Children's Lifestyle Behaviors Research Articles

Associations among COVID-19 Family Stress, Family Functioning, and Child Health-Related Quality of Life through Lifestyle Behaviors in Children.

The COVID-19 pandemic has resulted in lasting effects on children, necessitating a thorough understanding of its impact for effective recovery planning. This study investigated the associations among COVID-19 family stress, family functioning, children's lifestyle behaviors (i.e., healthy food intake, unhealthy food intake, physical activity, and screen time), and their health-related quality of life (HRQOL). Data from a 2022 survey of parents with children aged 5 to 12 (mean age of boys: 8.36, mean age of girls: 7.76) in the United States through the online Prolific platform were analyzed using path analysis and gender-based multi-group analysis. The results showed an inverse relationship between family stressors and functioning (β = -0.39, p < 0.05). COVID-19 family stress was negatively related to child physical HRQOL (β = -0.20, p < 0.05) but not psychosocial HRQOL. Family functioning showed a positive relation with child healthy food intake (β = 0.26, p < 0.05) and a negative relation with unhealthy diet consumption (β = -0.27, p < 0.05), while no significant associations were found with child physical activity and screen time. Family functioning was indirectly associated with both types of HRQOL through the child's eating patterns. These relationships were more pronounced for girls. The findings point to a complex interplay between family stress and functioning, dietary habits, and the HRQOL of children during the COVID-19 pandemic, particularly concerning girls' food intake and well-being.

Variations in Physical Activity and Screentime According to School Format During the COVID-19 Pandemic.

Early studies indicate children's physical activity (PA) decreased during the pandemic but may vary by school format and season. We longitudinally assessed changes in PA and screentime (ST) behaviors throughout 1 year of the COVID-19 pandemic and according to changes in school format. Parents of children (5-18 years) completed a survey about school format, home characteristics, PA, and ST. Initial data were collected in November 2020 with follow-up in February, May, and August 2021. Physical activity and ST were compared by season and school format using a 4 (format) × 4 (season) repeated measures analysis of variance. Children were active for at least 60 minutes/day less often in winter (2.4 ± 0.3 days; p < .001; n = 176) than in other seasons. Longitudinal analysis (n = 61) showed that PA was highest among students attending school fully in-person and lowest among students attending remotely, though school format differences were not significant. Non-school ST did not differ by season or school format. These results suggest that changes in school format influence students' lifestyle behaviors. The impact on children's lifestyle behaviors should be considered in planning for safe, in-person operation of schools in the event of future pandemics or natural disasters.

Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children.

The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6-10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases was performed for studies published from January 2016 to June 2022. Specific search terms and exclusion criteria were used. Based on the results, diet and physical activity interventions had favorable effects on a series of health outcomes, including anthropometric parameters, biomarkers, eating behavior and self-efficacy. Diet-only interventions had a positive impact specifically on eating habits, mostly on water consumption. Most successful interventions lasted for 1 school year, and they were characterized by parental involvement and teachers' training.

The impact of the COVID-19 pandemic on inequalities in lifestyle behaviours and mental health and wellbeing of elementary school children in northern Canada

ObjectivesThe COVID-19 pandemic has negatively affected children's lifestyle behaviours and mental health and wellbeing, and concerns have been raised that COVID-19 has also increased health inequalities. No study to date has quantified the impact of COVID-19 on health inequalities among children. We compared pre-pandemic vs. post-lockdown inequalities in lifestyle behaviours and mental health and wellbeing among children living in rural and remote northern communities. MethodsWe surveyed 473 grade 4–6 students (9–12 years of age) from 11 schools in rural and remote communities in northern Canada in 2018 (pre-pandemic), and 443 grade 4–6 students from the same schools in 2020 (post-lockdown). The surveys included questions on sedentary behaviours, physical activity, dietary intake, and mental health and wellbeing. We measured inequality in these behaviors using the Gini coefficient, a unitless measure ranging from 0 to 1 with a higher value indicating greater inequality. We used temporal changes (2020 vs. 2018) in Gini coefficients to assess the impact of COVID-19 on inequalities in lifestyle behaviours and mental health and wellbeing separately among girls and boys. ResultsInequalities in all examined lifestyle behaviours increased between 2018 and 2020. Inequalities in watching TV, playing video games, and using a cell phone increased among girls, while inequalities in playing video games, using computers and tablets, and consumption of sugar, salt, saturated fat and total fat increased among boys. Changes in inequalities in mental health and wellbeing were small and not statistically significant. ConclusionThe findings suggest that the COVID-19 pandemic has exacerbated inequalities in lifestyle behaviours among children living in rural and remote northern communities. If not addressed, these differences may translate into exacerbated inequalities in future health. The findings further suggest that school health programs can help mitigate the negative impact of the pandemic on lifestyle behaviours and mental health and wellbeing.

