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Erfani K, Grabowski A, Parker G, Garrity A, Peterson KE, Lee JM, Nanda U. Point of Decision Design to Address Adolescent Overweight and Obesity. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:182-194. [PMID: 36946329 PMCID: PMC11042780 DOI: 10.1177/19375867231153365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVES This study aims to utilize the point of decision design framework to understand how, where, and why adolescents and families make decisions about diet and physical activity and to explore how modifications to the environment can help to promote healthier choices and reduce obesity. BACKGROUND Child and adolescent obesity is a critical public health problem. As environmental factors are a primary contributor, understanding the role of design in our surrounding environment highlights an important area of interdisciplinary study. Design strategies have been used successfully to increase stair use and reduce sedentary behavior and can be used to further promote healthier diet and activity choices among adolescents and families. METHODS We leveraged the human-centered design-thinking process through (1) qualitative interviews and survey instruments, (2) persona and prompt development, and (3) a design workshop with multidisciplinary stakeholders. RESULTS Five personas were developed from the qualitative data and used in a design-thinking workshop. During the workshop, participants generated 12 influential factors and nine points of decision which were used to generate 33 solutions spanning the design continuum (from information and policy design to the design of urban, architectural, and interior environments) aimed at improving nutrition and physical activity among adolescents. Additionally, a tool kit was prototyped, which includes interview guides, a persona framework, and a workshop facilitation guide. CONCLUSIONS Our novel process led to the generation of design solutions that can be implemented to expand and improve upon existing interventions for childhood obesity and create environments that encourage positive health outcomes.
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Affiliation(s)
- Kimia Erfani
- A. Alfred Taubman College of Architecture and Urban Planning, University of Michigan, Ann Arbor, MI, USA
| | - Aria Grabowski
- Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Grant Parker
- A. Alfred Taubman College of Architecture and Urban Planning, University of Michigan, Ann Arbor, MI, USA
| | - Ashley Garrity
- Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA
- Division of Pediatric Endocrinology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Karen E. Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Joyce M. Lee
- Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA
- Division of Pediatric Endocrinology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Upali Nanda
- A. Alfred Taubman College of Architecture and Urban Planning, University of Michigan, Ann Arbor, MI, USA
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Loh YL, Yaw QP, Lau Y. Social media-based interventions for adults with obesity and overweight: a meta-analysis and meta-regression. Int J Obes (Lond) 2023:10.1038/s41366-023-01304-6. [PMID: 37012428 PMCID: PMC10069737 DOI: 10.1038/s41366-023-01304-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/05/2023]
Abstract
Social isolation and loneliness are growing public health concerns in adults with obesity and overweight. Social media-based interventions may be a promising approach. This systematic review aims to (1) evaluate the effectiveness of social media-based interventions on weight, body mass index, waist circumference, fat, energy intake and physical activity among adults with obesity and overweight and (2) explore potential covariates on treatment effect. Eight databases, namely, PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus PsycINFO and ProQuest, were searched from inception until December 31, 2021. The Cochrane Collaboration Risk of Bias Tool and Grading of Recommendations, Assessment, Development and Evaluation criteria evaluated the evidence quality. Twenty-eight randomised controlled trials were identified. Meta-analyses found that social media-based interventions had small-to-medium significant effects on weight, BMI, waist circumference, body fat mass and daily steps. Subgroup analysis found greater effect in interventions without published protocol or not registered in trial registries than their counterparts. Meta-regression analysis showed that duration of intervention was a significant covariate. The certainty of evidence quality of all outcomes was very low or low. Social media-based interventions can be considered an adjunct intervention for weight management. Future trials with large sample sizes and follow-up assessment are needed.
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Affiliation(s)
- Yue Lun Loh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qin Ping Yaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Linver MR, Urban JB, Chen WL, Gama L, Swomley VI. Predicting Positive Youth Development from Self-Regulation and Purpose in Early Adolescence. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:1312-1327. [PMID: 33957002 DOI: 10.1111/jora.12621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 06/12/2023]
Abstract
A Positive Youth Development (PYD) perspective emphasizes adolescents' potential for healthy, successful development. Researchers have introduced a variety of constructs that may promote PYD. For example, Intentional Self-Regulation (ISR) enables youth to seek out and use resources in the environment; purpose can help youth navigate and overcome obstacles. We examine connections between ISR, purpose and two PYD outcomes: confidence and connection. Data come from 763 Scottish youth (ages 12-14). We estimated fixed-effects regression models predicting confidence and connection from both ISR and purpose, confirming outcomes were independently associated with one or both predictors. Our findings are especially salient to the field of youth purpose, linking purpose with specific PYD outcomes.
