Prevalence of obesity among young Asian-American children

BACKGROUND: Asian-American children are considered to be at low risk of obesity, but previous estimates have not distinguished between children from different Asian countries. We estimate the prevalence of obesity among Asian-American children by mother\u27s country of origin, generational status, and family socioeconomic factors using a secondary analysis of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) wave III (children ∼4 years old) dataset. METHODS: The ECLS-B is a nationally representative study of children born in 2001 that oversampled births to Asian mothers. Asian ethnic categories included Chinese, Japanese, Filipino, Asian Indian, Korean, Vietnamese, and Other Asian/Pacific Islander. The primary outcome variable was weight status; overweight = BMI ≥85(th) and obese = BMI ≥95(th) percentile for age and gender. RESULTS: Twenty-six percent [95% confidence interval (CI) 23.6-29.1] of Asian-American 4 year olds were overweight or obese, and 13% (95% CI 10.2-15.2) were obese. Chinese-American children were at lower risk of overweight or obesity (23.5%, 95% CI 18.4-29.5 ) compared to whites (36%, 95% CI 34.3-37.7); Asian-Indian 4 year olds had the lowest rates of overweight or obesity (15.6%, 95% CI 8.0-28.2) and were most likely to be underweight (10%, 95% CI 4.9-19.4). Among Asians,Vietnamese-American children had the highest rate of overweight or obesity (34.7%, 95% CI 0.6-52.3). CONCLUSIONS: Vietnamese-American children are at elevated risk of obesity and overweight, whereas Chinese and Asian-Indian children are at low risk. After controlling for Asian ethnicity, maternal education, and household poverty status, Asian-American children whose mothers were born outside the United States were less likely to be obese [odds ratio = 0.55 (0.32-0.95), p = 0.03]

Nonabusive physical punishment and child behavior among African-American children: a systematic review.

BACKGROUND: The use of nonabusive physical punishment as a form of discipline has been greatly debated in the scientific and popular literature. Impact on child behavioral outcomes has frequently been found; however, the effects of its use are not clear, particularly for African-American children. This systematic review of the literature examined the impact of exposure to nonabusive physical punishment on the behavior of African-American children. METHODS: A search was conducted of PubMed and Psyclnfo from 1970 to 2000 using the key terms: corporal punishment, physical punishment, disciplinary practices, and discipline and parenting. Studies that described ethnicity of the population and included a majority of a well-described African-American population were included. Each study was required to include measurable data on child behavioral outcomes and at least one measure of discipline that assessed use of nonabusive physical punishment in children 0-14 years of age. RESULTS: All seven included studies used lower socioeconomic status (SES) and/or urban African-American populations. Study design and rural versus urban populations differentiated beneficial and detrimental outcomes. In all longitudinal studies, African-American children had beneficial or neutral outcomes. DISCUSSION: This review suggests that it is possible that there are benefits to nonabusive physical punishment for African-American children. However, needed are further longitudinal studies that better assess the multiple confounders that impact the use of discipline, such as SES, parental education level, and exposure to community or domestic violence

Internet and mobile technology use among urban African American parents: Survey study of a clinical population

Background: There is considerable potential for mobile technologies to empower pediatric patients and families by improving their communication with health professionals. National surveys suggest minority parents frequently communicate via mobile technology, but it is uncertain how amenable they are to receiving health care information in this format. Although the low cost and far reach characteristics of mobile health (mHealth) technology makes it advantageous for communication with minority parents, data on acceptance are needed.Objective: The objective of the study was to determine utilization of mobile and Internet technology by African American parents in an urban, underserved population, and to assess their interest in receiving health information via text messaging or other technologies (eg, social media and the Internet). Methods: A survey was administered to parents of children aged 1-12 years covered by public insurance receiving care at 3 pediatric primary care centers in Washington, DC. Results: The African American sample (N=302) was composed of primarily single (75.8%, 229/302) mothers. Almost half had more than a high school education (47.7%, 144/302) and incomes above US $25,000 per year (43.0$25,000 annually were 4 times as likely to own a tablet computer than their lower income counterparts. Of the participants, 80.8% (244/302) used social networking, primarily Facebook, and 74.2% (224/302) were interested in joining a social networking group about a health topic concerning their child. Although relatively few African American mothers (17.9%, 54/302) shared health information via texting, there was strong interest in receiving health information via mobile phones (87.4%, 264/302). There was no significant difference in Internet/mobile device use or interest in using these outlets to send/receive information about their children’s health between parents of healthy children and parents of children with chronic health conditions. Conclusions: Urban African American parents are active users of the Internet and mobile technology for social interactions, but they are less likely to use it for accessing or communicating health information. However, most parents expressed an interest in receiving health information or utilizing social networking to learn more about health topics. Mobile technology and social networks may be an underutilized method of providing health information to underserved minority populations

