Obesity Prevention Messages Research Articles

Native Americans’ Responses to Obesity Attributions and Message Sources in an Obesity Prevention Campaign

ABSTRACT This study investigated the effectiveness of Native American (NA) targeted obesity prevention messages. The researchers manipulated obesity attributions (internal vs. external) and message sources (NAs vs. non-NAs) in a 2 × 2 mixed experimental design to examine the way these message attributes influence NAs’ emotional, attitudinal, cognitive, and behavioral responses. One-hundred and eighteen Cheyenne and Arapaho (C&A) tribal citizens read two paper-based obesity prevention PSAs and then answered questions that assessed their message responses. The key findings demonstrated that the match between participants’ ethnicity and the message source’s ethnicity had a significant effect, as it reduced anger and promoted positive message attitudes and favorable source evaluations. Implications, limitations, and suggestions for future research and NA targeted health campaigns are discussed.

Development and Qualitative Pretesting of Child Feeding and Obesity Prevention Messages for Parents of Infants and Toddlers

BackgroundConsistent, evidence-based child feeding guidance targeted to parents of children ages birth to 24 months (B-24) is needed for early childhood obesity prevention. ObjectiveThe aim was to develop and pretest a comprehensive set of child feeding and obesity prevention messages for parents of children ages B-24. DesignA qualitative, 2-phase protocol, grounded in social and behavior change, was used as a conceptual interview framework to pilot test early childhood feeding messages with parents. Participants/settingParticipants were parents (n = 23) of children ages B-24. MethodsA core set of 12 messages and supporting materials were developed for parents of children ages B-24 based on previous research findings, current research evidence, and feeding guidance. Parents were individually interviewed using a semistructured script along with additional questions to rank perceptions of message qualities. Main outcome measuresOverall comprehension, importance, believability, ease of implementation, and likelihood of use of messages were assessed. Statistical analysis performedData analysis included qualitative thematic analysis and descriptive statistics for Likert-scaled responses. ResultsParticipants were primarily female, non-Hispanic White, with a mean age of 33.3 ± 6.8 years and at least a bachelor’s degree. Overall, most messages were understood, believable, perceived as important, and feasible by parents. Messages related to starting solid foods, encouraging child control of intake and self-feeding, and food allergen guidance were perceived as more difficult and less likely to be implemented by parents. ConclusionsAdditional research is needed to evaluate actual implementation of messages by diverse parents and resulting outcomes including impact on child weight.

Online Behavioral Screener with Tailored Obesity Prevention Messages: Application to a Pediatric Clinical Setting.

Obesity prevention involves promoting healthy eating and physical activity across all children. Can we leverage technology to feasibly survey children’s health behaviors and deliver theory-based and user-tailored messages for brief clinical encounters? We assessed the acceptability and utility of an online pediatric-adapted liking survey (PALS) and tailored messages among children receiving non-urgent care in a pediatric emergency department (PED). Two hundred and forty-five children (average age = 10 years, racially/ethnically diverse, 34% overweight/obese from measured indices, 25% of families reporting food insecurity) and their parents/caregivers participated. Each reported the child’s activity and behaviors using the online PALS and received two to three messages tailored to the responses (aligned with elaboration likelihood and transtheoretical models) to motivate behavioral improvements or reinforce healthy behaviors. Most children and parents (>90%) agreed the PALS was easy to complete, encouraging thought about their own/child’s behaviors. The child’s PALS responses appeared reasonable (fair-to-good child–parent intraclass correlations). Most children and parents (≥75%) reported the tailored messages to be helpful and favorable for improving or maintaining the targeted behavior. Neither message type (motivating/reinforcing) nor favorability responses varied significantly by the child’s weight or family’s food security status. In summary, children and parents found the PALS with tailored messages acceptable and useful. The message types and responses could help focus brief clinical encounters.