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Body Dissatisfaction, Eating Styles, Weight-Related Behaviors, and Health among Young Women in the United States. Nutrients 2022; 14:nu14183876. [PMID: 36145252 PMCID: PMC9505776 DOI: 10.3390/nu14183876] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Body dissatisfaction is a common condition that poses health behavior risks, such as the use of maladaptive eating styles instead of adaptive eating styles. Few studies have simultaneously examined both adaptive and maladaptive eating styles and their association with body dissatisfaction in a comprehensive manner. To address this gap, this study examined how body dissatisfaction is related to an array of adaptive and maladaptive eating styles, weight-related behaviors, and health status as well as the associations of health status, BMI, and weight-related behaviors with body dissatisfaction in 261 young adult women. Maladaptive eating styles, such as emotional eating, tended to rise in tandem with body dissatisfaction, differing significantly among body-dissatisfaction levels with medium to large effect sizes. For adaptive eating styles, as body dissatisfaction increased, compensatory restraint increased, intuitive eating declined, and mindful eating did not differ. Weight-related dietary, physical activity, and sleep behaviors did not differ by body dissatisfaction level. BMI increased and health status decreased as body dissatisfaction increased. Binary logistic regression revealed those who were body-dissatisfied had significantly lower health status, higher BMIs, and did not differ on weight-related behaviors. Study findings suggest strategies to improve health-promotion interventions aiming to increase body satisfaction.
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Kininmonth AR, Schrempft S, Smith A, Dye L, Lawton C, Fisher A, Llewellyn CH, Fildes A. Associations between the home environment and childhood weight change: a cross-lagged panel analysis. Int J Obes (Lond) 2022; 46:1678-1685. [PMID: 35739248 PMCID: PMC9395269 DOI: 10.1038/s41366-022-01170-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The obesogenic quality of the home environment is hypothesised to play an important role in children's weight development but few prospective studies have investigated relationships between the home environment and adiposity across childhood. OBJECTIVE To investigate the continuity and stability of the home environment from ages 4 to 12, and bi-directional relationships between the home environment and BMI-SDS from ages 4 to 12. METHODS Parents from the Gemini cohort completed the Home Environment Interview (HEI), a comprehensive measure of the obesogenic home environment, when their children were aged 4 and 12 (n = 149 families, n = 298 children). The obesogenic home environment was measured using four composite scores capturing the food, activity, media environments, and the overall home environment. Child weights and heights were used to calculate BMI-SDS. Continuity was assessed with Pearson's correlations between scores at each time point, and stability by changes in mean scores over time. Cross-lagged analyses were performed (HEI composites at age 4 to BMI-SDS at age 12 and the reverse) to measure the magnitude and direction of associations. RESULTS The home environment showed moderate-to-high continuity from ages 4 to 12 (r = 0.30-0.64). The overall home environment (r = 0.21, p < 0.01) and media composites (r = 0.23, p < 0.01) were cross-sectionally associated with child BMI-SDS at age 12, but not at age 4. Longitudinally, the home media environment at age 4 predicted increases in child BMI-SDS at age 12 (β; 95% CI = 0.18; 0.08,0.28, p < 0.01). No associations were observed for the reverse path, or the remaining composites (the overall, food and activity) in either direction. CONCLUSION This study provides evidence that the obesogenic home environment tracks across childhood and highlights the importance of the early home media environment for child weight development. The findings provide insight into key aspects of the home environment that could be targeted when developing obesity treatment or prevention strategies.
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Affiliation(s)
- Alice R Kininmonth
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK. .,Research Department of Behavioural Science and Health, University College London, London, UK.
| | - Stephanie Schrempft
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
| | - Andrea Smith
- Research Department of Behavioural Science and Health, University College London, London, UK.,MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Louise Dye
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Clare Lawton
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Abigail Fisher
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Clare H Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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Lipton-Inga M, Manzanarez B, Vidmar AP, Garcia S, Fink C, Iverson E, Geffner ME. Kids N Fitness Junior: Outcomes of an Evidence-Based Adapted Weight Management Program for Children Ages Three-Seven Years. Child Obes 2022; 18:56-66. [PMID: 34388029 PMCID: PMC10494906 DOI: 10.1089/chi.2021.0090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: Few weight management interventions target young children with obesity from low-income minority families. Objective: To conduct a nonrandomized, pragmatic, pilot study of an adapted, evidence-based, weight management program (Kids N Fitness [KNF]) customized for children ages 3-7 years (Kids N Fitness Jr. [KNF-JR]) on changes in adiposity, nutrition, and physical activity behaviors. Methods: One hundred eighty children (ages 3-16) with ≥85th percentile BMI and their parents participated in one of two 6-week weight management interventions dependent on the child's age: KNF-JR: 3-7 or regular KNF: 8-16. Comparisons were made between baseline anthropometrics and health questionnaire responses, and those from weeks 6 to 18. Two-sample tests for equality of proportions with continuity were used to measure proportions of success between KNF-JR and KNF. Results: At week 6, both cohorts showed a mean decrease in BMI z-score (zBMI) of -0.02 (p = 0.3 for KNF-JR [n = 43]; p = 0.02 for KNF [n = 59], with no significant group differences. Among program completers, 75% of KNF-JR and 83% of KNF maintained or lowered zBMI at week 18 (within-group difference p < 0.01). On average across all participants, at week 18 vs. baseline, improvements occurred in screen time (p < 0.01 KNF-JR, p < 0.02 KNF), sweetened beverage intake (p < 0.01 KNF-JR, p = 0.03 KNF), physical activity (p < 0.01 KNF-JR and KNF), and water (p = 0.01 KNF-JR, non-significant KNF) and vegetable (p < 0.01 KNF-JR, p = 0.02 KNF) consumption. Conclusion: This pilot demonstrated that an evidence-based weight management program can be adapted for all age groups and results in improved BMI status. Larger, randomized controlled trials are needed to verify effectiveness and sustained impact.