Interventions to promote healthy lifestyle behaviors in children and adolescents in summer day camps: a scoping review

BackgroundChildren and adolescents have suboptimal physical activity and eating habits during summer breaks. Unlike the school setting, there is little evidence on interventions to promote healthy lifestyle behaviors in Summer Day Camps (SDCs).MethodsThe aim of this scoping review was to examine physical activity, healthy eating, and sedentary behavior interventions in the SDCs. A systematic search on four platforms (EBSCOhost, MEDLINE, EMBASE, and Web of Science) was performed in May 2021 and was updated in June 2022. Studies related to promoting healthy behaviors, physical activity, sedentary behaviors and/or healthy eating among campers aged 6 to 16 in Summer Day Camps were retained. The protocol and writing of the scoping review were done according to the guidelines of the “Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR)”.ResultsMost interventions had a positive effect on the behavioral determinants or the behaviors themselves (i.e., physical activity, sedentary behaviors, or healthy eating). Involving counsellors and parents, setting camp goals, gardening, and education are all relevant strategies in promoting healthy lifestyle behaviors in SDCs.ConclusionsSince only one intervention directly targeted sedentary behaviors, it should strongly be considered for inclusion in future studies. In addition, more long-term and experimental studies are needed to establish cause-and-effect relationships between healthy behavior interventions in SDCs and behaviors of children and young adolescents.

Looking through mothers' lens on children's technology overuse, behavioral and psychosocial alterations during home confinement: future recommendations

BackgroundCOVID-19 home confinement protracted extended cohabitation and drastic changes in the children's lifestyle behaviors. During this time, mothers faced the foremost challenge to preserve their children's physical and psychological well-being. PurposeThis study aimed to investigate children's technology overuse, behavioral and psychosocial alterations during COVID-19 home confinement. MethodsA descriptive cross-sectional study was carried out in Alexandria city, Egypt. A sample of 375 mothers who had school-age children completed the Children's Behavioral and Psychosocial Changes during Home Confinement Questionnaire. FindingsMore than three-quarters of mothers reported alterations in children's behaviors related to technology overuse (76.8%). Similarly, 51.5% and 44.8% of mothers reported aggressive behaviors and alterations in children's feelings during COVID-19. Changes in eating patterns (50.7%), sleeping patterns (48.3%), physical activity (54.9%), and personal hygiene (54.4%) were also perceived as major challenges. ConclusionHome confinement related to the COVID-19 pandemic was identified as a great source of alteration in children's behaviors and psychosocial status. Children overused technology as a solely recreational outlet during confinement time. Consequently, mothers faced major challenges regarding the alteration in their children's lifestyle, technology overuse, disobedience, aggressive behaviors, feelings, and social interaction. So, COVID-19-related behavioral changes could be combated by adopting parents' guidelines. Nurses play a critical role in educating parents to keep an open channel of communication with their children. They should also remain vigilant for the changes in the regular children's lifestyles and behaviors during home confinement.

The effect of guardians' health literacy on the child's spending time at home: A cross-sectional study among Japanese schoolchildren.

The contents of children's daily activities and the amount of time spent on them has been directly linked to their health and development. Parental health behavior has also been considered a key factor, and the aim of this study was to determine the relationship between parent/guardian health literacy (HL) and their child's time spent at home by behavioral types. The study was conducted in elementary schools in Japan. The target subjects for this study were elementary schoolchildren (all grades, aged 6 to 12 years) and their parents/guardians, and almost 3000 schoolchildren and their parents/guardians in the Northern and Southern districts in Japan participated. The questionnaire for parents/guardians included amount of time spent per day on the seven major behavioral contents of their child's time at home, on weekdays and weekends, respectively, and a shortened five-item health literacy (HL) scale. Parent/guardian HL results were categorized into two groups (low HL group and high HL group), and we analyzed the association between the HL and child's time spent at home by behavioral contents. Children in the high HL parent/guardian group spent significantly less time watching TV and playing games than those in the low HL group, both on weekdays and weekends. Time spent playing outside on weekdays and on hobbies on weekdays and weekends was significantly longer for children in the high HL parent/guardian group than in the low HL group. Results of logistic regression analyses adjusted for confounders showed that higher parental/guardian HL reduced children's spending more than 30 minutes watching TV or playing games and increased children's spending more than 30 minutes on outside playing and doing hobbies. Parental/guardian HL affected the child's time spent at home. The results could suggest that increasing parental/guardian HL has strong potential to improve children's major lifestyle behaviors．.

