Parental Feeding Practices in Mexican American Families: Initial Test of an Expanded Measure

Background: Although obesity rates are high among Latino children, relatively few studies of parental feeding practices have examined Latino families as a separate group. Culturally-based approaches to measurement development can begin to identify parental feeding practices in specific cultural groups. This study used qualitative and quantitative methods to develop and test the Parental Feeding Practices (PFP) Questionnaire for use with Mexican American parents. Items reflected both parent’s use of control over child eating and child-centered feeding practices. Methods: In the qualitative phase of the research, 35 Latino parents participated in focus groups. Items for the PFP were developed from focus group discussions, as well as adapted from existing parent feeding practice measures. Cognitive interviews were conducted with 37 adults to evaluate items. In the quantitative phase, mothers and fathers of 174 Mexican American children ages 8–10 completed the PFP and provided demographic information. Anthropometric measures were obtained on family members. Results: Confirmatory factor analyses identified four parental feeding practice dimensions: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. Factorial invariance modeling suggested equivalent factor meaning and item response scaling across mothers and fathers. Mothers and fathers differed somewhat in their use of feeding practices. All four feeding practices were related to child body mass index (BMI) percentiles, for one or both parents. Mothers reporting more positive involvement had children with lower BMI percentiles. Parents using more pressure to eat had children with lower BMI percentiles, while parents using more restriction had children with higher BMI percentiles. Fathers using food to control behavior had children with lower BMI percentiles. Conclusions: Results indicate good initial validity and reliability for the PFP. It can be used to increase understanding of parental feeding practices, children’s eating, and obesity among Mexican Americans, a population at high risk of obesity

Parental feeding practices and child weight status in Mexican American families: a longitudinal analysis

Parental feeding practices are thought to influence children\u27s weight status, through children\u27s eating behavior and nutritional intake. However, because most studies have been cross-sectional, the direction of influence is unclear. Moreover, although obesity rates are high among Latino children, few studies of parental feeding practices have focused on this population. This 2-year longitudinal study examined mutual influences over time between parental feeding practices and children\u27s weight status, in Mexican American families with children 18 years old at baseline. Mothers (n = 322) and fathers (n = 182) reported on their feeding practices at baseline, 1-year follow-up, and 2-year follow-up. Weight status, defined by waist-height ratio (WHtR) and body mass index (BMI), was ascertained at all assessments. Cross-lagged panel models were used to examine the mutual influences of parental feeding practices and child weight status over time, controlling for covariates. Both mothers\u27 and fathers\u27 restriction of food predicted higher subsequent child weight status at Year 1, and for fathers this effect was also found at Year 2. Mothers\u27 and fathers\u27 pressure to eat predicted lower weight status among boys, but not girls, at Year 1. Child weight status also predicted some parental feeding practices: boys\u27 heavier weight predicted mothers\u27 less pressure to eat at Year 1, less use of food to control behavior at Year 2, and greater restriction at Year 2; and girls\u27 heavier weight at Year 1 predicted fathers\u27 less pressure to eat and less positive involvement in child eating at Year 2. This study provides longitudinal evidence that some parental feeding practices influence Mexican American children\u27s weight status, and that children\u27s weight status also influences some parental feeding practices. Feeding practices of both mothers and fathers were related to children\u27s weight status, underscoring the importance of including fathers in research on parental feeding practices and child obesity

Longitudinal Effects of Parental, Child and Neighborhood Factors on Moderate-Vigorous Physical Activity and Sedentary Time in Latino Children