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Affiliation(s)
- Megan Lipton-Inga
- The Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Brenda Manzanarez
- The Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Alaina P. Vidmar
- The Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Samantha Garcia
- The Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Cassandra Fink
- The Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Ellen Iverson
- The Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Mitchell E. Geffner
- The Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA, USA
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Validation of the Dutch Eating Behavior Questionnaire in a Romanian Adult Population. Nutrients 2021; 13:nu13113890. [PMID: 34836141 PMCID: PMC8619088 DOI: 10.3390/nu13113890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/26/2022] Open
Abstract
(1) Background: Obesity, part of the triple global burden of disease, is increasingly attracting research on its preventive and curative management. Knowledge of eating behavior can be useful both at the individual level (to individualize treatment for obesity) and the population level (to implement more suitable food policies). The Dutch Eating Behavior Questionnaire (DEBQ) is a widely used international tool to assess eating behavior, i.e., emotional, external and restricted eating styles. The aim of this study was to validate the Romanian version of DEBQ, as obesity is a major concern in Romania. (2) Methods: Our study tested the psychometric properties of the Romanian version of DEBQ on an adult population and explored the associations of eating behavior with weight status (3) Results: The study showed a factor load similar to the original version of the questionnaire and a very good internal validity (Cronbach’s alpha fidelity coefficient greater than 0.8 for all scales of the questionnaire) for the Romanian version of DEBQ and showed that all of the scales positively correlated with body mass index in both men and women. (4) Conclusions: This study will enable the use of the DEBQ Romanian version on the adult population of Romania where the findings could be incorporated into developing better strategies to reduce the burden of nutrition-related diseases.
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Byrne R, Terranova CO, Trost SG. Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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Arumugam CT, Said MA, Nik Farid ND. Screen-based media and young children: Review and recommendations. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2021; 16:7-13. [PMID: 34386158 PMCID: PMC8346754 DOI: 10.51866/rv1143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Early childhood development is influenced by a child's environmental experiences. The qualities of surrounding in which a child lives, grows up and learns are key for attaining their milestones. Increased availability of screen-based media in families leads to excessive screen time among young children, resulting in high chances of displacing parent-child interaction which is fundamental in a thriving child's process of learning and development. Numerous publications have investigated the potential health impacts of early exposure and excessive usage of screen-based media among children, with literature suggesting links between excessive screen time and behavioural difficulties, developmental delay and increased risk of obesity, among other issues. Existing guidelines from international bodies call for limiting screen time to an hour per day for children aged two to five years old and urge that children below the age of two should not be exposed to any screen time. To spark awareness among parents and caregivers concerning the potential health impacts of screen-based media usage among young children, child media habits are recommended to be incorporated as part of toddlers' developmental assessment in health clinics. A guideline for mindful usage of screen-based media focusing on children below the age of five tailored to a Malaysian context ought to be developed based on current evidence from research, theory and practice. A collaborative effort between concerned agencies is essential to ensuring a developmentally stimulating environment in which young children may grow up.
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Affiliation(s)
- Catherine Thamarai Arumugam
- Medical Degree (MD), Master of Public Health (MPH), Doctor in Public Health (DrPH) Candidate, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,
| | - Mas Ayu Said
- MBBS, MPH (Epidemiology), PhD, Centre for Epidemiology and Evidence-Based Practice (CEEBP), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Daliana Nik Farid
- MBBS (Adelaide), MPH (Malaya), DrPH (Malaya), Medical Lecturer and Public Health Specialist, Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Home food environment and associations with weight and diet among U.S. adults: a cross-sectional study. BMC Public Health 2021; 21:1032. [PMID: 34074262 PMCID: PMC8169424 DOI: 10.1186/s12889-021-11102-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The home provides the physical and social context for the majority of eating behaviors for U.S. adults. This study describes eleven dimensions of the home food environment among a national sample of U.S. adults and identifies which are associated with diet quality and overweight/obesity. METHODS A national sample of U.S. adults ages 18 to 75 was recruited from an online survey panel. Respondents (n = 4942) reported on foods available in the home, including 1) fruit and vegetables, 2) salty snacks/sweets, 3) less healthy beverages, as well as 4) food placement, 5) shopping practices for fruits and vegetables, 6) food preparation, 7) portion control methods, 8) family meals from restaurants, 9) family household practices around TV and eating, 10) presence of a TV in the dining area, and 11) ownership of a scale. Self-reported height and weight, fruit and vegetable intake, and percent calories from fat were also assessed. RESULTS Mean household size was 2.6, 32.7% had children in the home, and 23.1% lived alone. The majority were White (67.7%), with 12.3% Black and 14.3% Hispanic. Mean age was 44.4 and 48.3% were men. In multivariable models, seven features of the home food environment were associated with meeting the recommended fruit and vegetable intake guidelines, with food placement, meal preparation, frequency of shopping for fruit, and a greater variety of fruits and vegetables available in the home most strongly associated. Eight of 11 features were associated with percent energy from fat, including restaurant food for family meals, salty snacks and sweets availability, less healthy beverages availability, food placement, meal preparation, frequency of shopping for fruit, family eating with the TV on, and having a TV in the dining area. More diverse fruit and vegetable availability was associated with lower odds of overweight/obesity, and more frequent family eating while watching TV was associated with increased odds of overweight/obesity. CONCLUSION Targeting these dimensions of the home food environment may be a promising approach for future intervention research.
