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  • 1.

    【2hr】Child Care Provider Adherence to Infant and Toddler Feeding Recommendations: Findings from the Baby Nutrition and Physical Activity Self-Assessment for Child Care (Baby NAP SACC) Study

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    机译 托儿服务提供者遵守婴幼儿喂养建议：婴儿营养和体育锻炼自我评估的婴儿发现（婴儿NAP SACC）研究结果
    摘要：>Background: Identifying characteristics associated with the Institute of Medicine's (IOM) recommended feeding practices among infant and toddler care providers in child care centers could help in preventing childhood obesity.>Methods: In 2009, at baseline in a pilot intervention study of 29 licensed Massachusetts child care centers with at least 50% of enrolled children identified as racial minorities, 57 infant and 109 toddler providers completed feeding questionnaires. To assess provider adherence to six IOM-recommended behaviors, we used cluster-adjusted multivariable logistic regression models including provider type (infant or toddler), race, education, and center Child and Adult Care Food Program (CACFP) participation.>Results: In multivariable analysis, CACFP participation was associated with providers sitting with children at meals (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.2–21.7), offering fruits and vegetables (OR, 3.3; 95% CI 1.7–6.2), and limiting fast food (OR, 3.5; 95% CI, 1.8–6.7). Providers at centers serving meals family style were less likely to allow children to leave food unfinished (OR, 0.27; 95% CI, 0.09–0.77). Infant providers were more likely than toddler providers to sit with children at meals (OR, 6.98; 95% CI, 1.51–32.09), allow children to eat when hungry (OR, 3.50; 95% CI, 1.34–9.16), and avoid serving sugary (OR, 8.74; 95% CI, 3.05–25.06) or fast foods (OR, 11.56; 95% CI, 3.20–41.80).>Conclusions: CACFP participation may encourage IOM-recommended feeding practices among infant and toddler providers. Child care providers may benefit from education about how to feed infants and toddlers responsively, especially when offering foods family style. Future research should explore ways to promote child-centered feeding practices, while addressing barriers to providing children with nutrient-rich foods.
  • 2.

    【2hr】Treatment of Child/Adolescent Obesity Using the Addiction Model: A Smartphone App Pilot Study

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    机译 使用成瘾模型治疗儿童/青少年肥胖：智能手机应用程序先导研究
    摘要：>Background: The aim of this study was to test a weight loss program for young people based on an addiction treatment approach.>Methods: A pilot study (n=43) was conducted of a 20-week child/adolescent obesity intervention based on an addiction treatment model (staged, incremental withdrawal from problem foods, snacking/grazing, and excessive amounts at meals) and implemented by a server-integrated smartphone app with health professional support. The primary outcome was standardized %overBMI measured at four time points. Secondary outcomes were participants' self-ratings of self-esteem, control over food, and the degree they turned to food when stressed. User satisfaction data were collected with an online questionnaire. Latent growth modeling techniques were used to identify independent variables and possible mediating treatment process variables associated with weight change.>Results: Mean age of participants was 16 years (range, 10–21), 65% girls, and 84% Caucasian. Twenty-seven (63%) completed the program. There was a significant decrease in %overBMI over time of 7.1. There were significant improvements in participant ratings of self-esteem, control over food, and a reduction in turning to food when stressed. Males, younger participants, and participants with higher levels of program compliance achieved better weight loss. Participants who reported that calling obesity an addiction made their guilt worse experienced poorer weight loss. Females were more likely than males to report “addiction guilt,” and this partly mediated the overall gender effect.>Conclusions: The staged, incremental food withdrawal approach was feasible to implement and was useful in helping reduce excessive weight, particularly among boys.
  • 3.