Background: Moderate-vigorous physical activity (%MVPA) confers beneficial effects on child musculoskeletal health, cardiovascular fitness, and psychosocial well-being; in contrast, sedentary time (%SED) is emerging as a risk factor for health. This study aimed to identify parental, child and neighborhood factors influencing longitudinal assessments of body mass index (BMI) and activity patterns among Latino children, and to estimate lagged and cross-lagged effects between child BMI, %MVPA and %SED. Methods: A longitudinal design with assessments at baseline, 1 and 2 years follow-up (FU) was used to evaluate the effects of maternal and paternal factors (BMI, age, education level, acculturation, household income and household size), child factors (gender, age, BMI, pubertal status) and neighborhood factors (disorder, victimization) on child BMI, %MVPA and %SED, expressed as a percent of awake time, in 282 Latino children ages 8–10 y and their parents. This study was restricted to families with a mother and biological father or father figure in the child’s life. Results: Across time, total daily accelerometer counts (p = 0.04) and steps decreased (p = 0.0001), %SED increased (p = 0.0001), and %MVPA decreased (p = 0.02). Moderate lagged effects or tracking was seen for %MVPA and %SED (p = 0.001). %MVPA varied by gender (5.5% higher in boys than girls, p = 0.0001); child age (−0.4% per year, p = 0.03), and child BMI in boys only (−0.22%, p = 0.0002). Negative effects of paternal age, maternal education and maternal changes in BMI on %MVPA also were seen. %SED increased with child age (2.5% higher per year, p = 0.0001). Positive effects of paternal acculturation, maternal change in BMI, paternal age, and negative effects of household size on %SED were observed. A cross-lagged positive effect of BMI at FU1 on %SED at FU2 was observed for boys and girls (p = 0.03). Neighborhood disorder and victimization were not significant predictors of child BMI, %MVPA or %SED. Conclusion: The major child determinants of physical activity (age, gender and BMI) and minor parental influences (maternal BMI and education, paternal age and acculturation) should be considered in designing interventions to promote %MVPA and reduce %SED among Latino children as they approach adolescence. Keywords: Physical activity patterns, Accelerometers, Childhood obesity, Maternal factors, Paternal factors, Education level, Acculturation, Household income, Household size, Environment, Disorder, Victimizatio

Parental Feeding Practices and Child Weight Status in Mexican American Families: A Longitudinal Analysis

Parental feeding practices are thought to influence children\u27s weight status, through children\u27s eating behavior and nutritional intake. However, because most studies have been cross-sectional, the direction of influence is unclear. Moreover, although obesity rates are high among Latino children, few studies of parental feeding practices have focused on this population. This 2-year longitudinal study examined mutual influences over time between parental feeding practices and children\u27s weight status, in Mexican American families with children 18 years old at baseline. Mothers (n = 322) and fathers (n = 182) reported on their feeding practices at baseline, 1-year follow-up, and 2-year follow-up. Weight status, defined by waist-height ratio (WHtR) and body mass index (BMI), was ascertained at all assessments. Cross-lagged panel models were used to examine the mutual influences of parental feeding practices and child weight status over time, controlling for covariates. Both mothers\u27 and fathers\u27 restriction of food predicted higher subsequent child weight status at Year 1, and for fathers this effect was also found at Year 2. Mothers\u27 and fathers\u27 pressure to eat predicted lower weight status among boys, but not girls, at Year 1. Child weight status also predicted some parental feeding practices: boys\u27 heavier weight predicted mothers\u27 less pressure to eat at Year 1, less use of food to control behavior at Year 2, and greater restriction at Year 2; and girls\u27 heavier weight at Year 1 predicted fathers\u27 less pressure to eat and less positive involvement in child eating at Year 2. This study provides longitudinal evidence that some parental feeding practices influence Mexican American children\u27s weight status, and that children\u27s weight status also influences some parental feeding practices. Feeding practices of both mothers and fathers were related to children\u27s weight status, underscoring the importance of including fathers in research on parental feeding practices and child obesity

Mother-Reported Sleep, Accelerometer-Estimated Sleep, and Weight Status in Mexican American Children: Sleep Duration Is Associated with Increased Adiposity and Risk for Overweight/Obese Status

We know of no studies comparing parent-reported sleep with accelerometer-estimated sleep in their relation to pediatric adiposity. We examined: 1) the reliability of mother-reported sleep compared with accelerometer-estimated sleep, and 2) the relationship between both sleep measures and child adiposity. The current cross-sectional study included 304 Mexican American mother-child pairs recruited from Kaiser Permanente Northern California. We measured sleep duration, using maternal report and accelerometry, and child anthropometrics. Concordance between sleep measures was evaluated using the Bland-Altman method. We conducted zero-ordered correlations between mother-reported sleep, accelerometer-estimated sleep and child BMI z-scores (BMIz). Using linear regression, we examined three models to assess child BMIz with mother-reported sleep (model 1), accelerometer-estimated sleep (model 2), and both sleep measures (model 3). Children had an average age of 8.86 years (SD= .82). Mothers reported that their child slept 9.81 ± 0.74 (95% CI: 9.72, 9.89) hours, compared to 9.58 ± 0.71 (95% CI: 9.50, 9.66) hours based on accelerometry. Mother-reported sleep and accelerometer-estimated sleep were correlated (r = 0.33, p \u3c 0.001). BMIz outcomes were negatively associated with mother-reported sleep duration (model 1: β = −0.13; P = .02) and accelerometer-estimated sleep duration (model 2: β = −0.17; P \u3c .01). Accounting for both sleep measures, only accelerometer-measured sleep was related to BMIz (model 3: β = −0.14, P = .02). Each sleep measure was significantly related to adiposity, independent of covariates. Accelerometry appeared to be a more reliable measure of children’s sleep than maternal report, yet maternal report may be sufficient to examine the sleep-adiposity relationship when resources are limited

