The home environment is considered one of the most important settings in regards to the development of healthy eating habits among children. The primary purpose of this study was to explore parents' ...barriers and strategies in promoting healthy eating in the home. The secondary objective was to determine whether the barriers and strategies parents had were different between healthy weight and overweight/obese school-age children. Semi-structured individual interviews with 14 parents of healthy weight and 11 parents of overweight/obese children (6–12 years) were conducted in family homes from August 2014 to March 2015. Transcripts were recorded and codes and themes were verified by the research team and one qualitative expert. Themes emerging from both parents of healthy weight and overweight/obese children were: 1) Parents are busy and strapped for time; 2) Cost is a barrier in providing healthy food, but parents are resourceful; 3) Children ask for junk food regularly, but parents have strategies to manage; 4) Picky eaters are a challenge but parents know they have to overcome this barrier; and 5) Early exposure to unhealthy eating influences children's food choices but strategies can help. However, parents of overweight/obese children felt a lack of support from their spouses/partners for healthy eating in the home, which was not expressed among parents of healthy weight children. Additionally, barriers and strategies were similar among parents of children from different age groups 6–9 years vs. 10–12 years (pre-adolescents). Our results suggest while parents faced some challenges in promoting healthy eating in the home, they utilized several strategies to overcome these barriers, which are valuable for direct intervention to improve home food environment and manage children's weight.
Purpose:
Examining the effect of a workplace weight-loss program on weight loss, and physical, behavioral and mental well-being among overweight/obese healthcare workers.
Design:
Quasi experimental ...design
Setting:
Single healthcare setting
Participants:
Forty-one (48.0 ± 11.2 years) day-time shift healthcare employees with body mass index BMI >29 kg/m2.
Intervention:
Sixteen-week program with weekly group meetings/activities and individual appointments with nutrition/health experts.
Measures:
Objective (weight, BMI, blood pressure) and self-reported measures were collected at baseline, conclusion of the intervention and 3 to 6 months post-intervention.
Analysis:
Repeated measure analysis accounting for confounders.
Results:
Participants had an average of 13 pounds (5.6%) weight loss (224.2 ± 6.4 vs. 211.6 ± 6.4 lbs.; P < 0.0001) upon program completion with significant decreases in BMI (37.7 ± 1.0 vs. 35.1 ± 1.0 kg/m2; P < 0.0001). Extreme obesity (BMI≥40 kg/m2) rate was reduced from 36.6% to 17.1% (P < 0.0001). There were decreases in diastolic blood pressure (76.0 ± 1.4 vs. 68.7 ± 1.5 mmHg; P = 0.001) and self-reported blood glucose (119.9 ± 4.4 vs. 105.5 ± 4.6 mg/dL; P = 0.03). Participants had improvements in weekly physical activity (25% change; P = 0.01), nutrition behavior (33% change, P < 0.0001), sleep quality (23% change, P = 0.005), and depression (72% change, P < 0.0001). Twenty-seven participants had post-intervention follow-up data. On average participants regained 8 pounds, which was less than the initial weight loss (16 lbs., N = 27).
Conclusion:
The results suggest the program may benefit healthcare employees. Further emphasis should be placed on post-intervention weight management to prevent weight regain.
This study examines the effects of educational text messages on diabetes self-care activities, cardiovascular disease (CVD) risk awareness, and home food availabilities related to food choices among ...patients with type 2 diabetes. Quasi-experimental design was used with 40 patients (58.0 ± 10.6 years) in the intervention group and 39 (55.7 ± 12.2 years) in the control group. In addition to the usual care provided for all participants, the intervention group received three educational text messages weekly for 12 weeks. Pre- and post-intervention measures were collected for both groups. Ninety-four percent of the participants receiving text messages indicated the usefulness of this program. The intervention group either maintained the same level or demonstrated small improvements in diabetes self-care activities after the intervention. Significant increases in scores of CVD risk awareness (57% increase;
= 0.04) and availabilities of fresh fruits (320% increase;
= 0.01) and fresh vegetables (250% increase;
= 0.02) in the home and weekly total (16% increase;
= 0.02) and moderate/vigorous (80% increase;
= 0.006) physical activity levels were observed for the intervention group relative to the control group. The pilot results suggest the feasibility and usefulness of the text message program for diabetes education. The study is registered with Clinical Trials.gov (NCT03039569).
