A review of early influences on physical activity and sedentary behaviors of preschool‐age children in high‐income countries

Purpose: Promoting physical activity (PA) is a key component of preventing and controlling childhood obesity. Despite well‐documented benefits of PA, globally, rates of PA among young children have declined over the past decades, and most children are not accruing sufficient PA daily. Helping children develop the foundation for PA habits early in life is critical for the promotion of health in childhood and prevention of chronic diseases later in life, and will ultimately promote longer and healthier lives for individuals and the general population. The purpose of this review is to provide a synthesis of current evidence on influences on PA and sedentary behaviors of preschool‐age children in high‐income countries. Design and Methods: A systematic review of three databases was performed. Studies conducted in high‐income countries and published from 2000 onward that addressed influences on PA and sedentary behaviors of preschool‐age children were identified and reviewed. Additionally, reference lists of identified articles and relevant published reviews were reviewed. Studies that met the following inclusion criteria were considered: (a) sample included preschoolers (age ≤5 years); (b) PA and/or sedentary behaviors or factors associated with PA and/or sedentary behaviors was assessed; (c) published in English; (d) used either quantitative or qualitative methods; and (e) conducted in a high‐income country. Data were extracted from selected studies to identify influences on PA and sedentary behaviors of preschool‐age children and organized using the social–ecological model according to multiple levels of influence. Results: Results from included studies identify multiple factors that influence PA and sedentary behaviors of young children in high‐income countries at the various levels of the social–ecological model including intrapersonal, interpersonal, environmental, organizational, and policy. Practice Implications: Given pediatric nurses’ role as primary care providers, and their frequent and continued contact with parents and their children throughout childhood through well‐child visits, immunization, and minor acute illnesses, they are well positioned to promote and support the development of early healthful PA habits of children starting in early childhood

A qualitative study conducted in the USA exploring Latino fathers’ beliefs, attitudes and practices related to their young children’s eating, physical activity and sedentary behaviours

Objective: Increasing evidence documents fathers’ influential role in their children’s eating, physical activity (PA) and sedentary behaviours (SB). We aimed to expand limited existing research examining fathers’ influence in these areas by exploring Latino fathers’ beliefs, attitudes and practices related to eating, PA and SB of their young children. Designs: Seven focus group discussions were conducted in Spanish with Latino fathers (n 28) of children aged 2–8 years. Audio recordings were transcribed and translated verbatim without identifiers. Data were analysed using thematic analysis to identify key concepts and themes using NVivo 11 software. Results: Fathers expressed positive beliefs and attitudes about the importance of healthy eating for their young children, themselves and their families. Nevertheless, the majority reported familial practices including eating out, getting take-out, etc. that have been linked to increased obesity risk among Latino children. Fathers were more involved and engaged in children’s PA than eating and feeding. However, several fathers reported engaging predominantly in sedentary activities with their children, appeared permissive of children’s sedentary habits and struggled to set limits on children’s screen-time. Conclusions: We provide new information on Latino fathers’ beliefs and child feeding and PA practices that may provide important targets for interventions aimed at promoting healthful eating and PA behaviours of Latino children. Future research should further quantify the influence of Latino fathers’ parenting styles and practices on development of children’s eating, PA and SB. This information is needed to identify risk factors amenable to interventions and to design culturally appropriate parenting and family-based interventions targeting Latino children’s home environment and designed to meet this ethnic group’s specific needs

Non-Responsive Feeding Practices, Unhealthy Eating Behaviors, and Risk of Child Overweight and Obesity in Southeast Asia: A Systematic Review

Childhood obesity is increasing dramatically in many Southeast Asian countries, and becoming a significant public health concern. This review summarizes the evidence on associations between parental feeding practices, child eating behaviors, and the risk of overweight and obesity in Southeast Asian children 2–12 years old. We systematically searched five electronic academic/research (PubMed, PsycINFO, ProQuest Nursing, Medline, and CINAHL) databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for peer-reviewed studies published in English between January 2000 and December 2016. Fourteen observational studies met the inclusion criteria and were reviewed. Reviewed studies were examined separately for preschool- and school-aged children and revealed that non-responsive parental feeding practices and unhealthy child eating behaviors were associated with a risk of child overweight and obesity in several Southeast Asian countries. Nonetheless, due to the small number of identified studies (n= 14) and because only about half of the Southeast Asian countries (Thailand, Vietnam, Singapore, the Philippines, and Malaysia) were represented (5/11) in the examined studies, additional research is needed to further understand the factors associated with childhood obesity among children in Southeast Asia to develop interventions that are tailored to the specific needs of Southeast Asian countries and designed to address practices and behaviors that may promote childhood obesity