Evaluating the Effectiveness of a Family-Based Virtual Childhood Obesity Management Program Delivered During the COVID-19 Pandemic in Canada: Prospective Study.

Generation Health (GH) is a 10-week family-based lifestyle program designed to promote a healthy lifestyle for families with children who are off the healthy weight trajectory in British Columbia, Canada. GH uses a blended delivery format that involves 10 weekly in-person sessions, and self-guided lessons and activities on a web portal. The blended program was adapted to be delivered virtually due to the COVID-19 pandemic. Currently, the effectiveness of the virtual GH program compared with that of the blended GH program remains unclear. We aimed to (1) compare the effectiveness of the virtual GH program delivered during the COVID-19 pandemic with that of the blended GH program delivered prior to the pandemic for changing child physical activity, sedentary and dietary behaviors, screen time, and parental support-related behaviors for child physical activity and healthy eating, and (2) explore virtual GH program engagement and satisfaction. This study used a single-arm pre-post design. The blended GH program (n=102) was delivered from January 2019 to February 2020, and the virtual GH program (n=90) was delivered during the COVID-19 pandemic from April 2020 to March 2021. Families with children aged 8-12 years and considered overweight or obese (BMI ≥85th percentile according to age and sex) were recruited. Participants completed preintervention and postintervention questionnaires to assess the children's physical activity, dietary and sedentary behaviors, and screen time, and the parent's support behaviors. Intervention feedback was obtained by interviews. Repeated measures ANOVA was used to evaluate the difference between the virtual and blended GH programs over time. Qualitative interviews were analyzed using thematic analyses. Both the virtual and blended GH programs improved children's moderate-to-vigorous physical activity (F1,380=18.37; P<.001; ηp2=0.07) and reduced screen time (F1,380=9.17; P=.003; ηp2=0.06). However, vegetable intake was significantly greater in the virtual GH group than in the blended GH group at the 10-week follow-up (F1,380=15.19; P<.001; ηp2=0.004). Parents in both groups showed significant improvements in support behaviors for children's physical activity (F1,380=5.55; P=.02; ηp2=0.002) and healthy eating (F1,380=3.91; P<.001; ηp2=0.01), as well as self-regulation of parental support for children's physical activity (F1,380=49.20; P<.001; ηp2=0.16) and healthy eating (F1,380=91.13; P<.001; ηp2=0.28). Families in both groups were satisfied with program delivery. There were no significant differences in attendance for the weekly in-person or group video chat sessions; however, portal usage was significantly greater in the virtual GH group (mean 50, SD 55.82 minutes) than in the blended GH group (mean 17, SD 15.3 minutes; P<.001). The study findings suggested that the virtual GH program was as effective as the blended program for improving child lifestyle behaviors and parental support-related behaviors. The virtual program has the potential to improve the flexibility and scalability of family-based childhood obesity management interventions.

Association between overweight, obesity and sleep duration and related lifestyle behaviors is gender and educational stages dependent among children and adolescents aged 6-17 years: a cross-sectional study in Henan