Obesity prevention messages, risk behaviors for eating disorders and body mass index. Cluster analysis

Resumen. Los expertos en salud pública han argumentado que las campañas de prevención de la obesidad pueden tener efectos negativos para la salud, como los comportamientos de riesgo para los trastornos alimentarios. Este estudio tuvo como objetivo identificar la relación entre el índice de masa corporal, la presencia de comportamientos de riesgo para los trastornos alimentarios y escuchar los mensajes de prevención de la obesidad. Se midió a los adolescentes para calcular su índice de masa corporal. Se evaluó la presencia de conductas de riesgo para los trastornos alimentarios, y se registró el número y con frecuencia de mensajes de prevención de la obesidad que escucharon. Se utilizó un análisis de conglomerados para el análisis estadístico. Entre los resultados se encontró que los adolescentes informaron haber escuchado un promedio de siete mensajes diferentes de prevención de la obesidad en una semana; El mensaje más escuchado fue medir su cintura. Los comportamientos de riesgo más comunes para los trastornos alimentarios observados en los adolescentes fueron el ejercicio excesivo y el miedo a aumentar de peso. Se identificaron los grupos, un grupo eran adolescentes obesos que informaron haber escuchado menos mensajes de prevención de la obesidad y presentaron diversos comportamientos de riesgo para los trastornos alimentarios. Otro grupo fue el de adolescentes de peso normal que informaron haber escuchado más mensajes de prevención de la obesidad y presentaron pocos comportamientos de riesgo para los trastornos alimentarios. En conclusión, es aconsejable diseñar campañas que prevengan simultáneamente la obesidad y los comportamientos de riesgo para los trastornos alimentarios. Otro grupo fue el de adolescentes de peso normal que informaron haber escuchado más mensajes de prevención de la obesidad y presentaron pocos comportamientos de riesgo para los trastornos alimentarios. En conclusión, es aconsejable diseñar campañas que prevengan simultáneamente la obesidad y los comportamientos de riesgo para los trastornos alimentarios. Otro grupo fue el de adolescentes de peso normal que informaron haber escuchado más mensajes de prevención de la obesidad y presentaron pocos comportamientos de riesgo para los trastornos alimentarios. En conclusión, es aconsejable diseñar campañas que prevengan simultáneamente la obesidad y los comportamientos de riesgo para los trastornos alimentarios.

Goal-Framing and Temporal-Framing: Effects on the Acceptance of Childhood Simple Obesity Prevention Messages among Preschool Children's Caregivers in China.

A range of intervention models are available for childhood obesity prevention; however, few studies have examined the effectiveness of intervention messages. This study developed childhood simple obesity prevention messages on the basis of goal-framing and temporal-framing effects to improve message acceptance among the caregivers of preschool children and explored associated factors. A cross-sectional study was conducted among 592 caregivers of preschool children in urban kindergartens in China during March to April 2019. The framing messages were developed based on prospect theory and construal level theory. The majority (48.4%) of caregivers found the gain-framed, present-oriented message most salient for acceptance. We found that gender, education background, theme, and the use of negative words have impacts on goal-framing effects; and previous participation in a health related intervention, career category, and the theme have impacts on temporal-framing effects (p < 0.001). Goal-framing effects and temporal-framing effects can influence each other (p < 0.001). The findings suggest that the gain-framed, present-oriented message could be considered a strategy to improve the acceptance of information by caregivers. When framing a message, subtle differences like using negative words might affect the exertion of framing effects.

Does it matter who’s at risk?: Testing message framing and narrative as moderators of the effects of self-referencing in obesity prevention messages targeting Hispanic adults living in the U.S.

This study tested whether the effect of self-referencing in a health-marketing message was amplified or attenuated when combined with message framing and narrative. Hispanic adults (N = 146) were randomly assigned to read and respond to an obesity prevention message. Self-referencing messages generated greater cognitive elaboration but only when placed in a narrative. Conversely, self-referencing messages highlighting health risks of obesity produced higher levels of involvement and intention to increase physical activity and healthy eating. Health marketing professionals can use these findings to enhance the effectiveness of obesity prevention messages that target Hispanic adults.