    【2hr】Weight Management-Related Assessment and Counseling by Primary Care Providers in an Area of High Childhood Obesity Prevalence: Current Practices and Areas of Opportunity

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    机译 与肥胖管理相关的评估和儿童肥胖症高发地区的初级保健提供者的咨询：当前的实践和机会领域
    摘要：>Background: Childhood obesity in Georgia exceeds the national rate. The state's pediatric primary care providers (PCPs) are well positioned to support behavior change, but little is known about provider perceptions and practices regarding this role.>Purpose: The aim of this study was to assess and compare weight-management–related counseling perceptions and practices among Georgia's PCPs.>Methods: In 2012–2013, 656 PCPs (265 pediatricians, 143 family practice physicians [FPs], and 248 nurse practitioners/physician assistants [NP/PAs]) completed a survey regarding weight-management–related practices at well-child visits before their voluntary participation in a free training on patient-centered counseling and child weight management. Data were analyzed in 2014. Likert scales were used to quantify responses from 1 (strongly disagree or never) to 5 (strongly agree or always). Responses of 4 and 5 responses were combined to denote agreement or usual practice. Chi-squared analyses tested for independent associations between pediatricians and others. Statistical significance was determined using two-sided tests and p value <0.05.>Results: The majority of PCPs assessed fruit and vegetable intake (83%) and physical activity (78%), but pediatricians were more likely than FPs and NP/PAs to assess beverage intake (96% vs. 82–87%; p≤0.002) and screen time (86% vs. 74–75%; p≤0.003). Pediatricians were also more likely to counsel patients on lifestyle changes (88% vs. 71%; p<0.001) and to track progress (50% vs. 35–39%; p<0.05). Though all PCPs agreed that goal setting is an effective motivator (88%) and that behavior change increases with provider encouragement (85%), fewer were confident in their ability to counsel (72%).>Conclusions: Our results show that many PCPS in Georgia, particularly pediatricians, have incorporated weight management counseling into their practice; however, important opportunities to strengthen these efforts by targeting known high-risk behaviors remain.
  • 4.

    【2hr】Effects of a Cognitive-Behavioral Therapy-Based Immersion Obesity Treatment Program for Adolescents on Weight Fitness and Cardiovascular Risk Factors: A Pilot Study

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    机译 基于认知行为疗法的青少年浸入式肥胖治疗计划对体重健身和心血管危险因素的影响：一项初步研究
    摘要：>Background: Comprehensive, residential treatment for severe obesity in adolescents may be an alternative to bariatric surgery and more efficacious than outpatient treatment. The aim of this study was to evaluate the effects of a long-term cognitive-behavioral therapy–based immersion obesity treatment program for adolescents.>Methods: Twelve obese adolescents with BMIs above the 95th percentile completed a 14- to 18-week multicomponent intervention.>Results: We observed significant improvements in BMI z-score, waist circumference, mile run time, and blood lipids.>Conclusion: This study suggests that the tested program may be effective, at least in the short term; a randomized, controlled trial to further assess this model is warranted.
  • 5.

    【2hr】Evaluation of a Primary Care Intervention on Body Mass Index: The Maine Youth Overweight Collaborative

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    机译 体重指数的初级保健干预评估：缅因州青年超重合作组织
    摘要：>Background: We evaluated the impact of a brief primary-care–based intervention, The Maine Youth Overweight Collaborative (MYOC), on BMI (kg/m2) z-score change among participants with obesity (BMI ≥95th percentile for age and sex), overweight (BMI ≥85th and <95th percentile), and healthy weight (≥50th and <85th percentile).>Methods: A quasi-experimental field trial with nine intervention and nine control sites in urban and rural areas of Maine, MYOC focused on improvements in clinical decision support, charting BMI percentile, identifying patients with obesity, appropriate lab tests, and counseling families/patients. Retrospective longitudinal record reviews assessed BMI z-scores preintervention (from 1999 through October 2004) and one postintervention time point (between December 2006 and March 2008). Participants were youth ages 5–18 having two visits before the intervention with weight percentile greater than or equal to 95% (N=265). Secondary analyses focused on youths who are overweight (N=215) and healthy weight youth (N=506).>Results: Although the MYOC intervention demonstrated significant provider and office system improvements, we found no significant changes in BMI z-scores in intervention versus control youth pre- to postintervention and significant flattening of upward trends among both intervention and control sites (p<0.001).>Conclusions: This brief office-based intervention was associated with no significant improvement in BMI z-scores, compared to control sites. An important avenue for obesity prevention and treatment as part of a multisector approach in communities, this type of primary care intervention alone may be unlikely to impact BMI improvement given the limited dosage—an estimated 4–6 minutes for one patient contact.
  • 6.

