Abstract available through Circulation.

To examine the association between maternal depressive symptoms during early childhood of their offspring and later overweight in the children. Only children (n = 1,090) whose weights and heights were measured at least once for three time points (grades one, three and six) from the National Institute of Child Health and Human Development Study were included. Maternal depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale (CES-D) score of 16 or greater, were assessed using CES-D when the child was 1, 24, and 36 months. Childhood overweight was based on standardized height and weight measures taken during the interviews, and was defined according to appropriate CDC age- and sex-specific BMI percentiles. Generalized estimating equation was used to examine the impact of maternal depressive symptoms on the childhood overweight after adjusting for covariates. Compared to children of mothers without depression at any of the three time points, when children were one, 24 and 36 months of age, children of mothers with depression at all three time points were 1.695 times more likely to be overweight after adjusting for other child characteristics (95 % CI = 1.001–2.869). When further adjusted for maternal characteristics, children of mothers with depression at all three time points were 2.13 times more likely to be overweight (95 % CI = 1.05–4.31). Persistent maternal depressive symptoms may be associated with an increased risk of childhood overweight in their offspring. Children of mothers with depression may benefit from special attention in terms of obesity prevention.

No description available.

Thesis (MPH.) --University of Limpopo, 2018 / Background: Obesity and physical inactivity have been reported as the major contributing factors to non-communicable diseases and a public health problem worldwide. According to World health organization the global prevalence of obesity has increased more than doubled between 1980 and 2014. Many healthcare professionals fail to achieve sufficient levels of physical activity and most of them display poor dietary habits. The study conducted in South Africa among health care professionals in urban hospital in Gauteng province confirmed that 20% of them developed at least one NCD of which the contributing factors are obesity and physical inactivity. The aim of the study was to determine the prevalence of obesity and level of physical activity among health care professional in rural hospitals in Sekhukhune district, Limpopo province, South Africa. Methods: A quantitative descriptive study was conducted on 400 HCPs. The global questionnaire was closed ended. GPAQ was used for physical activity and anthropometric measurements were taken for BMI. A stratified random sampling method was used to sample HCPs. Data was analysed using SPSS version 23.0. Results: Most participants were females (71%), majority were between 30-39 years of age (46.3%), the highest category were nurses (77.8%), most of them their job title were assistants (44.5) and blacks (99.3%). The results revealed that 40.8% of HCPs were obese and 30.3% were overweight. Majority of (79.3%) were not engaging on work vigorous PA, however were engaging on work moderate PA. Also (60.5%) were not engaging on leisure vigorous PA, though 55.5% were engaging on leisure moderate PA. Majority (88.3%) had high sedentary (sitting) time. (35.50%) engaged in high activity of walking from one place to the other. In conclusion: There is a need for regular health promotion programmes among health care professionals with regard to obesity and importance of physical activity. The hospitals need to be equipped with onsite fitness centre that will be accessible to all HCPs. Physical activities support groups need to be established such as aerobics classes and fun run. Policies that guide participation in physical activities need to be drawn and be implemented accordingly in health sector, so as to promote healthy living habits. Key words: Obesity, Overweight, Level of physical activity, Health care professionals

School-based efforts to promote physical activity and healthier eating are a potentially effective approach to decreasing child obesity in rural populations. This article describes follow-up data on student activity and eating behaviors 4 years after implementation of the Winning with Wellness obesity prevention initiative. This project was based on the Centers for Disease Control and Prevention's coordinated school health model and used a community-based participatory research approach to address health behaviors in rural Appalachian elementary students. Results suggest significant increases in daily pedometer steps and healthier food selections by students as well as teacher support for continued health promotion efforts.

Childhood obesity has been an increasing problem in the United States, especially in rural areas. Effective prevention approaches are needed. This article describes the development, implementation, effectiveness, feasibility, and sustainability of a school-based obesity prevention pilot project, Winning with Wellness. The program was based on the coordinated school health model and included a community-based participatory research approach aimed at promoting healthy eating and physical activity in a rural Appalachian elementary school. Findings from this preliminary project revealed improvements in nutrition offerings and increased physical activity during the school day. In addition, the program was found to be acceptable to teachers, successfully implemented utilizing both existing and newly developed resources, and sustainable as evidenced in continued practice and expansion to other area schools.

