Obesity among children is a public health concern. Preschool-­‐aged children, especially those from low-­‐income families, are no exception to the obesity epidemic. During the RD Parent Empowerment Program, parents of Head Start children in Johnson City, TN completed a structured education program over the course of 4 workshops related to healthy habits of families. The goal was to empower parents to shop smart, cook healthy, and eat right. The Family Nutrition and Physical Activity (FNPA) screening tool was used as an assessment tool to evaluate behavior change over the course of the program. Improvement in overall FNPA score was seen at the conclusion of the program. Individual assessment of breakfast consumption, family meal patterns, fruit and vegetable intake, beverage choices, and restriction occurred. Participation in the RD Parent Empowerment Program resulted in maintaining healthy behaviors or improved behaviors for many participants. A larger sample may provide more conclusive results.

The purpose of this qualitative interpretive descriptive study was to better understand children’s perceptions of the use of motivational interviewing (MI) as a communication style for childhood obesity treatment. Childhood obesity in the United States has reached epidemic proportions and much research effort has been dedicated to reversing this trend. One approach that has demonstrated positive outcomes in the clinical setting is MI. Leading organizations in pediatric healthcare now recommend MI as a communication style to be used for childhood obesity-related behavior change. Although empiric studies have demonstrated improvement in outcomes when this communication style is used with patients and families, no study to date had looked at MI from the perspective of the child. Thorne’s (2008) framework for interpretive descriptive research was used for this study. Individual interviews with children ages 7 through 13 were conducted in an outpatient weight management clinic that utilizes MI as the primary communication style for facilitating behavior change. Qualitative data analysis was conducted utilizing Thorne’s recommendations for interpretive descriptive research. Five themes emerged from the data: 1) Empowerment, 2) Freedom to be Me, 3) Educating without “Educating”, 4) Unconditional Support, and 5) Blossoming. A conceptual model was developed from the research findings to help clinicians working with children in similar contexts glean a deeper understanding of the use of MI with children. Future research endeavors should focus on the implementation of this model in clinical practice to strengthen the conceptual links and determine applicability to practice.

As part of a cluster randomized controlled trial of a parent-mediated approach to treating overweight and obese children ages 5-11 years in Southern Appalachia, feedback on use of the NIH We Can! curriculum for parent group visit sessions in primary care was obtained from parents and providers in two intervention clinics. Parents/caregivers of 28 children in two primary care clinics were randomized to the intervention group to participate in four on-site 1.5 hour group sessions held every other week during an 8-10 week period. Five primary care providers (PCPs) in the two clinics were trained to lead the group sessions using the NIH We Can! online training and an additional 1-hour face-to-face training conducted by the project team. The Project Coordinator and one project team clinician (Pediatrician, Pediatric Psychologist, or Registered Dietician (RD)) was present during each group visit to answer any questions about the study protocol, behavior (Pediatric Psychologist) or nutrition/eating (RD). The Project Coordinator or RD called each parent during the week following each group visit to discuss the family’s progress and answer questions. Written feedback surveys were completed by parents and focus groups were conducted with providers following the last group session. Provider focus groups were recorded and later transcribed and coded to indentify themes. Among 22 (79%) parents/caregivers who completed group sessions and a feedback survey, 91% agreed/strongly agreed that “this program was very useful to me as a parent.” In addition, 95% said that they would “recommend We Can! to a friend” citing benefiting from information received from healthcare providers and parents as well as the opportunity for “fellowship” with other parents. All five PCPs led at least 1 or 2 group sessions and participated in focus groups. Most PCPs agreed that the We Can! leader’s guide and training prepared them to lead the group sessions. All providers reported that preparation time to lead a session (15-90 minutes) was reasonable. On average, providers perceived the group sessions to be moderately effective in promoting healthier eating, physical activity, and reducing screen time in their patients. Some providers were interested in continuing to offer a monthly group session for long-term support. These findings suggest parent and healthcare provider acceptability of using NIH We Can! parent group sessions to treat child overweight in primary care.

No description available.