    【2hr】Evaluation Protocol To Assess an Integrated Framework for the Implementation of the Childhood Obesity Research Demonstration Project at the California (CA-CORD) and Massachusetts (MA-CORD) Sites

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    机译 评估协议以评估在加利福尼亚州（CA-CORD）和马萨诸塞州（MA-CORD）基地实施的儿童肥胖研究示范项目的综合框架
    摘要：>Background: The long-term success of child obesity prevention and control efforts depends not only on the efficacy of the approaches selected, but also on the strategies through which they are implemented and sustained. This study introduces the Multilevel Implementation Framework (MIF), a conceptual model of factors affecting the implementation of multilevel, multisector interventions, and describes its application to the evaluation of two of three state sites (CA and MA) participating in the Childhood Obesity Research Demonstration (CORD) project.>Methods/Design: A convergent mixed-methods design is used to document intervention activities and identify determinants of implementation effectiveness at the CA-CORD and MA-CORD sites. Data will be collected from multiple sectors and at multiple levels of influence (e.g., delivery system, academic-community partnership, and coalition). Quantitative surveys will be administered to coalition members and staff in participating delivery systems. Qualitative, semistructured interviews will be conducted with project leaders and key informants at multiple levels (e.g., leaders and frontline staff) within each delivery system. Document analysis of project-related materials and in vivo observations of training sessions will occur on an ongoing basis. Specific constructs assessed will be informed by the MIF. Results will be shared with project leaders and key stakeholders for the purposes of improving processes and informing sustainability discussions and will be used to test and refine the MIF.>Conclusions: Study findings will contribute to knowledge about how to coordinate and implement change strategies within and across sectors in ways that effectively engage diverse stakeholders, minimize policy resistance, and maximize desired intervention outcomes.
  • 7.

    【2hr】Order of Magnitude Misestimation of Weight Effects of Childrens Meal Policy Proposals

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    机译 儿童饮食政策建议对体重影响的大小错误顺序
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  • 8.

    【2hr】Using the ANGELO Model To Develop the Childrens Healthy Living Program Multilevel Intervention To Promote Obesity Preventing Behaviors for Young Children in the US-Affiliated Pacific Region

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    机译 使用ANGELO模型开发儿童健康生活计划多层次干预措施以促进美国所属太平洋地区幼儿的预防肥胖行为
    摘要：>Background: Almost 40% of children are overweight or obese by age 8 years in the US-Affiliated Pacific, inclusive of the five jurisdictions of Alaska, Hawaii, American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands. This article describes how the Children's Healthy Living (CHL) Program used the ANGELO (Analysis Grid for Environments/Elements Linked to Obesity) model to design a regional intervention to increase fruit and vegetable intake, water consumption, physical activity, and sleep duration and decrease recreational screen time and sugar-sweetened beverage consumption in young children ages 2–8 years.>Methods: Using the ANGELO model, CHL (1) engaged community to identify preferred intervention strategies, (2) reviewed scientific literature, (3) merged findings from community and literature, and (4) formulated the regional intervention.>Results: More than 900 community members across the Pacific helped identify intervention strategies on importance and feasibility. Nine common intervention strategies emerged. Participants supported the idea of a regional intervention while noting that cultural and resource differences would require flexibility in its implementation in the five jurisdictions. Community findings were merged with the effective obesity-reducing strategies identified in the literature, resulting in a regional intervention with four cross-cutting functions: (1) initiate or strengthen school wellness policies; (2) partner and advocate for environmental change; (3) promote CHL messages; and (4) train trainers to promote CHL behavioral objectives for children ages 2–8 years. These broad functions guided intervention activities and allowed communities to tailor activities to maximize intervention fit.>Conclusions: Using the ANGELO model assured that the regional intervention was evidence based while recognizing jurisdiction context, which should increase effectiveness and sustainability.
  • 9.

