Enhancing Interventions for Pediatric Obesity Among Young Latino Children: A Mixed Methods Study

Recent national data indicate that nearly 1/3 of US youth are overweight (BMI % 85th). Of these children, a disproportionate number are Latino. This racial and ethnic disparity has been observed in young childhood and persists when considering the effectiveness of current childhood obesity interventions. Programs that have demonstrated success with other racial and ethnic groups have not translated into successful outcomes for Latino families. This may be due to inadequate attention to important cultural factors for Latinos. The goal of the present study was to describe the current state of cultural tailoring of pediatric obesity and health promotion interventions for Latinos through a systematic review of the literature (Study 1) and to delineate cultural factors which impact health behavior of Latino families with an overweight or obese child and may influence outcomes associated with involvement in pediatric obesity intervention programs (Study 2). Results from Study 1 indicated that peripheral, linguistic, constituent-involving, and socio-cultural strategies are the most commonly employed cultural tailoring strategies in existing interventions. There is, however, a range in the description of socio-cultural strategies and a lack of detail regarding underlying cultural constructs in existing interventions. Findings from focus groups revealed recurrent themes suggesting that cultural beliefs about children's body size influence parent perception of child overweight and cultural factors also influence health communication and impact parent understanding of their child's weight status. Additionally, cultural values of respeto, familismo, and pesonalismo impact family acceptance and adherence to treatment recommendations

Associations Among Peer Victimization, Social Anxiety and Children's Self-Reported Physical Activity

Psychosocial difficulties, including peer victimization and anxiety, have been found to influence physical activity engagement among school-aged children. Understanding the mechanisms through which these factors may exert their influence is important to the design and implementation of health promotion programs and prevention programs for pediatric obesity. In this study, a community sample of 74 4th - 6th grade students completed measures of peer victimization, weight-related criticism, social anxiety, and physical activity. Indirect effects were found such that peer victimization and weight-related criticism were associated with social anxiety which, in turn, was associated with decreased participation in high intensity physical activity. Social anxiety as a mediator in these relationships was not supported. These findings underscore the importance of identifying potential barriers to participation in physical activity and highlight potential pathways through which these barriers operate

Insurer and Employer Views on Pediatric Obesity Treatment: a Qualitative Study

This is the peer reviewed version of the following article: Hampl, S.E., Davis, A.M., Sampilo, M.L., Stephens, K.L. and Dean, K. (2013), Insurer and employer views on pediatric obesity treatment: A qualitative study. Obesity, 21: 795–799. doi:10.1002/oby.20112, which has been published in final form at http://doi.org/10.1002/oby.20112. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.OBJECTIVE The effectiveness of group-based comprehensive, multidisciplinary (stage 3) pediatric weight management programs is backed by a growing body of literature, yet insurance coverage of these programs is scarce to nonexistent, limiting their reach and long-term survival. The objective of this study was to better understand the perspectives of insurers and large employers on the issue of group-based treatment coverage. DESIGN AND METHODS The authors performed a qualitative study utilizing structured interviews with these stakeholders, following accepted techniques. RESULTS Six major themes emerged: cost, program effectiveness, corporate social responsibility, secondary parental (employee) benefits, coverage options and new benefit determination. CONCLUSION Future efforts to secure payment for group-based pediatric weight management programs should address these key themes

Youth Advocates’ Perceptions of Tobacco Industry Marketing Influences on Adolescent Smoking: Can They See the Signs?

Point-of-sale (POS) advertising at retail stores is one of the key marketing avenues used by the tobacco industry. The United States Surgeon General urges actions to eliminate POS tobacco advertisements because of their influence on youth smoking. Many youth empowerment programs are implemented to address tobacco industry marketing influences, including POS tobacco advertisements. While youth are asked to take on such collective action, little is known regarding their perceptions and understanding of tobacco industry marketing influences and related advocacy activities. This mixed methods study examined Oklahoma’s tobacco control youth empowerment program members’ perceptions of tobacco industry marketing influences. Four focus groups were held with active program members from rural and urban areas. Overall, the focus group participants viewed the program as purposeful, as an avenue to help others, and as a way to make a difference. Specifically, the older participants (median age = 18 years) identified tobacco industry marketing influences such as POS, movies, and magazine advertisements and reported participating in activities that counter POS tobacco advertisements at retail stores. Likewise younger participants (median age = 16 years), identified similar tobacco industry marketing influences, but also included tobacco use by friends and family as tobacco industry marketing influences. Moreover, the younger participants did not report engaging in activities that addressed POS tobacco advertisements. The study results suggest that the empowerment program should tailor its programming, training, materials, and activities with input from youth of various ages. Thoughtfully developed messages and specific activities can truly empower youth and maximize their contribution as change agents who address POS or other initiatives at the retail environments to prevent chronic diseases