Obesity/Overweight
Parental Predictions and Perceptions Regarding Long-Term Childhood Obesity-Related Health Risks
To assess how parents perceive long-term risks for developing obesity-related chronic health conditions.Material Hardship and Internal Locus of Control Over the Prevention of Child Obesity in Low-Income Hispanic Pregnant Women
To determine the relations between household material hardships and having a low internal locus of control over the prevention of child obesity in low-income Hispanic pregnant women.Are Graduating Pediatric Residents Prepared to Engage in Obesity Prevention and Treatment?
Little information is available to gauge residents' perceived receipt of comprehensive training and preparedness to manage children with obesity in practice.Association Between Meat and Meat-Alternative Consumption and Iron Stores in Early Childhood
To prevent iron deficiency, 2014 Canadian recommendations for healthy term infants from 6 to 24 months recommend iron-rich complementary foods such as meat and meat alternatives 2 or more times a day. The purpose of our study was to evaluate the association between meat and meat-alternative consumption and iron status in young children and the association between red meat consumption and iron status among children meeting recommendations.Hospitalization: Are We Missing an Opportunity to Identify Food Insecurity in Children?
Food security is the ability to access sufficient food to maintain a healthy, active life. Previous studies link food insecurity with adverse health outcomes. Our objectives were to determine the prevalence of food insecurity, identify sociodemographic risk factors, and quantify receipt of public nutrition assistance among recently hospitalized children in the United States.Association of Adolescent Depressive Symptoms With Health Care Utilization and Payer-Incurred Expenditures
Screening adolescents for depression is recommended by the US Preventive Services Task Force. We sought to evaluate the impact of positive depression screens in an adolescent population on health care utilization and costs from a payer perspective.Primary-Care Weight-Management Strategies: Parental Priorities and Preferences
To examine parental perspectives/rankings of the most important weight-management clinical practices and to determine whether preferences/rankings differ when parents disagree that their child is overweight.Health Care Utilization by Body Mass Index in a Pediatric Population
We tested the hypothesis that the frequency of emergency department (ED) visits, outpatient clinic visits, and hospitalizations were higher among children with higher body mass index (BMI) categories, even after controlling for demographics, socioeconomic status, and presence of other chronic medical conditions.Cost and Cost-Effectiveness of Students for Nutrition and eXercise (SNaX)
To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle school–based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education.Accuracy of Weight Perceptions in a Nationally Representative Cohort of US 8th Grade Adolescents
To describe the accuracy of weight perceptions in a nationally representative sample of US 8th graders, its relationship with weight control intentions (WCI), and the relationship of weight misperceptions and WCI with diet and activity behaviors.Treatment Interventions for Early Childhood Obesity: A Systematic Review
With 25% of preschool-age children in the United States being overweight or obese, effective interventions for these children would have significant public health implications. Randomized trials targeting this age group have been performed since the last systematic review.Table of Contents
353 Treatment Interventions for Early Childhood Obesity: A Systematic Review Byron A. Foster, Jill Farragher, Paige Parker, and Erica T. SosaOverweight and Obesity in a Sample of Children With Autism Spectrum Disorder
To determine the prevalence of overweight/obese status in children with autism spectrum disorders (ASD), identify associated characteristics, and develop a model to predict weight status.Active and Healthy Families: A Randomized Controlled Trial of a Culturally Tailored Obesity Intervention for Latino Children
There is a critical need for culturally relevant interventions to address obesity among Latino children, who have a greater risk of obesity and diabetes than non-Hispanic white children. To test the impact of a family-centered, culturally tailored obesity intervention delivered through group medical appointments on body mass index (BMI) and other measures of cardiovascular risk among Latino children.Family-Based Obesity Treatment in Children With Disabilities
To assess the relative effectiveness of an interdisciplinary, family-centered, tertiary-care pediatric weight management program for the treatment of patients with and without cognitive disabilities (CD).Asthma in US Mexican-Origin Children in Early Childhood: Differences in Risk and Protective Factors by Parental Nativity
Over 900,000 Mexican-origin children in the United States have asthma, but little is known about the extent to which development of this condition reflects early childhood exposure to social and environmental risks. The objectives of this research are to demonstrate the roles of risk and protective factors in the prevalence and severity of asthma in this population and provide comparisons with other racial/ethnic groups.Latino Parents' Perceptions of Weight Terminology Used in Pediatric Weight Counseling
To identify which English and Spanish terms Latino parents consider motivating, as well as culturally and linguistically appropriate, for provider use during weight counseling of overweight and obese Latino youth.Population-Level Obesity Surveillance: Monitoring Childhood Body Mass Index z-Score in a Safety-Net System