Epidemiologic surveillance indicates an increased susceptibility to obesity among children with special health care needs (SHCN) in comparison to children without. The present study investigated this disparity in weight severity between both groups, with a focus on the provision of obesity management counseling by physicians. This study consisted of a retrospective medical record review that acknowledged the effect of patient-provider interactions on health behaviors and risk perceptions. An independent sample t test compared the incidence of clinician-initiated obesity management counseling received by children with SHCN to that which was received by children without SHCN. This t test revealed a statistically significant difference between the weight management frequency received by youth with SHCN (M = 1.0, SD =.46498) and the weight management frequency received by youth without SHCN (M = 2.0, SD = .74975), t(100) = 7.826, p = .000, α =.05 over a 2-year timeframe. Bivariate correlation analysis validated a correlation between weight severity among children with SHCN and the incidence of clinician-initiated obesity management counseling. The results indicated a small but significant association between weight severity and weight management frequency among children with SHCN, r(50) = .287, p = .044, α =.05. These results support the need for a transformation in the delivery of preventive health services for children with SHCN, such as providing clinician-based obesity management strategies and increasing access to validated diagnosis-specific preventive health screening tools. These results promote positive social change by informing efforts to improve health outcomes and decrease health disparities experienced by people with SHCN.

The food decisions, dietary patterns, physical activity, and weight-related convictions of African American mothers are affected by their self-perceptions and views of body weight. The gap in the literature regarding the impact of these perceptions on children's food choices, eating habits, and body image is significant. Using the health belief model as the theoretical foundation and a cross-sectional survey as the research design, this study assessed the potential relationship between mothers' and children's eating habits and whether mothers' perceptions of their children's body image were reliable indicators of childhood obesity. Eighty-six mothers provided demographic information and completed the Child Feeding Questionnaire (CFQ) and the Figure Rating Scale (FRS); 86 children completed the FRS. All 172 participants self-reported weight and height. No other measurements were taken. Logistic regression and correlation analysis were used to answer the research questions. Correlation analysis showed a significant relationship between the mothers' perceptions of their children's body image and the children's self-perceptions of their body image. The results of regression analyses indicated that the mothers' perceptions of their weight as children influenced food choices for their children as well as their children's self-perception of body image. Positive social change in the African American community may occur by having community and health care professionals offer awareness programs to African American mothers.

Childhood obesity affects children from every socioeconomic level, but there is a higher prevalence of obesity among preschool-age children from low-income families. Some obese children are experiencing symptoms (e.g., high cholesterol and diabetes) generally experienced by adults. As a result, healthcare costs have increased. The purpose of this qualitative phenomenological study was to understand how low-income African American parents contribute to the prevalence of obesity in preschoolers. The conceptual framework and constructs from the health belief model (HBM) guided this study. Interview data were gathered from 8 participants who met the inclusion criteria of being a low-income African American parent with an overweight/obese child living in the Atlanta Region. Creswell's simplified version of Stevick-Colaizzi-Keen's data analysis led to the following themes among the participants. The themes were time restraints for preparing a healthy meal and limited activities-playtime, family time, America's childhood obesity, inappropriate diet, and lack of knowledge. Results demonstrated that parents might not understand that a lack of adequate sleep, physical activity, and healthy meals (consumed with parents) contribute to the prevalence of childhood obesity. Positive social change can be achieved through decreased healthcare costs associated with obesity related diseases by implementing the recommended 60 minutes of structured and unstructured playtime activities at learning centers and parents introducing small dietary changes, with healthy choices, which can start preschoolers eating healthier at a young age.

To determine the effects of a targeted curriculum and dual program involvement on childhood overweight status among low-income preschool children, a nutrition curriculum was developed. Three Special Supplemental Food Program for Women Infants and Children (WIC) clinics participated in the study: the control clinic, a clinic which received the targeted curriculum, and a third clinic which received the targeted curriculum and referred participant families to the Expanded Food and Nutrition lll Education Program (EFNEP). Participants were followed for six months. Data collected included anthropometrics, dietary intake, and parental behaviors. Results showed a decrease in body-mass index percentile, slight improvements in dietary intakes, and increased prevalence of healthy parental behaviors for all three clinics. Overall no significant differences between clinics were noted. Surveys indicated a positive impact of the curriculum in meeting desired objectives and a positive change on parents' self-efficacy.

