Shaping a Healthier Generation: Successful State Strategies to Prevent Childhood Obesity

Provides an overview of the socioeconomic and environmental risk factors and costs of childhood obesity. Presents examples of state policies to prevent the epidemic by promoting healthy behaviors in child care, school, community, and healthcare settings

A Retrospective Analysis of Maternal and Child Outcomes Following an Obesity Intervention Program

Background: One of the highest risk groups for childhood obesity and associated co-morbidities in the United States are low-income Hispanic preschool children. To reduce obesity, effective interventions are being sought to improve health behaviors among high risks groups. Objectives: To evaluate a subset of data from a larger 9-month promotora facilitated obesity intervention study. The aims were to determine: 1) pre- to post-program differences in health behaviors including: (a) children\u27s consumption of high carbohydrate beverages (HCB); and (b) maternal walking, beliefs, knowledge, self-efficacy, and relationship building regarding nutrition and physical activity; and 2) which covariates were significant for change in outcome variables. Methods: A retrospective data analysis, pre post single group design was used to analyze a subset of data from the larger study consisting of a case sample of 33 low-income, Hispanic mothers (18- to 35-year-olds) with pre-school children (3- to 5-year-olds). Differences in outcome variables for related samples between baseline and 9 months were examined using: descriptive statistics, a matched-pairs t-test, the Wilcoxon signed-ranks test, and the chi-square test. Pearson and Spearman correlations were performed to assess relationships between covariates and outcome variables, and if regression analysis assumptions were met. A backward step-wise linear regression was run to determine covariates significant for change in health behaviors. Results: From baseline to 9 months, there was a 56% decrease in children\u27s overall HCB consumption (soda, 100% juice, and sugary drinks); a 47% increase in water consumption; and a 58% increase in total maternal steps (Tuesday and Saturday). By 9 months, maternal beliefs were more positive about walking, knowledge increased about healthy drinks, and maternal self-efficacy improved regarding role modeling healthy behaviors. Gravida was correlated with increased Saturday steps and increased water consumption; and promotora visits were correlated with increased consumption of soda. Implications: Findings suggest a 9-month childhood obesity intervention program was effective in improving the target health behaviors for a low-income Mexican American community and identifying effective means for reducing the incidence of obesity in high risks groups. A larger randomized control trial is needed to further test the feasibility of this intervention program

ACCULTURATION AND POST-IMMIGRATION CHANGES IN OBESITY, PHYSICAL ACTIVITY, AND NUTRITION: COMPARING HISPANICS AND ASIANS IN THE WATERLOO REGION, ONTARIO, CANADA.

OBJECTIVES: The acculturation hypothesis speculates that as new immigrants get exposed to more obesogenic environments, they progressively acquire the unhealthy lifestyles of the host society, and their obesity risk gradually increases since time of arrival. However, the consistency of the presumed acculturation effect across immigrant groups and gender, and the reasons behind individual changes in lifestyle behaviors remain unclear. Thus, this study investigated the acculturation hypothesis in the Canadian context by comparing two foreign groups, Hispanics and East/Southeast Asians, which present contrasting post-settlement obesity patterns and behavioral trends. Methods: A 41-item questionnaire (including open-ended questions) was administered with 100 first-generation immigrants in the K-W Region to gather information on weight-relatedmeasures, acculturation levels, psychological stress, lifestyle behaviors, and perceived causes of changes in diet and physical activity. A logistic regression analysis was performed to estimate the likelihood of being overweight-obese, while interview transcripts were analyzed to identify response themes and explore causal relationships. RESULTS: Hispanics exhibited considerably higher body mass index levels and larger weight gains, and a nearly nine times higher overweight risk than East/Southeast Asians. Overweight risk was also higher for males and less-educated immigrants. Data collected shows that weight gains were larger for newcomers with high average psychological stress scores, and 38% of Hispanic participants mentioned either stress or depression as causes for their weight gains. The acculturation analysis revealed that East/Southeast Asians were significantly less integrated into Canadian society and more likely to maintain their traditional diets, while both groups reportedperceived-increased levels of recreational physical activity, which contradicts the belief of a linear uniform adoption of unhealthy lifestyle behaviors. DISCUSSION: Results support the notion that the impact of duration of residence does vary by ethnicity and gender. Future prevention efforts should focus on the foreign groups most likely to develop obesity, and pay particular attention to less-educated immigrants, who may be more likely to acquire unhealthy habits after settlement. Results also highlight the emergence of acculturative stress as a significant obesity-risk factor, and support the implementation of obesity preventive efforts that help immigrants manage post-settlement-related feelings of anxiety and depression through the inclusion of social integration strategies. In an increasingly diverse and multiethnic Canada, we expect the dissemination of the research findings to help recent and long-term immigrants to become more aware of obesity-relatedissues, and thus facilitate the adoption of healthier lifestyles after settlement in Canada

Health status in African American children and adolescents attending a community fine arts program

