Objectives: To examine associations between maternal smoking and overweight among school-aged children and also identify mothers and offspring characteristics that affect children's weight. Methods: We used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCY). Childhood overweight was defined as having Body Mass Index (BMI) of 85th percentile or above. Smoking patterns among mothers were assessed by questioning smoking behaviour 1 year before birth of the target child: never or ever smoking. Standardized procedures were used to measure height and weight. Descriptive statistics and generalized estimating equations (GEE) were used for the analysis. Results: Descriptive results showed that children of mothers who smoked anytime within 1 year before birth were more likely to be overweight and have higher BMI percentile averages. GEE results showed that children of mothers who were ever smokers 1 year before birth were more likely to be overweight (OR = 1.39, 95% CI: 1.01, 1.94) and have higher BMI percentile averages (b = 4.46, P = 0.036) from grades 1 through 6 than those of mothers who were never smokers. Additionally, the level of mother's education and birth weight were significantly associated with childhood overweight. Conclusions: Confirmed relationships between maternal smoking and overweight among school-aged children have important implications for public health policy because this evidence can be used to enhance smoking cessation 1 year before birth to improve the health status of mothers and offspring.

Objectives: To examine associations between maternal smoking and overweight among school-aged children and also identify mothers and offspring characteristics that affect children's weight. Methods: We used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCY). Childhood overweight was defined as having Body Mass Index (BMI) of 85th percentile or above. Smoking patterns among mothers were assessed by questioning smoking behaviour 1 year before birth of the target child: never or ever smoking. Standardized procedures were used to measure height and weight. Descriptive statistics and generalized estimating equations (GEE) were used for the analysis. Results: Descriptive results showed that children of mothers who smoked anytime within 1 year before birth were more likely to be overweight and have higher BMI percentile averages. GEE results showed that children of mothers who were ever smokers 1 year before birth were more likely to be overweight (OR = 1.39, 95% CI: 1.01, 1.94) and have higher BMI percentile averages (b = 4.46, P = 0.036) from grades 1 through 6 than those of mothers who were never smokers. Additionally, the level of mother's education and birth weight were significantly associated with childhood overweight. Conclusions: Confirmed relationships between maternal smoking and overweight among school-aged children have important implications for public health policy because this evidence can be used to enhance smoking cessation 1 year before birth to improve the health status of mothers and offspring.

Overweight and obesity among children and youth in the United States is a serious public health concern. The longitudinal relationships between maternal depression and childhood overweight and obesity were examined using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD). A national cohort of 1,384 children was followed from birth to adolescence and longitudinal data collected on multiple variables, including child weight and height, maternal depression, maternal influence, and family context. Maternal Depression was assessed by the Center of Epidemiological Studies Depression Scale (CES-D) and defined as a score of 16 or greater. Overweight and obesity were defined according to the recommended BMI age- and sex-specific percentiles. Maternal depression was assessed when the child was 1 month old, 36 months, and in grade 1. Overweight and obesity status was assessed at 36 months, grade 1, grade 3, and grade 6. The effect of changes or persistence in the pattern of maternal depression for different childhood age points on the development of childhood overweight and obesity was evaluated. A variety of statistical methods were used including t-test, ANOVA, multiple linear regression, multiple logistic regression, and generalized estimation equation (GEE). Results: After adjustment for confounding, compared with mothers with no depression at child's age of 1 month, 36 months, and in grade 1, mothers with depression at 1 or 2 of those time points had a 45% higher risk for childhood overweight and obesity at grade 3 (OR= 1.45, 95% CI= 1.01-2.07). For mothers with depression at all 3 time points, there was an even greater increase in risk at grade 3 (OR= 2.25, 95% CI= 1.05-4.84) and grade 6 (OR= 3.36, 95% CI= 1.46-7.77). Conclusion: Maternal depression is associated with childhood overweight and obesity. Child overweight and obesity intervention efforts may benefit from identifying strategies to improve maternal mental health status, including depression.

