Effectiveness of community outreach and engagement in recruitment success for a prebirth cohort.

IntroductionWe describe the effectiveness of community outreach and engagement in supporting recruitment for the US National Children's Vanguard Study between 2009 and 2012.MethodsThirty-seven study locations used 1 of 4 strategies to recruit 18-49-year-old pregnant or trying to conceive women: (1) Initial Vanguard Study used household-based recruitment; (2) Direct Outreach emphasized self-referral; (3) Enhanced Household-Based Recruitment enhanced Initial Vanguard Study strategies; and (4) Provider-Based Recruitment recruited through healthcare providers. Outreach and engagement included advance letters, interactions with healthcare providers, participation in community events, contacts with community organizations, and media outreach.ResultsAfter 1-2 years, 41%-74% of 9844 study-eligible women had heard about the National Children's Vanguard Study when first approached. Women who heard were 1.5-3 times more likely to consent. Hearing via word-of-mouth or the media most frequently predicted consent. The more sources women heard from the higher the odds of consent.ConclusionsWe conclude that tailored outreach and engagement facilitate recruitment in cohort studies

Sleep Duration Mediates the Relationship Between Health Behavior Patterns and Obesity

Objective: To examine associations between health behavior patterns and childhood obesity, and the mediating effect of sleep duration. Design: Population-based survey. Participants: Secondary analysis of data from the Infant Feeding Practices Study (age 6 years, n = 1073). Measurements: Mothers self-reported their child’s health behaviors including physical activity (PA), screen time, sleep duration, and diet. Latent class analysis determined the child’s patterns based on health behaviors. Sleep was examined as a mediator between the class membership variable and %BMIp95. Results: A 3-class model fit the data best, with classes labeled as “Poorest eaters” (low fruit/vegetable consumption, high fast food), “Healthy” (low screen time, highest fruit/vegetable consumption) and “Active, super-eaters, highest screen time” (highest PA and screen time, ate the most). “Poorest eaters” had an increased %BMIp95 (β = 4.11, P = .006) relative to the “Healthy” class. The “Poorest eaters” and “Active, super-eaters, highest screen time” classes had shorter sleep duration (β = −0.51, P \u3c .001; β = −0.38, P \u3c .001; respectively) relative to the “Healthy” class. Independent of class membership, each additional hour of sleep was associated with a %BMIp95 that was 2.93 U lower (P \u3c .001). Conclusions: Our results indicate that health behavior patterns mediated by sleep duration may influence a child’s %BMIp95. The bi-directionality of the relationship between health behaviors and sleep remains unclear. Our findings suggest the importance of a constellation of health behaviors on childhood obesity. Interventions should include a multitude of health behaviors and consider the possibility that improving diet and activity behaviors may facilitate improved sleep and lowered obesity risk among children

Maternal vegetable intake during and after pregnancy

Background: Improved understanding of vegetable intake changes between pregnancy and postpartum may inform future intervention targets to establish healthy home food environments. Therefore, the goal of this study was to explore the changes in vegetable intake between pregnancy and the postnatal period and explore maternal and sociodemographic factors that are associated with these changes. Methods: We examined sociodemographic, dietary, and health characteristics of healthy mothers 18-43y from the prospective Infant Feeding Practices II cohort (n = 847) (2005–2012). Mothers completed a modified version of the diet history questionnaire, a food-frequency measure, developed by the National Cancer Institute. We created four categories of mothers, those that were: meeting vegetable recommendations post- but not prenatally (n = 121; improved intake), not meeting vegetable recommendations during pregnancy and postnatally (n = 370; stable inadequate), meeting recommendations pre- but not postnatally (n = 123; reduced intake), and meeting recommendations at both time points (n = 233; stable adequate). To make our results more relevant to public health recommendations, we were interested in comparing the improved vegetable intake group vs. stable inadequate vegetable intake group, as well as those that reduced their vegetable intake compared to the stable adequate vegetable intake group. Separate multivariable-adjusted logistic regression were used to examine sociodemographic predictors of improved vs. stable inadequate and reduced vs. stable adequate vegetable intake. Results: Women with improved vegetable intake vs. stable inadequate smoked fewer cigarettes while women with reduced vegetable intake vs. stable adequate were more likely to experience less pregnancy weight gain. In adjusted models, employed women had greater odds of reduced vegetable intake (OR = 1.64 95% CI 1.14–2.36). In exploratory analyses, employment was associated with greater odds of reduced vegetable intake among low-income (OR = 1.79; 95% CI 1.03–3.1), but not higher income women (OR = 1.31; 95% CI 0.94–1.84). After further adjustment for paid maternity leave, employment was no longer associated with vegetable intake among lower income women (OR: 1.53; 95% CI: 0.76–3.05). Conclusions: More women with reduced vs. stable adequate vegetable intake were lower income and worked full time. Improved access to paid maternity leave may help reduce disparities in vegetable quality between lower and higher income women

The Association between Change in Physical Activity and Weight during Adolescence