Parallel evolution of vgsc mutations at domains IS6, IIS6 and IIIS6 in pyrethroid resistant Aedes aegypti from Mexico

Aedes aegypti is the primary urban mosquito vector of viruses causing dengue, Zika and chikungunya fevers –for which vaccines and efective pharmaceuticals are still lacking. Current strategies to suppress arbovirus outbreaks include removal of larval-breeding sites and insecticide treatment of larval and adult populations. Insecticidal control of Ae. aegypti is challenging, due to a recent rapid global increase in knockdown-resistance (kdr) to pyrethroid insecticides. Widespread, heavy use of pyrethroid spacesprays has created an immense selection pressure for kdr, which is primarily under the control of the voltage-gated sodium channel gene (vgsc). To date, eleven replacements in vgsc have been discovered, published and shown to be associated with pyrethroid resistance to varying degrees. In Mexico, F1,534C and V1,016I have co-evolved in the last 16 years across Ae. aegypti populations. Recently, a novel replacement V410L was identifed in Brazil and its efect on vgsc was confrmed by electrophysiology. Herein, we screened V410L in 25 Ae. aegypti historical collections from Mexico, the frst heterozygote appeared in 2002 and frequencies have increased in the last 16 years alongside V1,016I and F1,534C. Knowledge of the specifc vgsc replacements and their interaction to confer resistance is essential to predict and to develop strategies for resistance management

High Level of Pyrethroid Resistance in an Anopheles funestus Population of the Chokwe District in Mozambique

Background Although Anopheles funestus is difficult to rear, it is crucial to analyse field populations of this malaria vector in order to successfully characterise mechanisms of insecticide resistance observed in this species in Africa. In this study we carried out a large-scale field collection and rearing of An. funestus from Mozambique in order to analyse its susceptibility status to insecticides and to broadly characterise the main resistance mechanisms involved in natural populations. Methodology/Principal Findings 3,000 F1 adults were obtained through larval rearing. WHO susceptibility assays indicated a very high resistance to pyrethroids with no mortality recorded after 1h30min exposure and less than 50% mortality at 3h30min. Resistance to the carbamate, bendiocarb was also noted, with 70% mortality after 1h exposure. In contrast, no DDT resistance was observed, indicating that no kdr-type resistance was involved. The sequencing of the acetylcholinesterase gene indicated the absence of the G119S and F455W mutations associated with carbamate and organophosphate resistance. This could explain the absence of malathion resistance in this population. Both biochemical assays and quantitative PCR implicated up-regulated P450 genes in pyrethroid resistance, with GSTs playing a secondary role. The carbamate resistance observed in this population is probably conferred by the observed altered AChE with esterases also involved. Conclusion/Significance The high level of pyrethroid resistance in this population despite the cessation of pyrethroid use for IRS in 1999 is a serious concern for resistance management strategies such as rotational use of insecticides. As DDT has now been re-introduced for IRS, susceptibility to DDT needs to be closely monitored to prevent the appearance and spread of resistance to this insecticide

Engagement of adolescents with ADHD in a narrative-centered game-based behavior change environment to reduce alcohol use

