Browsing by Subject "Childhood obesity"
Now showing 1 - 10 of 10
Results Per Page
Sort Options
Item Characteristics of achieving clinically important weight loss in two paediatric weight management interventions(Wiley, 2021) Fiechtner, Lauren; Castro, Ines; Cheng, Erika R.; Sharifi, Mona; Gerber, Monica W.; Luo, Man; Goldmann, Don; Sandel, Megan; Block, Jason; Orav, E. John; Taveras, Elsie M.; Pediatrics, School of MedicineObjective: To examine characteristics and lifestyle behaviours associated with achieving clinically important weight loss (CIWL) in two paediatric weight management interventions (PWMIs). Methods: We examined 1010 children enrolled in the STAR and Connect for Health trials. We defined achieving CIWL as any participant who had decreased their BMI z-score by ≥0.2 units over 1 year. Using log-binomial regression we examined associations of child and household characteristics and lifestyle behaviours with achieving CIWL. Results: In multivariable analyses, children with severe obesity had a lower likelihood of achieving CIWL compared to children without severe obesity (RR: 0.68 [95% CI: 0.49, 0.95]). Children who were ≥10 years were less likely to achieve CIWL (RR: 0.56 [95% CI: 0.42, 0.74]) vs those 2-6 years of age. Children who consumed <1 sugary beverage per day at the end of the intervention were more likely to achieve CIWL vs those who did not meet the goal (RR: 1.36 [95% CI 1.09-1.70]). Conclusion: In this analysis of children enrolled in PWMIs, achieving CIWL was associated with younger age, not having severe obesity and consuming fewer sugary beverages at the end of the intervention. Focusing on intervening earlier in life, when a child is at a lower BMI, and reducing sugary beverages could allow for more effective PWMI's.Item The effect of sugar-sweetened beverage consumption on childhood obesity - causal evidence(2016-05-18) Yang, Yan; Terza, Joseph V.; Courtemanche, Charles; Jung, Haeil; Mak, Henry Y.; Wu, JisongCommunities and States are increasingly targeting the consumption of sugar sweetened beverages (SSBs), especially soda, in their efforts to curb childhood obesity. However, the empirical evidence based on which policy makers design the relevant policies is not causally interpretable. In the present study, we suggest a modeling framework that can be used for making causal estimation and inference in the context of childhood obesity. This modeling framework is built upon the two-stage residual inclusion (2SRI) instrumental variables method and have two levels – level one models children’s lifestyle choices and level two models children’s energy balance which is assumed to be dependent on their lifestyle behaviors. We start with a simplified version of the model that includes only one policy, one lifestyle, one energy balance, and one observable control variable. We then extend this simple version to be a general one that accommodates multiple policy and lifestyle variables. The two versions of the model are 1) first estimated via the nonlinear least square (NLS) method (henceforth NLS-based 2SRI); and 2) then estimated via the maximum likelihood estimation (MLE) method (henceforth MLE-based 2SRI). Using simulated data, we show that 1) our proposed 2SRI method outperforms the conventional method that ignores the inherent nonlinearity [the linear instrumental variables (LIV) method] or the potential endogeneity [the nonlinear regression (NR) method] in obtaining the relevant estimators; and 2) the MLE-based 2SRI provides more efficient estimators (also consistent) compared to the NLS-based one. Real data analysis is conducted to illustrate the implementation of 2SRI method in practice using both NLS and MLE methods. However, due to data limitation, we are not able to draw any inference regarding the impacts of lifestyle, specifically SSB consumption, on childhood obesity. We are in the process of getting better data and, after doing so, we will replicate and extend the analyses conducted here. These analyses, we believe, will produce causally interpretable evidence of the effects of SSB consumption and other lifestyle choices on childhood obesity. The empirical analyses presented in this dissertation should, therefore, be viewed as an illustration of our newly proposed framework for causal estimation and inference.Item Forever-Fit Summer Camp: The Impact of a 6-Week Summer Healthy Lifestyle Day Camp on Anthropometric, Cardiovascular, and Physical Fitness Measures in Youth With Obesity(SAGE, 2020-01) El Mikati, Hala K.; Boateng, Anthony O.; McKinney, Brett M.; Haberlin-Pittz, Katie; Pike, Julie; Perry, Patrick; Hannon, Tamara S.; Yazel-Smith, Lisa; Medicine, School of MedicinePediatric