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No description available.

No description available.

Childhood obesity is an extensive problem in the United States and North Dakota (CDC, 2014). Significant health consequences are linked to obesity, including type two diabetes, hypertension, hyperlipidemia, cardiovascular disease, cancers, and psychological disorders (Pandita et al., 2016; Xu & Mishra, 2018). Obesity comorbidities, previously presented in later adulthood, now emerge in younger populations (Pandita et al., 2016). Unfortunately, treatment of obesity is not effective, and therefore, prevention must be the primary focus (Daniels et al., 2015; Pandita et al., 2016). Diet and eating behaviors have a significant impact on weight, and children develop taste preferences and lifelong eating behaviors within the first few years of life (Birch & Anzman, 2010; Daniels et al., 2015; IOM, 2011). Therefore, targeting interventions on feeding and nutrition in infancy may foster healthy habits for life and play a role in the prevention of obesity. Responsive feeding interventions hold promise in supporting healthy growth. Ellyn Satter’s Division of Responsibility promotes the responsive feeding relationship between parent and child. The purpose of the practice improvement project was to address childhood obesity prevention through the development of an educational curriculum on feeding and nutrition. The parent-focused education correlated with each well child visit (WCV) between the ages of two weeks and three years. A multidisciplinary team of representatives from pediatrics, behavioral health, and patient education was consulted to develop the education. Ten providers at Midwestern primary care clinics reviewed the educational curriculum and provided feedback on the content and methods to deliver the education to parents. Most providers found the content to be accurate (n = 7; 70%) and comprehensive (n = 8; 80%). Three providers suggested expanding on topics such as breastfeeding and mixing formula. Providers unanimously agreed that the curriculum is relevant and understandable. A formal literacy evaluation resulted in grade-level readability scores between the 6th and 8th-grade levels. Almost all providers (n = 9) believed the curriculum would be valuable for use in practice. The preferred delivery method chosen was one on one provider to parent education. The project clinic plans to pilot the curriculum with parents attending infant and toddler WCVs.

Introduction: The prevalence of childhood overweight and obesity has steadily increased in recent decades, presenting a serious risk to public health and significant burden on individuals, healthcare systems, and society more broadly. Early intervention family-based lifestyle programs are an efficacious intervention for addressing childhood obesity. However, many studies have not included a process evaluation which can limit future scale-up of efficacious interventions. The Family Healthy Living Program (FHLP), an evidence-based, stakeholder-informed family-based healthy living intervention for children with a BMI-for-age ≥85th and their families was developed and piloted in British Columbia. The free 10-week program, based on the multi-process action control theory, utilized a blended delivery model consisting of 90-minute weekly group sessions plus online lessons, four community-based activities and four maintenance sessions. Topics included healthy eating, physical activity, sleep, screen-time, positive mental health, food and physical literacy, and behavior change techniques. Eleven programs ran in seven BC communities (September 2018-April 2019). Purpose: To evaluate the recruitment, intervention content, delivery, and implementation of the FHLP for quality improvements and to inform decisions about potential scale-up. Methods: A mixed-methods concurrent triangulation process evaluation design with equally-weighted qualitative and quantitative data was used and represented one component of a Type I hybrid effectiveness trial for the FHLP Study. Implementation was evaluated at both family and program delivery levels. Family measures were reach, recruitment, dose received, satisfaction, and facilitators and barriers to participation. Program delivery measures were adoption, fidelity, acceptability, feasibility, compatibility, and facilitators and barriers to program implementation. Qualitative data was collected through interviews and focus groups with parents, program leaders, recreation centre managers, and program support team. Quantitative data was collected from parent and child satisfaction surveys, weekly program leader surveys, attendance forms, and online lesson analytics. Quantitative descriptives were generated using SPSS. Qualitative interviews were recorded and transcribed using Transcriptive™ software, and analysis conducted using NVIVO. A framework analysis approach was applied. Results: 132 families were eligible (n=211 enquiries), and 79 families (88 children) registered (42%). 55 families (63 children) started the program and 80% completed. Of those, 82.5% of families attended 70% of sessions. 26% of families accessed 30%+ of core online lesson content. Average contact time was 17.7 hours (range 12.78-25.02). Family participation facilitators were: free of cost, location, sibling inclusion, and complimentary recreation passes. Participation barriers were: other commitments, illness, transportation, and scheduling. Program acceptability/satisfaction across parents and children was high, with satisfaction ratings over 4/5 for all measures. Seven of the nine (78%) communities originally identified as pilot sites implemented the program. Fidelity was 73.5% across program components (range 42-95%). At the delivery-level, implementation facilitators were high compatibility and feasibility, context (support from recreation centre, having qualified staff), and resources (room availability, manual, equipment, grant funding). Barriers to implementation were recruitment, small group size, attendance, and limited time to deliver material. Interviews showed program leader acceptability/satisfaction across all sites. Conclusions: The FHLP was acceptable and feasible for families and program delivery partners, but recruitment, attendance, and on-line engagement were implementation challenges. Program adjustments are recommended prior to scale-up. / Graduate / 2021-08-26