BackgroundTo investigate the associations between overweight, obesity and sleep duration and related lifestyle behaviors in children and adolescents at different gender and educational stages.MethodsA cross-sectional study comprising 18723 children and adolescents with a stratified cluster sampling method of Henan Province was conducted in 2019. A self-reported questionnaire was used to collect the information about demographic characteristics as well as sleep and lifestyle behaviors. Anthropometric measurements (height and weight) were taken and body mass index was computered as an indicator of overweight and obesity. The Chi-square test, one-way analysis of variance and multiple logistic regression were used to data analysis.ResultsAmong the respondents, 12657(67.6%) were with normal weight, 3711(19.8%) were overweight and 2355(12.6%) were obesity. The average age of the participants was 12.6 years old. The proportion of overweight and obesity in the 10191 boys was 18.7% and 14.2% respectively. The proportion of overweight and obesity in the 8532 girls was 21.2% and 10.6% respectively. In trend analyses, sleep duration at different gender found with the decreased of the sleep duration, the proportions of overweight/obesity in boys and girls were gradually increased (Ptrend<0.05). In the adjusted logistic regression models, the results showed stratified by gender, compared with the recommended sleep duration group, students with very short sleep duration and short sleep duration showed an increased ORadj of 2.56 and 2.13 in boys, 2.34 and 2.09 in girls respectively. According to different educational stages, those in very short sleep duration and short sleep duration showed an increased ORadj of 2.15 and 1.69 in primary school, 2.26 and 1.58 in middle school, 2.23 and 1.51 in high school respectively.ConclusionsChildren and adolescents with very short sleep duration and short sleep duration may increase the risk of overweight/obesity, the association differed based on the gender-specific and educational stages-specific. Gender and educational stages should be regarded as specific characteristics for the effects on overweight/obesity in Henan Province.

Laboured reading and musculoskeletal pain in school children - the role of lifestyle behaviour and eye wear: a cross-sectional study

BackgroundLifestyle behaviour in children and adolescents has become increasingly sedentary and occupied with digital work. Concurrently, there has been an increase in the prevalence of headache, neck- and low back pain, which are leading causes of disability globally. Extensive near work and use of digital devices are demanding for both the visual system and the upper body head-stabilizing musculature. Uncorrected vision problems are present in up to 40% of Nordic school children, and a lack of corrective eye wear may cause eyestrain, musculoskeletal pain and headache. The aim of this study was to investigate associations between laboured reading, musculoskeletal pain, uncorrected vision, and lifestyle behaviours in children and adolescents.MethodsThis was a cross-sectional study with a total of 192 Norwegian school children aged 10–11 and 15–16 years. As a part of a school vision testing program, the children completed an online questionnaire about general and ocular health, socioeconomic status, academic ambition, near work and related symptoms, upper body musculoskeletal pain, and physical and outdoor activities.ResultsThe 15–16-year-olds had a more indoor, sedentary, digital-based lifestyle with higher academic demands, compared with the 10–11-year-olds. Concurrently, reading became more laboured and upper body musculoskeletal pain increased with age. Girls reported more symptoms, higher academic ambitions, and more time spent on schoolwork and reading, compared with boys. Non-compliance in wearing prescribed eye wear (glasses or contact lenses), increased use of near digital devices, and experiencing visual stress (glare) were positively associated with laboured reading and upper body musculoskeletal pain.ConclusionsA screen-based lifestyle with high academic demands challenges the ability to sustain long hours of static, intensive near work. Extensive near work tires the visual system and upper body musculature and provokes laboured reading and musculoskeletal pain symptoms. This study emphasizes the importance of regular eye examinations in school children, and the need to raise awareness among children, parents, and school- and health personnel about the importance of optimal vision and visual environment for academic performance and health.

Dose-Response Relationship of a Blended In-Person and Online Family-Based Childhood Obesity Management Program: Secondary Analysis of a Behavior Intervention.

BackgroundThe Early Intervention Program (EIP) was a 10-week, blended, in-person and online lifestyle intervention for families with children who were off the healthy weight trajectory. The engagement pattern and the dose response of EIP have not been examined.ObjectiveThe aims of this paper are to examine families’ engagement patterns with the EIP and to evaluate the dose-response relationship between EIP engagement patterns and physical activity and healthy eating–related outcomes at 10 weeks.MethodsFamilies with children (8-12 years old) who are off the healthy weight trajectory (child BMI ≥85th percentile for age and sex) were recruited. Pre- and postintervention questionnaires assessed child lifestyle behaviors, parental support behaviors, family lifestyle habits, as well as parental physical activity and healthy-eating identity. Hierarchical cluster analysis of both in-person and online components was used to classify engagement patterns. Regression analysis assessed differences in outcomes by engagement groups.ResultsTwo distinct clusters of engagement groups were identified (N=66), which were in-person (IP; n=40, 61%) and in-person + online (IP+; n=26, 39%) engagement. Relative to the IP group at week 10, IP+ showed a greater child moderate-to-vigorous physical activity level (1.53, SD 0.56; P=.008), child physical activity confidence (1.04, SD 0.37; P=.007), parental support for child physical activity (5.54, SD 2.57; P=.04) and healthy eating (2.43, SD 1.16; P=.04), family habits for physical activity (3.02, SD 1.50; P=.049) and healthy eating (3.95, SD 1.84; P=.04), and parental identity for physical activity (2.82, SD 1.19; P=.02).ConclusionsThe online EIP portal complemented the in-person sessions. Additional engagement with the portal was associated with greater improvements in child physical activity and parental support behaviors, habits, and identity for physical activity.