Authoritative parenting, parenting stress, and self-care in pre-adolescents with type 1 diabetes

Parent involvement in type 1 diabetes (T1DM) care leads to improved adherence; however, the manner in which parents approach illness management interactions with children must also be considered. It was hypothesized that greater use of an authoritative parenting style and less parenting stress would be associated with greater behavioral adherence and better metabolic control. Ninety-five primary caregivers of preadolescents (ages 8-11) with T1DM completed questionnaires assessing parenting style, pediatric parenting stress, and child behavioral adherence. Caregivers primarily self-identified as using an authoritative parenting style. Greater authoritative parenting was associated with greater behavioral adherence and less difficulty with pediatric parenting stress; no differences in metabolic control were observed. Greater engagement in authoritative parenting behaviors may contribute to increased age-appropriate child behavioral adherence and less pediatric parenting stress. Interventions highlighting diabetes-specific authoritative parenting techniques may enhance health outcomes and improve overall family functioning

The Use of AAP-Recommended Disciplinary Practice Guidelines Among African American Caregivers of Children in Head Start Programs

OBJECTIVE: The American Academy of Pediatrics (AAP) recommends that parents not use harsh disciplinary practices. Previous studies have characterized the disciplinary practices of African American parents as harsh, with reliance on more aggressive techniques not currently recommended by the AAP. However, recent research has indicated more disciplinary practice diversity among African Americans. This study describes factors associated with the use of AAP-recommended disciplinary practices among lower-income African American caregivers of children in Head Start. METHODS: Subjects were caregivers of children at three Head Start sites. Participants were eligible for inclusion if the biological mother, biological father, or target child was identified as African American. Using consensus methods, responses to the Parental Discipline Methods Interview (PDMI) were described as consistent or inconsistent with AAP guidelines regarding use of negative disciplinary practices (e.g., spanking, yelling). Caregivers avoiding any of these inconsistent methods were referred to as “adherent.” RESULTS: “Adherent” caregivers were older (32.5 years vs. 30.4 years) and had more education (86.0% vs. 75.4% high school graduates). They were also less likely to report that their child had behavioral problems (12.9% vs. 25.2%) or deficient social skills (1.7% vs. 8.0%). CONCLUSIONS: Lower-income African American caregivers were more likely to use disciplinary practices consistent with AAP guidelines if they had higher levels of education and were living in an urban setting. Caregivers describing their child as having fewer behavior problems, better social skills, or themselves as less stressed were also more likely to be “adherent.

ASPIRA: Employing a Serious Game in an mHealth App to Improve Asthma Outcomes

This paper presents the design, implementation and evaluation of a home based intervention targeting economically disadvantaged children to improve asthma clinical outcomes. The monitoring and intervention activities were delivered within an embedded astronaut-themed game to promote user acceptance and compliance to the clinical protocol. An iterative, user-centered design process was used to prototype the asthma home monitoring system (ASPIRA) involving a tablet application, digital spirometer and a particulate monitor linked to a data management server. Children of low socio-economic demographic populations were the main target group for this study as they have significantly high asthma rates and lack of condition awareness. ASPIRA is the first intervention of its kind that provides the target audience an easy to use and low-cost in-home monitoring application. ASPIRA\u27s design is grounded in the principles of social cognitive theory and aims to increase use, participation and efficacy in the target population. We present the results of a pilot study to determine feasibility and preliminary efficacy of the resulting high-fidelity ASPIRA prototype among four families with asthmatic children living in the Seattle metropolitan area