Parents' impressions of inappropriate television content for Hispanic preschool children

Rates of childhood obesity have increased three-fold in the last 20 years, and experts estimate that well over half of adolescents with a Body Mass Index at or above the 95th percentile become obese adults. These trends are even more pronounced in ethnic minority and lower income populations that are disproportionately impacted by obesity and its complications. It would be appropriate, then, to focus obesity interventions on Hispanic children. Television viewing, especially, has been shown to contribute to obesity by increasing caloric intake and decreasing physical activity. Parent involvement has proven to be a critical component in changing children’s health behaviors. In order to explore parents’ motivations for limiting their children’s television viewing, I qualitatively analyzed data from twenty-five interviews with Houston area Head Start parents. Using Grounded Theory, four main categories of concern emerged from the audio-recorded conversations: developmentally inappropriate content, the influence of television, poor health behaviors/outcomes, and general disapproval with television. Developmentally inappropriate content was the most frequently mentioned category with 119 mentions. This included violence, the most common sub-theme. In all, parents were more concerned with television content that produced proximate consequences such as modeling violent behavior or inappropriate language. Content that encouraged behaviors that led to obesity or other delayed consequences were of less concern to the parents. This suggests that future interventions aimed at encouraging Hispanic parents to reduce their children’s television viewing should draw motivation from parents’ concerns about developmentally inappropriate content, rather than focusing on deleterious health outcomes such as obesity. ^

Validity and reliability of using MVP 4 Function Walk4Life digital pedometers to assess physical activity levels among preschool-aged Head Start children

The Surgeon General recommends preschoolers 3-5 years old accumulate 60 minutes of moderate-to-vigorous physical activity (MVPA) per day. However, there is limited data measuring physical activity (PA) and MVPA amongst this population. The purpose of this cross-sectional study is to determine the validity, reliability, and feasibility of using MVP 4 Function Walk4Life digital pedometers (MVP-4) in measuring MVPA among preschoolers using the newly modified direct observational technique, System for Observing Fitness Instruction Time-Preschool Version (SOFIT-P) as the gold standard. An ethnically diverse population of 3-5 year old underserved children were recruited from two Harris County Department of Education (HCDE) Head Start centers. For 2 days at baseline and 2 days at post-test, 75 children enrolled wore MVP-4 pedometers for approximately 6-hours per observation day and were observed using SOFIT-P during predominantly active times. Statistical analyses used Pearson "r" correlation coefficients to determine mean minutes of PA and MVPA, convergent and criterion validity, and reliability. Significance was set at p = <0.05. Feasibility was determined through process evaluation information collected during this study via observations from data collectors and teacher input. Results show mean minutes of PA and MVPA ranged between 30-42 and 11-14 minutes, respectively. Convergent validity comparing BMI percentiles with MVP-4 PA outcomes show no significance at pre-test; however, each measurement at post-test showed significance for MVPA (p = 0.0247, p = 0.0056), respectively. Criterion validity comparing percent MVPA time between SOFIT-P and MVP-4 pedometers was determined; however, results deemed insufficient due to inconsistency in observation times while using the newly developed SOFIT-P. Reliability measures show no significance at pre-test, yet show significant results for all PA outcomes at post-test (p = 0.001, p = 0.001, p = 0.0010, p = 0.003), respectively. Finally, MVP-4 pedometers lacked feasibility due to logistical barriers in design. Researchers feel the significant results at post-test are secondary to increased familiarity and more accurate placement of pedometers across time. Researchers suggest manufacturers of MVP-4 pedometers further modify the instrument for ease of use with this population, following which future studies ought to determine validity using objective measures or all-day direct observation techniques.^

Effect of parental weight status on the food packed in preschool children's lunches