To determine the utility of repeated patient-level body mass index (BMI) measurements among higher-risk patients seen at safety-net clinics as a community-level monitoring tool for overweight and obesity population trends.Exploring Innovative Approaches and Patient-Centered Outcomes From Positive Outliers in Childhood Obesity
New approaches for obesity prevention and management can be gleaned from positive outliers—that is, individuals who have succeeded in changing health behaviors and reducing their body mass index (BMI) in the context of adverse built and social environments. We explored perspectives and strategies of parents of positive outlier children living in high-risk neighborhoods.Parental Guidance Advised: Associations Between Parental Television Limits and Health Behaviors Among Obese Children
To examine associations between parental limits on TV viewing and child health behaviors.Sex Differences in Adult Outcomes by Changes in Weight Status From Adolescence to Adulthood: Results From Add Health
Changes in weight status from adolescence to adulthood may be associated with varying social, vocational, economic, and educational outcomes, which may differ by sex. We studied whether there are differences in adult outcomes by sex for different weight status changes in the transition to adulthood.Interaction between Maternal Prepregnancy Body Mass Index and Gestational Weight Gain Shapes Infant Growth
To quantify the combined effect of maternal prepregnancy obesity and maternal gestational weight gain (GWG) on the shape of infant growth throughout the first year of life.Middle School Student Attitudes About School Drinking Fountains and Water Intake
To describe middle school student attitudes about school drinking fountains, investigate whether such attitudes are associated with intentions to drink water at school, and determine how intentions relate to overall water intake.Patient Reported Outcomes as Indicators of Pediatric Health Care Quality
Health care reform has increased demand for pediatric health care quality evaluations, particularly those that assess the impact of care on patient and population health outcomes. Many of today's most common childhood conditions are characterized by symptoms, behaviors, and functional limitations that are best assessed as patient reported outcomes (PROs). Although they remain greatly underutilized, PROs have the potential to improve pediatric health care quality assessment at the point of care and through system-level performance evaluations.What Can Providers Learn From Childhood Body Mass Index Trajectories: A Study of a Large, Safety-Net Clinical Population
To describe childhood weight gain using body mass index (BMI) z-score trajectories in a low-income urban safety-net population and identify among gender- and race/ethnicity-specific groups any trends for increased risk.Prevalence of Overweight and Obesity in a Large Clinical Sample of Children With Autism
Overweight and obesity are major pediatric public health problems in the United States; however, limited data exist on the prevalence and correlates of overnutrition in children with autism.Screening of Depression in Overweight and Obese Children and Adolescents Presenting for Well Child Care Visits to the Children’s Hospital University of Illinois
Studies have shown an association between the development and persistence of obesity and depression in children. Prior to our QI project, there was no screening process for depression in overweight and obese patients presenting for well child care visits (WCC).Parental Psychological Distress and Children's Mental Health: Results of a National Survey
Questions persist as to which dimensions of child mental health are most associated with parental mental health status and if these associations differ by parental gender. We assessed associations between parental psychological distress and children's mental health.Parents' Obesity-Related Behavior and Confidence to Support Behavioral Change in Their Obese Child: Data From the STAR Study
Successful childhood obesity interventions frequently focus on behavioral modification and involve parents or family members. Parental confidence in supporting behavior change may be an element of successful family-based prevention efforts. We aimed to determine whether parents' own obesity-related behaviors were related to their confidence in supporting their child's achievement of obesity-related behavioral goals.Sleep Timing Moderates the Concurrent Sleep Duration–Body Mass Index Association in Low-Income Preschool-Age Children
To test the independent main and moderating effects of sleep timing on body mass index (BMI) in low-income preschool-age children (M = 4.11 years, SD = 0.54).Moving From Research to Practice in the Primary Care of Children With Autism Spectrum Disorders
Autism spectrum disorders (ASD), once thought rare, are now commonly encountered in clinical practice. Academic pediatricians may be expected to teach medical students and pediatric residents about ASD, but most likely received limited exposure to ASD during their training. In recent years, research that informs the clinical guidance provided to pediatricians regarding surveillance, screening, and ongoing management of children with ASD has accelerated. By 24 months of age, children with ASD exhibit delays across multiple domains of development, yet the diagnosis is frequently made much later.Current Australian Pediatric Practice in the Assessment and Treatment of ADHD