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Family Social Capital: Links to Weight-Related and Parenting Behaviors of Mothers with Young Children. Nutrients 2021; 13:nu13051428. [PMID: 33922656 PMCID: PMC8145036 DOI: 10.3390/nu13051428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 01/10/2023] Open
Abstract
Family social capital includes the social relationships, values, and norms shared by a family and is positively linked with children’s mental and physical health status. This cross-sectional study addresses a gap in the literature related to family social capital vis-à-vis weight-related behaviors and home environments of 557 mothers and their young children (ages 2 to 9 years). Mothers completed an online survey comprised of valid, reliable questionnaires assessing family relationships and weight-related behavioral and home environment measures. The measures that determined family social capital (i.e., supportive, engaged parenting behaviors; family cohesion; family conflict; and family meal frequency) yielded distinct tertile groups that differed significantly (p < 0.001) on every family social capital measure with large effect sizes. Analysis of variance with Tukey post-hoc test revealed greater family social capital was linked to significantly better maternal health, dietary intake, physical activity, and sleep behavior. Additionally, maternal modeling of healthy eating and physical activity, child feeding practices, and home environments was higher in groups with greater family social capital. Child mental and physical health, physical activity, and sleep quality were better in families with greater family social capital. Findings suggest greater family social capital is linked to healthier weight-related behaviors and home environments. Future intervention studies should incorporate strategies to build family social capital and compare longitudinal outcomes to traditional interventions to determine the relative value of family social capital on health behaviors.
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A Comparison of Weight-Related Behaviors of Hispanic Mothers and Children by Acculturation Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020503. [PMID: 33435478 PMCID: PMC7827543 DOI: 10.3390/ijerph18020503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 12/13/2022]
Abstract
Hispanic mothers and children in the United States experience a high prevalence of obesity, which may be affected by maternal acculturation level. Little is known about the association of acculturation on weight-related behaviors. This study describes differences in weight-related behaviors by acculturation level of Hispanic mothers residing in the U.S. and compares them to behaviors of White mothers. Acculturation level was determined using personal acculturation and acculturation environment variables. Cluster analysis of acculturation variables identified three groups of Hispanic mothers: low personal and environmental acculturation (n = 46), high personal and low environmental acculturation (n = 65), and high personal and environmental acculturation (n = 38). Results indicate that, compared to White mothers (n = 340), the least acculturated cluster of Hispanic mothers tended to model physical activity less often and the most acculturated exerted more pressure on children to eat. Mothers in the least acculturated cluster tended to rate children’s health status lower, indicate that children had greater fruit juice and less milk intakes, have more meals in locations associated with less healthy meals, and have the least space and supports for physical activity. Findings highlight relationships between maternal acculturation level and weight-related behaviors and suggest strategies for helping acculturating Hispanic mothers create healthier lifestyles and home environments.
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Delaney CL, Spaccarotella K, Byrd-Bredbenner C. A Comparison of Maternal Health Status and Weight-Related Cognitions, Behaviors, and Home Environments by Race/Ethnicity. Nutrients 2020; 12:E3592. [PMID: 33238533 PMCID: PMC7700294 DOI: 10.3390/nu12113592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/22/2022] Open
Abstract
This cross-sectional study compared weight-related cognitions, behaviors, and home environments of 568 mothers of young children (ages 2 to <9 years) by racial/ethnic group. Maternal health status was good and did not differ by race/ethnicity. Mothers were somewhat confident in their ability to promote healthy physical activity and eating behaviors in their children, with White and Asian mothers having greater confidence than Hispanic mothers. Mothers had low physical activity, with Hispanic mothers getting more sedentary screentime than White and Asian mothers. Mothers' dietary intake did not differ. Modeling of healthful behaviors was more frequent in White than Hispanic mothers. Asian mothers tended to use non-recommended feeding patterns more than White, Hispanic, and Black mothers. Children's physical activity and screentime did not differ by race/ethnicity. Asian children tended to drink less sugar-sweetened beverages and more milk than counterparts. All reported frequent family meals, with Hispanic mothers reporting more family meals eaten in less healthful locations. Household food environments did not differ. However, White mothers reported greater access to physical activity space and supports than Hispanic mothers. Race/ethnicity may link with maternal weight-related cognitions, behaviors, and home environments and thus can help inform the development of interventions tailored by race/ethnicity.
