The Voice of Low-Income Adolescent Mothers on Infant Feeding

Adolescent mothers\u27 feeding practices impact infant weight gain. Infant obesity, especially in low-income families, is rapidly increasing. The aim of the exploratory study reported here was to identify factors affecting low-income African American and non-Hispanic White adolescent mothers\u27 infant feeding practices and useful learning modalities. Two focus groups were conducted by a trained facilitator using a semi-structured topic guide. Three themes emerged: (1) feeding decisions related to introduction of solid foods; (2) feeding information/advice provided by others; and (3) useful learning strategies. These themes can be used by Extension professionals in designing nutrition education programs for adolescent mothers

Healthy babies through infant-centered feeding protocol: an intervention targeting early childhood obesity in vulnerable populations

<p>Abstract</p> <p>Background</p> <p>Poor feeding practices during infancy contribute to obesity risk. As infants transition from human milk and/or formula-based diets to solid foods, these practices interfere with infant feeding self-regulation and healthy growth patterns. Compared with other socioeconomic groups, lower-income mothers are more likely to experience difficulty feeding their infants. This may include misinterpreting feeding cues and using less-than-optimal feeding styles and practices, such as pressuring infants during mealtimes and prematurely introducing solid food and sweetened beverages. The Healthy Babies trial aims to determine the efficacy of a community-based randomized controlled trial of an in-home intervention with economically and educationally disadvantaged mother-infant dyads. The educational intervention is being conducted during the infant's first 6 months of life to promote healthy transition to solids during their first year and is based on the theory of planned behavior.</p> <p>Methods/Design</p> <p>We will describe our study protocol for a multisite randomized control trial being conducted in Colorado and Michigan with an anticipated sample of 372 economically and educationally disadvantaged African American, Hispanic, and Caucasian mothers with infants. Participants are being recruited by county community agency staff. Participants are randomly assigned to the intervention or the control group. The intervention consists of six in-home visits by a trained paraprofessional instructor followed by three reinforcement telephone contacts when the baby is 6, 8, and 10 months old. Main maternal outcomes include a) maternal responsiveness, b) feeding style, and c) feeding practices. Main infant outcome is infant growth pattern. All measures occur at baseline and when the infant is 6 and 12 months old.</p> <p>Discussion</p> <p>If this project is successful, the expected outcomes will address whether the home-based early nutrition education intervention is effective in helping mothers develop healthy infant feeding practices that contribute to improving infant health and development and reducing the risk of early-onset childhood obesity.</p> <p>Trial Registration</p> <p>Current Controlled Trials <a href="http://www.anzctr.org.au/ACTRN126100000415000.aspx">ACTRN126100000415000</a></p

Enhancing self-regulation as a strategy for obesity prevention in Head Start preschoolers: the growing healthy study

Abstract Background Nearly one in five 4-year-old children in the United States are obese, with low-income children almost twice as likely to be obese as their middle/upper-income peers. Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested, and effects are modest. We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity. Methods/design The Growing Healthy study is a randomized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start, a federally-funded preschool program for low-income children. Interventions are delivered by community-based, nutrition-education staff partnering with Head Start. The first intervention (n = 200), Preschool Obesity Prevention Series (POPS), addresses evidence-based obesity prevention behaviors for preschool-aged children and their parents. The second intervention (n = 200) comprises POPS in combination with the Incredible Years Series (IYS), an evidence-based approach to improving self-regulation among preschool-aged children. The comparison condition (n = 200) is Usual Head Start Exposure. We hypothesize that POPS will yield positive effects compared to Usual Head Start, and that the combined intervention (POPS + IYS) addressing behaviors well-known to be associated with obesity risk, as well as self-regulatory capacity, will be most effective in preventing excessive increases in child adiposity indices (body mass index, skinfold thickness). We will evaluate additional child outcomes using parent and teacher reports and direct assessments of food-related self-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction. Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Trial registration number Clinicaltrials.gov Identifier: NCT01398358http://deepblue.lib.umich.edu/bitstream/2027.42/112539/1/12889_2012_Article_4758.pd

Cross- lagged associations between behaviour problems and obesity in head start preschoolers

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155893/1/ijpo12627_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155893/2/ijpo12627.pd

The Influence of Parenting Stress on Mealtime Behaviors of Low-Income African-American Mothers of Toddlers

Family stress theory provides a structure to obtain and analyze maternal perceptions of toddler feeding challenges within low-income African-American households. Focus groups, with a total of 20 mothers, were conducted in four counties in a Midwestern state in the United States. The following themes emerged from the data analysis: identification and appraisal of feeding challenges, child temperament, maternal psychological and physical states, and coping behaviors. Study conclusions provide suggestions related to child feeding that Extension educators should consider when offering culturally appropriate mealtime management interventions for African-American parents of young children