It is currently estimated that over one-third of children aged 6-11 years in the United States are overweight or obese with some of the highest rates documented in Southern Appalachia. Primary care providers are uniquely positioned to intervene, however, lack of time as well as training and confidence in using behavioral techniques have been cited as barriers. Recommended strategies include use of a multidisciplinary team approach, family-centered communication, behavioral strategies, and care delivery following the chronic care model, including enhancement of parent self-management. The purpose of this study was to develop and evaluate a parent-mediated approach utilizing physician’s brief motivational interviewing and parent group sessions to treat child overweight and obesity in the primary care setting in Southern Appalachia. The current study enrolled 67 children (5-11 years) with BMI≥85th percentile and a parent/primary caregiver from four primary care practices in Southern Appalachia. The two participating Pediatric practices and two Family Medicine practices were randomized to intervention or usual care control groups. Providers in the intervention group were trained to deliver two individual visits, using brief motivational interviewing and following the AAP 15-minutes obesity prevention protocol, and four group visits using the NIH We Can! Curriculum with parents over an 8-10 week period. Trained study staff also completed four phone calls using brief motivational interviewing with parents following each group visit. Child weight and height and parent surveys were collected for both intervention and control groups at baseline, three, and six months. Additionally, parents in the intervention group completed We Can! surveys at baseline and following the fourth group session. An analysis of covariance (ANCOVA) was performed to test for the effect of treatment on zBMI at three and six months post-intervention. We Can! survey results were analyzed using paired t-tests. Data on 53 (82%) and 46 (69%) of participants was available at 3 and 6 months, respectively. While the point estimate of the treatment effect was in the expected direction, the effect of treatment assignment did not have a statistically significant effect on the zBMI at either three or six months. However, significant (p This study provides preliminary data on the use of a combination of individual and group visits with parents to treat overweight and obesity in children in primary care.

No description available.

Childhood overweight and obesity rates have grown immensely in recent years in the United States, especially in rural areas. The current study evaluated health care providers’ perceptions of training and implementation of a cluster-randomized clinical trial, Parent-Led Activity and Nutrition (PLAN) for Healthy Living, for treatment of overweight and obesity in children 5-11 years of age. Five physicians (3 in a pediatric clinic and 2 in a family medicine clinic) were trained in (1) brief motivational interviewing techniques for individual visits with parents, and (2) the National Institutes of Health (NIH) We Can! (Ways to Enhance Children’s Activity and Nutrition) Curricula to lead group sessions with these same parents aimed at providing them with the tools necessary to aid in changing their family’s eating and physical activity behaviors. Upon completion of the 10-week intervention, physicians (N = 4) participated in focus groups with research staff to discuss their experiences with the study. Based on the individual visit training in brief motivational interviewing, the principle of supporting self-efficacy was used by all providers during individual visits and was determined to be of most help. One physician commented that individual sessions would likely be more effective with families that are well-known by the provider, and several physicians believed that longer-term follow-up visits conducted by a registered dietician or nurse are feasible. Findings revealed that physician preparation time for a group session with parents was within the range of 15-90 minutes, with all providers believing this time was well-spent. The provider ratings of group session effectiveness were very high, approximately a 6 on a 7 point scale. Several providers felt the group visits were more effective than the individual visits. Additionally, some providers suggested continuing the group sessions on a monthly basis for long-term support. The collective data suggests that physicians view PLAN as an acceptable and feasible approach to the treatment of child overweight and obesity.

Introduction. Previous research shows overweight children report poorer health-related quality of life (HRQoL), primarily in the areas of physical health and social functioning. These relations may be especially important to understand in rural populations characterized by poorer health behaviors and limited access to healthcare resources. Objective. The purpose of the current study was to investigate the relation between HRQoL (overall, physical, and social) and weight perception as well as actual weight status in middle school students residing in Southern Appalachia. Methods. 397 middle school students participating in Winning with Wellness, a school-based obesity prevention study, completed a written survey including the Pediatric Quality of Life Inventory. Results from a question on self-perceived weight were used to assign students to 1 of 4 weight-perception groups (underweight, healthy weight, overweight, or obese). Actual body mass index (BMI) percentile data collected by the schools was available for a subset of 152 students and used to classify students’ actual weight status according to Centers for Disease Control and Prevention guidelines. Results. Students who perceived them self to be overweight or obese reported significantly lower overall as well as lower physical and social HRQoL compared to students who perceived them self as a healthy weight. In the sub-sample with actual weight data, students whose actual weight status was obese reported significantly lower overall HRQoL than students whose weight status was in the healthy weight range. Conclusion. Our findings with students in Southern Appalachia are consistent with previous research documenting poorer HRQoL in overweight children and substantiate the need for more inclusive programs that target psychosocial well-being. The understanding of the role of weight perception in addition to actual weight may also inform future efforts at prevention and intervention.