Sociocultural and interpersonal influences on latina women’s beliefs, attitudes, and experiences with gestational weight gain

Latinos are the largest and fastest-growing minority group in the U.S., and Latina women represent the largest portion of minority births, having the highest birth rate in the U.S. for over 20 years. In addition, Latina women are at increased risk of entering pregnancy being overweight or having obesity and gaining excess gestational weight. Excess gestational weight gain (GWG) has short- and long-term adverse health outcomes for the woman and her child. Although culturally tailored interventions show promise toward promoting healthy GWG among Latina women, findings from current interventions have had mixed results, suggesting the need for further tailoring to meet the needs of this heterogeneous population group. This qualitative study was designed to explore first-time pregnant, low-income Latina women’s beliefs, attitudes, and experiences with GWG. The study employed qualitative research using semi-structured interviews conducted with 23 first-time pregnant Latina women between 22 and 36 weeks of gestation. Interviews were conducted by trained bilingual staff, transcribed verbatim, and analyzed using thematic analysis. Results showed that participants were uncertain if their GWG was within a healthy range. Although the majority of participants knew that GWG should be limited, they were not sure what the amount should be. In addition, the majority of participants reported attitudes of acceptance of and resignation to excessive GWG as being part of pregnancy. Several women appeared to believe that they did not have control over their weight gain during pregnancy. Moreover, analysis identified that sociocultural and interpersonal factors such as social support influence the beliefs, attitudes, and experiences with GWG of the low-income, majority immigrant Latina women who participated in this study. Study findings can be used to further tailor prenatal care practices and interventions aimed at altering modifiable risk factors associated with excess GWG among Latinas. Future interventions designed for low-income, immigrant Latina women that consider sociocultural influences on women’s beliefs and attitudes related to GWG, as well as the influence of social support networks on women’s health behaviors during pregnancy, will likely be more effective in preventing excessive GWG

Assessing health professionals’ perception of health literacy in Rhode Island community health centers: a qualitative study

Background: Limited health literacy is linked with poor health behaviors, limited health care access, and poor health outcomes. Improving individual and population health outcomes requires understanding and addressing barriers to promoting health literacy. Methods: Using the socio-ecological model as a guiding framework, this qualitative study (Phase 1 of a larger ongoing project) explored the interpersonal and organizational levels that may impact the health literacy levels of patients seeking care at federally qualified community health centers (FQCHCs) in Rhode Island. Focus groups were conducted with FQCHC employees (n = 37) to explore their perceptions of the health literacy skills of their patients, health literacy barriers patients encounter, and possible strategies to increase health literacy. The focus groups were audio-recorded and transcribed, and transcripts were coded using a process of open, axial, and selective coding. Codes were grouped into categories, and the constant comparative approach was used to identify themes. Results: Eight unique themes centered on health literacy, sources of health information, organizational culture’s impact, challenges from limited health literacy, and suggestions to ameliorate the impact of limited health literacy. All focus group participants were versed in health literacy and viewed health literacy as impacting patients’ health status. Participants perceived that some patients at their FQCHC have limited health literacy. Participants spoke of themselves and of their FQCHC addressing health literacy through organizational- and provider-level strategies. They also identified additional strategies (e.g., training staff and providers on health literacy, providing patients with information that includes graphics) that could be adopted or expanded upon to address and promote health literacy. Conclusions: Study findings suggest that strategies may need to be implemented at the organizational-, provider-, and patient- level to advance health literacy. The intervention phase of this project will explore intervention strategies informed by study results, and could include offering health literacy training to providers and staff to increase their understanding of health literacy to include motivation to make and act on healthy decisions and strategies to address health literacy, including the use of visual aids

Associations Between Maternal Depressive Symptoms and Nonresponsive Feeding Styles and Practices in Mothers of Young Children: A Systematic Review