HelperFriend, a Serious Game for Promoting Healthy Lifestyle Behaviors in Children: Design and Pilot Study.

BackgroundThe use of health games is a promising strategy for educating and promoting healthy lifestyle behaviors among children.ObjectiveWe aimed to describe the design and development of a serious game, called HelperFriend, and evaluate its feasibility, acceptability, and preliminary effects in children in a pilot study. HelperFriend is a vicarious experiential video game designed to promote 3 lifestyle behaviors among young children: physical activity, healthy eating, and socioemotional wellness.MethodsParticipants aged 8 to 11 years were recruited from an elementary school and randomized to receive a healthy lifestyle behavior educational talk (control) or play six 30-minute sessions with HelperFriend (intervention). Assessments were conducted at baseline (T0) and after the intervention (ie, 4 weeks) (T1). The primary outcome was gain in knowledge. The secondary outcomes were intention to conduct healthy behaviors, dietary intake, and player satisfaction.ResultsKnowledge scores of intervention group participants increased from T0 to T1 for physical activity (t14=2.01, P=.03), healthy eating (t14=3.14, P=.003), and socioemotional wellness (t14=2.75, P=.008). In addition, from T0 to T1, the intervention group improved their intention to perform physical activity (t14=2.82, P=.006), healthy eating (t14=3.44, P=.002), and socioemotional wellness (t14=2.65, P=.009); and there was a reduction in their intake of 13 unhealthy foods. HelperFriend was well received by intervention group.ConclusionsHelperFriend appears to be feasible and acceptable for young children. In addition, this game seems to be a viable tool to help improve the knowledge, the intention to conduct healthy behaviors, and the dietary intake of children; however, a well-powered randomized controlled trial is needed to prove the efficacy of HelperFriend.

Lifestyle and Behavior of Children During COVID-19

Due to the COVID-19 epidemic, the term "change in children's lifestyle behavior" is currently a hot topic in society. Children's lifestyle behaviors may have been altered by home confinement during the epidemic, although evidence is still emerging and limited, which talks about SDG 3: Good Health and Well-Being. The present study focuses on the important factors that lead to change in lifestyle of children, to examine the effects of COVID-19 confinement, and to suggest preventive measures. The design used for this study is descriptive and an online survey was conducted within Tamilnadu with a sample size of 105. Correlation, chi-square are the tools used for testing the variables. This study identifies an adverse impact on mental health, such as decreased well-being and increased post-traumatic stress disorders (PTSD) and anger. These findings should be taken into account to design and implement health strategies for preserving children’s health during pandemics.

Lifestyle Behaviors and Parents' Mental Well-Being Among Low-Income Families During COVID-19 Pandemic.