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Affiliation(s)
- Colleen L. Delaney
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08854, USA;
| | - Kim Spaccarotella
- Department of Biological Sciences, Kean University, Union, NJ 07083-7131, USA;
| | - Carol Byrd-Bredbenner
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08854, USA;
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Understanding the food-family relationship: A qualitative research in a Chilean low socioeconomic context. Appetite 2020; 156:104852. [PMID: 32866585 DOI: 10.1016/j.appet.2020.104852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 01/17/2023]
Abstract
Our life is comprised of, among other things, many food and eating decisions. Therefore, we are in a constant relationship with food. Although many health providers and researchers have recommended having a positive relationship with food for better health and well-being, what the human relationship with food entails is still unclear. The aim of this study is to explore the relationship with food among families in Chile, a country that has the highest rate of obesity among OECD countries. In this qualitative study, we conducted eight focus groups in three regions of Chile (North, Center, and South). We recruited women living with their partners and children who represented the family point of view. For data analysis, we used the Atlas.ti program and conducted a thematic analysis. We found that the family relationship with food had five dimensions: (1) An identity dimension that allowed families to describe themselves or some of their family members; (2) an emotional dimension in which family expressed feelings and emotions through food; (3) a social dimension in which family members got together through food; (4) a health dimension in which family related to food to obtain benefits from it or to avoid enemy food; (5) a practical dimension in which families were organized around food tasks. Our findings show that the relationship that Chilean families have with food is a complex phenomenon. All the dimensions should be taken in consideration to create or improve interventions that seek to improve eating habits or prevent nutrition-related diseases from a family perspective.
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Maternal Sleep Quality is Associated with Personal and Parenting Weight-Related Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155312. [PMID: 32718007 PMCID: PMC7432550 DOI: 10.3390/ijerph17155312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/13/2020] [Accepted: 07/18/2020] [Indexed: 02/07/2023]
Abstract
Mothers of young children tend to report poor-quality sleep, yet little is known about links between maternal sleep quality and weight-related behaviors and parenting practices. Thus, mothers of preschoolers completed an online cross-sectional survey assessing their sleep, physical activity, dietary behaviors, eating styles, child feeding practices, family meal behaviors, and health parameters. Comparisons by sleep quality using the Pittsburgh Sleep Quality Index item (i.e., very bad/bad, n = 87; fair, n = 255; and good/very good, n = 193) revealed mothers with poor-quality sleep had weight-related behaviors associated with higher Body Mass Index (BMI) (lower physical activity, fewer fruits/vegetables, more emotional and disinhibited eating). Poor-quality sleepers also engaged in parenting practices contrary to recommendations, such as less frequent modeling of healthy eating and physical activity, more control of child feeding, and fewer family meals. Mothers reporting poor-quality sleep tended to have lower parenting self-efficacy, poorer overall health status, more days of poor mental and physical health, greater depression, more stress, and higher BMIs. Future nutrition research should establish the directionality between sleep quality and health behaviors. Future interventions should help mothers develop strategies for improving sleep quality, such as increased physical activity and fruit and vegetable intake, and helping mothers realize how their sleep quality may affect parenting practices.
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Brazilian immigrant fathers' perspectives on child's eating and feeding practices: a qualitative study conducted in the United States. Public Health Nutr 2020; 23:3211-3225. [PMID: 32576301 DOI: 10.1017/s1368980020001123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Brazilians comprise a rapidly growing immigrant Latino group in the USA, yet little research has focused on health issues affecting Brazilian children in immigrant families. As increasing evidence is documenting fathers' influential role in their children's eating behaviours and ultimately weight status, the current study sought to explore the Brazilian immigrant fathers' perspectives and practices related to child's feeding practices and their preschool-aged children's eating. DESIGN Qualitative study using in-depth, semi-structured interviews. Interviews were conducted in Portuguese by native Brazilian research staff using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed thematically using a hybrid approach that incorporated deductive and inductive analytical approaches. SETTING Massachusetts. PARTICIPANTS Twenty-one Brazilian immigrant fathers who had at least one child aged 2-5 years. RESULTS Results revealed fathers' awareness of the importance of healthy eating for their children, their influence as role models and their involvement in feeding routines of their preschool-aged children. Moreover, fathers were receptive to participating in family interventions to promote their children's healthy eating. Nearly all fathers reported wanting to learn more and to do 'what's right' for their children. CONCLUSIONS The current study provides new information about Brazilian immigrant fathers' views about factors influencing their children's healthy eating behaviours and paternal feeding practices. Future research should quantify fathers' feeding styles and practices and solicit fathers' input in the design of culturally appropriate family interventions targeting the home environment of preschool-aged children of Brazilian immigrant families.
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Ansari S, Haboubi H, Haboubi N. Adult obesity complications: challenges and clinical impact. Ther Adv Endocrinol Metab 2020; 11:2042018820934955. [PMID: 32612803 PMCID: PMC7309384 DOI: 10.1177/2042018820934955] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 05/24/2020] [Indexed: 12/18/2022] Open
Abstract
The complications associated with adult obesity are overwhelming national healthcare systems. No country has yet implemented a successful population-level strategy to reverse the rising trends of obesity. This article presents epidemiological data on the complications of adult obesity and discusses some of the challenges associated with managing this disease at a population and individual level.
