Parental Recall of Doctor Communication of Weight Status: National Trends From 1999 Through 2008

To examine time trends in parental reports of health professional notification of childhood overweight over the last decade and to determine the characteristics most associated with such notification

Is childhood overweight a special health care need?

Background: Children with special health care needs (CSHCN) are those who: (1) have or are at increased risk for a chronic medical condition and (2) require more health care than children generally. Because the CSHCN designation is intended to improve access to care, including securing a medical home and public programs that address the health needs of CSHCN, an important policy issue is whether childhood overweight meets both criteria that define CSHCN. Methods: This is a cross-sectional analysis of two nationally representative data sources, the 2001-2002 National Health and Nutrition Examination Survey (NHANES) and the 2002 Medical Expenditure Panel Survey (MEPS). Both surveys are used to examine the relationship between overweight and health status. NHANES is used to examine the relationship between overweight and three chronic conditions: dyslipidemia, dysglycemia, and hypertension. MEPS is used to examine the relationship between overweight, health care use and expenditures, and a medical home. Results: Overweight children, compared to healthy-weight children, have significantly increased risk for high total cholesterol, high or borderline LDL cholesterol, low HDL cholesterol, high triglycerides, high fasting glucose, high glycohemoglobin, and high systolic blood pressure. Overweight children report worse health status than healthy-weight children. Compared to healthy weight children, overweight children are less likely to have any health care expenditure; this difference does not remain after adjusting for socioeconomic status. Having a medical home tends to be associated with greater health care use and expenditures, though not consistently. Conclusions: These findings suggest that overweight children may meet the definition of CSHCN. They are clearly at increased risk for chronic health conditions that require more health care than that needed by healthy-weight children. Including overweight children under the umbrella of CSHCN is one potential strategy for improving access to care and enhancing health care resources available to overweight children. Such strategies to address overweight during childhood are critical to prevent chronic conditions, improve health status, and reduce health care expenditures, both during childhood and into adulthood

Healthy for Now? A Cross-Sectional Study of the Comorbidities in Obese Preschool Children in the United States

Examine health of preschoolers by BMI status

Accuracy of Child and Adolescent Weight Perceptions and Their Relationships to Dieting and Exercise Behaviors: NHANES

Recent public health and media attention on child obesity may have altered accuracy of self-perception of obesity and associated weight control behaviors in children and adolescents. Thus, we examined whether accuracy of weight perceptions were associated with weight loss behaviors

Pass the popcorn: "obesogenic" behaviors and stigma in children's movies.

OBJECTIVE: To determine the prevalence of obesity-related behaviors and attitudes in children's movies. METHODS: A mixed-methods study of the top-grossing G- and PG-rated movies, 2006-2010 (4 per year) was performed. For each 10-min movie segment, the following were assessed: 1) prevalence of key nutrition and physical activity behaviors corresponding to the American Academy of Pediatrics obesity prevention recommendations for families; 2) prevalence of weight stigma; 3) assessment as healthy, unhealthy, or neutral; 3) free-text interpretations of stigma. RESULTS: Agreement between coders was >85% (Cohen's kappa = 0.7), good for binary responses. Segments with food depicted: exaggerated portion size (26%); unhealthy snacks (51%); sugar-sweetened beverages (19%). Screen time was also prevalent (40% of movies showed television; 35% computer; 20% video games). Unhealthy segments outnumbered healthy segments 2:1. Most (70%) of the movies included weight-related stigmatizing content (e.g., "That fat butt! Flabby arms! And this ridiculous belly!"). CONCLUSIONS: These popular children's movies had significant "obesogenic" content, and most contained weight-based stigma. They present a mixed message to children, promoting unhealthy behaviors while stigmatizing the behaviors' possible effects. Further research is needed to determine the effects of such messages on children

A review of Kenya's cancer policies to improve access to cancer testing and treatment in the country

Background: Cancer is the third-leading cause of mortality in Kenya, resulting in unique challenges to the country’s health system. An increase in the number of cancer cases in Kenya over the past decade resulted in legislative actions and policies to guide delivery of cancer services. Kenya’s new national cancer control strategy and past policy efforts provide an opportunity to synergise information and enhance understanding to improve cancer diagnosis and treatment in the country. The objectives of this study are to (1) document policy-modifiable factors based on a review of policy documents and results of a key informant survey and (2) develop recommendations to improve policies affecting cancer testing and treatment services in Kenya. This study builds upon our previous study Improving Access to Cancer Testing and Treatment in Kenya (Makau Barasa et al. J Global Oncol 2(216), 2017). Methods: The study applied an in-depth systematic review of Kenya’s cancer policies and guidelines, a qualitative analysis of results from a section of a semi-structured key informant survey focused on the opinions of clinicians delivering cancer services as well as cancer support groups and advocacy leaders, and a stakeholder analysis identifying key policy-makers and implementers. Details of the complete key informant survey were published in our previous study. Results: Kenya’s cancer policies have guided progress made in providing the legal and implementation frameworks for the development and delivery of cancer services at the national and county levels. Some policy implementation gaps are noted. These include inadequate financing for cancer services, limited research and data to support policy formulation, and the concentration of cancer services in urban areas. The key informant survey identified policy-modifiable actions that can address some of the gaps and improve the delivery of and access to cancer testing and treatment services in the country. Some of these include addressing the financial barriers affecting cancer testing and treatment services; increasing stakeholder engagement in training health personnel to deliver cancer testing and treatment services; decentralising cancer services and improving cancer surveillance and research; and increasing education and awareness about cancer symptoms, screening procedures and treatment options. A set of priority policy actions were selected from the study findings and used to develop recommendations for Kenya’s policy-makers and stakeholders. Conclusions: Revisions to Kenya’s cancer policies are seeking to address gaps noted in past policies and to improve access to cancer testing and treatment in Kenya. However, based on study findings, additional actions can be taken to strengthen policy implementation. Considering the policy formulation and implementation process and costs, this study recommends focusing on three priority policy actions that can have significant impact on improving access to cancer testing and treatment services. These include addressing financing, insurance and human resources gaps; increasing stakeholder engagement; and decentralising health services for better surveillance and data to inform policies

Behaviors and motivations for weight loss in children and adolescents: Weight Loss Behaviors and Motivations in Children

Examine the association between weight loss behaviors and motivations for weight loss in children and adolescents and the association of weight status with these behaviors and motivations in a nationally representative sample

Racial Disparities Across Provider Specialties in Opioid Prescriptions Dispensed to Medicaid Beneficiaries with Chronic Noncancer Pain

Chronic pain affects both psychological and physical functioning, and is responsible for more than $60 billion in lost productivity annually in the United States. Although previous studies have demonstrated racial disparities in opioid treatment, there is little evidence regarding disparities in treatment of chronic non-cancer pain (CNCP) and the role of physician specialty

Source of Parental Reports of Child Height and Weight during Phone Interviews and Influence on Obesity Prevalence Estimates among Children Aged 3–17 Years

We compared parental reports of children’s height and weight when the values were estimated vs. parent-measured to determine how these reports influence the estimated prevalence of childhood obesity