BackgroundThe coronavirus 2019 (COVID-19) pandemic has negatively altered many families’ lifestyles and the mental well-being of parents, especially those who have a low income and young children. To improve low-income parents’ mental well-being, especially during a pandemic, understanding parents’ and children’s lifestyle behaviors and the relationship between their lifestyle behaviors and parents’ mental well-being is essential.ObjectiveThis cross-sectional study examined relationships between lifestyle behaviors (sleep, physical activity, screen time, and eating behavior of parents and children) and low-income parents’ well-being (stress, anxiety, and depression) during COVID-19.MethodsParents were recruited from two Michigan Head Start organizations as well as across the United States; 408 parents completed an online survey. Demographic characteristics were assessed, along with parents’ sleep, physical activity, screen time, and dietary intake; stress, anxiety, and depression were also examined. Children’s sleep time, physical activity, screen time, and fruit/vegetable intake were assessed. Descriptive statistics, correlations, and the multivariate general linear model procedure were used.ResultsApproximately 69.4% of parents reported moderate stress levels, and 17.2% reported high levels. Most parents had sleep disturbances, attained minimal physical activity, and consumed <5 fruits/vegetables per day; average screen time was >2 hours per day. Only 41% of preschoolers were active 7 days a week and slept ≥10 hours per day. Two thirds had >2 hours per day of screen time, and less than one fifth consumed ≥5 fruits/vegetables per day. After adjusting for parents’ demographics and children’s lifestyle behaviors, parents’ sleep disturbance was positively correlated with their levels of stress, anxiety, and depression. After controlling for parents’ demographics and lifestyle behaviors, child sleep time was negatively associated with parents’ stress levels. Family demographics and parents’ and children’s lifestyle behaviors explained 33.4%, 29.8%, and 28.1% of the variances in parents’ stress, anxiety, and depression, respectively.DiscussionMost parents and preschoolers were not meeting many lifestyle behavior recommendations, indicating a need for interventions. Improving parents’ sleep quality and reducing bedtime challenges involving their preschoolers may be necessary for enhancing parental mental well-being.

Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity: Longitudinal study update.

ObjectiveA previous report from our group identified directionally unfavorable dietary and lifestyle behavior trends in longitudinally monitored children and adolescents with obesity early in the COVID‐19 pandemic lockdown. The current study aimed at extending these previous observations in youths with obesity on the dietary and lifestyle behavioral consequences of the extended COVID‐19 lockdown in Verona, Italy.MethodsThe sample included 32 children and adolescents with obesity participating in the longitudinal OBELIX study. Diet and lifestyle information were collected pre‐pandemic, 3 weeks into the national lockdown, and 9 months later when home confinement continued to be mandatory. Changes in outcomes over the study time points were evaluated for significance using repeated‐measures ANOVA and post‐hoc pairwise t‐tests with Bonferroni corrections.ResultsAs previously reported, meals/day, fried potato intake, and red meat ingestion increased significantly (p < 0.001) during the initial lockdown. Sleep time and screen time increased and sports participation decreased significantly (p < 0.001) during the initial lockdown. These changes in health behaviors remained significantly different from baseline at the second lockdown assessment, with the exception sleep time returned to baseline levels.ConclusionsUnfavorable diet and lifestyle behavioral changes in response to the initial COVID‐19 lockdown in children and adolescents with obesity have largely been sustained over the course of the pandemic. There is an urgent need to intervene on these behaviors to prevent further deleterious effects on long‐term child health; access to weight management care is critically important for these children. In addition to intervening on these behaviors, our findings should help to inform ongoing lockdown policies.

Barriers to nutrition and physical activity participation for Australian children in foster and kinship care

Foster and kinship carers face unique and complex challenges in caring for Australia’s most vulnerable children. It is therefore necessary to ensure that home-based carers are adequately upskilled and supported to promote the health of children in their care. The aim of this paper was to better understand the barriers to developing healthy lifestyle behaviours (relevant to nutrition and physical activity) among children in home-based care, from the perspective of foster and kinship carers. Focus group sessions were conducted with 21 carers: eight foster carers and 13 kinship carers. Four key themes were identified: (1) Childhood experience and children’s healthy lifestyle behaviours; (2) There are personal costs of being a carer; (3) Carers require support to develop healthy lifestyle behaviours in children; and (4) Broader systemic factors impact healthy lifestyle development. Carers in the current study described their experience of key emotional, financial, and systemic barriers to facilitating healthy lifestyle behaviours among the children in their care. To address such challenges, carers recommended the development of trauma-informed support, education, and resources to prioritise and facilitate healthy lifestyle development among children in home-based care.

Prospective Associations between Maternal and Child Diet Quality and Sedentary Behaviors.

As the most likely primary caregivers, mothers are an integral part of children’s social influence and are therefore greatly involved in shaping their children’s behaviors. The objectives were to determine the prospective associations between maternal and child diet quality and sedentary behaviors. This study, within the framework of a community-based intervention study, included 1130 children aged 8–10 years and their mothers. The study was carried out during two academic years (2012/2014) with a mean follow-up of 15 months. Exposure and outcome variables were measured at baseline and follow-up, respectively. Diet quality was assessed by the KIDMED questionnaire and the short Diet Quality Screener, respectively. Sedentary behaviors were determined by standardized questions of sedentary behaviors. Maternal consumption of fruits, vegetables, fish, legumes, pasta/rice, dairy products, nuts and baked goods were positively associated (p < 0.05) with the corresponding child behavior. Multiple linear regression models adjusted for sex, age, maternal education and intervention group revealed significant cross-sectional (p < 0.005) and prospective (p < 0.01) associations between maternal and child overall diet quality and sedentary behaviors. Maternal diet quality and sedentary behaviors were predictive for these lifestyle behaviors in children.