Background: Childhood obesity is a significant global public health problem due to increasing rates worldwide. Growing evidence suggests that nonresponsive parental feeding styles and practices are important influences on children’s eating behaviors and weight status, especially during early childhood. Therefore, understanding parental factors that may influence nonresponsive parental feeding styles and practices is significant for the development of interventions to prevent childhood obesity. Objective: The objectives of this systematic review were to (1) identify and review existing research examining the associations between maternal depressive symptoms and use of nonresponsive feeding styles and practices among mothers of young children (2-8 years of age), (2) highlight the limitations of reviewed studies, and (3) generate suggestions for future research. Methods: Using the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols) guidelines, six electronic academic databases were searched for peer-reviewed, full-text papers published in English between January 2000 and June 2016. Only studies with mothers 18+ years old of normally developing children between 2 and 8 years of age were included. Of the 297 citations identified, 35 full-text papers were retrieved and 8 were reviewed. Results: The reviewed studies provided mixed evidence for associations between maternal depressive symptoms and nonresponsive feeding styles and practices. Two out of three studies reported positive associations with nonresponsive feeding styles, in that mothers with elevated depressive symptoms were more likely than mothers without those symptoms to exhibit uninvolved and permissive or indulgent feeding styles. Furthermore, results of reviewed studies provide good evidence for association between maternal depressive symptoms and instrumental feeding (3 of 3 reviewed studies) and nonresponsive family mealtime practices (3/3), but mixed evidence for pressuring children to eat (3/6) and emotional feeding (1/3). In addition, evidence for the association between maternal depressive symptoms and restricting child food intake was mixed: one study (1/6) found a positive association; two studies (2/6) found a negative association; whereas one study (1/6) found no association. Conclusions: This review indicates that the results of studies examining the associations between maternal depressive symptoms and parental feeding styles and practices are mixed. Limitations of studies included in this review should be noted: (1) the use of a diverse set of self-report questionnaires to assess parental feeding practices is problematic due to potential misclassification and makes it difficult to compare these outcomes across studies, thus caution must be taken in drawing conclusions; and (2) the majority of included studies (6/8) were cross-sectional. There is a need for additional longitudinal studies to disentangle the influence of depression on parental feeding styles and practices. Nevertheless, given that depressive symptoms and feeding styles and practices are potentially modifiable, it is important to understand their relationship to inform obesity prevention interventions and programs

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis

Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15–44). Participants (n = 147) were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers′ Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish) administered by bilingual interviewers. About one-third (34%) of participants were classified as having obesity (BMI ≥ 30 kg/m2), 28.3% had elevated depressive symptoms (CES-D ≥ 16), and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR) = 2.80, 95% confidence interval (CI): 1.24–6.33). Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02–1.09). Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in the U.S. when designing interventions targeting Latina immigrants

Seasonal distribution and drivers of surface fine particulate matter and organic aerosol over the Indo-Gangetic Plain

The Indo-Gangetic Plain (IGP) is home to 9 % of the global population and is responsible for a large fraction of agricultural crop production in Pakistan, India, and Bangladesh. Levels of fine particulate matter (mean diameter &lt;2.5 µm, PM2.5) across the IGP often exceed human health recommendations, making cities across the IGP among the most polluted in the world. Seasonal changes in the physical environment over the IGP are dominated by the large-scale south Asian monsoon system that dictates the timing of agricultural planting and harvesting. We use the WRF-Chem model to study the seasonal anthropogenic, pyrogenic, and biogenic influences on fine particulate matter and its constituent organic aerosol (OA) over the IGP that straddles Pakistan, India, and Bangladesh during 2017–2018. We find that surface air quality during pre-monsoon (March–May) and monsoon (June–September) seasons is better than during post-monsoon (October–December) and winter (January–February) seasons, but all seasonal mean values of PM2.5 still exceed the recommended levels, so that air pollution is a year-round problem. Anthropogenic emissions influence the magnitude and distribution of PM2.5 and OA throughout the year, especially over urban sites, while pyrogenic emissions result in localised contributions over the central and upper parts of IGP in all non-monsoonal seasons, with the highest impact during post-monsoon seasons that correspond to the post-harvest season in the agricultural calendar. Biogenic emissions play an important role in the magnitude and distribution of PM2.5 and OA during the monsoon season, and they show a substantial contribution to secondary OA (SOA), particularly over the lower IGP. We find that the OA contribution to PM2.5 is significant in all four seasons (17 %–30 %), with primary OA generally representing the larger fractional contribution. We find that the volatility distribution of SOA is driven mainly by the mean total OA loading and the washout of aerosols and gas-phase aerosol precursors that result in SOA being less volatile during the pre-monsoon and monsoon season than during the post-monsoon and winter seasons.</p