To study the characteristics of children diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Australia, and the assessment and management practices of their pediatricians.Maternal Depressive Symptoms and Child Obesity in Low-Income Urban Families
To characterize the relationship between maternal depressive symptoms and child weight status, obesity-promoting feeding practices, and activity-related behaviors in low-income urban families.Accuracy of Child and Adolescent Weight Perceptions and Their Relationships to Dieting and Exercise Behaviors: A NHANES Study
Recent public health and media attention on child obesity may have altered accuracy of self-perception of obesity and associated weight control behaviors in children and adolescents. Thus, we examined whether accuracy of weight perceptions were associated with weight loss behaviors.Family Physical Activity and Meal Practices Associated With Disordered Weight Control Behaviors in a Multiethnic Sample of Middle-School Youth
Family practices around weight-related behaviors can shape children's development of disordered weight control behaviors (DWCB), such as vomiting, taking laxatives, or taking diet pills without a prescription. This study examined family meal and physical activity (PA) practices associated with DWCB among a multiethnic sample of youth.Parental and Home Environmental Facilitators of Sugar-Sweetened Beverage Consumption Among Overweight and Obese Latino Youth
To explore parental and home environmental facilitators of sugar-sweetened beverage (SSB) and water consumption among obese/overweight Latino youth.Health Status, Emotional/Behavioral Problems, Health Care Use, and Expenditures in Overweight/Obese US Children/Adolescents
To examine the association of overweight/obesity with health, health care utilization, and expenditures in a national sample of 10- to 17-year-old children and adolescents.Contents
181 Health Care for Children and Youth in the United States: 13 Years of Evidence Carolyn M. Clancy, Francis Chesley, and Denise DoughertyDo High-Risk Preschoolers or Overweight Mothers Meet AAP-Recommended Behavioral Goals for Reducing Obesity?
The American Academy of Pediatrics (AAP) has issued specific behavioral recommendations to prevent obesity. It is unclear how often high-risk preschoolers and overweight mothers meet recommended behavior goals and whether meeting these goals is negatively associated with overweight/obesity.Weight Change in Pediatric TennCare Recipients Referred to a Commercial Weight Loss Program
The epidemic of overweight and obesity in the United States is not limited to adults but also affects children and adolescents. Low-income children are disparately affected because they have an elevated risk for developing obesity. Effective interventions are urgently needed to prevent and treat obesity in children. In 2006, Tennessee Medicaid (TennCare) and Weight Watchers formed the TennCare Weight Watchers Partnership Program, which allowed pediatric recipients to attend Weight Watchers with no out-of-pocket cost.Childhood Obesity in Secondary Care: National Prospective Audit of Australian Pediatric Practice
In many countries, pediatricians offer skilled secondary care for children with conditions more challenging than can readily be managed in the primary care sector, but the extent to which this sector engages with the detection and management of obesity remains largely unexplored. This study aimed to audit the prevalence, diagnosis, patient, and consultation characteristics of obesity in Australian pediatric practices.Table of Contents
83 To Create a Better World for Children and Families: The Case for Ending Childhood Poverty Benard P. DreyerDevelopment of Mental Health Problems and Overweight Between Ages 4 and 11 Years: A Population-Based Longitudinal Study of Australian Children
To investigate timing and strength of associations between mental health and overweight in childhood; to investigate how the cumulative burden of each of these problems affects the other.Associations Between Neighborhood Resources and Physical Activity in Inner-City Minority Children
The role of neighborhood physical activity resources on childhood physical activity level is increasingly examined in pediatric obesity research. We describe how availability of physical activity resources varies by individual and block characteristics and then examine its associations with physical activity levels of Latino and black children in East Harlem, New York City.Adverse Childhood Experiences: Translating Knowledge into Identification of Children at Risk for Poor Outcomes
To pilot test a tool to screen for adverse childhood experiences (ACE), and to explore the ability of this tool to distinguish early child outcomes among lower- and higher-risk children.Associations Between Obesity and Comorbid Mental Health, Developmental, and Physical Health Conditions in a Nationally Representative Sample of US Children Aged 10 to 17
This large population-based study of US children considered the association of obesity with a broad range of comorbidities. This study examined relationships between weight status and health for US children.Dietary and Physical Activity Behaviors of New York City Children From Different Ethnic Minority Subgroups
To examine racial/ethnic differences in diet and physical activity behaviors in ethnic minority New York City children.Notes to a Young Investigator on How We Might Change the World