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Affiliation(s)
| | - Hasan Haboubi
- Department of Gastroenterology, Guy’s & St Thomas’ Foundation trust, London, England, UK
| | - Nadim Haboubi
- Consultant Physician, University of South Wales, Pontypridd, Rhondda Cynon Taff, UK
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18
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Quick V, Eck KM, Delaney C, Lewis R, Byrd-Bredbenner C. Stability of Differences in Weight-Related Characteristics of Mothers across Economic, Cultural, Social, and Environmental-Health Indicators of Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3866. [PMID: 31614823 PMCID: PMC6843972 DOI: 10.3390/ijerph16203866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/03/2019] [Accepted: 10/05/2019] [Indexed: 11/16/2022]
Abstract
This study explored the differences in weight-related characteristics when socioeconomic status (SES) was assessed by economic, cultural, social, and environmental-health capital individually and as a composite with the goal of determining the stability of differences across types of capital and to ascertain whether single or a combination of capital indicators of SES should be used in nutrition and public health studies. Mothers (n = 557) of young children completed a survey assessing capital and weight-related characteristics. Mothers with higher economic, cultural, and social capital and composite SES had fewer sugar-sweetened beverage servings, fewer meals in front of the TV, more food security, and greater neighborhood space/supports for physical activity than comparators. Few differences occurred among environmental-health capital groups. Composite SES performed similarly to individual economic, cultural, and social capital measures. Findings suggest single SES indicators may be sufficiently stable to capture differences in weight-related characteristics. Each capital type captures a unique aspect of SES; thus, assessing an array of capital types could advance understanding of SES aspects on weight-related characteristics.
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Affiliation(s)
- Virginia Quick
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
| | - Kaitlyn M Eck
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
| | - Colleen Delaney
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
| | - Ryan Lewis
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
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19
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Xiong R, Spaccarotella K, Quick V, Byrd-Bredbenner C. Generational Differences: A Comparison of Weight-Related Cognitions and Behaviors of Generation X and Millennial Mothers of Preschool Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132431. [PMID: 31323912 PMCID: PMC6651214 DOI: 10.3390/ijerph16132431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/04/2019] [Accepted: 07/06/2019] [Indexed: 01/25/2023]
Abstract
A ‘generation’ is an identifiable group sharing birth years and significant life events at critical developmental ages. There is a paucity of literature examining how parental cognitions and lifestyle behaviors differ by generation and whether generational differences are substantial enough to warrant consideration during the development of health interventions. This study compared generational differences in weight-related cognitions and lifestyle behaviors of mothers of young children who were categorized as Generation X (born 1965–1981, n = 158) and Generation Y (aka Millennials; born 1982–1999, n = 162). Survey results indicated that Generation X had significantly higher family affluence; thus, this was controlled in subsequent analyses. Analysis of covariance indicated that Millennials had more positive expectations about the benefits of engaging in healthy eating and physical activity than comparators, but not significantly so. Millennial mothers placed significantly higher value on physical activity for themselves than Generation X mothers, but both generations were neutral on the value of personal physical activity. No generational differences were noted in self-efficacy of mothers for promoting childhood obesity-prevention practices to children and self-efficacy for personally engaging in weight-protective behaviors. Millennial mothers had significantly more family meals/week, however generations did not differ on the value placed on family meals, where family meals were eaten, or whether media devices were used at mealtime. Few differences were noted between the generations for most child feeding behaviors, except that Millennials reported placing significantly less pressure on children to eat. Mothers’ modeling of weight-related behaviors as a means for children’s observational learning about healthy eating, physical activity, and sedentary behaviors did not differ by generational group. The eating behaviors of mothers differed little between generations. Millennial mothers allowed significantly more media devices in children’s bedrooms and personally engaged in more screen time daily than comparators. Overall, the two generational groups were more similar than different in weight-related cognitions as well as for personal and parenting lifestyle behaviors. The results suggest that tailoring interventions for individuals at a similar life-stage (e.g., mothers of young children) by generation may not be warranted.