Relationship of Adult and Child Dietary Intakes in Michigan and Implications for Programming Region-Wide

Healthful dietary intakes are crucial for stemming the current childhood obesity epidemic. We examined the dietary intakes of 392 Michigan children aged 1–12 years. About 70% and 58% of children ate fruits and vegetables, respectively, each day; 26% drank sugar-sweetened beverages; and 31% ate with a television on. Children\u27s vegetable intakes were significantly and moderately correlated with their parents\u27 vegetable intakes (r = .34–.38), but their fruit intakes were more related to their grandparents\u27 fruit intakes (r = .31). Due to the relative representativeness of our sample and similarities in eating patterns across the region, Extension professionals may consider our study findings when designing tailored nutrition education programs for families in the midwestern United States

Enhancing self-regulation as a strategy for obesity prevention in Head Start preschoolers: the growing healthy study

Abstract Background Nearly one in five 4-year-old children in the United States are obese, with low-income children almost twice as likely to be obese as their middle/upper-income peers. Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested, and effects are modest. We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity. Methods/design The Growing Healthy study is a randomized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start, a federally-funded preschool program for low-income children. Interventions are delivered by community-based, nutrition-education staff partnering with Head Start. The first intervention (n = 200), Preschool Obesity Prevention Series (POPS), addresses evidence-based obesity prevention behaviors for preschool-aged children and their parents. The second intervention (n = 200) comprises POPS in combination with the Incredible Years Series (IYS), an evidence-based approach to improving self-regulation among preschool-aged children. The comparison condition (n = 200) is Usual Head Start Exposure. We hypothesize that POPS will yield positive effects compared to Usual Head Start, and that the combined intervention (POPS + IYS) addressing behaviors well-known to be associated with obesity risk, as well as self-regulatory capacity, will be most effective in preventing excessive increases in child adiposity indices (body mass index, skinfold thickness). We will evaluate additional child outcomes using parent and teacher reports and direct assessments of food-related self-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction. Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Trial registration number Clinicaltrials.gov Identifier: NCT01398358</p

Externalizing behavior is prospectively associated with intake of added sugar and sodium among low socioeconomic status preschoolers in a sex-specific manner

Abstract Background High intake of added sugar and sodium is a public health concern for preschool-aged children living in the US. Externalizing behavior may predict higher consumption of added sugar and/or sodium; however, previous studies have mostly been cross-sectional. The aim was to evaluate whether externalizing behavior is prospectively related to added sugar and intake in a sex-specific manner among preschoolers. Methods This was a secondary analysis of 524 preschool children (48% male) from Michigan who participated in an obesity prevention trial that occurred during one school year from 2011 to 2015. Teacher-assessed externalizing behaviors and three 24-h dietary recalls were completed at baseline and follow-up. We used linear mixed effects regression to evaluate the association between externalizing behavior at baseline and added sugar (% of total Calories) and sodium intake (mg/1000 Calories) at follow-up. In adjusted analysis, we included baseline income-to-needs ratio, child race/ethnicity, and baseline overweight status. All models were adjusted for total energy intake and accounted for clustering by classroom. Results Baseline externalizing behavior was positively associated with added sugar intake at follow-up among boys; after adjustment for confounders, every 5 points lower externalizing T-score (corresponding to higher externalizing behavior) was associated with a 0.6 higher percentage of added sugar per total Calories (95% CI 0.2 to 1.1; P value = 0.004). In contrast, girls with higher levels of externalizing behavior had lower consumption of added sugars; after confounder adjustment, every 5 points lower externalizing T-score was related to 0.6 lower percentage intake (95% CI -1.0 to −0.1; P value = 0.01). Baseline externalizing behavior was inversely associated with sodium intake at follow-up among boys. After potential confounder adjustment, for every 5 points lower externalizing behavior T-score, there was a 22 mg/1000 Cal lower sodium intake (95% CI -45 to 1; P value = 0.06). In contrast, after adjustment for confounders, every 5 points lower externalizing T-score among girls was related to 24 mg/1000 Cal higher sodium intake (95% CI 1 to 46; P value = 0.04). Conclusions Externalizing behavior among preschool-aged children was prospectively related to added sugar and sodium intake in a sex-dependent manner. Trial registration NCT01398358 Registered 19 July 2011.https://deepblue.lib.umich.edu/bitstream/2027.42/138809/1/12966_2017_Article_591.pd