    【2hr】The Role of Motivation in Family-Based Guided Self-Help Treatment for Pediatric Obesity

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    机译 动机在小儿肥胖症的家庭指导性自助治疗中的作用
    摘要：>Background: Identifying factors associated with effective treatment for childhood obesity is important to improving weight loss outcomes. The current study investigated whether child or parent motivation throughout the course of treatment predicted reductions in BMI.>Methods: Fifty 8- to 12-year-old children with overweight and obesity (BMI percentiles 85–98%) and their parents participated in a guided self-help weight loss program, which included 12 brief sessions across 5 months. Parents and interventionists reported on child and parent motivation level at each session. Multilevel slopes-as-outcome models were used to examine growth trajectories for both child and parent BMI across sessions.>Results: Greater interventionist-rated child motivation predicted greater reductions in child BMI; parent motivation did not. However, interventionist-rated parent motivation predicted greater reductions in parent BMI, and its impact on BMI became more pronounced over the course of treatment, such that sustained motivation was more important than initial motivation. Children who were older, Latino, or who had lower initial BMIs had slower reductions in BMI.>Conclusions: This study suggests that motivation may be an important predictor of reduced BMI in child obesity treatment, with sustained motivation being more important than initial motivation. In particular, interventionist-rated, but not parent-rated, motivation is a robust predictor of child and parent BMI outcomes. Future research may evaluate whether motivational interventions can enhance outcome, with particular attention to improving outcomes for Latino children.
  • 10.

    【2hr】Pediatric Severe Obesity: Time To Establish Serious Treatments for a Serious Disease

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    机译 小儿严重肥胖：是时候为严重疾病建立认真的治疗方法了
    摘要：
  • 11.

    【2hr】Fruits and Vegetables Displace But Do Not Decrease Total Energy in School Lunches

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    机译 水果和蔬菜代替但不减少学校午餐的总能量
    摘要：>Background: The high overweight and obesity prevalence among US children is a well-established public health concern. Diet is known to play a causal role in obesity. Increasing fruit and vegetable (FV) consumption to recommended levels is proposed to help reduce obesity, because their bulk and low energy density are believed to reduce energy-dense food consumption (volume displacement hypothesis). This study tests this hypothesis at the lunch meal among upper-elementary students participating in a Farm to School (F2S) program.>Methods: Digital photographs of students' school lunch trays were visually analyzed to identify the food items and amounts that were present and consumed before and after the meal. Using the USDA Nutrient Database, total and FV-only energy were calculated for each tray. Analysis of total- and non-FV energy intake was performed according to (1) levels of FV energy intake, (2) FV energy density, and (3) previous years of Farm to School programming.>Results: Higher intake of FV energy displaced non-FV energy, but total energy did not decrease across FV energy intake groups. High-FV-energy-density trays showed lower non-FV energy intake than low-FV-energy-density trays (470±179 vs. 534±219 kcal; p<0.0001). Trays from schools with more previous years of F2S programming decreased total and non-FV energy intake from school lunches (p for trend<0.0001, both).>Conclusions: Increased FV consumption reduces non-FV energy intake, but does not reduce total energy intake. Therefore, this study does not support the volume displacement hypothesis and suggests calorie displacement instead.
  • 12.

    【2hr】Accessibility Over Availability: Associations Between the School Food Environment and Student Fruit and Green Vegetable Consumption

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    机译 可获得性超过可用性：学校饮食环境与学生水果和绿色蔬菜消费之间的关联
    摘要：>Background: No national studies have examined associations between (1) school food availability and accessibility and (2) secondary student fruit and vegetable (FV) consumption. This article uses 5 years of nationally representative data from secondary school students to examine associations between the school food environment and student fruit and green vegetable consumption.>Methods: From 2008 to 2012, cross-sectional, nationally representative data from US middle and high school students were collected annually on self-reported fruit and green vegetable consumption. Each year, data from administrators at each relevant school were collected on food item availability (any venue) and accessibility (total number of school sources). Data were obtained from 10,254 eighth-grade students in 317 schools and 18,898 tenth- and 12th-grade students in 518 schools. Associations were estimated by multi-level models controlling for student- and school-level characteristics.>Results: Availability showed minimal association with student consumption. Candy/regular-fat snack accessibility was associated negatively with middle school fruit consumption. Salad bar availability and accessibility were positively associated with middle school green vegetable consumption; FV accessibility was associated positively with high school fruit and green vegetable consumption. Significant associations were consistent across student racial/ethnic and socioeconomic groups.>Conclusions: Forthcoming USDA nutrition standards for school foods and beverages sold outside of reimbursable meal programs should result in the removal of school candy/regular-fat snacks. In deciding which items to make available under the new standards, schools should consider increasing the number of FV sources—including salad bars—thereby potentially increasing student FV consumption.
  • 13.