This study examined the effects of educational text messages on diabetes self-care, cardiovascular disease (CVD) risk awareness and food choices (home food availability) among patients with type 2 ...diabetes. Quasi-experimental design was used with 40 patients (58.0±10.6 years) in the intervention and 39 (55.7±12.2 years) in the control group. In addition to the usual care provided for all participants, the intervention group received three educational text messages weekly for 12 weeks (total of 36 text messages). Pre- and post-intervention measures were collected for both groups. Analysis of covariance was used to assess the intervention effects. Ninety-four percent (94%) of the participants receiving text messages indicated the usefulness of this program and would highly recommend this program to others with type 2 diabetes. The intervention group either maintained the same level at baseline or demonstrated a trend of improvement in self-care activities (healthy eating, exercise, blood glucose testing, medication adherence and foot care) after intervention. Non-statistical significant improvements in weekly MET (Metabolic Equivalent Test) minutes for total minutes of exercise (absolute change=768 minutes; p=0.62) and moderate/vigorous physical activities (absolute change=1688 minutes, p=0.62) were observed for the intervention group. There was no significant differences in nutrients intake (carbohydrate, sugar, added sugar, total fat, and saturated fat) between the intervention and control group at baseline and at 12-week follow-up and no significant changes were observed for dietary nutrients after intervention. However, significant increases in scores of CVD awareness (P=0.04) and availability of fresh fruits (P=0.01) and fresh vegetables (P=0.02) in the home were observed for intervention relative to control group. The pilot results suggest the feasibility and usefulness of the text message program for diabetes education.
Disclosure
M.J. Nepper: None.
Funding
University of Nebraska-Lincoln
Given the importance of parental influence on children’s eating habits, we explored perceptions of parents of overweight (body mass index–for-age percentile ≥85%) preschoolers (3-5 years) and ...overweight school-aged children (6-12 years) regarding challenges in promoting fruit and vegetable intake and how they and other family members influence their overweight children’s dietary habits. Focus groups were conducted with 13 parents of overweight preschoolers and 14 parents of overweight school-aged children. Codes and themes were developed by inductive data analysis. Four common themes were identified: short shelf life of fresh fruits and vegetables prohibiting parents from purchasing, children’s taste changes in fruits and vegetables, parents having the primary influence on children’s dietary intake, and wanting fruits and vegetables “ready to go.” Parents of school-aged children were more concerned about their children’s weight, and extended family members negatively influenced children’s dietary intake compared with parents of preschoolers. Our findings provide valuable insight for nutrition/health educators when developing family-based interventions for weight management.
Abstract only
Background
Given the importance of parental influences on children's fruit and vegetable intakes and limited research conducted on parental views of providing fruit and vegetables to ...their children in the home, the objective of the study was to explore and compare parental perceptions of barriers and motivations in providing fruits and vegetables in the home environment between overweight/obese preschoolers (3–5 years) and overweight/obese school‐aged children (6–12 years).
Methods
A total of 13 parents of overweight/obese (>85
th
%) preschoolers and 14 parents of overweight/obese (>85
th
%) school‐aged children, recruited from Early Head Start and Head Start programs (preschoolers) and family‐based weight management programs (school‐aged children) participated in the qualitative study with focus group interviews from February 2015 to September 2015. Qualitative codes and themes regarding parental views were developed using content analysis, and were verified by the research team and qualitative experts.
Results
There were similarities and a few differences between parents of preschoolers and school‐aged children in barriers and motivations in providing fruits and vegetables in the home. Common barriers between both groups of parents were children less accepting of vegetables, the high price of fruits and vegetables, possible wasting of fruits and vegetables if not eaten before spoiling, and that if fruits and vegetables were not “ready to go”, they were less likely to be eaten. Parents of overweight/obese school‐aged children were more concerned regarding their child's weight and that extended family members (such as grandparents) were viewed as more of a negative influence compared to parents of overweight/obese preschoolers.
Conclusions and Implications
These findings suggest that parents of both overweight/obese preschoolers and school‐aged children face similar yet different barriers and motivations which need to be addressed when developing intervention strategies for weight management.
Support or Funding Information
This research was supported by the Ann A. Hertzler Research Grant from Academy of Nutrition and Dietetics Foundation.
Abstract only
Objective
To compare the differences in the availability and visibility of home healthy and unhealthy foods and family meal frequency and quality between healthy weight and ...overweight/obese children.