Parents' perceptions of obesity prevention during infancy: a qualitative study.

Infancy appears to be a critical period for establishing a person's weight set point. It remains unclear which interventions during infancy may be most effective in preventing later obesity and which ones are most acceptable to parents. The aim of this study was to examine the attitudes of parents of children aged 2 years and under toward different obesity prevention messages and their preferences with regard to these messages. Using a qualitative research design, we conducted semistructured interviews followed by a focus group. Parents of children under 2 years of age were purposively recruited from 2 communities in British Columbia, Canada, and asked for their opinions about various health promotion messages relating to obesity prevention. A theoretical thematic analysis was used to analyze the data. Thirty-three parents participated in the study. Participants reported that many of the current recommendations (no screen time, no sugary beverages) are unrealistic, unclear and inconsistent, making them difficult to follow and causing parents to feel guilty; they had a more positive response to the feeding roles message. Parents noted the importance of starting education early and targeting the broader community. Several important and interesting themes were identified in this study, which increases our understanding of parents' attitudes toward and preferences for the messages presented. Obesity prevention information for today's busy parents needs to be realistic, supportive and timely.

Pediatric Adapted Liking Survey: A Novel, Feasible and Reliable Dietary Screening in Clinical Practice

Purpose: Rapid yet useful methods are needed to screen for dietary behaviors in clinical settings. We tested the feasibility and reliability of a pediatric adapted liking survey (PALS) to screen for dietary behaviors and suggest tailored caries and obesity prevention messages. Methods: In an observational study, children admitted to a pediatric emergency department (PED) for nonurgent care were approached to complete the PALS (33 foods, 4 nonfoods including brushing teeth). Measured height/weight were used for body mass index (BMI) percentile determination. Feasibility was assessed by response rate and PALS completion time. Reliability was assessed by internal consistency of food groups and test-retest reliability for PED-home reported PALS. Results: PALS was completed by 144 children (96% of approached) – 54% male (average age = 11 ± 3 years) with diversity in family income (43% publicly insured), race/ethnicity (15% African American, 33% Hispanic, 44% Caucasian) and adiposity (3% underweight, 50% normal, 31% overweight, 17% obese, 8% extremely obese). The average completion time was 3: 52 min, and conceptual food groups had reasonable internal reliability. From 57% (n = 82) with PED-home completion, PALS had a good/excellent test-retest reliability. Relative preferences for sweets versus brushing teeth identified unique groups of children for tailored prevention messages (high sweet/brushing preference, sweets > brushing, brushing > sweets). Females with higher adiposity reported significantly greater preference for sweet/high-fat foods, independently of demographic variables; the relationship was nonsignificant in males and with the other food groups. Conclusion: The PALS appears to be a fast, feasible and reliable dietary screener in a clinical setting to assist in forming tailored diet-related messages for dental caries and obesity prevention.

Integrated care clinic: Creating enhanced clinical pathways for integrated behavioral health care in a family medicine residency clinic serving a low-income, minority population.

Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs). We implemented the ICC at the Broadway Family Medicine Clinic serving a low-income (<$25,000 annual income/year) and minority population (>70% African American) in Minnesota. We conducted a pre- and postevaluation of the ICC during regular clinic activity. Pilot findings indicated that the creation of ICC and the use of enhanced clinical pathways (e.g., 5-2-1-0 obesity prevention messages, Transitional Care Management, postpartum depression screening visits, warm hand-offs) to facilitate regular use of integrated BH care resulted in 6 integrated care visits per BHC per clinic half-day. In addition, changes in the behavioral/mental health therapy appointment time slot (from 60 to 30 min) reduced therapy no-show rates. Transitional Care Management (TCM) visits also showed improved pre- and postchanges in patient and clinician satisfaction and reductions in patient hospital readmission rates. The transformation into a fully integrated BH family medicine clinic through the creation of ICC and enhanced clinical pathways to facilitate regular integrated BH care showed promising pilot results. Future research is needed to examine associations between ICC and patient outcomes (e.g., weight, depressive symptoms). (PsycINFO Database Record