    【2hr】The Food Environment of Youth Baseball

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    机译 青少年棒球的饮食环境
    摘要：>Background: Sports, such as youth baseball (YB), are popular outlets for increasing activity, yet there has been no investigation of food environments surrounding them. The aim of this study was to observe the types of foods available and consumed by players and spectators at YB events.>Methods: This was an observational assessment, by environmental scan, of foods consumed by players and family members at a YB field in northwest North Carolina.>Results: Participants included boys from six YB teams (n=51) between 8 and 11 years of age and families. A total of 12 YB games were observed. Most team snacks (72%) consisted of high-calorie food items, including French fries, candy, and cookies; most beverages (53%) consumed by players were sugar sweetened. We observed 313 spectators and players, who consumed a total of 249 foods and 276 beverages. Most food and beverage items (89%) were purchased from the concession stand, of which 73% were considered less-healthy options.>Conclusions: High-calorie snacks and sugar-sweetened beverages dominate the YB environment. Despite the benefits of participating in sports, families of children participating in sports leagues may be increasing their risk for poor nutritional habits as a result of increased exposure to unhealthy foods and disruption of meal times.
  • 14.

    【2hr】Xanthine Oxidase and Cardiovascular Risk in Obese Children

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    机译 黄嘌呤氧化酶和肥胖儿童的心血管风险
    摘要：>Background: Pathological mechanisms of how childhood obesity leads to increased risk of cardiovascular disease (CVD) are not fully characterized. Oxidative-stress–related enzymes, such as xanthine oxidase (XO), have been linked to obesity, endothelial dysfunction, and CVD in adults, but little is known about this pathway in children. The aim of this study was to determine whether differential XO activity is associated with endothelial dysfunction, CVD risk factors, or cytokine levels.>Methods: Fasting plasma samples were obtained from obese (BMI ≥95th percentile; n=20) and age- and gender-matched healthy weight (BMI >5th and <85th percentile; n=22) children and adolescents (mean age, 12±3 years) to quantify XO activity. In addition, fasting cholesterol, insulin, glucose, blood pressure, endothelial function, and cytokine levels were assessed.>Results: We observed a 3.8-fold increase in plasma XO activity in obese, compared to healthy weight, children (118±21 vs. 31±9 nU/mg of protein; p<0.001). Plasma XO activity was correlated with BMI z-score (r=0.41), waist circumference (r=0.41), high-density lipoprotein cholesterol (r=−0.32), oxidized low-density lipoprotein (r=0.57), adiponectin (r=−0.53), and monocyte chemotactic protein-1 (r=−0.59).>Conclusion: XO activity is highly elevated in obese children and correlates with CVD risk factors, suggesting that XO may play a role in increasing cardiovascular risk early in life in the context of obesity.
  • 15.

    【2hr】iPhone App Adherence to Expert-Recommended Guidelines for Pediatric Obesity Prevention

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    机译 iPhone App遵循专家推荐的小儿肥胖症预防指南
    摘要：>Background: Pediatric obesity is a serious and prevalent problem. Smartphone technology, which is becoming increasingly available to children of diverse backgrounds, presents a unique opportunity to instill healthy behaviors before the onset of obesity. Past studies have examined the use of smartphone applications as tools of health behavior modification for adults. The present study examines the content of children's exercise and nutrition smartphone apps.>Method: Sixty-two iPhone apps were identified and coded by two independent raters for adherence to expert-recommended behaviors (e.g., five fruits/vegetables per day) and strategies (e.g., self-monitoring diet/physical activity) for the prevention of pediatric obesity.>Results: App behavioral and strategy index scores were uniformly low. Apps were more likely to address expert-recommended behaviors for the prevention of pediatric obesity (93.5%), whereas few apps addressed recommended strategies (20.9%). The most common behaviors addressed included physical activity (53.2%) and fruit/vegetable consumption (48.3%). Other important behaviors (e.g., screen time [1.6%] and family meals together [1.6%]) were rarely addressed.>Conclusions: Current children's diet and exercise apps could be improved with increased adherence to expert-recommended guidelines, especially expert-recommended strategies.
  • 16.

