The impact of environmental, parental and child factors on health-related behaviors among low-income children

Abstract

This was a cross sectional study of caregivers of preschool children (n = 432). Caregivers were interviewed using validated scales. Structural equation modeling was used to examine associations with the outcomes. Adjusting for study region, demographics and caregiver's body mass index, we found significant associations between PHCB and higher mealtime ritualizations (β: 0.21, 95% confidence interval [CI]: 0.11; 0.32, more parental modeling (β: 0.39, 95% CI: 0.27; 0.49) and less parental restrictive behavior (β: -0.19, 95% CI: -0.29; -0.10). More parental covert control (β: 0.44, 95% CI: 0.35; 0.54), more parental overt control (β: 0.14, 95% CI: 0.03; 0.25) and less parental permissive behavior (β: -0.25, 95% CI: -0.34; -0.09) were significantly associated with LUCB. Findings suggest the synergistic effects of mealtime ritualizations and covert control at the environmental-level and parental modeling, overt control, restrictive and permissive behavior at the parent-level on the outcomes. Most factors are modifiable and support multidisciplinary interventions that promote healthy child weight-related behaviors.

Routines and child development: A systematic review

“…Daily routines, particularly mealtimes, are associated with healthier eating habits (Bost et al, 2014; Musaad et al, 2017), such as an increased consumption of nutrient‐rich foods, including fruits and vegetables, grains, calcium‐rich foods, protein, iron, folate, fiber, and vitamins A, C, E, and B‐6 (Abar et al, 2017; Gillman et al, 2000; Lee et al, 2002; Neumark‐Sztainer et al, 2004), and decreased intake of sugary beverages and obesogenic foods (Mauskopf et al, 2015; Wenhold & Harrison, 2018). These routines can also lead to reduced picky eating in preschoolers (Cole et al, 2018), lower risk of disordered eating in children and adolescents (Ackard & Neumark‐Sztainer, 2001; Munoz et al, 2007; Neumark‐Sztainer et al, 2004), and improved nutrition in high‐risk environments (Beardslee et al, 1982; Yoos et al, 1999).…”

Parents of minor children lose less weight during a behavioral weight loss intervention: Findings from the Rural LEAP trial

“…22 With 40% of family households in the United States having minor children, 23 attendance, self-monitoring, and meeting diet and physical activity goals), all well-established mediators of weight loss. 24,25 The mechanisms by which parenting roles can influence attempts at behavior change are complex, 26,27 and may include competing demands (e.g., related to caretaking), stress and time-related barriers between work and family roles, 28 and the influence of children, family dynamics, and the home environment on food choices and screen time. [29][30][31] In…”

“…Participants with minor children performed significantly worse on key indicators of intervention adherence (session attendance, self‐monitoring, and meeting diet and physical activity goals), all well‐established mediators of weight loss. 24 , 25 The mechanisms by which parenting roles can influence attempts at behavior change are complex, 26 , 27 and may include competing demands (e.g., related to caretaking), stress and time‐related barriers between work and family roles, 28 and the influence of children, family dynamics, and the home environment on food choices and screen time. 29 , 30 , 31 In addition, parents of minor children may differ from non‐parents or parents of older children in other ways that indirectly influence weight loss success, for example, differences in living situations, neighborhood contextual factors, or prioritization of weight and health behaviors.…”

Adaptation and Validation of the Instrument ‘Children Care Quality at Hospital’ for Portuguese

“…Em relação à segunda subescala, os itens são também sobreponíveis, exceto o item já referido; por fim, na subescala "Ambiente emocional" (fator 3), os itens são integralmente sobreponíveis. O ambiente durante a hospitalização infantil é também referido na literatura como fonte de satisfação/insatisfação entre as crianças (23,(36)(37)(38). Estas salientam os aspetos físicos como o equipamento associado à prestação de cuidados (como as bombas infusoras) por ser desconhecido e ameaçador (39).…”