Childhood obesity has become a growing problem in America; rates have tripled over the past 30 years, and more than 17 percent of America's children are classified as overweight or obese.  To combat the rise in childhood obesity, the federal government mandated in 2004 that all public school districts adopt a local school wellness policy that incorporates goals to improve the wellness environments of these public schools.  Previous research has indicated that the success of these policies is mixed; however, there has been no comprehensive research evaluating the quality of school wellness policies in Virginia, Maryland and the District of Columbia. The purpose of this research is to evaluate local wellness policies within the Mid-Atlantic region.  These evaluations include a preliminary wellness policy evaluation based on locale (rural and urban school districts), an evaluation of the strength and comprehensiveness of template-based policies versus locally developed policies, and a comprehensive evaluation of physical activity policies within Virginia, Maryland and DC.  The last study included is an evaluation of the association between physical activity policy quality and physical activity rates within selected middle schools. The results of this research show that wellness policy quality across the Mid-Atlantic region is weak and moderately comprehensive, and that the adoption process may impact the quality of a local policy.  Furthermore, physical activity policy within the region is also weak and moderately comprehensive, and the results show that school districts that have adopted stronger and more comprehensive polices may be associated with higher local physical activity rates. / Ph. D.

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Childhood obesity is a national problem in the United States and has known implications as a potential cause of chronic illnesses as the child transitions into adulthood. A primary care clinic in the southwestern United States had a high percentage of obese Hispanic children within its population; therefore, the nurses and the pediatrician needed an evidence-based clinical practice guideline (CPG) to manage Hispanic children with a body mass index greater than the 95th percentile for their age. The purpose of the project was to develop a culturally competent CPG to manage childhood obesity in this primary care practice. The social cognitive theory provided the framework to develop the CPG. The final project resulted in an evidence-based CPG that was validated by an expert physician panel. The implication of this project is that nurses and providers can provide culturally competent education to the parent and child to reduce obesity among the pediatric Hispanic population. This project may create positive social change by modifying unhealthy cultural practices and behaviors, preventing chronic diseases, and reducing health care costs for the children within the selected practice.

The World Health Organization, Surgeon General of the United States, and Public Health Agency of Canada have all stated that childhood obesity is one of the most serious health challenges of the 21st century. Thus a purported obesity epidemic among children has generated intense interest in its associated health risks. Increasingly, the medical literature and media blame mothers for failing to provide proper care for their children's health by ignoring the growing weight of their children. While previous literature explores how parenting magazines can be considered public educators about children's health, there is limited literature addressing what parenting magazines specifically say about mothers and childhood obesity. Through a qualitative content analysis of the Canadian parenting magazine Today’s Parent, this paper argues that Today’s Parent stigmatizes mothers by blaming them for the weight issues of children, and suggests future research is needed to investigate to what extent this influences parenting practices.

Abstract Purpose: Acculturation is associated with negative health behaviors and dietary practices among Latino’s in the U.S. Many social aspects include educational attainment, poverty, cultural norms and socio-cultural markers such as acculturation have been shown to directly and indirectly influence risk for obesity. However, few studies have examined the impact that acculturation has on obesity among children. For this reason, the objective of this thesis is to examine the prevalence and correlates of overweight in Latino children focusing specifically on language spoken at home as a proxy measure for acculturation. Methods: Secondary analysis were conducted of the National Survey of Children’s Health (2003). The cross-sectional analyses were limited to Hispanic children ages 6-17. Descriptive, bivariate, and multivariate analyses were conducted. Multivariate logistic regression analyses were conducted to determine the association between overweight and language spoken at home, age, gender, educational attainment, media use, neighborhood safety and exercise frequency. Finally, stratified analyses were conducted to determine the prevalence and correlates of overweight in Spanish versus English speaking households. Results: Currently, the CDC reports that the prevalence of overweight among Latino children is 22%, higher than both non-Hispanic white and non-Hispanic black respectively. The findings show that Spanish language spoken at home is significantly associated with overweight among Latino children (Adj.OR 1.25 95% CI:1.09-1.43). Educational attainment showed significant association with increase in overweight; the lower the educational attainment the more likely these children were overweight. Additionally, frequent exercise reduced likelihood of overweight. Conclusions: Although, the findings are contradictory to the literature,primary language is associated with overweight for Latino children. The results also suggest that there are important similarities and differences between primary Spanish and English speaking Latino household that can be used to inform prevention programs and strategies for reducing overweight specifically among Latinos.