I'd like to express my sincere gratitude to the APA for this tremendous honor and recognition. I am also extremely grateful to my mentors: my high-school biology teacher, Ben Kirkland; my college mentor, Ernest Williams; my Robert Wood Johnson Clinical Scholars Program mentors, Alvan Feinstein and Ralph Horwitz; my Robert Wood Johnson Harold Amos Medical Faculty Development Program mentor, Sandy Schwartz; and my cherished pediatric colleagues and mentors, Michael Weitzman, Paul Wise, and Fernando Mendoza.Contents
357 Preconception Women’s Health and Pediatrics: An Opportunity to Address Infant Mortality and Family Health Tina L. Cheng, Milton Kotelchuck, and Bernard GuyerRacial/Ethnic Disparities in Health-Related Quality of Life and Health in Children Are Largely Mediated by Family Contextual Differences
To examine (1) racial/ethnic disparities in health-related quality of life (HRQOL), and overall health status among African-American, Hispanic, and white 5th graders in the general population and (2) the extent to which socioeconomic status (SES) and other family contextual variables mediate any disparities.Nutrition Education Via a Touchscreen: A Randomized Controlled Trial in Latino Immigrant Parents of Infants and Toddlers
To investigate whether educational modules presented on a touchscreen computer increase immediate nutrition and feeding knowledge in low-income, Spanish-speaking Latino immigrant parents.Exercise Intervention in Childhood Obesity: A Randomized Controlled Trial Comparing Hospital-Versus Home-Based Groups
The aim of this study was to compare the effect of a hospital clinic group- versus home-based combined exercise–diet program for the treatment of childhood obesity.Obese and Hungry in the Suburbs: The Hidden Faces of Food Insecurity
What is it about those last 30 minutes of clinic?…Accuracy of Parental Report and Electronic Health Record Documentation as Measures of Diet and Physical Activity Counseling
To determine whether parental reports and electronic health record documentation of physician counseling on nutrition and physical activity reflect actual counseling provided.A Simulation of Affordability and Effectiveness of Childhood Obesity Interventions
This study seeks to project at what level of effectiveness and cost a population-based or targeted intervention would yield a positive net economic benefit.A National and State Profile of Leading Health Problems and Health Care Quality for US Children: Key Insurance Disparities and Across-State Variations
Parent/consumer–reported data is valuable and necessary for population-based assessment of many key child health and health care quality measures relevant to both the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009 and the Patient Protection and Affordable Care Act of 2010 (ACA).The Children’s Health Insurance Program Reauthorization Act Quality Measures Initiatives: Moving Forward to Improve Measurement, Care, and Child and Adolescent Outcomes
In 2009, a publicly transparent evidence-informed process responded to the requirement of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) legislation to identify an initial core set of recommended children’s health care quality measures for voluntary use by Medicaid and the Children’s Health Insurance Program, which together cover almost 40 million of America’s children and adolescents. Future efforts under CHIPRA will be used to improve and strengthen the initial core set, develop new measures as needed, and post improved core measure sets annually beginning in January 2013.Underdiagnosis of Pediatric Obesity during Outpatient Preventive Care Visits
To examine obesity diagnosis, obesity-related counseling, and laboratory testing rates among obese pediatric patients seen in US preventive outpatient visits and to determine patient, provider, and practice-level factors that are associated with obesity diagnosis.16. Obesity and Overweight - Do Resident Physicians Recognize and Document in an at Risk Population?
The rapid increase in obesity and overweight children in the general pediatric population is a significant concern for practicing pediatricians. A recent press release sponsored by the Piedmont Healthcare Foundation found 41% of Greenville County youth overweight or obese - above the SC state rate 31.5% and the National rate 28.8%. Knowing the associated morbidity and mortality of obesity, development of a protocol to identify and treat an at risk population at the Center for Pediatric Medicine (CPM) was felt necessary.Characteristics Associated With Low Self-Esteem Among US Adolescents
Low self-esteem in adolescents has been associated with a number of risk and protective factors in previous studies, but results have been mixed. Our objective was to examine characteristics associated with low self-esteem in a large national sample of young adolescents.Use of a Pediatrician Toolkit to Address Parental Perception of Children's Weight Status, Nutrition, and Activity Behaviors
Communication of children's weight status and targeted counseling by pediatricians may change parental perceptions or child dietary and physical activity behaviors. The aim of this study was to determine whether accuracy of parental perception of children's weight status and reports of related behaviors changed following a brief pediatrics resident intervention.Changes in Body Mass Index Z Score Over the Course of the Academic Year Among Children Attending Head Start
We tested the hypothesis that among 3- to 5-year-old children attending Head Start, body mass index z score will decline during the academic year and increase during the summer.Annual Report on Health Care for Children and Youth in the United States: Racial/Ethnic and Socioeconomic Disparities in Children's Health Care Quality
The aim of this study was to explore the joint effect of race/ethnicity and insurance status/expected payer or income on children's health care quality.Maternal Perceptions of Infant Hunger, Satiety, and Pressuring Feeding Styles in an Urban Latina WIC Population
