Effects of Enhancing School-Based Body Mass Index Screening Reports with Parent Education on Report Utility and Parental Intent To Modify Obesity Risk Factors

Bailey‐Davis, Lisa; Peyer, Karissa L.; Fang, Yinan; Kim, Jae Kwang; Welk, Greg

doi:10.1089/chi.2016.0177

Cited by 18 publications

(28 citation statements)

References 24 publications

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“…First, because of the design of the cross-sectional survey project, which collected all of the data at a single time point, there was a limit to the inference of the causation between the chemical exposures and obesity. Second, we used the education level of the individuals themselves instead of their parents' education level, which can be a factor, since parental education can change their intention to alter the obesity risk factor [38]. Third, chemical concentrations below the limit of detection were simply replaced by the value of the limit of detection divided by the square root of 2, which may cause inaccurate results.…”

Section: Discussionmentioning

confidence: 99%

Using three statistical methods to analyze the association between exposure to 9 compounds and obesity in children and adolescents: NHANES 2005-2010

Jiang

Jin

et al. 2020

Environ Health

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Background: Various risk factors influence obesity differently, and environmental endocrine disruption may increase the occurrence of obesity. However, most of the previous studies have considered only a unitary exposure or a set of similar exposures instead of mixed exposures, which entail complicated interactions. We utilized three statistical models to evaluate the correlations between mixed chemicals to analyze the association between 9 different chemical exposures and obesity in children and adolescents. Methods: We fitted the generalized linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) to analyze the association between the mixed exposures and obesity in the participants aged 6-19 in the National Health and Nutrition Examination Survey (NHANES) 2005-2010. Results: In the multivariable logistic regression model, 2,5-dichlorophenol (2,5-DCP) (OR (95% CI): 1.25 (1.11, 1.40)), monoethyl phthalate (MEP) (OR (95% CI): 1.28 (1.04, 1.58)), and mono-isobutyl phthalate (MiBP) (OR (95% CI): 1.42 (1.07, 1.89)) were found to be positively associated with obesity, while methylparaben (MeP) (OR (95% CI): 0.80 (0.68, 0.94)) was negatively associated with obesity. In the multivariable linear regression, MEP was found to be positively associated with the body mass index (BMI) z-score (β (95% CI): 0.12 (0.02, 0.21)). In the WQS regression model, the WQS index had a significant association (OR (95% CI): 1.48 (1.16, 1.89)) with the outcome in the obesity model, in which 2,5-DCP (weighted 0.41), bisphenol A (BPA) (weighted 0.17) and MEP (weighted 0.14) all had relatively high weights. In the BKMR model, despite no statistically significant difference in the overall association between the chemical mixtures and the outcome (obesity or BMI z-score), there was nonetheless an increasing trend. 2,5-DCP and MEP were found to be positively associated with the outcome (obesity or BMI z-score), while fixing other chemicals at their median concentrations.

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Section: Discussionmentioning

confidence: 99%

Using three statistical methods to analyze the association between exposure to 9 compounds and obesity in children and adolescents: NHANES 2005-2010

Jiang

Jin

et al. 2020

Environ Health

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“…Both FNPA and Healthy Kids risk assessments offer potential value to clinicians to involve parents in selfassessing risk using validated tools. This study did not evaluate parent experience or behaviour change following FNPA risk assessment; however, promising results have been observed in earlier studies (15,16). Enhancing BMI screening with FNPA risk assessment at routine WCVs was beneficial for children aged 2-9 and 2-5 overall, specifically those with normal weight at baseline, compared with children whose parents did not complete FNPA at baseline.…”

Section: Discussionmentioning

confidence: 82%

“…Both FNPA and Healthy Kids risk assessments offer potential value to clinicians to involve parents in self‐assessing risk using validated tools. This study did not evaluate parent experience or behaviour change following FNPA risk assessment; however, promising results have been observed in earlier studies .…”

Section: Discussionmentioning

confidence: 95%

“…The present study examined the feasibility of collecting FNPA assessments under real‐world conditions and the effectiveness of integrating the assessment during WCV on child BMI over a 1‐year period. Given that exposure to FNPA has been associated with parent intent to reduce risk behaviours associated with childhood obesity , the hypothesis was that children whose parents completed the FNPA at baseline would have lower BMI at follow‐up when compared with children whose parents did not complete FNPA, regardless of whether this was due to failure or lack of opportunity to respond. Results are reported by child baseline weight category to evaluate the effectiveness of the intervention on primary and secondary prevention.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of enhancing well‐child visits with family nutrition and physical activity risk assessment on body mass index