obesity is a public health concern with lifestyle intervention as the first-line treatment. Forever-Fit Summer Camp (FFSC) is a 6-week summer day program offering physical activity, nutrition education, and well-balanced meals to youth at low cost. The aim of the study was to assess the efficacy of this program that does not emphasize weight loss rather emphasizes healthy behaviors on body mass index, cardiovascular and physical fitness. Methods: The inclusion criteria were adolescents between 8 and 12 years and body mass index (BMI) ≥85th percentile. The data were collected at baseline and week 6 (wk-6) and was analyzed for 2013-2018 using paired-sample t tests. Results: The participants' (N = 179) average age was 10.6 ± 1.6 years with a majority of females (71%) and black race/ethnicity (70%). At wk-6, BMI and waist circumference decreased by 0.8 ± 0.7 kg/m2 and 1.0 ± 1.3 in, respectively. Resting heart rate, diastolic and systolic blood pressure decreased by 8.5 ± 11.0 bpm, 6.3 ± 8.8 mmHg, and 6.4 ± 10.1 mmHg, respectively. The number of pushups, curl-ups, and chair squats were higher by 5.8 ± 7.5, 6.7 ± 9.1, and 7.7 ± 8.5, respectively. Conclusion: The FFSC is efficacious for improving BMI, cardiovascular, and physical fitness in the short term. The effect of similar episodic efforts that implement healthy lifestyle modifications throughout the school year should be investigated.Item Listening to the community: identifying obesity prevention strategies for rural preschool-aged children(Frontiers Media, 2024-05-31) Pope, Katherine Jochim; Lightfoot, Alexandra F.; Harrison, Lisa Macon; Getz, Deborah; Gittelsohn, Joel; Ward, Dianne; Hannon, Tamara S.; Erinosho, Temitope; Pediatrics, School of MedicineMulti-level interventions promoting healthy weight in rural preschool children aged 2–5 years are limited. With the goal of developing a community-informed obesity prevention intervention for rural preschool-aged children, the purpose of this descriptive study was to identify: (1) community settings and intervention strategies to prioritize for an intervention; (2) potential implementation challenges and solutions; and (3) immediate interventions the study team and community partners could collaboratively implement. Workshops occurred in two rural communities in Indiana (2 workshops) and North Carolina (2 workshops), with high obesity rates. A guide was developed to moderate discussions and participants voted to rank community settings and intervention strategies. There were 9–15 participants per workshop, including parents, childcare providers, and representatives of community organizations. Community settings identified as priorities for child obesity prevention included the home, educational settings (preschools), food outlets, recreational facilities, and social media. Priority intervention strategies included providing nutrition and physical activity education, increasing access to healthy foods and physical activity in the built environment, and enhancing food security. Potential intervention implementation challenges centered on poor parental engagement; using personalized invitations and providing transportation support to families were proffered solutions. Immediate interventions to collaboratively implement focused on making playgrounds esthetically pleasing for physical activity using game stencils, and nutrition education for families via quarterly newsletters. This participatory approach with community partners provided insight into two rural communities’ needs for child obesity prevention, community assets (settings) to leverage, and potential intervention strategies to prioritize. Findings will guide the development of a multi-level community-based intervention.Item Multilevel Correlates of Healthy BMI Maintenance and Return to a Healthy BMI among Children in Massachusetts(Mary Ann Liebert, 2017-04) Fiechtner, Lauren; Cheng, Erika R.; Lopez, Gabriel; Sharifi, Mona; Taveras, Elsie M.; Pediatrics, School of MedicineOBJECTIVES: To examine predictors of healthy BMI maintenance (HBM) or return to a healthy BMI (RHB) among children. METHODS: We studied 33,272 children in Massachusetts between 2008 and 2012. We used multinomial logistic regression to examine associations of individual- and neighborhood-level factors with the odds of: (1) HBM: maintenance of a healthy BMI ≥5th to <85th percentile and (2) RHB: transition to a healthy BMI range from an initial BMI ≥85th percentile between two clinic visits spanning an average of 3.5 years. RESULTS: Racial/ethnic minorities had lower odds of HBM and RHB than non-Hispanic white children. Higher neighborhood educational attainment was associated with an increased