Problem. Recent statistics show that over a fifth of children aged 2-5 years in 2006-2008 were overweight, with 7% above the 97 th percentile of the BMI-for-age growth charts (extreme obesity). Because poor diet is an important environmental determinant of obesity and the preschool years are crucial developmentally, examination of factors related to diet in the pre-school years is important for obesity prevention efforts. ^ Objective. The goals of this study were to determine the association between BMI of the parents and the number of servings of fruits, vegetables, and whole grains (FVWG) packed; the nutrient content of preschool children’s lunches; and norms and expectations about FVWG intake.^ Methods. This study was a cross sectional analysis of parents enrolled in the Lunch is in the Bag program at baseline. The independent measure was weight status of the parents/caregivers, which was determined using body mass index (BMI) calculated from self-reported height and weight. BMI was classified as healthy weight (BMI <25) or overweight/obese (BMI ≥25). Outcomes for the study included the number of servings of fruits, vegetables and whole grains (FVWG) in sack lunches, as well as the nutrient content of the lunches, and psychosocial constructs related to FVWG consumption. Linear regression analysis was conducted and adjusted for confounders to examine the associations of these outcomes with parental weight status, the main predictor. ^ Results. A total of 132 parent/child dyads were enrolled in the study; 59.09% (n=78) of the parents/caregivers were healthy weight and 39.01% (n=54) of the parents/caregivers were overweight/obese. Parents/caregivers in the study were predominantly white (68%, n=87) and had at least some college education (98%, n=128). No significant associations were found between the weight status of the parents and the servings of fruits, vegetables and whole grain packed in preschool children’s lunchboxes. The results were similar for the association of parental weight status and the nutrient contents of the packed lunches. Both healthy weight and overweight/obese parents packed less than the recommended amounts of vegetables (mean servings = 0.49 and 0.534, respectively) and whole grains (mean servings = 0.58 and 0.511, respectively). However, the intentions of the obese/overweight parents were higher compare to the healthy for vegetables and whole grains.^ Conclusion. Results from this study indicate that there are few differences in the servings of fruits, vegetables and whole grains packed by healthy weight parents/caregivers compared to overweight/obese parents/caregivers in a high income, well-educated population, although neither group met the recommended number of servings of vegetables or whole grains. Thus, results indicate the need for behaviorally-based health promotion programs for parents, regardless of their weight status; however, this study should be replicated with larger and more diverse populations to determine if these results are similar with less homogenous populations.^

Food availability in the home and dietary intake of the Harris County Department of Education Head Start population

Background. The prevalence of obesity and overweight children has been an ongoing health epidemic in the US for the last several decades. The problem has consistently worsened and has disproportionately been the most prevalent among low socioeconomic status (SES) populations. Food availability in the home has been suggested to be a potential factor related to overweight and obesity, as availability is likely associated with intake. Food availability of low SES preschool aged children has not been well examined. The purpose of this study was to explore the food environment of the Harris County Department of Education (HCDE) Head Start population, and describe reported frequency of intake of particular food groups. The effect of food availability on reported intake was also examined.^ Methods. This was a cross-sectional study of secondary data analysis. Data obtained from 17 HCDE Head Start Centers was analyzed using PASW 18 Statistical Software. Demographic analyses included population, age, gender, race, parent occupation, type of home, and language spoken in the home. Descriptive statistics included reported availability of foods in the home as well as frequency of intake.^ Regression analysis examined the relationship of availability of foods on intake. The food categories included were: dark leafy green and orange vegetables, other vegetables, fruits, soda, salty snacks, and sweet snacks. For both vegetable categories reported intake of fresh, frozen, and canned vegetables were included. For the fruit category, intake of fresh, frozen, canned, and dried fruits were reported.^ Results. Results showed that 90-95% of parents reported having vegetables and fruits available in the home. However, the only significant relationship between availability and intake was for fresh fruit and dried fruit. No associations were seen among the vegetable groups. Other vegetables (bell peppers, eggplant, tomatoes, onions, iceberg lettuce, asparagus) that were frozen, approached significance for availability on intake, however once adjusted for confounders the relationship was no longer present. Among soda, salty snacks, and sweet snacks the only significant relationship was seen for soda availability and intake. Salty snacks and sweet snacks presence in the home was not a predictor of increased frequency of intake.^ Conclusions. This research supported the hypothesis that availability of foods has an impact on intake for fresh fruits, dried fruits and soda. No associations were seen for vegetables, salty snacks and sweet snacks. Additionally, most of the parents reported having fruits and vegetables in the home, but reported intakes were not meeting the Dietary Guidelines for Americans recommendations. Strengths of the study included the large sample size taken from numerous HCDE Head Start Centers. Limitations included questionable reliability of participant’s responses, ability to generalize to other populations, and the use of secondary data rather than prospectively collected data.^