Development of a Medical Center Kiosk to Promote Pediatric Obesity Risk Reduction

To assist with pediatric obesity risk reduction, pediatricians have partnered with the Expanded Food and Nutrition Education Program (EFNEP). Parents are referred by pediatricians to receive nutrition education in the medical clinic site provided by EFNEP. Development of an education kiosk to be placed in the clinic waiting room to facilitate pediatric obesity risk communication between parents of pediatric patients and pediatricians and increase referrals to the EFNEP intervention. Select kiosk content. Conduct formal planning meetings with researchers, medical clinic and IT (Information Technology) staff to determine type of kiosk plus location and content output (directly to patient or via medical record). Design and code kiosk program based on content selected and medical staff priorities. Content of kiosk was based on previous longitudinal validation results of two pediatric obesity risk assessment tools, Healthy Kids and My Child at Mealtime. Based on three meetings with clinic staff and physicians, and two meetings with IT staff, a small scale, mobile iPad kiosk with attached receipt style printer and location in the clinic were determined. The kiosk programming generated tailored pediatric obesity prevention messages based on a 21-item survey. The tailored printout encourages the parent to discuss messages with their pediatrician and the EFNEP intervention offered at the clinic. Development of a medical center kiosk to facilitate pediatric obesity risk reduction requires collaboration between content experts, clinic staff, IT personal, design and programming experts. Printing nutrition messages via iPad kiosk proved challenging due to medical center Wi-Fi connectivity and security issues. The kiosk will be pilot tested with parents in spring 2017.

Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

BackgroundChildhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services.MethodsWe conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia.ResultsThematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers.ConclusionThis study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD communities to ensure equitable delivery of care. Collaborative approaches between health systems, immigrant services, early years’ services and community health services are urgently needed to address obesity-related disparities in Australia.

Preventing Obesity and Eating Disorders in Adolescents.

Obesity and eating disorders (EDs) are both prevalent in adolescents. There are concerns that obesity prevention efforts may lead to the development of an ED. Most adolescents who develop an ED did not have obesity previously, but some teenagers, in an attempt to lose weight, may develop an ED. This clinical report addresses the interaction between obesity prevention and EDs in teenagers, provides the pediatrician with evidence-informed tools to identify behaviors that predispose to both obesity and EDs, and provides guidance about obesity and ED prevention messages. The focus should be on a healthy lifestyle rather than on weight. Evidence suggests that obesity prevention and treatment, if conducted correctly, do not predispose to EDs.

Readiness of communities to engage with childhood obesity prevention initiatives in disadvantaged areas of Victoria, Australia.

Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives. Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives. Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score=4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives. Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia. What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities' readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities. However, no studies in Australia have assessed disadvantaged communities' readiness to engage in obesity prevention initiatives. What does this paper add? This paper addresses the current gap in the knowledge of disadvantaged communities' level of readiness to engage in childhood obesity prevention initiatives in Australia. The study also identified the key factors responsible for low readiness of disadvantaged communities to participate in current childhood obesity prevention services. By using the Community Readiness model this study shows the readiness levels specific to the various dimensions of the model; Understanding dimension-specific readiness allows us to identify strategies that are tailored to each dimension, as guided by the model. What are the implications for practitioners? With the increasing burden of childhood obesity on disadvantaged communities, policymakers and health practitioners are facing a crisis in obesity prevention and management. Almost every year, new interventions are being planned and implemented. However if the target communities are not ready to participate in the available interventions these efforts are futile. This study exposes the key factors responsible for low readiness to participate in current obesity prevention services by disadvantaged communities. Addressing these key factors and improving readiness before designing new interventions will improve the participation of disadvantaged communities in those interventions. The study findings ultimately have the potential of reducing obesity-related disparities in Australia.