Methods
Forty‐two overweight/obese and 40 healthy weight children (9.8±2.6 years) and their parents participated in the study. In‐home assessment for food availability and visibility was conducted and children's weight and height were measured by researchers. Self‐report survey regarding demographics and family meals were completed by the parents. Logistic regression analysis was used to examine associations of demographic characteristics, home food availability and visibility and family meal variables with children's weight status.
Results
The availability of home total unhealthy foods was significantly and inversely associated with overweight/obesity among children. The association was not significant after adjusting for single‐parent household and parent working status. Lower visibility of home total unhealthy foods (OR=0.60, 95% CI=0.39–0.92, P=0.02) and lower frequency of family meals (OR=0.10, 95% CI=0.01–0.96, P=0.02) were significantly associated with children being overweight/obese after adjustment for covariates. Parents who worked full‐time (OR=4.14, 95% CI=1.62–10.54, P=0.008), single parent household (OR=5.25, 95% CI=1.72–16.07, P=0.002), and older parents (OR=1.11, 95% CI=1.03–1.20, P=0.004) were positively associated with overweight/obesity of children.
Conclusion
Helping and educating parents to create a healthier home food environment is important for both overweight/obese and healthy weight children.
Support or Funding Information
This research was supported by the University of Nebraska‐Lincoln Research Council Faculty Seed grant and in part by Agriculture and Food Research Initiative (AFRI) Grant 2011‐67002‐30202 from the U.S. Department of Agriculture (USDA) National Institute of Food and Agriculture, Childhood Obesity Prevention: Transdisciplinary Graduate Education and Training in Nutrition and Family Sciences or Child Development or Related Fields to Prevent Childhood Obesity.
The home food environment is an important setting in regard to a child’s dietary intake and the development of obesity, since 65% to 72% of daily calories are consumed in the home. Research is ...beginning to explore how the home food environment may influence children’s weight status. It is suggested that homes with healthy weight children are more likely to have healthier food options available and limit access to unhealthy foods. Prior research on the influence of the home food environment on children and adolescent’s weight status is not clear, as some researchers have found that the home food environment does not influence the weight status of children and adolescents, while other researchers have found conflicting results. The purpose of this study is to 1) to develop and test a parent-friendly home food checklist to assess the availability and visibility of healthy and unhealthy food and beverages in the home; 2) to compare the differences in the availability and visibility of home healthy and unhealthy foods and family meal variables between healthy weight and overweight children; and 3) to explore challenges and strategies in promoting healthy eating in the home among parents of healthy weight and overweight children. The study found that the home food checklist showed acceptable validity and reliability and can be used independently by parents to assess the foods in the home. Additionally, the study found that overweight children and adolescents had lower scores of total unhealthy foods and total unhealthy refrigerator foods visible compared to healthy weight children. Overweight among children was inversely associated with refrigerator visibility of unhealthy foods in the home, and children who had family meals more frequently were less likely to be overweight. The study determined that while parents faced numerous challenges in promoting healthy eating in the home, they utilized several strategies in providing healthy foods. The home environment is complex and multifactorial and continues to warrant further research to understand fully the impact of the home environment on a child’s weight.
Primary objective: Understanding the aspects of the home food environment of children and adolescents such as the availability, accessibility, and visibility of home healthy and unhealthy foods and ...the frequency and quality of family meals is necessary for developing direct interventions for weight management. This review examined the literature on associations of home food environment including availability, accessibility, and visibility of home healthy and unhealthy foods and frequency and quality of family meals with children’s eating behaviors and weight status and methods to assess the availability and accessibility of foods in the home. Main outcomes and results: Research suggests:1) the availability and/or accessibility of home healthy or unhealthy foods were associated with children or adolescents’ dietary intakes; 2) the link between home food availability and accessibility with weight status is weak; 3) the evidence on associations of frequency or nutritional quality of family meals with weight status is inconsistent; 4) the in-home assessments for food availability, accessibility and visibility appear to be necessary; however the assessment tools may need to be further improved to capture the quantity of the healthy and unhealthy foods in the home; and 5) repeated in-home assessments are needed to help determine the stability of foods routinely purchased at home. Conclusions: The obesogenic home environment is complex. This review aims to provide valuable insights for designing direct interventions for weight management in children and adolescents by improving their home food environment.
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