The Winning With Wellness (WWW) project was a school-based obesity prevention program that was developed to promote healthy eating and physical activity in youth residing in rural Appalachia. The project was based on the Coordinated School Health model (Centers for Disease Control and Prevention (CDC), 2013a) and used a community-based participatory research approach with an emphasis on feasibility and sustainability. The purpose of this study was to examine self-reported health outcomes for middle school students across the course of the intervention. Sixth grade middle school students (N = 149; 52% girls) from four schools in Northeast Tennessee completed a survey assessing demographic factors and health behaviors as well as the Pediatric Quality of Life Inventory (PedsQL, Varni, Seid, & Kurtin, 2001) at baseline and follow-up, approximately 9-months after project implementation. Across the course of the intervention there were no statistically significant changes from baseline to follow-up in fruit and vegetable consumption, physical activity, or screen time. Further, there were no statistically significant changes in health-related quality of life (HRQoL). The lack of change in health behaviors is similar to a recent study also emphasizing sustainability (Neumark-Sztainer, Story, Hannan, & Rex, 2003). Unlike in the current study, Palacio-Vieira and colleagues (2008) found HRQoL to significantly decline with age in a population-based sample of Spanish youth. It will be important to examine whether or not obesity interventions may ameliorate this effect as well as to test the feasibility and school/structural support for sustained intervention implementation at a level that promotes lifestyle change.

Introduktion: Barn med överviktsproblem ökar i världen och är ett växande problem även i Sverige. Övervikt hos barn i tidig ålder ökar risken för att barnen senare i livet ska drabbas av följdsjukdomar vilket gör att det är viktigt att tidiga åtgärder vidtas. Distriktsköterskor som arbetar inom barn och skolhälsovård arbetar för att främja barns hälsa, bland annat genom att förebygga och hjälpa föräldrar till barn som är överviktiga. Syfte: Var att beskriva distriktssköterskors upplevelser av att samtala med föräldrar till barn med övervikt. Metod: En systematisk litteraturstudie, databassökningarna gjordes i databaserna Cinahl, PubMed och PsycInfo. Artiklarnas resultat analyserades med hjälp av en kvalitativ innehållsanalys. Resultat: Presenteras i två kategorier och sex underkategorier. De två kategorierna är: Hinder i samtalen och Samtalens möjligheter. Distriktsköterskor upplevde att samtalen med föräldrar till överviktiga barn var känslosamma och att ämnet var svårt att ta upp. Samtalen upplevdes bygga på goda relationer och förutsatte en god kommunikation vilken kunde hindras av ett flertal barriärer Konklusion: Distriktsköterskors arbete handlade många gånger om relationer till föräldrar och barn. Det visade sig att distriktsköterskor ansåg att ämnet var svårt att tala om och att de saknade utbildning och riktlinjer för hur de skulle gå till väga i samtalen med föräldrar till barn med övervikt. / Introduction: Children with obesity problems are increasing in numbers and are a growing problem in Sweden. Being overweight in early age increases the risk that the children will suffer later in life, which means that it is important that early actions are taken. District nurses who work in child and school health care, work to promote children's health by preventing and helping parents whose children are overweight Aim: The district nurse's experiences of conversations with parents of overweight children. Method: A qualitative systematic literature review with inductive approach, database searches were done in the databases Cinahl, Pubmed and PsycInfo. The results of the articles were analyzed using a qualitative content analysis. Results: Presented in two categories and six subcategories. The two categories were: Obstacles in conversations and Opportunities for conversation. Nurses felt that conversations with parents of obese children was emotional and that the subject was difficult to bring up. The conversations were based on good relationships and required good communication, which could be prevented by a number of barriers. Conclusion: The district nurse's work was often about relationships with parents and children. It turned out that the district nurse considered the topic difficult to talk about and that there was a lack of education and guidelines for how to proceed in the conversations with parents to overweighed children.

No description available.