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Affiliation(s)
- Ruiying Xiong
- School of Medicine, University of Pennsylvania, Blockley Hall, Philadelphia, PA 19104, USA
| | - Kim Spaccarotella
- Department of Biological Sciences, Kean University, 1000 Morris Avenue, Union, NJ 07082, USA
| | - Virginia Quick
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
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Adams AK, Tomayko EJ, A Cronin K, J Prince R, Kim K, Carmichael L, Parker T. Predictors of Overweight and Obesity in American Indian Families With Young Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:190-198. [PMID: 30241707 PMCID: PMC6400322 DOI: 10.1016/j.jneb.2018.07.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 07/06/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To describe sociodemographic factors and health behaviors among American Indian (AI) families with young children and determine predictors of adult and child weight status among these factors. DESIGN Descriptive, cross-sectional baseline data. SETTING One urban area and 4 rural AI reservations nationwide. PARTICIPANTS A total of 450 AI families with children aged 2-5 years participating in the Healthy Children, Strong Families 2 intervention. INTERVENTION Baseline data from a healthy lifestyles intervention. MAIN OUTCOME MEASURES Child body mass index (BMI) z-score and adult BMI, and multiple healthy lifestyle outcomes. ANALYSIS Descriptive statistics and stepwise regression. RESULTS Adult and child combined overweight and obesity rates were high: 82% and 40%, respectively. Food insecurity was high (61%). Multiple lifestyle behaviors, including fruit and vegetable and sugar-sweetened beverage consumption, adult physical activity, and child screen time, did not meet national recommendations. Adult sleep was adequate but children had low overnight sleep duration of 10 h/d. Significant predictors of child obesity included more adults in the household (P = .003; β = 0.153), an adult AI caregiver (P = .02; β = 0.116), high adult BMI (P = .001; β = 0.176), gestational diabetes, high child birth weight (P < .001; β = 0.247), and the family activity and nutrition score (P = .04; β = 0.130). CONCLUSIONS AND IMPLICATIONS We found multiple child-, adult-, and household-level factors influence early childhood obesity in AI children, highlighting the need for interventions to mitigate the modifiable factors identified in this study, including early life influences, home environments, and health behaviors.
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Affiliation(s)
- Alexandra K Adams
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT.
| | - Emily J Tomayko
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Kate A Cronin
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Ronald J Prince
- Department of Population Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Kyungmann Kim
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | | | - Tassy Parker
- Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM
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Lindsay AC, Moura Arruda CA, Tavares Machado MM, De Andrade GP, Greaney ML. Exploring Brazilian Immigrant Mothers' Beliefs, Attitudes, and Practices Related to Their Preschool-Age Children's Sleep and Bedtime Routines: A Qualitative Study Conducted in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1923. [PMID: 30181465 PMCID: PMC6165127 DOI: 10.3390/ijerph15091923] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/23/2018] [Accepted: 09/01/2018] [Indexed: 12/26/2022]
Abstract
In the United States (US), racial/ethnic minority children, low-income children, and children of immigrant families are at increased risk of childhood obesity. Mounting evidence documents that sleep duration and sleep quality are important modifiable factors associated with increased risk of obesity among preschool-aged children. The number of Brazilian immigrants in the US is increasing, yet no existing research, to our knowledge, has examined factors affecting sleep and bedtime routines of children of Brazilian immigrant families. Therefore, the purpose of this qualitative study was to explore Brazilian immigrant mothers' beliefs, attitudes, and practices related to sleep and bedtime routines among preschool-aged children. Seven focus group discussions (FGDs) were conducted with 37 Brazilian immigrant mothers of preschool-age children living in the US. The audio-recordings of the FGDs were transcribed verbatim in Portuguese without identifiers and analyzed using thematic analyses. Mothers also completed a brief questionnaire assessing socio-demographic and acculturation. Analyses revealed that most mothers were aware of the importance of sleep and sleep duration for their children's healthy growth and development. Mothers also spoke of children needing consistent bedtime routines. Nevertheless, many mothers reported inconsistent and suboptimal bedtime routines (e.g., lack of predictable and orderly bedtime activities such as bath, reading, etc. and use of electronics in bed). These suboptimal routines appeared to be influenced by day-to-day social contextual and environmental factors that are part of Brazilian immigrant families' lives such as parents' work schedule, living with extended family, living in multi-family housing, neighborhood noise, etc. Analyses identified several modifiable parenting practices related to young children's sleep and bedtime routines (e.g., irregular bedtime, late bedtime, inconsistent bedtime routines, use of electronics in bed, etc.) that can be addressed in parenting- and family-based obesity prevention interventions. Interventions should consider the social context of the home/family (e.g., parents' work schedules) and the environment (e.g., multi-family housing; neighborhood noise, etc.) faced by Brazilian immigrant families when developing health promotion messages and parenting interventions tailored to this ethnic group.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | | | - Márcia M Tavares Machado
- Department of Community Health, Federal University of Ceará, Fortaleza, Ceará 62010-560, Brazil.