Background: Attention deficit hyperactivity disorder (ADHD) affects about 13% of adolescents and is associated with substance use-related morbidity and mortality. While evidence on effective interventions to reduce alcohol use among adolescents with ADHD is limited, parent-teen communication about alcohol use has been found to be protective. Other approaches, such as educational interventions, hold promise to reduce alcohol-related harms in adolescents with ADHD. Digital technology offers an innovative approach to health behavior change, expanding access to services and may promote learning for neurodiverse youth, including teens with ADHD. INSPIRE, a narrative-centered game-based behavior change environment designed to promote self-regulation and self-efficacy to prevent risky alcohol use has been found to engage a general adolescent population. The goals of this pilot study are (1) to examine the engagement of youth with ADHD in INSPIRE; and (2) to examine if INSPIRE fosters parent-teen communication. Method: Adolescents diagnosed with ADHD aged 14–16 were recruited from developmental medicine clinics and invited to a focus group offered via Zoom. Participants completed a pre-survey, interacted with the INSPIRE game, and answered a post-survey as well as open-ended questions about their gaming experience during the focus group. Engagement was measured through both self-report using subscales from the User Engagement Scale and computer data; survey and qualitative data collected information on parent-teen communication. Univariate statistics described adolescent characteristics, Rank-sum and Fisher’s exact tests examined relationships among variables, and qualitative analysis identified themes in open-ended questions. Results: Of adolescent participants (N = 40), 45% identified as female, 17.5% Black, 7.5%, Hispanic, and 62.5% White. Post-survey mean engagement subscales of Usability (on a 5-point scale) was 3.67 (SD = 0.74), and Satisfaction was 3.63 (SD = 0.75). Computer data indicated that participants played the game for a median of 24 min. Adolescents shared that playing the game strengthened refusal skills and their ability to navigate social gatherings with alcohol. Post-survey, 63% planned to share information from INSPIRE with a parent. Conclusion: Findings suggest that INSPIRE may support facilitating youth with ADHD to learn the developmental competencies needed to mitigate risk and thrive. INSPIRE warrants further testing to explore its impact on alcohol use in youth with ADHD

Investigating preferences for mosquito-control technologies in Mozambique with latent class analysis

<p>Abstract</p> <p>Background</p> <p>It is common practice to seek the opinions of future end-users during the development of innovations. Thus, the aim of this study is to investigate latent classes of users in Mozambique based on their preferences for mosquito-control technology attributes and covariates of these classes, as well as to explore which current technologies meet these preferences.</p> <p>Methods</p> <p>Surveys were administered in five rural villages in Mozambique. The data were analysed with latent class analysis.</p> <p>Results</p> <p>This study showed that users' preferences for malaria technologies varied, and people could be categorized into four latent classes based on shared preferences. The largest class, constituting almost half of the respondents, would not avoid a mosquito-control technology because of its cost, heat, odour, potential to make other health issues worse, ease of keeping clean, or inadequate mosquito control. The other three groups are characterized by the attributes which would make them avoid a technology; these groups are labelled as the bites class, by-products class, and multiple-concerns class. Statistically significant covariates included literacy, self-efficacy, willingness to try new technologies, and perceived seriousness of malaria for the household.</p> <p>Conclusions</p> <p>To become widely diffused, best practices suggest that end-users should be included in product development to ensure that preferred attributes or traits are considered. This study demonstrates that end-user preferences can be very different and that one malaria control technology will not satisfy everyone.</p

Pyrethroid Resistance in an Anopheles funestus Population from Uganda

Background: The susceptibility status of Anopheles funestus to insecticides remains largely unknown in most parts of Africa because of the difficulty in rearing field-caught mosquitoes of this malaria vector. Here we report the susceptibility status of the An. funestus population from Tororo district in Uganda and a preliminary haracterisation of the putative resistance mechanisms involved. Methodology/Principal Findings: A new forced egg laying technique used in this study significantly increased the numbers of field-caught females laying eggs and generated more than 4000 F1 adults. WHO bioassays indicated that An. funestus in Tororo is resistant to pyrethroids (62% mortality after 1 h exposure to 0.75% permethrin and 28% mortality to 0.05% deltamethrin). Suspected DDT resistance was also observed with 82% mortality. However this population is fully susceptible to bendiocarb (carbamate), malathion (organophosphate) and dieldrin with 100% mortality observed after exposure to each of these insecticides. Sequencing of a fragment of the sodium channel gene containing the 1014 codon conferring pyrethroid/DDT resistance in An. gambiae did not detect the L1014F kdr mutation but a correlation between haplotypes and resistance phenotype was observed indicating that mutations in other exons may be conferring the knockdown resistance in this species. Biochemical assays suggest that resistance in this population is mediated by metabolic resistance with elevated level of GSTs, P450s and pNPA compared to a susceptible strain of Anopheles gambiae. RT-PCR further confirmed the involvement of P450s with a 12-fold over-expression of CYP6P9b in the Tororo population compared to the fully susceptible laboratory colony FANG. Conclusion: This study represents the first report of pyrethroid/DDT resistance in An. funestus from East Africa. With resistance already reported in southern and West Africa, this indicates that resistance in An. funestus may be more widespread than previously assumed and therefore this should be taken into account for the implementation and management of vector control programs in Africa