CONTEXT: Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention research. OBJECTIVE: This review investigated the involvement of fathers in obesity treatment and prevention programs targeting children and adolescents [0–18 years], DATA SOURCES: A systematic review of English, peer-reviewed articles across 7 databases, Retrieved records included at least 1 search term from 2 groups: “participants” (eg, child* parent*) and “outcomes”: (eg, obes* diet*). STUDY SELECTION: Randomized controlled trials [RCTs] assessing behavioral interventions to prevent or treat obesity in pediatric samples were eligible. Parents must have “actively participated” in the study DATA EXTRACTION: Two authors independently extracted data using a predefined template, RESULTS: The search retrieved 213 eligible RCTs. Of the RCTs that limited participation to 1 parent only (n = 80), fathers represented only 6% of parents. In RCTs in which participation was open to both parents (n = 133), 92% did not report objective data on father involvement, No study characteristics moderated the level of father involvement, with fathers underrepresented across all study types. Only 4 studies (2%) suggested that a lack of fathers was a possible limitation. Two studies (1%) reported explicit attempts to increase father involvement, LIMITATIONS: The review was limited to RCTs published in English peer-reviewed journals over a 10-year period, CONCLUSIONS: Existing pediatric obesity treatment or prevention programs with parent involvement have not engaged fathers. Innovative strategies are needed to make participation more accessible and engaging for fathers,
Objective To evaluate racial/ethnic disparities among children and adolescents in meeting the 4 daily 5-2-1-0 nutrition and activity targets in a nationally representative sample. The 5-2-1-0 message summarizes 4 target daily behaviors for obesity prevention: consuming ≥5 servings of fruit and vegetables, engaging in ≤2 hours of screen time, engaging in ≥1 hour of physical activity, and consuming 0 sugar-sweetened beverages daily. Study design The National Health and Nutrition Examination Survey (2011–2012) data were used. The study sample included Hispanic (n = 608), non-Hispanic black (n = 609), Asian (n = 253), and non-Hispanic white (n = 484) youth 6–19 years old. The 5-2-1-0 targets were assessed using 24-hour dietary recalls, the Global Physical Activity Questionnaire, and sedentary behavior items. Outcomes included meeting all targets, no targets, and individual targets. Multivariable logistic regression models accounting for the complex sampling design were used to evaluate the association of race/ethnicity with each outcome among children and adolescents separately. Results None of the adolescents and <1% of children met all 4 of the 5-2-1-0 targets, and 19% and 33%, of children and adolescents, respectively, met zero targets. No racial/ethnic differences in meeting zero targets were observed among children. Hispanic (aOR, 1.76 [95% CI, 1.04–2.98]), non-Hispanic black (aOR, 1.82 [95% CI, 1.04–3.17]), and Asian (aOR, 1.48 [95% CI, 1.08–2.04]) adolescents had greater odds of meeting zero targets compared with non-Hispanic whites. Racial/ethnic differences in meeting individual targets were observed among children and adolescents. Conclusions Despite national initiatives, youth in the US are far from meeting 5-2-1-0 targets. Racial/ethnic disparities exist, particularly among adolescents.
Objective Examine longitudinal associations between sources of social support and social undermining for healthy eating and physical activity and weight change. Design and Methods Data are from 633 employed adults participating in a cluster-randomized multilevel weight gain prevention intervention. Primary predictors included social support and social undermining for two types of behaviors (healthy eating and physical activity) from three sources (family, friends, and coworkers) obtained via self-administered surveys. The primary outcome (weight in kg) was measured by trained staff. Data were collected at baseline, 12 months, and 24 months. Linear multivariable models examined the association of support and social undermining with weight over time, adjusting for intervention status, time, gender, age, education, and clustering of individuals within schools. Results Adjusting for all primary predictors and covariates, friend support for healthy eating (β=−0.15), coworker support for healthy eating (β=−0.11), and family support for physical activity (β=−0.032) were associated with weight reduction at 24 months (p-values<0.05). Family social undermining for healthy eating was associated with weight gain at 24 months (β=0.12; p=0.0019). Conclusions Among adult employees, friend and coworker support for healthy eating and family support for physical activity predicted improved weight management. Interventions that help adults navigate family social undermining of healthy eating are warranted.
The COVID-19 pandemic is the greatest global public health crisis since the 1918 influenza outbreak. As of early June, the novel coronavirus has infected more than 6.3 million people worldwide and more than 1.9 million in the United States (US). The total number of recorded deaths due to COVID-19 are growing at an alarming rate globally (³383,000) and nationally (³109,000) Evidence is mounting regarding the heavier burden of COVID-19 infection, morbidity, and mortality on the underserved populations in the US. This commentary focuses on this global health pandemic and how mitigation of the virus relies heavily on health behavior change to slow its spread, highlighting how the pandemic specifically affects the most socially and economically disadvantaged populations in the US. The commentary also offers short, intermediate and long-term research and policy focused recommendations. Both the research and policy recommendations included in this commentary emphasize equity-driven: (1) research practices, including applying a social determinants and health equity lens on monitoring, evaluation, and clinical trials activities on COVID-19; and (2) policy actions, such as dedicating resources to prioritize high-risk communities for testing, treatment, and prevention approaches and implementing organizational, institutional, and legislative policies that address the social and economic barriers to overall well-being that these populations face during a pandemic. It is our hope that these recommendations will generate momentum in delivering timely, effective, and lifesaving changes.
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