School-based body mass index (BMI) screenings seek can improve parents' recall about their child's weight, increase concern about excess weight, and correct parents' misperceptions to help them make informed decisions about their child's health. However, schools have questioned parents' understanding of and attitudes about BMI, and have expressed concern about parents' reactions to BMI reports. Using a sample of school nurses (n=7) and parents/guardians (n=125) from the School District of Philadelphia (SDP), this research addressed these concerns by clarifying: 1) parents'/guardians' perceptions and knowledge about BMI; 2) the challenges schools face in communicating with parents/guardians; and 3) the messages that can be communicated to parents/guardians to help them understand their child's BMI-for-age category and why their child's BMI is measured in his/her school. The research used framing theory and perceptual mapping methods to study and improve communication about BMI to parents/guardians in the School District. The four-phase study design incorporated qualitative (focus groups and semi-structured in-depth interviews) and quantitative (cross-sectional survey) methods to assist in the development of an evidence-informed BMI report card template for the SDP. Messages were constructed to meet the needs of four distinct groups of parents/guardians that emerged from the factor and cluster analyses - "Passive Parents," "Neutral Parents," "Confident Advocates" and "Active Worriers." Although each cluster of parents/guardians had their own unique perceptions and varying degrees of assuredness and confidence related to BMI concepts, the majority of parents/guardians in this study shared common favorable perceptions about BMI measures, school-based screening programs and BMI report cards. / Public Health

ABSTRACT INTRODUCTION: Studies on the topic of adverse childhood experiences (ACEs) and childhood obesity collectively indicate an association, but there is a lack of replication in nationally representative sample of children aged 10-17 years. This study aims to expand on the definition of ACEs to include: socio-economic hardship, racial discrimination, witness or victim of neighborhood violence, and bereavement, and to examine their individual and joint association with BMI levels, especially childhood obesity (primary outcome). METHODS: The 2011-2012 National of Children’s Health (NSCH) was used for this study (N=45,309). One child interview weight was produced; hence, the estimates are generalized to all non-institutionalized children 10-17 years of age in the US and each state. Statistical methods used included descriptive statistics and multivariable multinomial logistic regression models. ACEs examined included: (1) Socioeconomic hardship, (2) Parental divorce or separation, (3) Bereavement, (4) Incarcerated family member, (5) Witness to domestic violence, (6) Victim/witness of neighborhood violence, (7) Household mental illness, (8) Household substance abuse, (9) Racial discrimination. BMI for the same sex and age (10-17 years) percentile relative measurement, using growth charts recommended by CDC, among children and teens were used as indicators of BMI. BMI-95th percentile or greater was considered obese. RESULTS: The prevalence of childhood obesity and ACE exposure was higher for boys compared to girls. Controlling for gender, among those who were obese, White-non-Hispanic children had the highest prevalence of obesity compared to other races for both genders. Southern States constituted 80% and 60 % of top 10 states with the highest prevalence of childhood obesity and ACE, respectively. Approximately 25.4 million (89.5%) children aged 10-17 years had experienced 3 or less ACE. The most prevalent ACE category of nine asked about for child was-living with parents who were either divorced or separated after his/her birth (26.77%) and the least prevalent was living with a parent who died (4.84 %). ACEs were not mutually exclusive, and all nine categories of ACEs were interrelated. The adjusted odds ratio of covariates to their reference groups that were only statistically significant for childhood obesity relative to healthy weight encompassed: a) Place of residence in metropolitan statistical area, b) two or more chronic health conditions of 18 asked about, c) Watching TV, videos, or playing video games across categories >1 to≥4 hours, d) family members in the household eat a meal together 7 days of the week, e) and computer, cell phone or electronic device use ≤1 hour. Moreover, the explanatory variables, namely, age, sex, the physical health status of parents, and physical activity, were strongly related to childhood obesity (associated both with higher odds and lower odds of outcome) compared to overweight and underweight BMI categories. CONCLUSIONS: This is the first study to explore the co-occurrence, individual and joint association of ACEs with childhood obesity using nationally representative sample of children aged10-17 years in the U.S. Having childhood obesity, BMI-95th percentile or above was strongly related to ACE dichotomy, ACE score ≥2 and two ACE types (socioeconomic hardship and bereavement) than the probability of overweight, BMI-85th to 94th percentile. Underweight-BMI less than 5th percentile had only statistically significant association with socioeconomic hardship ACE category. Sociodemographic, parental, and childhood related factors were also independently associated with childhood obesity.