    【2hr】Maternal Infant Feeding Behaviors and Disparities in Early Child Obesity

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    机译 早期肥胖儿童的母婴喂养行为和差异
    摘要：>Background: Although disparities in child obesity exist during infancy, the underlying mechanisms are unclear. Assessing dissimilarities in feeding practices, styles, and beliefs may provide a better understanding of these mechanisms. This study sought to identify modifiable maternal-infant feeding behaviors that may contribute to disparities in early child obesity.>Methods: This study is a cross-sectional analysis comparing mothers with infants (2 weeks to 6 months old) in a low-risk group of high-income white mothers to a high-risk group of low-income Hispanic mothers. Regression analysis was used to explore relationships between each group and (1) infant feeding practices, including breastfeeding, giving juice, and adding cereal to bottles, (2) controlling feeding styles, (3) beliefs about infant hunger and satiety, and (4) infant weight status.>Results: The sample included 412 mothers (low-risk group, n=208; high-risk group, n=204). The high-risk group was less likely to exclusively breastfeed (adjusted odds ratio [AOR], 0.43; 95% confidence interval [CI], 0.22–0.83), more likely to introduce juice (AOR, 12.25; 95% CI, 3.44–43.62), and add cereal to the bottle (AOR, 10.61; 95% CI, 2.74–41.0). The high-risk group exhibited greater restrictive and pressuring feeding styles and was more likely to believe that mothers can recognize infant hunger and satiety and less likely to believe that infants know their own hunger and satiety. High-risk infants were more likely to have a weight-for-length percentile >85th percentile (AOR, 2.66; 95% CI, 1.10–6.45).>Conclusions: Differences in infant feeding behaviors may contribute to disparities in early child obesity. Longitudinal studies are needed to determine the effect of these differences on child obesity.
  • 17.

    【2hr】Stage 1 Treatment of Pediatric Overweight and Obesity: A Pilot and Feasibility Randomized Controlled Trial

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    机译 小儿超重和肥胖的1期治疗：先导性和可行性随机对照试验
    摘要：>Background: Staged clinical treatment of pediatric obesity is recommended, but untested. Understanding the lowest intensity stage's effectiveness is necessary for future research.>Methods: This was a randomized controlled trial of children ages 4 to <9 years. Participants were recruited after routine evaluations at a primary care pediatric clinic revealed a BMI ≥85th percentile. The intervention was patterned after the “Prevention plus, Stage 1” treatment recommended by an expert committee. Groups were compared for changes, over a 3-month time period, in BMI z-score and parental reports of behavioral issues related to childhood obesity using intent-to-treat (ITT) analysis.>Results: Seventy-two (30% of eligible) children were enrolled and 64 were remeasured at 3-month follow-up. ITT analysis revealed that both groups improved mean BMI z-score [adjusted change −0.07, control, and −0.04, intervention; 95% confidence interval (CI) of difference=−0.14–0.20]. Over half of the children in each group improved their BMI z-score (adjusted proportion decreasing=55% in control vs. 72% in intervention; 95% CI of difference=−0.07–0.42). The intervention group improved comparatively to the control group on numerous behavioral indicators.>Conclusions: Implementation of the lowest intensity stage of current recommendations is feasible and possibly of benefit toward lifestyle changes. Results of this study can be used by future clinical researchers designing protocols to test the full multi-staged approach for the treatment of pediatric overweight and obesity in primary care clinical settings.
  • 18.