This study examined the longitudinal associations of family income level, maternal marital status, and maternal employment with body mass measurements and the development of overweight and obesity. Multiple linear and logistic regressions were used to assess the effects of the exposure variables on weight status with simultaneous adjustment for the exposure variables and the covariates. Key findings include: Children in families with incomes below the poverty line at child's 24 or 54 months of age were at a higher risk of becoming overweight and obese at child's third grade than children in families with incomes above the poverty line; longer maternal working hours at child's 54 months of age was associated with an increased risk of overweight and obesity at child's third grade. In conclusion, this study confirms that family poverty status and maternal working hours are associated with child's overweight and obesity risk.

Objective: To examine the prevalence of psychosocial concerns presenting in 3 pediatric primary care clinics serving rural Appalachia. The association between pediatric weight status and psychosocial concerns was examined. Methods: Caregivers of children presenting in one of 3 pediatric primary care facilities completed a demographic questionnaire and the Pediatric Symptom Checklist. Results: Approximately 21.4% of children were identified as having a clinically significant behavioral health concern. Among children with available weight status data, ~53% of the children were identified as overweight. Children identified having significant behavioral concerns were more likely to have a lower weight status than those with nonsignificant behavioral concerns. Specifically, children with lower z-BMI tended to have more attention problems. Conclusions: Psychosocial concerns and childhood overweight are prevalent concerns in pediatric primary care serving rural residents. Further research is needed to understand the complex relationship between weight status and psychosocial concerns to development more effective prevention and intervention programs.

Background While previous research indicates that low maternal sensitivity in mother-child interactions puts children at risk of overweight and obesity, maternal intrusiveness has rarely been investigated in association with children's weight. We investigated whether maternal sensitivity and intrusiveness in early childhood predict children's increased body mass index standard deviation scores (BMI-SDS) at school age. BMI-SDS are standardized for age and gender with respect to a reference standard. Methods At baseline (t1), we assessed maternal sensitivity and (non-)intrusiveness of 116 mothers with their children (48.3% female) aged 5–47 months (M = 24.00, SD = 11.36) using the emotional availability scales. We obtained anthropometric data for mothers at t1 by measuring height and weight in the laboratory and for children at birth assessed by medical staff. Six years later (t2) we obtained anthropometric data for children in the laboratory or based on parental report. Linear regression analyses were run with child BMI-SDS at t2 as outcome and sensitivity and (non-)intrusiveness as predictors, adjusting for confounders and exploring child age and gender as moderators. Results Maternal sensitivity only negatively predicted children's BMI-SDS in girls, while maternal intrusiveness predicted higher child BMI-SDS at school age regardless of child gender. The effect of maternal non-intrusiveness remained significant when controlling for confounders. Conclusion Maternal intrusiveness in early childhood seems to represent a risk factor for increased BMI-SDS in children, while lower maternal sensitivity tends to be a risk factor for increased BMI-SDS in girls. This may have implications for prevention or intervention programmes.

The prevalence of childhood overweight and obesity is increasing at an alarming rate in the United States. Currently more than 1 in 3 children aged 2-19 are overweight or obese. This is of major concern because childhood overweight and obesity leads to chronic conditions such as type II diabetes and tracks into adulthood, where more severe adverse health outcomes arise. In this study I used the premise of the social ecological model (SEM) to analyze the common levels that a child is exposed to daily; the intrapersonal level, the interpersonal level, the school level, and the community level to better understand what risk factors are significantly associated with child weight status. Data came from the 2012 National Survey of Children's Health (NSCH) (n=41,361). Frequencies and confidence intervals were used to describe risk factors at each level. Bivariate analyses were conducted between each risk factor and the outcome variable. Using all risk factors that were significantly associated with overweight and obesity in the bivariate analyses, multinomial logistic regressions were performed for each SEM level. The 4 SEM levels were then analyzed together using stagewise multinomial logistic regression. A significance level cutoff of 0.05 was applied to all analyses. Thirty-three percent of participants were overweight or obese. Child sex, race, age, child physical activity participation, mother’s education and health, the child’s family structure, the child’s participation in extracurricular activities, frequency of family meals at home, safety and engagement in school, the number of amenities and the safety and support within their communities were found to be significantly associated with child weight status. The odds ratios of the covariates in the final stagewise model were similar to those in each individual model. Understanding both the risk factors associated with child overweight and obesity in each individual level and in the complete socio-ecological perspective is important when working toward more effective policy and program creation and the reduction of childhood obesity. Recognizing that all levels of a child's SEM influence his or her likelihood of being overweight or obese can lead to more effective strategies that tackle multiple SEM levels collectively instead of each level independently.