BACKGROUND: Over recent decades, the nationwide prevalence of chronic disease among children and adolescents has been on the rise. Conditions such as obesity pose a significant risk to the physical and mental health of individuals in youth as well as in adulthood, as these health risks track into later years and increase in severity. Low-income and racial/ethnic minorities are disproportionately affected by chronic conditions. In particular, African American (AA) youth are reported to have a higher prevalence of fair/poor health than their Caucasian peers. Compounding the effects of this racial disparity in health is the disparity AA youth face in SES, as many live in poverty. The individual and environmental influences associated with factors of race and SES contribute to negative health behaviors leading to poor health status among AA youth living in disadvantaged communities. Health disparities have been shown to manifest in the earliest years of life, therefore the monitoring of at-risk populations of children and adolescents is essential to identifying, addressing, and reducing poor health outcomes throughout the course of life. OBJECTIVE: To determine the health status of AA children and adolescents living in a low-income community using multiple health measures, examine the relationships between these health measures in AA youth, as well as to identify barriers to participation in a family-oriented health promotion program. METHODS: A total of 111 AA boys and girls attending a community fine arts program located in a low-income suburb of Chicago participated in the study. Data from anthropometric measurements, the 20-m Shuttle Run Test, and curl-ups were collected and analyzed to assess the health measures of Body Mass Index (BMI) and BMI Percentile, Cardiorespiratory Fitness (CRF), and Muscular Fitness (MF), respectively. Data pertaining to barriers encountered in attending a health promotion program were collected from 13 families who were active members of the community fine arts program and had participated in health promotion program. The cross-sectional survey consisted of questions pertaining to the different components of the intervention program as well as to family demographic information. RESULTS: The prevalence of overweight and obesity in the entire study population was 34.2%, with 31.6% of boys and 34.8% of girls being classified as overweight/obese. 16.2% of youth categorized specifically as obese, with 26.3% of boys and 15.2% of girls being obese. 43.9% of study participants aged 10-18 years needed improvement in CRF, all of whom were girls. All but one boy reached the healthy fitness zone for curl-ups. Significant positive correlations were found between BMI and age as well as curl-ups and age, and significant negative correlation was found between CRF and age as well as BMI and CRF for AA youth. Of reported barriers, scheduling conflicts and time constraints were consistently most listed by survey respondents. CONCLUSION: Within the at-risk population of AA youth studied, despite high levels of MF, a large proportion presented with problematic health as indicated by the high levels of poor CRF and weight status observed, suggesting a need for intervention in order to address these health issues. An intervention program targeting youth within this and similar communities should take into consideration attenuating excessive program-associated expenses as well as offering more scheduling options and information on efficient food preparation and exercise

New research directions on disparities in obesity and type 2 diabetes

Obesity and type 2 diabetes disproportionately impact U.S. racial and ethnic minority communities and lowâ income populations. Improvements in implementing efficacious interventions to reduce the incidence of type 2 diabetes are underway (i.e., the National Diabetes Prevention Program), but challenges in effectively scalingâ up successful interventions and reaching atâ risk populations remain. In October 2017, the National Institutes of Health convened a workshop to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases. Common features of guiding frameworks to understand and address disparities and promote health equity were described. Promising research directions were identified in numerous areas, including study design, methodology, and core metrics; program implementation and scalability; the integration of medical care and social services; strategies to enhance patient empowerment; and understanding and addressing the impact of psychosocial stress on disease onset and progression in addition to factors that support resiliency and health.This report discusses a workshop convened by the National Institutes of Health to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154507/1/nyas14270_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154507/2/nyas14270.pd

Situating Food Insecurity in a Historic Albuquerque Community: The Whorled Relationship between Food Insecurity and Place

This article examines conceptualizations of the relationship between food insecurity and place. We use an ethnographically inspired and community-engaged approach to situate our analysis of fluid dynamics at work in a community with high levels of food insecurity. We propose that the relationship between place and people’s experience of food insecurity is recursive, dialectical, and “whorled.” This relationship reflects complex, interconnected, and multidimensional processes with consequences for the health of residents. Our research demonstrates the key nature of the health-place nexus by exploring how food insecurity articulates with place in unexpected ways that go beyond discussions of food, food environments, food access, food practices or food systems that have become common in the literature

Aligning Community-Engaged Research to Context.

Community-engaged research is understood as existing on a continuum from less to more community engagement, defined by participation and decision-making authority. It has been widely assumed that more is better than less engagement. However, we argue that what makes for good community engagement is not simply the extent but the fit or alignment between the intended approach and the various contexts shaping the research projects. This article draws on case studies from three Community Engagement Cores (CECs) of NIEHS-funded Environmental Health Science Core Centers (Harvard University, UC Davis and University of Arizona,) to illustrate the ways in which community engagement approaches have been fit to different contexts and the successes and challenges experienced in each case. We analyze the processes through which the CECs work with researchers and community leaders to develop place-based community engagement approaches and find that different strategies are called for to fit distinct contexts. We find that alignment of the scale and scope of the environmental health issue and related research project, the capacities and resources of the researchers and community leaders, and the influences of the sociopolitical environment are critical for understanding and designing effective and equitable engagement approaches. These cases demonstrate that the types and degrees of alignment in community-engaged research projects are dynamic and evolve over time. Based on this analysis, we recommend that CBPR scholars and practitioners select a range of project planning and management techniques for designing and implementing their collaborative research approaches and both expect and allow for the dynamic and changing nature of alignment

F as in Fat: How Obesity Threatens America's Future 2011

Outlines 2008-10 national and state obesity rates, health indicators, and policies to address the epidemic; regional, economic, and social barriers to healthy choices; impact of the 2010 healthcare reform and Let's Move initiative; and recommendations