Approximately 35.5% of U.S. children ages 6-11 are overweight or obese. Obesity prevention programs in the school setting have produced mixed results, but interventions conducted in the afterschool setting may increase healthy eating (HE) and physical activity (PA) beyond efforts in a typical school day. Studies to date have shown some success in increasing PA in this setting. Moreover, 23% of children grades K-5 attend afterschool care programs. Treatment successes using a family-based approach warrants parental involvement in this setting, but few studies have examined the impact of parent inclusion. The CATCH Kids Club is a curriculum aimed to increase HE and PA in the afterschool care setting with children grades K-5. The NIH We Can! is a family-based intervention geared towards parents of children ages 8-13 and aims to assist families in increasing HE and PA as well as reducing screen time. The current study sought to understand 1) school community perceptions of child obesity, nutrition, and PA, 2) current efforts of the afterschool care program to promote HE and PA, and 3) how a combined student- and parent- focused intervention could be integrated into afterschool care. Researchers conducted focus groups and tested measurement instruments with afterschool personnel and parents of children in the afterschool care program. All personnel (N = 12; 83% Female; 92% Caucasian) agreed that greater afterschool care health promotion efforts could be made. Over half the sample (58%) described afterschool snacks as “not very healthy” or “not at all healthy” and placed the average amount of daily PA at 1 hour. Barriers to healthy habits included mandates on individually wrapped snack purchases and space available for PA. Personnel demonstrated interest in learning the CATCH curriculum. However, personnel were concerned about amount of staff needed to deliver the program, effects of varying attendance levels of students, and parent participation due to busy schedules. Results revealed that parents (N = 8; 75% female; 100% Caucasian) had little knowledge of what occurred during the afterschool care program including types of snacks provided and amount of PA received. All parents were supportive of the implementation of CATCH Kids Club, and all expressed interest in participating in the We Can! sessions. Parents reported preference for short (30-45 minute), bimonthly sessions occurring upon child pick-up. Results suggest that delivering 2012 Appalachian Student Research Forum Page 81 CATCH Kids Club and the NIH We Can! curricula in the afterschool setting would be of interest to both personnel and parents and would be feasible if time-limited and convenient. These findings will contribute to the development of an afterschool care program pilot intervention, Wellness Partners, directed at both students 5-11 years of age and their parents using modified CATCH Kids Club and NIH We Can! curricula. This cluster randomized controlled pilot study utilizing both quantitative and qualitative methodologies will provide preliminary data to further refine and conduct a fully-powered, large scale trial of the intervention’s efficacy in preventing obesity

Geography disparities exist in obesity and obesity related conditions. This study aimed to examine the geographic differences in obesity prevalence and its risk factors among Asian Americans in California. Data (n = 4,000) from the 2013–2014 California Health Interview Survey were used. Obesity (≥27.5 kg/m2) was defined according to the World Health Organization Asian body mass index cut points in Asian groups. Results suggest that 66.5% of Asians lived in urban areas. Among Asian adults, obesity prevalence was highest in Filipinos (33.8%) and lowest in Koreans (12.8%). Compared to rural Vietnamese, obesity prevalence was higher for urban Vietnamese (8.3% vs. 20.2%, p = 0.0318). Weighted multiple logistic regression analyses showed that being 45–64 years (vs. 65 years or above), being Japanese, Filipino, or other Asians (vs. Chinese) were associated with a higher odds of obesity among urban residents; whereas being 18–44 years and being 45–64 years (vs. 65 years or older), being male, having high school education (vs. having graduate education) were associated with a higher odds of obesity among rural residents. Being Vietnamese (vs. Chinese) was associated with 64% decreased odds of obesity only among rural residents (95% confidence interval = 0.14–0.94). The findings show geography disparities in obesity among Asians in California.

Abstract available in The FASEB Journal.

The interplay between child characteristics and parenting is increasingly implicated as crucial to child health outcomes. Based on data from a national birth cohort, this study assessed the joint effects of children's temperamental characteristics and maternal sensitivity on the development of childhood obesity. Infant temperament, assessed by maternal report, was categorized into three types: easy, average, and difficult. Maternal sensitivity, assessed by observing maternal behaviors during mother-child semi-structured interaction, was categorized into two groups: sensitive and insensitive. Child's weight and height were measured longitudinally from age two years to Grade 6 and body mass index (BMI) was calculated. Obese (≥ the 95th percentile) and overweight-or-obese (≥ the 85th percentile) were defined based on sex and age specific BMI percentiles. Generalized estimating equations were used to analyze data. The proportions of children who were obese and overweight-or-obese increased as they got older, 5.47% and 15.58% at 2 years of age, to 18.78% and 34.34% at Grade 6. Children with easy temperament and under the care of a sensitive mother were at the lowest risks of obesity and overweight-or-obesity over childhood. The joint effects of children's temperament and maternal sensitivity on overweight-or-obesity largely depended on childhood phases. For instance, children with difficult temperament and under the care of an insensitive mother had much higher risks during school age but not during early childhood. In conclusion, parents may need to tailor their parenting strategies to particular child temperamental characteristics in order to prevent and control the development of childhood obesity.

The proportion of obese adolescents in Southern Appalachia is among the highest in the nation. Currently there are few effective programs that address this issue, especially among high school students. Through funding from the National Institute on Minority Health and Health Disparities in the National Institutes of Health, the Team Up for Healthy Living Project targets obesity prevention in adolescents through a crosspeer intervention. The specific aims of the project are: 1) To develop a peer-based health education program focusing on establishing positive peer norms and supportive peer relationships toward healthy eating and physical activity among high school students, 2) To test the efficacy of the program, and 3) To explore the mechanisms underlying the program. The intervention is based on the Theory of Planned Behavior, which presupposes that human behavior is primarily driven by attitude, subjective norms, perceived behavior control, and social support. Through influencing these components, the intervention is expected to improve eating behavior, increase physical activity, and lead to healthier body weight among adolescents in Southern Appalachia. Ten area high schools were selected to be a part of the project, and schools were matched based on similar demographics (school size and number of students enrolled) and were randomized to intervention or control. Wave one of baseline data collection was completed in January 2012; with 265 students assigned to intervention and 276 to control. A second wave of subject recruitment will occur in fall 2012. To deliver the intervention, undergraduate students from the disciplines of Public Health, Nutrition, and Kinesiology were trained as peer facilitators. These peer facilitators are teaching the eight-week Team Up curriculum during Lifetime Wellness classes at intervention schools. The curriculum focuses on nutrition awareness, physical activity, leadership, and communication skills. Page 84 2012 Appalachian Student Research Forum Control group participants receive their regularly scheduled Lifetime Wellness curriculum. Body mass index percentile, dietary behavior, and physical activity among study subjects will be assessed at baseline, and at three and twelve months post-baseline. In addition, peer group norms, body image, supportive peer relationships, role modeling, behavioral control/self-efficacy, attitudes, and intentions toward healthy eating and physical activity will also be assessed. Group differences will be assessed at each data collection period. The long-term goal of the study is to establish an effective academia-community partnership program to address adolescent obesity disparity in Southern Appalachia.