Bailey‐Davis

Kling

Wood³

et al. 2019

Obesity Science & Practice

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Summary Objective Integration of behavioural risk assessment into well‐child visits is recommended by clinical guidelines, but its feasibility and impact is unknown. Methods A quasi‐experimental study evaluated the feasibility and effectiveness of risk assessment on body mass index (BMI) at 1‐year follow‐up. Children with assessments (intervention) were compared with those who did not complete assessments (non‐respondent) and those who received standard care (non‐exposed). Results Analyses included 10,647 children aged 2–9 years (2,724 intervention, 3,324 non‐respondent and 4,599 non‐exposed). Forty‐five per cent of parents completed the assessments. Intervention and non‐respondent groups differed in change in BMI z ‐score at 1 year by −0.05 (confidence interval [CI]: −0.08, −0.02; P = 0.0013); no difference was observed with non‐exposed children. The intervention group had a smaller increase in BMI z ‐score (0.07 ± 0.63) than non‐respondent group (0.13 ± 0.63). For children with normal weight at baseline, intervention versus non‐respondent groups differed in BMI z ‐score change by −0.06 (CI: −0.10, −0.02; P = 0.0025). However, children with overweight at baseline in the intervention versus the non‐exposed group differed in BMI z ‐score change (0.07 [CI: 0.02, 0.14]; P = 0.016). When analysed by age, results were similar for 2‐ to 5‐year‐olds, but no differences were found for 6‐ to 9‐year‐olds. Conclusion Automating risk assessment in paediatric care is feasible and effective in promoting healthy weight among preschool but not older children.

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“…Evidence has shown that clinicians who are educated about care guidelines for overweight children were more likely to report using sources such as AAP News and other journals for latest evidence on the prevention and counseling of children who are overweight (Klein et al, 2010). Furthermore, Bailey-Davis, Peyer, Fang, Kim, and Welk (2017) found that parents who received this education on home environmental strategies were more likely to engage in modifying childhood obesity risk factors. Ihmels et al (2009) developed the Family Nutrition and Physical Activity (FNPA) tool designed to screen for family environmental factors that place a child at risk of becoming overweight.…”

Section: Introductionmentioning

confidence: 99%

Effects of family nutrition and physical activity screening for obesity risk in school‐age children

Herbenick

James

Milton

et al. 2018

Specialist Pediatric Nursing

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Purpose An obesogenic home environment is a major contributor to overeating and sedentariness in school‐aged children, as children have less autonomy during this phase of development and are influenced by family environmental cues. The purpose of this study was to implement a screening tool at a low socioeconomic elementary school clinic to identify children at risk of developing obesity and provide standardization for practitioners on educating parents regarding child obesity risk factors. Design and Methods An evidence‐based practice design utilizing the Family Nutrition and Physical Activity (FNPA) tool was completed at all visits of patients ages 4 to 11. Parents completed the 20‐item screening tool related to 10 factors (family meal patterns, family eating habits, food choices, beverage choices, restriction/reward, screen time behavior and monitoring, healthy environment, family activity involvement, child activity involvement, family routine). The nurse practitioner (NP) provided parents with education regarding healthy home practices based on American Academy of Pediatrics (AAP) recommendations. Level of obesity risk (low, moderate, and high) was determined based on the FNPA score and body mass index (BMI) of the patient. Patients identified as at‐risk were scheduled for a 2‐month follow‐up and rescreened to determine if lifestyle modifications were made. Results Twenty‐seven children were screened using the FNPA tool, with an initial mean FNPA score of 64. Ninety‐three percent were classified as a moderate or high risk for obesity (BMI percentile 85th or greater and/or moderate‐high risk FNPA scores). Seven percent had a healthy BMI and low‐risk FNPA scores and did not require follow‐up intervention. Sixty‐seven percent of patients scores improved at follow‐up, with an average FNPA score of 70. Effect size stratified by risk category was low‐risk score 0.07 and moderate‐risk score 1.49 with a standard deviation of 5.36. Practice Implications Implementation of the FNPA tool at a school‐based clinic is a feasible opportunity to identify children at risk for obesity and allows for anticipatory guidance by the NP to increase awareness of parental influence as role models for healthy lifestyle behaviors.

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Effects of Enhancing School-Based Body Mass Index Screening Reports with Parent Education on Report Utility and Parental Intent To Modify Obesity Risk Factors

Abstract: Parental education can enhance the utility of the SBMIS report and parental intention to modify at least one obesity risk factor. SBMIS reports prompted parents of children with overweight and obesity to seek clinical care and limit sugar-sweetened drinks.

Cited by 18 publications

References 24 publications

Using three statistical methods to analyze the association between exposure to 9 compounds and obesity in children and adolescents: NHANES 2005-2010

Using three statistical methods to analyze the association between exposure to 9 compounds and obesity in children and adolescents: NHANES 2005-2010

Feasibility of enhancing well‐child visits with family nutrition and physical activity risk assessment on body mass index

Effects of family nutrition and physical activity screening for obesity risk in school‐age children

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