Eat, play, view, sleep: Exploring Mexican American mothers' perceptions of decision making for four behaviors associated with childhood obesity risk

ObjectiveThis mixed methods study sought to understand who makes decisions about whether preschool-aged Mexican American children engage in eating, outdoor play, sleep, and screen time behaviors. MethodsForty Mexican American mothers of children ages 3–4 participated in two interviews, during which both closed- and open-ended questions elicited perceptions of who made decisions for the four behaviors, as well as who was present, mealtime rules, and food choice values. Interviews were transcribed, coded for emergent themes, and compared across participants. ResultsParticipants generally perceived themselves to be primary decision makers for all four behaviors; however, food decisions often seemed to be made collaboratively with the child. Fathers were most likely to participate in evening television decisions. Other family members were rarely mentioned. Selecting foods that children liked was a strong food choice value, while cost was rarely mentioned. Participants appeared to have low perceived control over their child's behaviors relative to their perceived roles in decision making. ConclusionsMothers may be the primary audience for obesity prevention messages for preschool-aged, Mexican American children; however, health promotion programs may need to increase mothers' awareness of their control over children's behaviors. Understanding how children's behaviors are regulated is an important aspect of obesity prevention for low-income, Mexican American children.

A Pilot Study To Explore How Low-Income Mothers of Different Ethnic/Racial Backgrounds Perceive and Implement Recommended Childhood Obesity Prevention Messages

Mothers often serve as the "gatekeepers" of food and the eating experience for young children in the home. Children of different ethnic/racial groups have different obesity prevalence rates, but little is known about how mothers of these groups interpret or implement common childhood obesity prevention messages. The purpose of this mixed methods pilot study was to explore comprehension and implementation of common childhood obesity prevention messages and to identify feeding styles among low-income mothers of young children. White, black, and Hispanic low-income mothers (n=30) of children ages 3-10 were recruited from Indiana. Mothers were interviewed individually regarding the perception and implementation of eight commonly used nutrition and/or physical activity messages. Other outcomes included the results of the Caregiver Feeding Styles Questionnaire and self-reported weight of mothers and child(ren). Interviews were analyzed using thematic analysis to find common themes among the different ethnic/racial groups. Childhood obesity prevention messages were often interpreted or implemented differently among the different ethnic/racial groups. For example, white mothers cited control as a means to manage a child's weight more often compared to the other racial/ethnic groups, whereas black and Hispanic mothers reported catering to a child's preference more frequently compared to white mothers. The pilot study provides evidence that it may be prudent to tailor nutrition messages to mothers of different ethnic/racial backgrounds during nutrition education.

Perceptions of factors and messages related to childhood obesity among Mexican‐origin parents

The purpose of this qualitative study was to examine perceptions, barriers, and opportunities related to the prevention of childhood obesity in a Mexican‐origin population. Following a protocol described by Krueger and Casey, Spanish‐speaking graduate students conducted five focus groups in 2010–11 among Mexican‐origin parents (n=34) of children, ages two to eight years old, in Fresno County, CA. Transcripts were prepared, based on digital recording of the sessions, and analyzed using constant comparative analysis. Two researchers independently analyzed the data for emerging themes. When asked about factors contributing to the increase in childhood obesity in the US compared to rural Mexico, parents identified changes in physical activity, less time for food preparation, poor food quality in the US, fast food, parenting practices, and school food choices. When asked about the clarity and relevance of key obesity prevention messages, parents identified promotion of family meals and fruit and vegetables as being among the most important areas to emphasize in nutrition education programs targeting this population. Some found messages about small portion sizes confusing. Emerging themes from this research can be used to develop a culturally‐nuanced childhood obesity intervention for Mexican‐origin families. Funded by UC Davis Jastro Shields and Healthy Children, Healthy Family USDA‐NIFA grant (# 82705).