    【2hr】A Pilot Study of the Effects of a Tailored Web-Based Intervention on Promoting Fruit and Vegetable Intake in African American Families

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    机译 基于网络的量身定制干预措施对促进非洲裔美国家庭水果和蔬菜摄入量的影响的初步研究
    摘要：>Background: The current study examined the effects of a Web-based tailored parenting intervention on increasing fruit and vegetable intake in African American families.>Methods: Forty-seven African American parents (mean age, 41.32±7.30; 93.6% female) with an adolescent (mean age, 13.32±1.46; 59.6% female) participated in a Web-based autonomy-support parenting tailored intervention session to increase both parent and youth fruit and vegetable (F&V) intake. The session lasted 45–60 minutes and included three phases: a feedback phase; a Web-based information phase, and a goal-setting and action plan phase. Self-reported measures of parenting skills [based on autonomy (choice), support, and communication] and F&V intake (assessed as average daily intake) were assessed at baseline and at a 1-week follow-up session.>Results: There was a significant increase in parents' self-reports of daily fruit intake from pretest to the 1-week follow-up. Parent and adolescent combined F&V intake also significantly increased from pretest to 1-week follow-up. Overall, parents reported that the program was easy to navigate and that they enjoyed participating in the Web-based online program.>Conclusions: Current findings provide preliminary support for an autonomy-support parent tailored Web-based program for improving dietary intake in African American families.
  • 19.

    【2hr】Social Support May Buffer the Effect of Intrafamilial Stressors on Preschool Childrens Television Viewing Time in Low-Income Families

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    机译 社会支持可能会缓冲家庭内压力因素对低收入家庭学龄前儿童电视收看时间的影响
    摘要：>Background: Excessive television (TV) viewing in preschool children has been linked to negative outcomes during childhood, including childhood obesity. In a sample of low-income families, this study examined associations between intrafamilial factors and preschool children's TV-viewing time and the moderating effect of social support from nonfamily members on this association.>Methods: In 2010, 129 mothers/female guardians of 2- to 5-year-old children enrolled at five Head Start centers in Rensselaer County, New York, completed a self-report survey. The survey assessed child TV-viewing time (including TV, DVDs, and videos) and intrafamilial risk factors, including maternal perceived stress, depressive symptoms, TV viewing, leisure-time physical activity (inactivity), and family functioning. Social support from nonfamily members (nonfamily social support) was also measured and examined as an effect modifier.>Results: Children watched TV an average of 160 minutes per day. Moderate depressive symptoms (Personal Health Questionnaire depression scale scores ≥10), higher perceived stress, poorer family functioning, and higher maternal TV-viewing were significantly and independently associated with greater minutes of child TV viewing, controlling for covariates. In all instances, nonfamily social support moderated these associations, such that negative experiences within the family environment were linked with higher child TV-viewing time under conditions of low nonfamily social support, but not high nonfamily support.>Conclusions: Social support from nonfamily members may buffer potentially negative effects of intrafamilial factors on preschool children's TV-viewing time.
  • 20.

    【2hr】Parent Report of Childs Health-Related Quality of Life after a Primary-Care-Based Weight Management Program

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    机译 一项基于基本护理的体重管理计划后父母关于儿童健康相关生活质量的报告
    摘要：>Background: Health-related quality of life (HRQoL) has been recognized as an important target and health outcome in obesity research. The current study aimed to examine HRQoL in overweight or obese children after a 10-week primary-care–based weight management program, Parent-Led Activity and Nutrition for Healthy Living, in southern Appalachia.>Methods: Sixty-seven children (ages 5–12 years) and their caregivers were recruited from four primary care clinics, two of which were randomized to receive the intervention. Caregivers in the intervention groups received two brief motivational interviewing visits and four group sessions led by providers as well as four phone follow-ups with research staff. Caregivers completed the PedsQL and demographic questionnaires at baseline and at 3, 6, and 12 months postintervention. Child height and weight were collected to determine standardized BMI.>Results: Caregivers of children receiving the weight control intervention reported no statistically significant improvements in child total HRQoL, as compared to the control group, across the course of treatment (β=0.178; 95% confidence interval, −0.681, 1.037; p=0.687). Additionally, no statistically significant improvements were found across other HRQoL domains.>Conclusions: Future studies examining HRQoL outcomes in primary care may consider treatment dose as well as methodological factors, such as utilization of multiple informants and different measures, when designing studies and interpreting outcomes.
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