Bakgrund: Barn har rätt till stöd som möjliggör en god hälsa och sjuksköterskor inom barnhälsovården (BVC-sjuksköterskor) ska arbeta hälsofrämjande genom ett stödjande och vägledande arbetssätt. En tidig identifiering av viktproblem är väsentlig eftersom åtgärder bör implementeras under tidig barndom. För att minska utveckling av till exempel hjärt- och kärlsjukdomar samt diabetes är det viktigt att BVC-sjuksköterskor aktivt arbetar mot övervikt och fetma. Medvetandegörande om de faktorer som kan påverka BVC-sjuksköterskor i det hälsofrämjande arbetet är viktigt för att kunna utveckla och förbättra arbetet. Syftet var att belysa vilka faktorer som kan påverka BVC-sjuksköterskans hälsofrämjande arbete mot övervikt och fetma. Metod: En integrativ litteraturöversikt genomfördes. Artikelsökning genomfördes i elva olika databaser. Sökningen genererade i 20 resultatartiklar som bearbetades systematiskt. Resultat: Resultatet presenteras utifrån analysens framkomna kategorier: BVC-sjuksköterskans stödjande faktorer, BVC-sjuksköterskans hindrande faktorer, Föräldrarnas påverkan och BVC-sjuksköterskans förhållningssätt. Resultatet diskuterades utifrån Nola J Penders omvårdnadsteori. Konklusion: BVC-sjuksköterskor påverkas av olika faktorer som har betydelse för det hälsofrämjande arbetet. För att uppnå framgång i det hälsofrämjande arbetet är det viktigt att föräldrar är involverade och har insikt i barnets rådande överviktsproblematik. BVC-sjuksköterskor efterfrågar mer utbildning i kommunikation samt mer kunskap om hur övervikt och fetma ska hanteras inom barnhälsovården. För att vidareutveckla BVC-sjuksköterskors hälsofrämjande arbete för överviktiga och feta barn krävs mer forskning inom området. / Background: Children are entitled to receive support that enables their good health. Support and guidance are fundamental aspects in the child health care. An early identification of weight problems is essential because the measures should be implemented in early childhood. To reduce the development of cardiac diseases and diabetes, it is important that the child health care nurse works actively against children with weight problems and obesity. Various factors can affect the child health care nurse in health promotion. Awareness concerning these factors are important in order to develop and improve health promotion. The aim was to illustrate the factors that may affect the child health care nurse´s health promotion for children with weight problems and obesity. Method: An integrative literature review was performed. Article search was conducted from eleven different databases. The search generated 20 articles that were processed systematically. Result: The results are presented on the basis of the analysis presented originated categories: child health care nurse supportive factors, child health care nurse impeding factors, the influence of parents and child health care nurse approach. The results were discussed according to nursing theorist Nola J. Pender´s theory. Conclusion: Child health care nurses affected by various factors that are important for health promotion. To achieve success in health promotion, it is important that parents are involved and have an insight into their child's current weight problems. Child health care nurses feel they need more training in communication and more knowledge about how weight problems and obesity should be handled within child health care. To help develop the child health care nurse health promotion for children with weight problems and obesity further research is required.

