Engaging Low-Income Parents in Childhood Obesity Prevention from Start to Finish: A Case Study

Prevention of childhood obesity is a national priority. Parents influence young children’s healthy lifestyles, so it is paradoxical that obesity interventions focus primarily on children. Evidence and theory suggest that including parents in interventions offers promise for effective childhood obesity prevention. This case study engaged parents’ as co-researchers in the design, implementation and evaluation of an intervention for low-income families with a child enrolled in Head Start. Parent engagement mechanisms include: (1) targeted partnership development (2) operationalizing a Community Advisory Board (CAB) that was the key decision making body; (3) a majority of CAB members were parents who were positioned as experts, and (4) addressing structural barriers to parent participation. Lessons learned are provided for future research, and practice

Identifying Sources of Children’s Consumption of Junk Food in Boston After-School Programs, April–May 2011

Introduction: Little is known about how the nutrition environment in after-school settings may affect children’s dietary intake. We measured the nutritional quality of after-school snacks provided by programs participating in the National School Lunch Program or the Child and Adult Care Food Program and compared them with snacks brought from home or purchased elsewhere (nonprogram snacks). We quantified the effect of nonprogram snacks on the dietary intake of children who also received program-provided snacks during after-school time. Our study objective was to determine how different sources of snacks affect children’s snack consumption in after-school settings. Methods: We recorded snacks served to and brought in by 298 children in 18 after-school programs in Boston, Massachusetts, on 5 program days in April and May 2011. We measured children’s snack consumption on 2 program days using a validated observation protocol. We then calculated within-child change-in-change models to estimate the effect of nonprogram snacks on children’s dietary intake after school. Results: Nonprogram snacks contained more sugary beverages and candy than program-provided snacks. Having a nonprogram snack was associated with significantly higher consumption of total calories (+114.7 kcal, P < .001), sugar-sweetened beverages (+0.5 oz, P = .01), desserts (+0.3 servings, P < .001), and foods with added sugars (+0.5 servings; P < .001) during the snack period. Conclusion: On days when children brought their own after-school snack, they consumed more salty and sugary foods and nearly twice as many calories than on days when they consumed only program-provided snacks. Policy strategies limiting nonprogram snacks or setting nutritional standards for them in after-school settings should be explored further as a way to promote child health

Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis

Background: A wide range of interventions has been implemented and tested to prevent obesity in children. Given parents’ influence and control over children’s energy-balance behaviors, including diet, physical activity, media use, and sleep, family interventions are a key strategy in this effort. The objective of this study was to profile the field of recent family-based childhood obesity prevention interventions by employing systematic review and quantitative content analysis methods to identify gaps in the knowledge base. Methods: Using a comprehensive search strategy, we searched the PubMed, PsycIFO, and CINAHL databases to identify eligible interventions aimed at preventing childhood obesity with an active family component published between 2008 and 2015. Characteristics of study design, behavioral domains targeted, and sample demographics were extracted from eligible articles using a comprehensive codebook. Results: More than 90% of the 119 eligible interventions were based in the United States, Europe, or Australia. Most interventions targeted children 2–5 years of age (43%) or 6–10 years of age (35%), with few studies targeting the prenatal period (8%) or children 14–17 years of age (7%). The home (28%), primary health care (27%), and community (33%) were the most common intervention settings. Diet (90%) and physical activity (82%) were more frequently targeted in interventions than media use (55%) and sleep (20%). Only 16% of interventions targeted all four behavioral domains. In addition to studies in developing countries, racial minorities and non-traditional families were also underrepresented. Hispanic/Latino and families of low socioeconomic status were highly represented. Conclusions: The limited number of interventions targeting diverse populations and obesity risk behaviors beyond diet and physical activity inhibit the development of comprehensive, tailored interventions. To ensure a broad evidence base, more interventions implemented in developing countries and targeting racial minorities, children at both ends of the age spectrum, and media and sleep behaviors would be beneficial. This study can help inform future decision-making around the design and funding of family-based interventions to prevent childhood obesity. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0571-2) contains supplementary material, which is available to authorized users

Biography of Leann L Birch, PhD, 25 June 1946 – 26 May 2019

On 26 May, 2019, the nutrition community lost a visionary ambassador, trusted advisor, and cherished mentor. Leann Birch was a pioneer in bringing a developmental psychology perspective to the study of children\u27s nutrition as a means to respond to real-world questions raised by parents. Leann Elsie Traub was born in Owosso, Michigan 25 June, 1946. She grew up primarily in Southern California and received a bachelor\u27s degree in psychology from California State University, Long Beach, in 1971. She completed her graduate studies at the University of Michigan where she received a master\u27s degree in 1973 and a doctorate in 1975, both in psychology. She subsequently held faculty appointments reflecting affiliations with nutrition as well as human development at the University of Illinois, Urbana-Champaign (1976–1992), the Pennsylvania State University (1992–2014), and the University of Georgia (2014–2019). Over this time, Leann was a prolific scientist, publishing \u3e250 publications (with \u3e51,000 citations) and receiving \u3e$30 million in federal research funding. The public health impact and reach of Leann\u27s work is profound. References to her work can be found everywhere: federal dietary guidance, position statements from leading professional organizations, early-childhood education policies, anticipatory guidance given in the pediatrician\u27s office, and popular books on feeding children

Maternal depression and childhood obesity: A systematic review

Objective. Maternal depression is prevalent and has been associated with parenting practices that influence child weight. In this systematic review we aimed to examine the prospective association between maternal depression and child overweight.Methods. We searched four databases (PsycINFO, PubMed, Embase, and Academic Search Premier) to identify studies for inclusion. We included studies with a prospective design with at least one year follow-up, measuring maternal depression at any stage after childbirth, and examining child overweight or obesity status, body mass index z-score or percentile, or adiposity. Two authors extracted data independently and findingswere qualitatively synthesized.Results. We identified nine prospective studies for inclusion. Results were examined separately for episodic depression (depression at a single measurement occasion) and chronic depression (depression on multiple measurement occasions). Mixed results were observed for the relationship between episodic depression and indicators of child adiposity. Chronic depression, but not episodic depression,was associated with greater risk for child overweight.Conclusions.While chronic depression may be associated with child overweight, further research is needed. Research is also needed to determine whether maternal depression influences child weight outcomes in adolescence and to investigate elements of the family ecology that may moderate the effect of maternal depression on child overweight

A Cascade of Champions: A Qualitative Study about the MA-CORD Media Competition Implementation

A media competition was part of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study. Criss et al., previously outlined the development and implementation of the competition, including variation in reach and adoption of the intervention across schools and afterschool programs. In this qualitative study, we examine community, provider, and organizational factors that explain the variation of media competition reach in school and afterschool programs, and describe the awareness of the media competition across other community sectors. Durlak and DuPre’s ecological framework for understanding effective implementation provided the theoretical underpinnings for this study. Fifty-four key informant interviews were conducted, transcribed, and analyzed. Organizational capacity of committed teachers/staff and adaptability of the media competition seemed to be drivers for higher reach within school and afterschool programs. Salient themes that emerged as facilitators of effective implementation were having a cascade of champions and providing opportunity to participate in the media competition outside traditional class time. Clinics and coalitions were identified as additional sectors aware of the media competition. Specifically, our findings offer a new perspective on intervention design and a recommended direction for further study