Background: The home environment, which includes parenting practices, is an important setting in which children develop their health behaviors. We examined the role of parenting practices in the home environment among underserved youth.Methods: We examined baseline data of a family-focused pediatric obesity intervention. Parenting practices (monitoring, discipline, limit setting of soda/snacks [SS] and screen media [SM], pressure to eat, and reinforcement) and availability of fruits/ vegetables (FV) and sugar-sweetened beverages (SSBs), family meals, television (TV) watching during meals, TVs in the home, owning active video games/sports equipment, and household food security were assessed in 301 parent/caregivers of overweight/ obese children (ages 7-12 years; BMI ‡ 85th percentile). Associations were evaluated using Spearman's rank correlation coefficients and logistic regression models adjusted for potential confounders.Results: Parents/caregivers (ages 22-67 years) were largely Hispanic/Latino (74.1%), female (92.4%), and reported high levels of limit setting SS and low levels of pressure to eat. Parent age, gender, country of birth, and years living in the United States accounted for differences among several parenting practices. Adjusted logistic regression models identified several statistically significant associations, including: Monitoring was positively associated with availability FV (odds ratio [OR] = 2.19; 95% confidence interval [CI], 1.25, 3.82); limit setting SS was inversely associated with availability of SSBs (OR = 0.40; 95% CI, 0.21, 0.75); and limit setting SM was inversely associated with TV viewing during family meals (OR = 0.51; 95% CI, 0.31, 0.85). Nearly 40% of our population was food insecure, and food insecurity was positively associated with pressure to eat (OR = 1.77; 95% CI, 1.01, 3.15).Conclusions: Parenting practices play an important role in the home environment, and longitudinal studies are needed to examine these associations in the context of family-focused pediatric obesity interventions.

Background Lifestyle assessment and intervention tools are useful in promoting pediatric weight management. The present study aimed to establish convergent validity and reliability for a quick simple measure of food intake and physical activity/sedentary behaviour. The HABITS questionnaire can be used to identify and monitor behavioural intervention targets. Methods Thirty-five youths (ages 7–16 years) were recruited from the waiting area of the Jacobi Medical Center Child and Teen Health Services. To establish convergent validity for the HABITS questionnaire, study participants completed the HABITS questionnaire, a 24-h recall and a modified version of the Modifiable Activity Questionnaire for Adolescents (MAQ). Participants completed a second HABITS questionnaire within 1 month to assess test–retest reliability. Internal consistency for dietary and physical activity/sedentary behaviour subscales was assessed using Cronbach’s alpha, and test–retest reliability was assessed using Cohen’s Kappa coefficient. Spearman’s rank correlation coefficients were calculated for individual items using the 24-h recall and the MAQ as reference standards. Results The HABITS questionnaire subscales showed moderate internal consistency (Cronbach’s alpha of 0.61 and 0.59 for the dietary and physical activity/sedentary behaviour subscale, respectively). The test–retest reliability was 0.94 for the dietary subscale and 0.87 for the physical activity/sedentary behaviour subscale. Several items on the HABITS questionnaire were moderately correlated with information reported in the MAQ and the 24-h recall (r = 0.38–0.59, P < 0.05). Conclusions The HABITS questionnaire can reliably be used in a paediatric setting to quickly assess key dietary and physical activity/sedentary behaviours and to promote behaviour change for weight management.

BackgroundImplementing evidence-based recommendations for treating pediatric overweight and obesity is challenging in low-resource settings. We conducted a randomized controlled trial to evaluate the effects of implementing the American Academy of Pediatrics overweight/obesity recommendations using a Standard Care approach alone or with the addition of an enhanced program in a safety-net pediatric primary care setting (located in Bronx, New York, United States).MethodsIn a 12-month trial, families of children (age 7–12 years; body mass index ≥85th American percentile for age and sex; 74% self-identified as Hispanic/Latino; n = 360) were randomly assigned to receive Standard Care Alone or Standard Care + Enhanced Program. An English/Spanish bilingual staff provided the Standard Care Alone consisting of quarterly semi-structured pediatrician visits targeting family-based behavioral changes. The Standard Care + Enhanced Program was enriched with eight Skill-Building Core and monthly Post-Core Support sessions.ResultsThe mean body mass index Z-score declined in both arms (P < 0.01) with no significant difference between the Standard Care Alone (0.12 kg [SE: 0.03]) and Standard Care + Enhanced Program (0.15 kg [SE: 0.03]) arm (P = 0.15). Compared to the Standard Care Alone, the Standard Care + Enhanced Program resulted in significantly greater improvements in total cholesterol (P = 0.05), low-density lipoprotein cholesterol (P = 0.04), aspartate aminotransferase (P = 0.02), and alanine transaminase (P = 0.03) concentrations.ConclusionsSafety-net primary care settings can provide efficacious pediatric weight management services. Targeted family-based behavioral counseling helps overweight/obese children achieve a modest body mass index Z-score improvement. A more intensive lifestyle intervention program may improve some metabolic parameters.Trial registrationClinicalTrials.gov Identifier: NCT00851201. Registered 23 February 2009.Electronic supplementary materialThe online version of this article (10.1186/s12966-017-0639-z) contains supplementary material, which is available to authorized users.

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