odds of HBM and RHB. Higher neighborhood median household income, proximity to a supermarket, and access to more open recreational space were associated with a higher odds of HBM. Children of ages 2-5 years at baseline had higher odds of RHB and HBM than children 13 years and older. CONCLUSIONS: Early childhood interventions and efforts to create health-promoting neighborhoods including improving access to supermarkets and open recreational space could have important effects on obesity prevention and management.Item Physical and psychosocial determinants of quality of life in children with obesity(Elsevier, 2023-07-23) Mansker, Beau L.; Schwartzkopf, Katherine; Velez, Jose A., II; Perkins, Anthony J.; Naramore, Sara K.; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthBackground: Obesity has a negative impact on the physical and psychosocial quality of life of children. As rates of obesity continue to increase, it is important to recognize the widespread effects obesity has on children and their families. Methods: This clinical investigation evaluated the self-reported quality of life of children with obesity in a weight management program and compared this to a parent/guardian's perspective of the child's quality of life using the Pediatric Quality of Life survey 4.0. The quality of life of children with obesity was compared to children with other chronic diseases and healthy children. Results: An association was discovered between the guardians' responses to the Pediatric Quality of Life survey and the child's age. Guardians with children younger than 11 years reported higher quality of life scores than guardians of children 11 years and older. Race, comorbidities of obesity, insurance type, household structure, and parental education attainment were not significantly associated with a child's quality of life. Children with obesity had a lower quality of life compared to children who were organ transplant recipients and children with organic gastrointestinal disease. Conclusions: These results emphasize the need to evaluate and treat the physical and psychosocial components of wellbeing in children with obesity at an early age.Item Stakeholder perspectives on barriers for healthy living for low-income african american families(Frontiers Media S.A., 2014-12-04) Jones, Veronnie Faye; Rowland, Michael L.; Young, Linda; Atwood, Katherine; Thompson, Kirsten; Honaker, Sarah Morsbach; Williams, Joel E.; Johnson, Knowlton; Davis, Deborah Winders; Department of Pediatrics, IU School of MedicineBACKGROUND: Childhood obesity is a growing problem for children in the United States, especially for children from low-income, African American families. OBJECTIVE: The purpose of this qualitative study was to understand facilitators and barriers to engaging in healthy lifestyles faced by low-income African American children and their families. METHODS: This qualitative study used semi-structured focus group interviews with eight African American children clinically identified as overweight or obese (BMI ≥ 85) and their parents. An expert panel provided insights in developing culturally appropriate intervention strategies. RESULTS: Child and parent focus group analysis revealed 11 barriers and no definitive facilitators for healthy eating and lifestyles. Parents reported confusion regarding what constitutes nutritional eating, varying needs of family members in terms of issues with weight, and difficulty in engaging the family in appropriate and safe physical activities; to name a few themes. Community experts independently suggested that nutritional information is confusing and, often, contradictory. Additionally, they recommended simple messaging and practical interventions such as helping with shopping lists, meal planning, and identifying simple and inexpensive physical activities. CONCLUSION: Childhood obesity in the context of low-resource families is a complex problem with no simple solutions. Culturally sensitive and family informed interventions are needed to support low-income African American families in dealing with childhood obesity.Item The Association of Food Insecurity on Body Mass Index Change in a Pediatric Weight Management Intervention(Wiley, 2023) Persaud, Alicia; Evans, E. Whitney; Perkins, Meghan; Simione, Meg; Cheng, Erika R.; Luo, Mandy; Burgun, Rachel; Taveras, Elsie M.; Fiechtner, Lauren; Pediatrics, School of MedicineBackground: Childhood obesity is a critical public health concern. One potential determinant to obesity that is less understood is food insecurity. Objective: To examine the association of food security status on body mass index (BMI) change in a Pediatric Weight Management Intervention (PWMI) consistent with national treatment recommendations. Methods: This analysis included 201 participants from the Healthy Weight Clinic (HWC). Using linear mixed models, we compared BMI and %BMIp95 change per year between the food insecure group and food secure group, adjusting for baseline BMI, age and sex, and SNAP enrolment. Results: In fully adjusted models, children in households with food insecurity had a 0.50 (0.26-0.74) kg/m2 BMI increase per year and a 2.10 (1.02-3.19) %BMIp95 increase per year compared to households that were food secure. Conclusions: When comparing the BMI effect of the HWC between the food insecure group and food secure group, those experiencing food insecurity in the HWC had an increase in BMI compared to those with food security. These findings suggest that food insecurity may reduce the effectiveness of PWMIs consistent with national recommendations; however, more studies should be conducted to better understand this relationship.Item UNTITLED(Office of the Vice Chancellor for Research, 2012-04-13) Mohamed, Nasra; Sener, Cansu; Starks, JoyChildhood obesity has more than tripled in the past 30 years. The num-ber of children diagnosed as obese from ages 6 to 11 has increased from 7% in 1980 to 20% in 2008. Obese children are more likely to become obese adults, and they are at the risk for adult health problems such as diabetes and heart diseases. The management of childhood obesity is in prevention, which includes changing lifestyle habits and physical activity. Dietary behav-ior and physical activity are influenced by many factors such as the envi-ronment and family. Although there are many programs that target adult obesity, treatment for childhood obesity is primarily limited to clinical set-tings and may not be accessible to children living in vulnerable populations. There is a need to provide effective treatment for obese children in commu-nity-based settings. The goal of this project is to create a fun e-book that targets children with entertaining, interactive technology that will teach and entice them to participate in eating healthy and exercising regularly. It also will guide and support the children to make healthier and informed choices. The e-book is designed as an educational tool for children, with variety of features that will help children engage in managing their weight. Features such as animated pictures, flip pages with real book sounds, pages that can zoom in and out, embedded videos, the ability to highlight, and a search en-gine, will help illustrate the meaning of a healthy body and food, with tested examples. The sound effects and highlight features will help children to fol-low the stories more easily. Search engines and hyperlinked words will assist with pronunciation and will help children understand and interact with the e-book. The effectiveness of this e-book will be evaluated by surveying the children after its use.Item Urban Park Development and Pediatric Obesity Rates: A Quasi-Experiment Using Electronic Health Record Data(MDPI, 2016-04-08) Goldsby, TaShauna U.; George, Brandon J.; Yeager, Valerie A.; Sen, Bisakha P.; Ferdinand, Alva; Sims, Devon M. T.; Manzella, Bryn; Cockrell Skinner, Ashley; Allison, David B.; Menachemi, Nir; Department of Health Policy and Management, Richard M. Fairbanks School of Public HealthINTRODUCTION: Childhood obesity affects ~20% of children in the United States. Environmental influences, such as parks, are linked with increased physical activity (PA). OBJECTIVE: To examine whether changes in Body Mass Index (BMI) z-score were associated with construction of a new park. METHODS: A quasi-experimental design was used to determine whether living in proximity of a park was associated with a reduction in BMI z-score. Children were selected from health clinics within an 11 mile radius of the park. A repeated-measure ANOVA was employed for analysis of the relationship between exposure (new park) and BMI z-score. RESULTS: Participants were 1443 (median age 10.3 range (2-17.9 years), BMI: z-score 0.84 ± 1.09) African American (77.4%) adolescents. Change in BMI z-score was not statistically different for children living at different distances from the park after controlling for age, gender, race, ethnicity, or payer type (p = 0.4482). We did observe a small 0.03 increase in BMI z-score from pre- to post-park (p = 0.0007). There was a significant positive association between child's baseline age and BMI z-score (p < 0.001). CONCLUSIONS: This study found proximity to a park was not associated with reductions in BMI z-score. Additional efforts to understand the complex relationship between park proximity, access, and PA are warranted.