Introdução: Diante do acelerado aumento da obesidade infantil e da ciência de que suas consequências perduram ao longo da vida, na grande maioria dos casos, fica evidente, a necessidade de prevenção precoce do excesso de peso na infância para reduzir esse importante problema de saúde pública. A promoção da alimentação adequada e saudável e a promoção da saúde estão intensamente relacionadas, por isso, tratar crianças com excesso de peso implica considerá-las em seus contextos familiares e sociais com um olhar além da gordura corporal, mas de respeito às suas histórias, sentimentos, conflitos, valores, crenças e saberes. Objetivo - Descrever, interpretar e compreender as vivências familiares relativas ao aconselhamento nutricional para crianças com obesidade. Métodos - Pesquisa qualitativa, de caráter exploratório, com produção dos dados por meio de grupos focais. Os sujeitos participantes foram os familiares de crianças que realizam acompanhamento nutricional devido ao diagnóstico de obesidade na Policlínica Centro de São Bernardo do Campo. A amostragem foi constituída através do critério de saturação quando nos dados produzidos não emergiram novos temas que contribuíssem para a reflexão teórica. Foi utilizada análise de conteúdo para analisar os dados produzidos. Resultados - Foram realizados 12 grupos focais que compuseram uma amostra total de 13 participantes, entre eles, mães, avó e tia. As categorias que emergiram dos dados abarcaram as memórias alimentares da infância dos familiares; a imagem corporal das crianças percebidas pelos familiares e pelas próprias crianças, segundo as percepções dos familiares; a dimensão afetiva do comportamento alimentar; as manifestações infantis sobre o aconselhamento nutricional, segundo os familiares; às experiências familiares após o aconselhamento nutricional; as redes de apoio social reconhecidas, e os comportamentos alimentares familiares, tanto em ambiente doméstico, quanto no lazer. Conclusão - O alimento demonstrou ter funções que vão além do suprimento das necessidades biológicas por agregarem significados culturais, comportamentais e afetivos a partir dos quais os indivíduos se relacionam. As vivências e trajetória de vida de cada uma dessas famílias são únicas e fundamentam a forma como as situações são experienciadas individualmente por elas e impactam diretamente em suas atitudes e comportamentos. A comida e o comer se mostraram ligadas a história, as memórias e a dimensão afetiva que compõe cada uma dessas pessoas. / Introduction - Faced with the accelerated increase in childhood obesity and the knowledge that its consequences lasts throughout life in the vast majority of cases, it is evident, the need for early prevention of overweight in childhood to reduce this important public health problem. The promotion of the adequate and healthy food, and the promotion of health are intensely related, therefore, treating overweight children involves considering them in their family and social contexts with a look beyond body fat, but that respects their stories, feelings, conflicts, values, beliefs and knowledges. Objective - To describe, interpret and understand family experiences related to nutritional counseling for obese children. Methods - Qualitative exploratory research, with the production of data through focus groups. The subjects of this research were the relatives of children who undergo nutritional monitoring due to the diagnosis of obesity in the Downtown Polyclinic of São Bernardo do Campo. The sampling was constituted through the saturation criterion when, in the data produced, no new themes emerged that contributed to the theoretical reflection. Content analysis was used to analyze the produced data. Results - Twelve focus groups comprised a total sample of 13 participants, including mothers, grandmother and aunt. The categories that emerged from the data encompassed the family members´s childhood memories around food; the body image of the children perceived by the relatives and by the children themselves, according to the perceptions of the relatives; the affective dimension of eating behavior; infant manifestations on nutritional counseling, according to the relatives; family experiences after nutritional counseling; the recognized social support networks, and family eating behaviors, both in the domestic and leisure settings. Conclusion - The food has demonstrated characteristics that go beyond the supply of biological needs, since it adds cultural, behavioral and affective meanings from which individuals relate themselves. The experiences and life trajectory of each family are unique and base the way in which the situations are experienced individually by them and directly impact on their attitudes and behaviors. Food and eating were linked to the history, memories and affective dimension that compose each of these people.