Feasibility and reliability of the Self Administered Children's Lifestyle Assessment (SACLA), a new tool to measure children's lifestyle behaviors: the VIF Program.

SummaryObjectivesTo develop a self-administered children health-related behaviors assessment, and to test its feasibility and reliability in a group of French children.MethodsA sample of 216 children participated in the first stage of this study, dedicated to the feasibility assessment. An independent sample of 99 children participated in the assessment of reliability via questionnaire test and retest.ResultsMissing or inappropriate responses on different parts of the questionnaire ranged from 0 to 35%, more evident on the drink intake and sleep areas. Some questions in fact have been modified or removed. No problems were reported on the dimensions of physical activity habits and sedentary behaviors. The mean percentage of agreement in test-retest reliability for the questionnaire dimensions was 78% (47-99%). Overall, kappa coefficients were good.ConclusionsThis questionnaire is an acceptable and reliable instrument for assessing lifestyle habits in French children.

A qualitative study of cognitive, behavioral, and environmental influences on Hispanic mothers’ early childhood feeding practices

Young children's lifestyle behaviors are largely shaped by their parents. There are socioeconomic risk factors particular to Hispanic populations that influence the way parents feed their children. As obesity continues to be a public health issue with substantial inequities across race and ethnicity, it is critical to understand Hispanic parents' food choices and feeding practices. The objective of this qualitative study is to identify the behavioral, environmental, and cognitive factors that influence the parental food choices and feeding behaviors of Hispanic mothers of children ages 0–5 years. Snowball sampling was used to recruit participants from the community (n = 30) who were 1) female; 2) Hispanic; 3) over the age of 18; and 4) a mother to child(ren) between the ages zero and five. Each interview consisted of a brief demographic survey and a set of open-ended questions based on Social Cognitive Theory constructs. A thematic analysis using a combined deductive and inductive approach was used to analyze transcriptions. Results indicated that mothers' attitudes around breastfeeding were connected with their challenges, while their attitudes around solid foods were expressed in their feeding strategies. Mothers used strategies of modeling, repeated exposure, and practices of “sneaking” in healthy foods and bribing to promote healthy eating. Mothers were most likely to seek out information from (1) pediatricians, (2) female family members, and (3) the internet. Hispanic mothers actively seek out information from many different sources that impact how they feed their young children. Understanding their trusted sources and how it influences the SCT constructs is an important step in preventing early childhood obesity.

Design of the GOT Doc study: A randomized controlled trial comparing a Guided Self-Help obesity treatment program for childhood obesity in the primary care setting to traditional family-based behavioral weight loss

Currently one-third of children in the United States have overweight or obesity (OW/OB). The goal of Healthy People 2020 is to reduce the proportion of children with OW/OB and increase the proportion of primary care visits that include nutrition and weight-related counseling. Unfortunately, many health care providers find it difficult to offer effective weight-related counseling and treatment in the primary care setting. Therefore, new models of care are needed that allow a greater proportion of children with OW/OB and their parents to access care and receive quality weight management treatment. The current paper describes the GOT Doc study which is designed to test the effectiveness of a Guided Self-Help (GSH) model of obesity treatment that can be delivered in the primary care setting compared to a traditional Family-Based Behavioral weight loss treatment (FBT) delivered at an academic center. We will assess the impact of this program on attendance (access to care) and changes in child BMI percentile/z-score. We will also examine the impact of this treatment model on change in child lifestyle behaviors, parent support behaviors, and parent self-efficacy and empowerment to make behavior change. Finally, we will assess the cost-effectiveness of this model on changes in child BMI percentile/z-score. We believe the GSH intervention will be a cost-effective model of obesity management that can be implemented in community practices around the country, thereby increasing access to treatment for a broader proportion of our population and decreasing rates of childhood obesity.