Browsing by Subject "Pediatric Obesity"

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    Characterizing Behavior Change Interventions to Improve Pediatric Obesity Prevention Research
    (2016-09) JaKa, Meghan
    Behavior change interventions to prevent pediatric obesity are critical. The efficacy of these interventions has been modest and reasons for the less-than-desired results are unclear. This dissertation includes three manuscripts aimed at characterizing and identifying effective components within the ‘black box’ of pediatric obesity prevention interventions. The first manuscript assesses the reliability of a standardized method for coding characteristics of an intervention delivered to parents of 5- to 10-year-old children at risk for becoming overweight or obese. The second manuscript evaluates if parents, when given choice in a pediatric obesity prevention intervention, spend time discussing the weight-related behaviors most relevant to their child’s obesity risk. The purpose of the third manuscript is to identify relationships between specific intervention characteristics and study outcomes (i.e., change in child weight-related behaviors and BMI percentile). By using reliable, standardized methods to identify effective intervention characteristics, this dissertation paves the way for future researchers to design more focused interventions, ultimately leading to successful prevention of pediatric obesity.
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    The positive deviance approach to childhood obesity and cardiometabolic risk in children living in low-income and racially and ethnically diverse households
    (2021-11) Nogueira de Brito, Junia
    Pediatric obesity is a highly prevalent public health problem, with children living in low-income and racially and ethnically diverse households being disproportionately affected. Food- and physical activity-related parenting practices may influence children’s weight. However, there is limited evidence about specific parenting practices that may be protective of childhood obesity among parents of children living in low-income and racially and ethnically diverse households. There is also limited evidence about longitudinal patterns of childhood adiposity and their associations with emerging cardiometabolic risk. The ‘positive deviance’ approach to childhood obesity provided a framework to characterize parenting practices associated with positive deviance and examine associations with emerging cardiovascular risk within low-income and racially and ethnically minoritized families. For manuscript 1, data were drawn from the Family Matters study to examine the association between several parenting practices and changes in child weight status over 18-months. The use of controlling food-related parenting practices was more common among parents of children identified as positive deviant relative to children with higher weight status, while parent-led weight-related conversations with their child were less common among children identified as positive deviant. For manuscript 2, data came from the NET-Works obesity prevention trial among children ages 2-4, which were followed to ages 7-11 in the NET-Works 2 study. This paper described the associations between BMI trajectories derived by group-based trajectory modeling and changes in biomarkers of cardiometabolic risk. A trajectory of increased BMI from early to middle childhood was associated with more adverse inflammatory and adipokine profiles in pre-adolescence compared to a trajectory of decreasing BMI over time. For manuscript 3, qualitative data from the Positive Deviance Project were used to identify parenting practices that might be protective of childhood obesity among children ages 2-5. The results suggested parents of children identified as positive deviant predominantly engaged in positive parenting practices relative to parents of children with higher weight status. This dissertation contributes to the understanding of positive parenting practices that may be protective for childhood obesity among families from socioeconomically disadvantaged backgrounds. Additionally, it provides longitudinal evidence that children following an increased BMI trajectory that started as young as age 2 were associated with emerging dysregulation in cardiometabolic processes.