Introdução: Diante do acelerado aumento da obesidade infantil e da ciência de que suas consequências perduram ao longo da vida, na grande maioria dos casos, fica evidente, a necessidade de prevenção precoce do excesso de peso na infância para reduzir esse importante problema de saúde pública. A promoção da alimentação adequada e saudável e a promoção da saúde estão intensamente relacionadas, por isso, tratar crianças com excesso de peso implica considerá-las em seus contextos familiares e sociais com um olhar além da gordura corporal, mas de respeito às suas histórias, sentimentos, conflitos, valores, crenças e saberes. Objetivo - Descrever, interpretar e compreender as vivências familiares relativas ao aconselhamento nutricional para crianças com obesidade. Métodos - Pesquisa qualitativa, de caráter exploratório, com produção dos dados por meio de grupos focais. Os sujeitos participantes foram os familiares de crianças que realizam acompanhamento nutricional devido ao diagnóstico de obesidade na Policlínica Centro de São Bernardo do Campo. A amostragem foi constituída através do critério de saturação quando nos dados produzidos não emergiram novos temas que contribuíssem para a reflexão teórica. Foi utilizada análise de conteúdo para analisar os dados produzidos. Resultados - Foram realizados 12 grupos focais que compuseram uma amostra total de 13 participantes, entre eles, mães, avó e tia. As categorias que emergiram dos dados abarcaram as memórias alimentares da infância dos familiares; a imagem corporal das crianças percebidas pelos familiares e pelas próprias crianças, segundo as percepções dos familiares; a dimensão afetiva do comportamento alimentar; as manifestações infantis sobre o aconselhamento nutricional, segundo os familiares; às experiências familiares após o aconselhamento nutricional; as redes de apoio social reconhecidas, e os comportamentos alimentares familiares, tanto em ambiente doméstico, quanto no lazer. Conclusão - O alimento demonstrou ter funções que vão além do suprimento das necessidades biológicas por agregarem significados culturais, comportamentais e afetivos a partir dos quais os indivíduos se relacionam. As vivências e trajetória de vida de cada uma dessas famílias são únicas e fundamentam a forma como as situações são experienciadas individualmente por elas e impactam diretamente em suas atitudes e comportamentos. A comida e o comer se mostraram ligadas a história, as memórias e a dimensão afetiva que compõe cada uma dessas pessoas. / Introduction - Faced with the accelerated increase in childhood obesity and the knowledge that its consequences lasts throughout life in the vast majority of cases, it is evident, the need for early prevention of overweight in childhood to reduce this important public health problem. The promotion of the adequate and healthy food, and the promotion of health are intensely related, therefore, treating overweight children involves considering them in their family and social contexts with a look beyond body fat, but that respects their stories, feelings, conflicts, values, beliefs and knowledges. Objective - To describe, interpret and understand family experiences related to nutritional counseling for obese children. Methods - Qualitative exploratory research, with the production of data through focus groups. The subjects of this research were the relatives of children who undergo nutritional monitoring due to the diagnosis of obesity in the Downtown Polyclinic of São Bernardo do Campo. The sampling was constituted through the saturation criterion when, in the data produced, no new themes emerged that contributed to the theoretical reflection. Content analysis was used to analyze the produced data. Results - Twelve focus groups comprised a total sample of 13 participants, including mothers, grandmother and aunt. The categories that emerged from the data encompassed the family members´s childhood memories around food; the body image of the children perceived by the relatives and by the children themselves, according to the perceptions of the relatives; the affective dimension of eating behavior; infant manifestations on nutritional counseling, according to the relatives; family experiences after nutritional counseling; the recognized social support networks, and family eating behaviors, both in the domestic and leisure settings. Conclusion - The food has demonstrated characteristics that go beyond the supply of biological needs, since it adds cultural, behavioral and affective meanings from which individuals relate themselves. The experiences and life trajectory of each family are unique and base the way in which the situations are experienced individually by them and directly impact on their attitudes and behaviors. Food and eating were linked to the history, memories and affective dimension that compose each of these people.

Objetivo: El objetivo del estudio fue evaluar si la alimentación complementaria Baby Led Weaning tiene efecto protector de la malnutrición por exceso en preescolares y determinar sus características sociodemográficas y la proporción de preescolares con normopeso y malnutridos por exceso que recibieron este tipo de alimentación. Tuvo un alcance de niños cuyos padres y/o madres pertenecen a grupos de redes sociales de maternidad o paternidad asociados a profesionales de la salud. Metodología: El diseño fue observacional, analítico, retrospectivo tipo caso control, 38 casos y 66 controles con una relación caso control de 1/1.73. La población de estudio estuvo conformada por niños de uno u otro sexo de 24 a 60 meses de edad. Se utilizó una red de contactos de profesionales de la salud para difundir la encuesta virtual. Los datos recabados de duración de lactancia, método de alimentación complementaria y tipo de parto y otros de interés fueron extrapolados a Excel y posteriormente al software SPSS para determinar la asociación y el OR para estudio de casos y controles. Resultados: En el análisis descriptivo se obtuvo mayor participación de los países de Argentina y Perú. En su mayoría, los casos y controles fueron del género femenino con edad media de 34.17 meses. En el análisis inferencial se obtuvo una OR de 0.187 (IC 95% 0.078-0.444), lo que significa que la Alimentación Complementaria BLW reduce significativamente el riesgo de padecer malnutrición por exceso en (1-0.187=0.81) 81%, respecto a los que tuvieron Alimentación Complementaria Convencional. Conclusión: Se concluye que la AC BLW tiene efecto protector de malnutrición por exceso en preescolares, sin embargo, se deben realizar estudios de cohorte para evaluar prospectivamente la evolución del infante desde que se inicia la AC hasta los 60 meses, considerando otras variables biopsicosociales. / Objective: The objective of the study was to evaluate if the Complementary Feeding Baby Led Weaning (AC BLW) has a protective effect against malnutrition due to excess in preschool children and to determine their sociodemographic characteristics and the proportion of preschool children with normal weight and malnourished by excess who received this type of feeding. It had a scope of children whose fathers and / or mothers belong to maternity or paternity social network groups associated with health professionals. Methodology: The design was observational, analytical, retrospective, case-control type, 38 cases and 66 controls with a case-control ratio of 1 / 1.73. The study population consisted of children of either sex between 24 and 60 months of age. A network of contacts of health professionals was used to disseminate the virtual survey. The data collected on the duration of lactation, the method of complementary feeding and the type of delivery, and others of interest, were extrapolated to Excel and later to the SPSS software to determine the association and the OR for a case-control study. Results: In the descriptive analysis, greater participation was obtained from the countries of Argentina and Peru. Most of the cases and controls were female with a mean age of 34.17 months. In the inferential analysis, an OR of 0.187 (95% CI 0.078-0.444) was obtained, which means that the AC BLW significantly reduces the risk of suffering from malnutrition due to excess in (1-0.187 = 0.81) 81%, with respect to the who had Conventional Complementary Food (AC CV). Conclusion: It is concluded that AC BLW has a protective effect against malnutrition due to excess in preschool children, however, cohort studies should be carried out to prospectively evaluate the evolution of the infant from the beginning of the AC to 60 months, considering other biopsychosocial variables. / Tesis