Contexte : L’obésité est une problématique multifactorielle qui peut s’accompagner d’un lot de complications autant chez les enfants que chez les adultes. Certains comportements alimentaires ont été associés à l’obésité pédiatrique, comme manger en absence de faim (MAF). Or, les déterminants de MAF n’ont pas tous été élucidés, en partie parce que ce comportement est difficile à évaluer. Objectifs : Le premier objectif est d’effectuer une revue systématique sur les déterminants individuels, familiaux et environnementaux de MAF chez les enfants et les adolescents âgés de 3 à 17 ans. Le deuxième objectif est de valider une traduction française d’un questionnaire permettant de mesurer MAF chez les enfants québécois de 7 à 15 ans. Méthodes : Pour la revue systématique (objectif #1), les critères d’éligibilité incluaient, entre autres, une population pédiatrique (3 à 17 ans) et l’évaluation d’au moins un facteur associé à MAF. Pour la validation transculturelle du questionnaire (objectif #2), des garçons et des filles âgés de 7 à 15 ans ont rempli le questionnaire à deux reprises dans un intervalle de 4 semaines. Nous avons évalué la validité de construit (structure et association avec le score z d’IMC) et la fidélité du questionnaire (cohérence interne et stabilité temporelle). Résultats : La synthèse des 81 articles inclus dans la revue systématique a révélé que chez les enfants, MAF était positivement associé à l’âge, à l’adiposité et à la présence de l’allèle A du gène FTO (fat mass and obesity associated gene). MAF semblait également davantage présent les garçons que chez les filles, mais certains facteurs familiaux, comme l’utilisation de pratiques parentales restrictives, étaient davantage associés à la présence de MAF chez les filles. MAF semble se stabiliser et persister à l’adolescence. L’étude sur la validation du questionnaire a montré que le questionnaire traduit possède une structure similaire à celle du questionnaire original. Chacune des 3 dimensions (émotions négatives, la fatigue ou l’ennui et les facteurs externes) avait une cohérence interne et une stabilité adéquate et MAF en réponse aux émotions négatives était associé à un score z d’IMC plus élevé. Conclusion : Ce mémoire contribuera au développement des connaissances sur le comportement MAF chez les enfants et les adolescents, en faisant le point sur les facteurs qui sont associés à MAF et en fournissant un outil permettant de mesurer facilement MAF en français / Background: Obesity is a multifactorial problematic which can lead to a variety of complications in both children and adults. Eating behaviors have been associated with obesity during childhood, such as eating in the absence of hunger (EAH). However, not all determinants of EAH have been elucidated, in part because this behavior is difficult to assess. Objectives: The first objective is to conduct a systematic review of the literature on individual, familial and environmental factors associated with EAH in children and adolescents aged 3-17 years old. The second objective is to perform a transcultural validation of a French translation of a questionnaire for the assessment of EAH in children and adolescents aged 7-15 years old. Methods: For the systematic review (objective #1), eligibility criteria for the study selection included a pediatric population (3-17 years of age) and evaluation of at least one factor potentially associated with EAH. For the transcultural validation of the questionnaire (objective #2), boys and girls aged 7-15 years old completed the questionnaire twice within 4 weeks. We assessed construct validity (structural validity and associations with BMI z-score) and reliability (internal consistency and temporal stability) of the questionnaire. Results: Synthesis of the 81 included studies in this systematic review revealed that among children, EAH is positively associated with age, with adiposity and with the presence of the A allele of the FTO gene (fat mass and obesity associated gene. This behavior is also more prevalent among boys than girls, but some familial factors, such as parental restrictive feeding practices, were associated with more EAH in girls. EAH also appears to remain present into adolescence. The transcultural validation revealed that the French translated version of the questionnaire had a similar structure compared to the original questionnaire. All dimensions (negative affect, fatigue/boredom and external cues) had an adequate internal consistency and temporal stability and EAH in response to negative affect was associated with a higher BMI z-score. Conclusions: This dissertation will contribute to fill the knowledge gaps about EAH in children and adolescents, by identifying factors associated with EAH and by providing a tool to easily measure EAH in French.