Abstract Objective: To investigate the association between annual change in physical activity and subsequent annual change in weight status in adolescents over a 4 year period. Design: Longitudinalstudy design with annualdata collection over 4 years. Setting: Suburban school district in Pittsburgh, PA. Participants: 1245 adolescents aged 11-16 years. Main outcome measures: Physical activity and body mass index (BMI) percentile. Analysis: Generalized estimating equation (GEE). Results: 994 participants (53% male) were included in the analyses. The longitudinal associations between changes in physical activity and BMI% were mostly small and non-significant. However, compared with those who did not change their physical activity, a large annual increase in physical activity (>10 hr/wk) was associated with a significant increase in BMI%. Results were broadly similar for total and vigorous physical activity, boys and girls and for healthy and unhealthy (>85th percentile) BMI%. Conclusions and Implications: The role of physical activity in the development of obesity during adolescence therefore remains unclear. Further work is needed to elucidate the role of physical activity in the preventionof obesity

Maternal dietary intake during pregnancy and offspring body composition: The Healthy Start Study

Consistent evidence of an influence of maternal dietary intake during pregnancy on infant body size and composition in human populations is lacking, despite robust evidence in animal models

The National Childrens Study: An Introduction and Historical Overview

The National Children’s Study (NCS) was an ambitious attempt to map children’s health and development in a large representative group of children in the United States. In this introduction, we briefly review the background of the NCS and the history of the multiple strategies that were tested to recruit women and children. Subsequent articles then detail the protocols and outcomes of 4 of the recruitment strategies. It is hoped that lessons learned from these attempts to define a study protocol that could achieve the initial aims of the NCS will inform future efforts to conceptualize and execute strategies to provide generalizable insights on the longitudinal health of our nation’s children

Longitudinal association between television watching and computer use and risk markers in diabetes in the SEARCH for Diabetes in Youth Study: Television watching and risk markers in diabetes

The study provides evidence of the longitudinal association between screen time with hemoglobin A1c and cardiovascular risk markers among youth with type 1 (T1D) and type 2 diabetes (T2D)

Pathways between maternal depression, the family environment, and child BMI z scores

Purpose: Modifiable aspects of the family environment that contribute to overweight in younger children have been identified, including parental feeding practices, child eating behaviors, and parenting practices related to eating and household routines. Maternal depression influences many of these factors, yet research examining pathways that may link maternal depression through the family environment to child weight is lacking. The current study examined parental feeding practices, child eating behaviors, and eating and household routines as potential mediators between maternal depressive symptoms and child weight at age six. The study also tested for differential effects of early versus concurrent maternal depressive symptoms. Methods: Longitudinal data on 1130 mothers and their children who participated in the Infant Feeding Practices Study II (IFSP II) and its Year 6 Follow-Up study were analyzed. A multi-step, multiple mediator model assessed direct and indirect relationships between early depressive symptoms (two months post-partum) and concurrent depressive symptoms with child Body Mass Index (BMI) z scores at age six. Potential mediators included parental feeding practices, child eating behaviors, and eating and household routines. Results: Higher early depressive symptoms directly explained lower child BMI z scores. Early depression also worked through concurrent depression, the child\u27s food responsiveness, and the hours the child slept on week nights to explain higher child BMI z scores. Parental efforts to make sure the child eats enough directly predicted lower child weight but did not mediate the effects of early or concurrent maternal depressive symptoms. Conclusions: The findings suggest the need for greater attention to the relationships between maternal depression and child weight as a critical step toward developing effective obesity prevention strategies

Longitudinal assessment of anxiety and depression symptoms in U.S. adolescents across six months of the coronavirus pandemic

Abstract Background The present study aimed to describe anxiety and depression symptoms at two timepoints during the coronavirus pandemic and evaluate demographic predictors. Methods U.S. high school students 13–19 years old completed a self-report online survey in May 2020 and November 2020-January 2021. The Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Depression and Anxiety short forms queried depression and anxiety symptoms. Results The final sample consisted of 694 participants (87% White, 67% female, 16.2 ± 1.1 years). Nearly 40% of participants reported a pre-pandemic depression diagnosis and 49% reported a pre-pandemic anxiety diagnosis. Negative affect, defined as both moderate to severe depression and anxiety PROMIS scores, was found in ~ 45% of participants at both timepoints. Female and other gender identities and higher community distress score were associated with more depression and anxiety symptoms. Depression symptoms T-score decreased slightly (− 1.3, p-value  ≤ 0.001). Conclusion Adolescent mental health screening and treatment should be a priority as the pandemic continues to impact the lives of youth

Effectiveness of community outreach and engagement in recruitment success for a prebirth cohort.

IntroductionWe describe the effectiveness of community outreach and engagement in supporting recruitment for the US National Children's Vanguard Study between 2009 and 2012.MethodsThirty-seven study locations used 1 of 4 strategies to recruit 18-49-year-old pregnant or trying to conceive women: (1) Initial Vanguard Study used household-based recruitment; (2) Direct Outreach emphasized self-referral; (3) Enhanced Household-Based Recruitment enhanced Initial Vanguard Study strategies; and (4) Provider-Based Recruitment recruited through healthcare providers. Outreach and engagement included advance letters, interactions with healthcare providers, participation in community events, contacts with community organizations, and media outreach.ResultsAfter 1-2 years, 41%-74% of 9844 study-eligible women had heard about the National Children's Vanguard Study when first approached. Women who heard were 1.5-3 times more likely to consent. Hearing via word-of-mouth or the media most frequently predicted consent. The more sources women heard from the higher the odds of consent.ConclusionsWe conclude that tailored outreach and engagement facilitate recruitment in cohort studies