Controlling feeding styles in which parents regulate feeding without responding to child cues have been associated with poor self-regulation of feeding and increased weight, but have not been well studied in infancy. We sought to assess maternal perception of infant feeding cues and pressuring feeding styles in an urban Latina Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) population.The Contribution of Dietary Factors to Dental Caries and Disparities in Caries
Frequent consumption of simple carbohydrates, primarily in the form of dietary sugars, is significantly associated with increased dental caries risk. Malnutrition (undernutrition or overnutrition) in children is often a consequence of inappropriate infant and childhood feeding practices and dietary behaviors associated with limited access to fresh, nutrient dense foods, substituting instead high-energy, low-cost, nutrient-poor sugary and fatty foods. Lack of availability of quality food stores in rural and poor neighborhoods, food insecurity, and changing dietary beliefs resulting from acculturation, including changes in traditional ethnic eating behaviors, can further deter healthful eating and increase risk for early childhood caries and obesity.Obesity Prevention and Control: From Clinical Tools to Public Health Strategies
Four papers in this issue of Academic Pediatrics address several key aspects of the clinical and community approach to the obesity epidemic. Despite the centrality of body mass index to the assessment of obesity, the study by Oettinger and colleagues1 demonstrates that few parents in that sample had a clear understanding of the meaning of the measure. Nonetheless, the color-coding intervention of the growth charts to demonstrate healthy weight, overweight, and obesity increased parental understanding of risk.Getting a Handle on the Media: Where Should We Focus Our Efforts?
Concern about adverse effects of entertainment media have been around since movies were first exhibited in this country in 1896. Just 11 years later, Chicago became one of the first cities to censor movies, when the city council empowered the chief of police to deny permits for exhibitors to show movies with objectionable content. If denied a permit, the movie producer was required to cut scenes to meet the censor's standards. Despite ongoing concern about the “powerful” effects of entertainment media, until recently there were few studies actually linking entertainment media to what we now call risky behaviors.Color-Coding Improves Parental Understanding of Body Mass Index Charting
To assess parental understanding of body mass index (BMI) and BMI percentiles by using standard versus color-coded charts; to investigate how parental literacy and/or numeracy (quantitative skills) affects that understanding.Electronic Media Use and Adolescent Health and Well-Being: Cross-Sectional Community Study
To describe time adolescents spend using electronic media (television, computer, video games, and telephone); and to examine associations between self-reported health/well-being and daily time spent using electronic media overall and each type of electronic media.Associations Between Media Use and Health in US Children
Television viewing has been associated with poorer health attributes, but relationships between computer use and health are less clear. The aim of this study was to determine associations between TV and computer use, both separately and combined, and health attributes in US children.Prevalence and Trends of Severe Obesity Among US Children and Adolescents
To determine the extent to which the 2007 definitions for severe obesity (body mass index [BMI] ≥99th percentile for age and gender) and morbid obesity (BMI ≥40 kg/m2) affects different groups of American children and adolescents and has increased over time.Childhood Obesity and Neighborhood Food-Store Availability in an Inner-City Community
Prior studies have shown an association between fast-food restaurants and adolescent body size. Less is known about the influence of neighborhood food stores on a child's body size. We hypothesized that in the inner-city, minority community of East Harlem, New York, the presence of convenience stores and fast-food restaurants near a child's home is associated with increased risk for childhood obesity as measured by body mass index (BMI).Built Environment and Weight Disparities Among Children in High- and Low-Income Towns
To assess differences in built environment and child weight, and associations between them in high- and low-income communities.Early Childhood Health Promotion and Its Life Course Health Consequences
To explore whether health promotion efforts targeted at preschool-age children can improve health across the life span and improve future economic returns to society.How Pediatricians Can Improve Diet and Activity for Overweight Preschoolers: A Qualitative Study of Parental Attitudes
This study sought feedback from parents of overweight preschoolers on terms for overweight and treatment strategies pediatricians could use to help parents improve diet and activity for their children.Family History and Parents' Beliefs About Consequences of Childhood Overweight and Their Influence on Children's Health Behaviors
The aims of this study were to examine factors related to 1) parental perception of health risks for overweight children and 2) parents’ self-efficacy for influencing their children's dietary and physical activity behaviors, especially in relation to family history (FH) of diabetes and cardiovascular disease (CVD).