| | - Gabriela P De Andrade
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
| | - Mary L Greaney
- Health Studies & Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
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Quick V, Martin-Biggers J, Povis GA, Worobey J, Hongu N, Byrd-Bredbenner C. Long-term follow-up effects of the HomeStyles randomized controlled trial in families with preschool children on social cognitive theory constructs associated with physical activity cognitions and behaviors. Contemp Clin Trials 2018; 68:79-89. [DOI: 10.1016/j.cct.2018.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/01/2018] [Accepted: 03/12/2018] [Indexed: 12/19/2022]
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Kong A, Schiffer L, Antonic M, Braunschweig C, Odoms-Young A, Fitzgibbon M. The relationship between home- and individual-level diet quality among African American and Hispanic/Latino households with young children. Int J Behav Nutr Phys Act 2018; 15:5. [PMID: 29334994 PMCID: PMC5769425 DOI: 10.1186/s12966-018-0645-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/03/2018] [Indexed: 11/12/2022] Open
Abstract
Background The quality of most Americans’ diets is far from optimal. Given that many Americans consume a significant portion of calories in the home, intervening in this setting could be beneficial. However, the relationship between the home food environment and diet quality is not well understood. This study examined the relationship between diet quality at the individual level with home-level diet quality using an index that measures compliance with federal dietary guidance. Methods This was a cross sectional study that enrolled 97 African American and Hispanic/Latino low-income parent-child dyads. Diet quality at the individual level was assessed through two 24-h dietary recalls collected for parents and children, respectively. Diet quality at the home level was assessed with two home food inventories conducted in participants’ homes. Diet quality scores at the home and individual levels were computed by applying the Healthy Eating Index-2010 (HEI-2010) to these data. Linear models adjusted for potential confounding factors were used to examine the relationship between diet quality at the home and individual levels. Results Total HEI-2010 scores from parents and children’s diets were positively associated with HEI-2010 scores based on home food inventories (parent diet: β: 0.36, 95% CI: 012–0.60; child diet: 0.38 95% CI: 013–0.62). Positive associations were also observed between individual level and home level subcomponent HEI-2010 scores for total fruit (parent: 0.55 95% CI: 0.16–0.94; child: 0.49 95% CI: 0.03–0.94), whole fruit (parent only: 0.41 95% CI: 0.07–0.74), greens and beans (parent only: 0.39 95% CI: 0.05–0.74), and whole grain (children only: 0.33 95% CI: 0.04–0.63). Conclusion This study demonstrated that individual level diet quality was positively associated with home-level diet quality. Findings from this study can help us to address modifiable targets of intervention in the home to improve diet quality.
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Affiliation(s)
- Angela Kong
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor St, Chicago, IL, 60612, USA. .,Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Linda Schiffer
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.,Department of Pediatrics, University of Illinois at Chicago, 1835 W Polk St. Chicago, Chicago, IL, 60612, USA
| | - Mirjana Antonic
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.,Department of Pediatrics, University of Illinois at Chicago, 1835 W Polk St. Chicago, Chicago, IL, 60612, USA
| | - Carol Braunschweig
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor St, Chicago, IL, 60612, USA
| | - Angela Odoms-Young
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor St, Chicago, IL, 60612, USA
| | - Marian Fitzgibbon
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.,University of Illinois Cancer Center, 914 S. Wood St. MC 700, Chicago, IL, 601612, USA
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Byrd-Bredbenner C, Delaney C, Martin-Biggers J, Koenings M, Quick V. The marketing plan and outcome indicators for recruiting and retaining parents in the HomeStyles randomized controlled trial. Trials 2017; 18:540. [PMID: 29141692 PMCID: PMC5688718 DOI: 10.1186/s13063-017-2262-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 10/13/2017] [Indexed: 11/23/2022] Open
Abstract
Background Despite the critical importance of successful recruitment and retention to study integrity, reporting of recruitment and retention strategies along with factors associated with successful recruitment and retention of participants in health-related interventions remain rare, especially for health and obesity prevention programs. Thus, the purpose of this article is to retrospectively examine the recruitment and retention marketing plan used in the online HomeStyles randomized controlled trial (RCT) and discuss outcomes associated with completion of the intervention. Methods The HomeStyles RCT is an online intervention developed to motivate parents of young children to gain the skills and self-confidence needed to shape home environments and lifestyles to be protective against childhood obesity. Using the seven Ps of services marketing (i.e., people, place, product, physical evidence, price, promotion, and process), a comprehensive and systematic plan for recruitment and retention was implemented and outcomes assessed. Results A total of 489 parents with a young child aged 2 to < 6 years were eligible to participate, a final capture rate of 33%. Only 23% of Hispanic participants chose to use the Spanish-language version of HomeStyles intervention materials, below the demand anticipated. However, Hispanic enrollment overall was substantially higher than the U.S. population proportion (i.e., 17%). The number of participants prematurely leaving the study was similar in both treatment groups, indicating attrition was not differential. Completers reported high satisfaction of HomeStyles, using a 1–5 scale (strongly disagree to strongly agree) on guide attractiveness, interestingness, and usefulness. Despite all the retention efforts, the average monthly recruitment accrual rate of ~ 33 eligible enrolled participants at baseline (i.e., 489 participants/15-month recruitment period), declined to ~ 18, 11, 9, and 8 remaining recruited participants/month at midpoint, post, follow-up, and long-term follow-up surveys, respectively. In general, survey completers were significantly more likely to be female and perceived their child’s health status to be better, and they were significantly less likely to be restrictive of their child’s food intake. Conclusions The findings of the present study highlight the need for far-reaching, concentrated, and varied recruitment strategies; sufficient time in the research plan for recruitment and retention activities; and creative, tireless, flexible, persistent project staff for health-related interventions.
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Affiliation(s)
- Carol Byrd-Bredbenner
- Rutgers, The State University of New Jersey, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA
| | - Colleen Delaney
- Rutgers, The State University of New Jersey, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA
| | - Jennifer Martin-Biggers
- Rutgers, The State University of New Jersey, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA
| | - Mallory Koenings
- Rutgers, The State University of New Jersey, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA
| | - Virginia Quick
- Rutgers, The State University of New Jersey, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA.
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