to Adolescence. JAMA Psychiatry 2019; 76:721-729. [PMID: 30892586 PMCID: PMC6583661 DOI: 10.1001/jamapsychiatry.2019.0169] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Obesity and internalizing mental illness begin in childhood, have common risk factors, and are leading causes of disease burden. OBJECTIVES To examine the comorbidity, codevelopment, and temporal precedence in body mass index (BMI) and internalizing symptoms from early childhood to midadolescence and to investigate the sex differences and socioeconomic confounding in their association. DESIGN, SETTING, AND PARTICIPANTS This longitudinal study used data on individuals from the Millennium Cohort Study, a nationally representative, prospective birth cohort study in the United Kingdom of more than 19 000 individuals born from September 1, 2000, to January 11, 2002, who were assessed to date at the ages of 9 months and 3, 5, 7, 11, and 14 years. Data from 17 215 participants (88.21% of full cohort sample) with socioeconomic information in early childhood and BMI or internalizing symptoms during at least 1 assessment from 3 to 14 years of age were included in the present study. Data analysis was performed from May to November 2018. MAIN OUTCOMES AND MEASURES Outcomes were BMI estimated from objectively measured height and weight and internalizing symptoms assessed using parental reports. Three measures of socioeconomic position were controlled for: parent educational level, occupational status, and equivalized family income. RESULTS Among the 17 215 participants (8394 [48.8%] female), obesity and internalizing problems were not more likely to co-occur in early childhood (odds ratio [OR] at 3 years, 1.02; 95% CI, 0.69-1.50), whereas at 11 and 14 years of age, they were more likely to co-occur (OR at 11 years, 1.68; 95% CI, 1.38-2.05; OR at 14 years, 1.49; 95% CI, 1.22-1.83). Piecewise latent growth models revealed no codevelopment of BMI and internalizing symptoms from 3 to 7 years of age (r = 0.01), whereas their slopes were associated between 7 and 14 years of age (r = 0.23). Initial level and rate of change in each domain in early childhood was not associated with rate of change in the other domain at older ages. Cross-lagged models indicated no cross-domain pathways before 7 years of age, with some weak cross-domain pathways emerging between 7 and 14 years of age. Socioeconomic position attenuated some of these associations, leaving a BMI-to-internalizing symptoms pathway in later childhood and an internalizing symptoms-to-BMI pathway in early adolescence. CONCLUSIONS AND RELEVANCE The findings suggest that BMI and internalizing symptoms become more associated and reciprocal as children get older and that some of their temporal associations can be attributed to socioeconomic factors. The emergence of cross-domain temporal pathways in middle childhood suggests that social, physiologic, and psychological processes begin to play an increasingly important role in these health outcomes. Prevention and early intervention efforts may benefit from targeting both health outcomes in childhood.
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Affiliation(s)
- Praveetha Patalay
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom,MRC Unit for Lifelong Health and Ageing and Centre for Longitudinal Studies, University College London, London, United Kingdom
| | - Charlotte A. Hardman
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
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Rodgers RF, Wertheim EH, Damiano SR, Gregg KJ, Paxton SJ. A qualitative, prospective study of children's understanding of weight gain. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2019; 37:369-381. [PMID: 30767250 DOI: 10.1111/bjdp.12279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 01/11/2019] [Indexed: 11/29/2022]
Abstract
This study examined 3- to 5-year-old children's understandings of increases in body size via a qualitative prospective approach. A sample of 259 children (55.2% girls) was interviewed at 3, 4, and 5 years old. Participants were shown an average and a larger size figure of a child of their gender and age. Responses to 'Why do you think the boy/girl got bigger here?' were coded using thematic analysis. Diet was cited as a mechanism for increased body size by almost 50% of children referring to this by age 5. Few children mentioned physical activity. Responses suggesting that increases in body size had negative implications increased between ages 3 and 5. Awareness of associations between diet and weight gain emerges as young as 3 years old and increases over time, as do negative attitudes about weight gain. This age may be opportune for interventions targeting sustainable healthy behaviours. Statement of contribution What is already known on this subject? Even very young children present weight bias. Their understanding of the social messages regarding weight and shape increases with age. Older children present a partial understanding of how diet and physical activity are related to body size. What does this study add? Very young children's understandings of increases in body size were investigated. Eating and food-related mechanisms, as well as ageing, were salient. By age 5, over a third of children associated increases in body size with negative implications.
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Affiliation(s)
- Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France
| | - Eleanor H Wertheim
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Stephanie R Damiano
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Karen J Gregg
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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