Parent behavioral and psychosocial risk and protective factors associated with child obesity in Delhi, India

This study used data from the Addressing the Emerging Obesity Epidemic in India: A Social Marketing Approach to address three aims: 1) evaluate the association between parent and child weight status in Delhi, India; 2) examine the association between parenting monitoring and encouragement behaviors and child dietary, physical activity, sedentary behaviors and weight status in Delhi, India; and 3) examine the association between parent dietary, physical activity, and sedentary behaviors and child dietary, physical activity, sedentary behaviors, and weight status in Delhi, India. The study was cross-sectional by design and collected anthropometric and behavioral-psychosocial measures from 6th and 8th grade children and parents in six private schools in Delhi, India. Overall, this study found 29.6% of children and 77.7% of parents to be overweight/obese, which are similar to levels found in the US (Flegal, Carroll, Kit, & Ogden, 2012; Ogden et al., 2014). Parent weight status was found to be a strong predictor of child weight status after controlling for child grade and sex. However, while maternal weight status (OR=1.51, 95% CI: 1.04-2.20) was associated with child weight status, paternal weight status was not (OR=1.10, 95% CI: .810-1.48). This association was particularly strong between mothers and sons (OR=2.13, 95% CI: 1.39-3.27). Parents reported high levels of monitoring and encouragement (37%-87%). Several parent monitoring and encouragement behaviors were positively and significantly associated with child overweight/obesity and levels of the behaviors in children: monitoring child sedentary behavior (OR=1.08, p=0.000), encouraging limiting unhealthy food consumption (OR=1.08, p=0.000), and encouraging limiting sedentary behavior (OR=1.18, p=0.050). While only parent energy-dense (ED) food and sugar-sweetened beverage (SSB) consumption were significantly associated with child overweight/obesity (ED was negatively associated: OR=0.70, p=0.26; while SSB was positively associated: OR=1.63, p=0.018), all parent dietary behaviors were significantly and positively associated with those behaviors in children. Parent moderate to vigorous exercise was the only physical activity or sedentary behavior significantly associated with child overweight/obesity and that behavior in children (OR=1.18, p=0.011; Beta=0.30, p=0.000). The results of this study provide initial evidence that parent weight status and dietary behaviors are strong predictors of child weight status and dietary behaviors in Delhi, India. Future research should use more robust methods to continue to explore the relationship between parenting behaviors (monitoring and encouraging) and parent behaviors with child overweight/obesity to better understand the nature of the relationship. Interventions to begin to address child overweight and obesity should include parents as direct targets, particularly for modeling healthy dietary behaviors and achieving healthy weight status

WHO Global Situational Alert System: a mixed methods multistage approach to identify country-level COVID-19 alerts

Background Globally, since 1 January 2020 and as of 24 January 2023, there have been over 664 million cases of COVID-19 and over 6.7 million deaths reported to WHO. WHO developed an evidence-based alert system, assessing public health risk on a weekly basis in 237 countries, territories and areas from May 2021 to June 2022. This aimed to facilitate the early identification of situations where healthcare capacity may become overstretched.Methods The process involved a three-stage mixed methods approach. In the first stage, future deaths were predicted from the time series of reported cases and deaths to produce an initial alert level. In the second stage, this alert level was adjusted by incorporating a range of contextual indicators and accounting for the quality of information available using a Bayes classifier. In the third stage, countries with an alert level of ‘High’ or above were added to an operational watchlist and assistance was deployed as needed.Results Since June 2021, the system has supported the release of more than US$27 million from WHO emergency funding, over 450 000 rapid antigen diagnostic testing kits and over 6000 oxygen concentrators. Retrospective evaluation indicated that the first two stages were needed to maximise sensitivity, where 44% (IQR 29%–67%) of weekly watchlist alerts would not have been identified using only reported cases and deaths. The alerts were timely and valid in most cases; however, this could only be assessed on a non-representative sample of countries with hospitalisation data available.Conclusions The system provided a standardised approach to monitor the pandemic at the country level by incorporating all available data on epidemiological analytics and contextual assessments. While this system was developed for COVID-19, a similar system could be used for future outbreaks and emergencies, with necessary adjustments to parameters and indicators