Bakgrund: Fetma hos barn är ett stort växande hälsoproblem som bland annat kan leda till hjärt- och kärlsjukdomar, diabetes och låg livskvalitet. Det är av stor betydelse att upptäcka fetma vid tidig ålder för att minska risken för följdsjukdomar. Föräldrarna är viktiga för deras barns behandling av fetma. Barnsjuksköterskan har en viktig roll och bör arbeta personcentrerat utifrån familjens behov.  Syfte: Beskriva barnsjuksköterskors erfarenheter av föräldrars delaktighet i deras barns behandling av fetma på barnmottagningar. Material och metod: Studien har en kvalitativ design och utgjordes av tolv individuella intervjuer av barnsjuksköterskor. Intervjuerna analyserades med hjälp av Graneheim och Lundmans kvalitativa innehållsanalys. Resultat: I resultatet framkom två kategorier och sex underkategorier. Utmaningar i arbetet som handlar om känsloladdat ämne, motivation och situationens allvar. Strategier för delaktighet som innefattar att skapa förutsättningar, att ge stöd och att ge råd. Slutsats: Barnsjuksköterskorna ansåg att föräldrarnas delaktighet var viktig för att nå framgång i barnets behandling av barnfetma. Barnsjuksköterskorna använde sig av olika strategier för att öka föräldrarnas delaktighet men det kunde finnas flera hinder för delaktighet hos föräldrarna och detta var en utmaning för barnsjuksköterskans arbete. / Background: Child obesity is a major growing health problem, that can lead to cardiovascular disease, diabetes and poor quality of life, among other things. It is of great importance to detect obesity at an early age to reduce the risk of sequelae. The parents are very important in the obesity treatment of their children. The pediatric nurse plays an importance role and should have a person centered focus, based on the needs of the family. Purpose: The aim of the study was to describe pediatric nurses´ experiences of parental involvement in the treatment of their obese child at pediatric clinics. Material and methods: A qualitative study based on twelve individual interviews with pediatric nurses. The interviews were analyzed by using Graneheim and Lundman´s qualitative content analysis. Results: Two categories and six subcategories emerged in the result. Challenges in the work that deals with emotional subject, motivation and understanding the gravity of the situation. Strategies for participation that include creating opportunities, to give support and to give advice. Conclusion: The pediatric nurses considered, that parental involvement was important to achieve a successful treatment of child obesity. The pediatric nurses used different strategies to increase parental involvement, but there could be several barriers to parental involvement, and this was a challenge for the pediatric nurses.

Childhood obesity has many negative impacts on health and occurs due to genetic, environmental, and contextual factors (U.S. Department of Health and Human Services and U.S. Department of Agriculture [HHS and USDA], 2015). A major concern for this population of children is the resulting adverse effects on motor development, including challenges reaching appropriate developmental milestones impacting overall development and participation in daily activities (Cataldo et al., 2016). Occupational therapy practitioners can address multiple areas which contribute to this problem, including motor development and body functions, feeding and healthy meal preparation skills, family routines and activities of daily living, as well as contextual and cultural factors (American Occupational Therapy Association [AOTA], 2020). WHOLE Family is an online family based approach directed at positively impacting childhood obesity and motor development through a holistic approach.