Harnessing the power of advertising to prevent childhood obesity

BackgroundSocial marketing integrates communication campaigns with behavioural and environmental change strategies. Childhood obesity programs could benefit significantly from social marketing but communication campaigns on this issue tend to be stand-alone.MethodsA large-scale multi-setting child obesity prevention program was implemented in the Hunter New England (HNE) region of New South Wales (NSW), Australia from 2005–2010. The program included a series of communication campaigns promoting the program and its key messages: drinking water; getting physically active and; eating more vegetables and fruit. Pre-post telephone surveys (n = 9) were undertaken to evaluate awareness of the campaigns among parents of children aged 2–15 years using repeat cross-sections of randomly selected cohorts. A total of 1,367 parents (HNE = 748, NSW = 619) participated.ResultsAt each survey post baseline, HNE parents were significantly more likely to have seen, read or heard about the program and its messages in the media than parents in the remainder of the state (p < 0.001). Further, there was a significant increase in awareness of the program and each of its messages over time in HNE compared to no change over time in NSW (p < 0.001). Awareness was significantly higher (p < 0.05) in HNE compared to NSW after each specific campaign (except the vegetable one) and significantly higher awareness levels were sustained for each campaign until the end of the program. At the end of the program participants without a tertiary education were significantly more likely (p = 0.04) to be aware of the brand campaign (31%) than those with (20%) but there were no other statistically significant socio-demographic differences in awareness.ConclusionsThe Good for Kids communication campaigns increased and maintained awareness of childhood obesity prevention messages. Moreover, messages were delivered equitably to diverse socio-demographic groups within the region.

Qualitative evidence of the disconnect between intent and interpretation of common child obesity prevention messages

Many health professionals disseminate similar obesity prevention messages regarding food selection and eating and physical activity behaviors, based on varying levels of supporting evidence. A pilot study of 44 low‐income mothers of children aged 4–10 years explored mothers understanding of selected messages. Mothers were asked to report perceptions of how each targeted behavior might prevent children from becoming overweight. Six states used a single recruitment strategy, interview guide and protocol based on a card sort activity with projective interviewing techniques. Targeted behaviors included eating together as a family, limiting sedentary activities, restricting access to food, portion sizes, eating out, choosing healthful foods, sweetened beverage intake and eating breakfast daily. Some surprising interpretations were revealed regarding perceived relationship of messages to weight status. Examples include eating together as a family could lead to overeating and playing video games could keep children from snacking. Informants expressed uncertainty about how eating breakfast could impact weight and confusion regarding food restriction. These findings suggest health professionals need to be clear in translating research into meaningful messages. Funding was provided by authors’ institutions.

Comparing adolescent-focused obesity prevention and reduction messages

Drug abuse, smoking, and disordered eating literature reveal that some health promoting messages can induce unintended or harmful effects on the target audience. Scholars recommend careful messaging in social marketing campaigns, by shifting the focus away from health outcomes. This study tests the effects of adolescent-targeted obesity prevention messages (body-image, health benefit) with positive experience and unrelated messages on health behavior intentions and unintended effects. A pre-post experiment ( N = 95) reveals that body-image public service advertisements (PSAs) may increase anxiety when compared to unrelated PSAs (no main effect, significant planned comparisons are found). Health benefit PSAs are more readable ( F = 4.59, p < .05) than all other PSA groups and show higher healthy eating planning ( F = 3.19, p < .05) compared to unrelated ones. No significant weight attitudes, self-esteem, and stages of change differences are found by message type. Overall, health benefit messages are not less effective.

Overview of the expert committee's recommendations for prevention, diagnosis, and treatment of child and adolescent obesity

To revise the 1998 recommendations on childhood obesity, an expert committee comprised of representatives from 15 professional organizations appointed experienced scientists and clinicians to be members of three writing groups to review the literature and recommend approaches to the prevention, assessment, and treatment of childhood obesity and overweight. Providers, including pediatric cardiologists, can now provide obesity prevention messages for most children and suggest weight-control interventions for those with excess weight. Body mass index (BMI) should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risk to assess a child's obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors which are likely to promote the maintenance of a healthy weight. For assessment, the recommendations include methods to screen for current medical conditions and future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose four stages of obesity care. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic, and also identify ways healthcare providers and healthcare systems can be part of broader efforts.