Associations between mother's and children's moderate-to-vigorous physical activity and sedentary time in the family context

The manner in which mothers' and children's moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) are associated across different settings (i.e., at home versus outside of the home, on weekdays versus weekends) is not well understood. The purposes of this study were to: (Strong et al., 2005) describe associations between mothers' and children's levels of MVPA and ST, and (U.S. Department of Health and Human Services, 2008) determine how setting and mothers' and children's characteristics moderate the associations. We used baseline data from the University of Michigan Healthy Families baseline data (2013–2015) from 55 mothers who have children in two age groups (3–5.99years [n=25] and 10–12.99years [n=30]) for the analysis. MVPA and ST data were collected using accelerometry over a seven day period. Proportion of time spent in MVPA and ST between 08:00am and 08:59pm was calculated. Mixed-effects models were used to examine associations. After controlling for selected mother and child characteristics and setting variables, MVPA and ST levels were positively associated in mothers and their children (P<0.001). The mother-child associations for MVPA and ST were 1.7 times (β=0.365 versus β=0.216) and 2.2 times (β=0.255 versus β=0.117) stronger, respectively, when both were at home together. The association did not differ by day of the week. The variations by setting underline the importance of developing home-based, family-centered interventions to increase PA and decrease ST. Keywords: Physical activity, Sedentary time, Home environmen

Assessing the feasibility of parent participation in a commercial weight loss program to improve child body mass index and weight-related health behaviors

Objectives: Little is known about how children’s health might be affected by parents’ participation in commercial weight loss programs. Given that more than 3.2 million people subscribe to just one commercial weight loss program, Weight Watchers , any secondary effects on children’s weight-related health behaviors (e.g. dietary behaviors, physical activity, and sedentary time) and body mass index from parent participation in commercial weight loss programs may have significant public health implications. This study examined the feasibility of conducting a study to assess such effects. Methods for recruitment and retention, and perceived acceptability and satisfaction among participants in small-scale preliminary study, were evaluated. Changes in body mass index and health behaviors among the parent–child dyads were also measured to test whether a larger-scale study would be warranted. Methods: This was an 8-week, pre–post observational feasibility study involving 20 parent–child dyads where both members had overweight or obesity. Physical and behavioral data were collected at baseline and 8 weeks from both members of the dyads. Parenting data were collected at the same time periods through parents’ self-report. Bivariate correlation was used to quantify the associations in changes for dyad members. Results: Feasibility goals for retention and perceived acceptability/satisfaction among participants were met. We reached approximately 80% of our enrollment goal. Parents showed a significant decrease in body mass index of 0.53 points (p < 0.05), while children showed a significant increase in raw body mass index (0.42, p < 0.05) and body mass index percentile (0.59, p < 0.05). However, correlation between changes in parent body mass index and changes in children body mass index percentile was positively correlated (r = 0.24, p = 0.31). A decrease in parent intake of total fat was associated with a decrease in the intake of fat in their children (r = 0.47, p < 0.05). Conclusion: Our findings support the viability of a larger-scale follow-up to assess the potential of using parent-only commercial weight loss program as a mechanism for improving health behaviors and body mass index in children with overweight or obesity

Enrolling caregivers in obesity interventions to improve obesity-related outcomes in children

In this study, we assessed the influences of change in moderate-to-vigorous physical activity (MVPA)/sedentary time (ST) of caregivers participating in a commercial weight-loss program on their children’s change in MVPA/ST. Data from 29 caregivers and their children were collected over 8 weeks. We used multivariable linear regression to assess associations of changes in caregiver’s percent of time spent in MVPA/ST and changes in their child’s percent of time spent in MVPA/ST. For caregivers that decreased body mass index (BMI) over 8 weeks, changes in caregivers’ MVPA was strongly associated with the change in children’s MVPA (β = 2.61 [95% CI: 0.45, 4.77]) compared to caregivers who maintained/increased BMI (β = 0.24 [–2.16, 2.64]). Changes in caregivers’ ST was strongly associated with changes in children’s ST (β = 2.42 [1.02, 3.81]) compared to caregivers who maintained/increased BMI (β = 0.35 [–0.45, 1.14]). Findings reinforce encouraging caregivers to enroll in weight-loss programs for the benefit of their children as well as for themselves

Do prelicensure nursing students\u27 backgrounds impact what they notice and interpret about patients?

Background: Academic educators are challenged to foster the development of clinical judgment in diverse learners. The impact of nursing students\u27 backgrounds on clinical judgment has not previously been studied. Aims: 1. Determine what identifiable background variables influence what students notice and how they interpret what is noticed; 2. Identify some implications for pedagogical approaches that may foster clinical judgment development among diverse learners. Sample: Prelicensure/preregistration students, representing three international English-speaking programs in 3 countries, comprised the sample (N = 532). All were enrolled in the first course in which perioperative content was taught. Data collection: An online learning activity was designed to elicit responses to a simulated case study of an expert nurse role model caring for an older adult patient experiencing delirium several days post-operatively. Data analysis: Dyads of coders did three rounds of coding. Logistic and multinomial logistic regression models used background variables to look for patterns in student responses. Findings: The data strongly suggest that background variables impact clinical judgment, however, not in interpretable patterns. Conclusion: Nurse educators must acknowledge that prelicensure students\u27 backgrounds impact their clinical judgment and assist them to learn to think like nurses

A blended learning activity to model clinical judgment in practice: A multisite evaluation

Background: Observing how experienced nurses assess and manage complex situations may assist students in developing clinical judgment. Method: Evaluation of a combined learning activity including an audiovisual simulation demonstrating expert nurse care of a patient with delirium delivered across three international programs. Participants responded to five survey questions; two open-ended questions; and provided information about previous experiences with delirium. Results: Highest rated benefits: watching an expert nurse; and how assessment and care were provided. Qualitative themes: global perspectives; questions that challenged; level of realism; the expert nurse; technical issues; and contribution to learning and practice. Conclusion: Irrespective of country/program, participants rated the learning activity as beneficial in developing skills for clinical judgment