<p>Syftet med föreliggande studie var att beskriva hur skolsköterskor upplever problematiken kring övervikt/fetma hos barn i låg- och mellanstadiet och att undersöka vilka strategier skolsköterskorna har för att förebygga/hjälpa dessa barn. Ännu ett syfte med studien var att undersöka hur skolsköterskorna ser på samarbetet med föräldrar, lärare och andra skolsköterskor i detta problem. Metoden var att intervjua sju skolsköterskor på låg- och mellanstadiet i två kommuner i Mellansverige. Intervjuerna spelades in på band och transkriberades ordagrant. Meningsbärande enheter plockades ut och materialet kategoriserades och resulterade i tre huvudkategorier och tio subkategorier. Resultatet visade att de sju intervjuade skolsköterskorna ansåg att det är ett problem med övervikt/fetma hos skolbarn. Skolsköterskorna hade inte några särskilda strategier för att förebygga övervikt/fetma och riktlinjerna från skolhälsovården är oklara, men fyra av skolsköterskorna höll på att arbeta fram en förebyggande strategi på egen hand. Alla skolsköterskor hade mer eller mindre en strategi för att hjälpa överviktiga/feta skolbarn genom att prata kost och motion på hälsosamtalen. Fyra av skolsköterskorna hade arbetat fram eget material. Materialet användes sedan för att hjälpa barnen att få ett annat tankesätt och en förändrad livsstil. Alla sju skolsköterskor ansåg att ett fungerande samarbete med föräldrar, lärare och andra skolsköterskor underlättar arbetet med de överviktiga barnen.</p> / <p>The aim of the existing study was to describe how school nurses experience the complex of problems about obesity among primary school and middle school children, also to examine which strategies school nurses use to prevent/help these children. Amongst other aims, this study examines how school nurses experience cooperation with parents, teachers and other school nurses within this area. The method used was to interview seven school nurses in primary school and middle school from two school regions in the middle of Sweden. The interviews were recorded on tape and transcribed in verbatim. Sense bearing units were picked out and the material was categorized, which resulted in three main categories with ten subcategorise. The results showed that the seven interviewed school nurses considered that there is a problem with obesity in school children. The school nurses didn’t have any specific strategies to prevent obesity and the guidelines from the school health board were indistinctive, but four of the school nurses were working on preventive strategies on their own hand. All of the school nurses more or less had a strategy for helping obese school children, by meens of talking about nutrition and fysical exercise in health sessions. Four of the school nurses had created their own material. The material was then used to help the children with another way of thinking and change in lifestyle. All seven school nurses considered that a working cooperation with parents, teachers and other school nurses facilitated the work with the obese children.</p>

Syftet med föreliggande studie var att beskriva hur skolsköterskor upplever problematiken kring övervikt/fetma hos barn i låg- och mellanstadiet och att undersöka vilka strategier skolsköterskorna har för att förebygga/hjälpa dessa barn. Ännu ett syfte med studien var att undersöka hur skolsköterskorna ser på samarbetet med föräldrar, lärare och andra skolsköterskor i detta problem. Metoden var att intervjua sju skolsköterskor på låg- och mellanstadiet i två kommuner i Mellansverige. Intervjuerna spelades in på band och transkriberades ordagrant. Meningsbärande enheter plockades ut och materialet kategoriserades och resulterade i tre huvudkategorier och tio subkategorier. Resultatet visade att de sju intervjuade skolsköterskorna ansåg att det är ett problem med övervikt/fetma hos skolbarn. Skolsköterskorna hade inte några särskilda strategier för att förebygga övervikt/fetma och riktlinjerna från skolhälsovården är oklara, men fyra av skolsköterskorna höll på att arbeta fram en förebyggande strategi på egen hand. Alla skolsköterskor hade mer eller mindre en strategi för att hjälpa överviktiga/feta skolbarn genom att prata kost och motion på hälsosamtalen. Fyra av skolsköterskorna hade arbetat fram eget material. Materialet användes sedan för att hjälpa barnen att få ett annat tankesätt och en förändrad livsstil. Alla sju skolsköterskor ansåg att ett fungerande samarbete med föräldrar, lärare och andra skolsköterskor underlättar arbetet med de överviktiga barnen. / The aim of the existing study was to describe how school nurses experience the complex of problems about obesity among primary school and middle school children, also to examine which strategies school nurses use to prevent/help these children. Amongst other aims, this study examines how school nurses experience cooperation with parents, teachers and other school nurses within this area. The method used was to interview seven school nurses in primary school and middle school from two school regions in the middle of Sweden. The interviews were recorded on tape and transcribed in verbatim. Sense bearing units were picked out and the material was categorized, which resulted in three main categories with ten subcategorise. The results showed that the seven interviewed school nurses considered that there is a problem with obesity in school children. The school nurses didn’t have any specific strategies to prevent obesity and the guidelines from the school health board were indistinctive, but four of the school nurses were working on preventive strategies on their own hand. All of the school nurses more or less had a strategy for helping obese school children, by meens of talking about nutrition and fysical exercise in health sessions. Four of the school nurses had created their own material. The material was then used to help the children with another way of thinking and change in lifestyle. All seven school nurses considered that a working cooperation with parents, teachers and other school nurses facilitated the work with the obese children.