April Oh

Parenting Styles and Practices in Children's Obesogenic Behaviors: Scientific Gaps and Future Research Directions

Given the emerging global childhood obesity epidemic and the specter of a generation of children who will have a shorter life expectancy than that of their parents, recent research has focused on factors that influence childrens weight status and obesogenic behaviors (i.e., eating, physical activity, and screen media use). Parents act as primary socializing agents for children, and thus growing evidence supports the role of parenting styles and practices in childrens obesity-related behaviors and weight. Studying these processes in children and adolescents is important for several reasons. First, diet and physical activity behaviors and weight status track from childhood and adolescence into adulthood. Furthermore, diet and physical activity behaviors and weight status confer significant risk for cancer, diabetes, cardiovascular disease, and other chronic diseases. The purpose of this article is to describe the scientific gaps that need to be addressed to develop a more informed literature on parenting styles and practices in the domains of weight status and obesogenic behaviors, as identified by an expert panel assembled by the National Cancer Institute.

Neighborhood Environment and Adherence to a Walking Intervention in African American Women

This secondary analysis examined relationships between the environment and adherence to a walking intervention among 252 urban and suburban, midlife African American women. Participants received an enhanced or minimal behavioral intervention. Walking adherence was measured as the percentage of prescribed walks completed. Objective measures of the womens neighborhoods included walkability (land use mix, street intersection density, housing unit density, public transit stop density), aesthetics (physical deterioration, industrial land use), availability of outdoor (recreational open space) and indoor (recreation centers, shopping malls) walking facilities/spaces, and safety (violent crime incidents). Ordinary least squares regression estimated relationships. The presence of one and especially both types of indoor walking facilities were associated with greater adherence. No associations were found between adherence and other environmental variables. The effect of the enhanced intervention on adherence did not differ by environmental characteristics. Aspects of the environment may influence African American women who want to be more active.

The Association of State Law to Physical Education Time Allocation in US Public Schools

OBJECTIVES We examined whether public schools in states with specific and stringent physical education (PE) laws, as assessed by the Physical Education-Related State Policy Classification System (PERSPCS), available on the Classification of Laws Associated with School Students (C.L.A.S.S.) Web site, reported more weekly PE time in the most recent School Health Policies and Programs Survey (SHPPS). METHODS Schools (n=410) were grouped by their states PERSPCS time requirement scores (none, nonspecific requirement, or specific requirement). Average weekly school-level PE was calculated using the SHPPS-reported PE minutes. Weighted analyses determined if PE minutes/week differed by PERSPCS group. RESULTS Schools in states with specific requirement laws averaged over 27 and 60 more PE minutes/week at the elementary and middle school levels, respectively, compared with schools within states with nonspecific laws and over 40 and 60 more PE minutes per week, respectively, compared with elementary and middle schools in states with no laws. High school results were nonsignificant. CONCLUSIONS Public health guidelines recommend at least 60 minutes of daily physical activity for children, and PE may further this goal. Strong codified law with specific time requirements for PE may be an important tool contributing toward adequate PE time and daily physical activity recommendations.

Health Disparities in Awareness of Physical Activity and Cancer Prevention: Findings from the National Cancer Institute's 2007 Health Information National Trends Survey (HINTS)

This national study examines differences between racial/ethnic groups on awareness of physical activity and reduced cancer risk and explores correlates of awareness including trust, demographic, and health characteristics within racial/ethnic groups. The 2007 Health Information and National Trends Survey (HINTS) provided data for this study. After exclusions, 6,809 adults were included in analyses. Awareness of physical activity in reduced cancer risk was the main outcome. Logistic regression models tested relationships. Non-Hispanic Blacks had a 0.71 (0.54,0.93) lower odds of being aware of physical activity in reduced cancer risk than non-Hispanic Whites. Current attempts to lose weight were associated with greater odds for awareness among non-Hispanic Blacks and Hispanics (p < .01). Among non-Hispanic Blacks, trust in traditional and Internet media was associated with greater odds of awareness (p < .01). This study is the first national study to examine racial/ethnic disparities in awareness of physical activity and cancer risk. Comparisons between racial/ethnic groups found Black–White disparities in awareness. Variables associated with awareness within racial/ethnic groups identify potential subgroups to whom communication efforts to promote awareness may be targeted.

Neighborhood Characteristics, Adherence to Walking, and Depressive Symptoms in Midlife African American Women

BACKGROUND African American women have more symptoms of depressed mood than white women. Adverse neighborhood conditions may contribute to these symptoms. Although reductions in depressive symptoms with physical activity have been demonstrated in white adults, little research has examined the mental health benefits of physical activity in African American women. Further, it is unknown whether physical activity can offset the effects of living in disadvantaged neighborhoods on depressive symptoms. The purpose of this study was to examine the relationships among neighborhood characteristics, adherence to a physical activity intervention, and change over time in depressive symptoms in midlife African American women. METHODS Two hundred seventy-eight women participated in a home-based, 24-week moderate-intensity walking intervention. Either a minimal treatment (MT) or enhanced treatment (ET) version of the intervention was randomly assigned to one of the two community health centers. Walking adherence was measured as the percentage of prescribed walks completed. Objective and perceived measures of neighborhood deterioration and crime were included. RESULTS Adjusting for demographics, body mass index (BMI), and depressive symptoms at baseline, walking adherence and objective neighborhood deterioration were associated with significantly lower depressive symptoms, whereas perceived neighborhood deterioration was associated with significantly higher depressive symptoms at 24 weeks. CONCLUSIONS Adherence to walking as well as aspects of the environment may influence depressive symptoms in African American women. In addition to supporting active lifestyles, improving neighborhood conditions may also promote mental health among African American women.

Perceptions of Cancer Controllability and Cancer Risk Knowledge: The Moderating Role of Race, Ethnicity, and Acculturation

Literature suggests racial/ethnic minorities, particularly those who are less-acculturated, have stronger fatalistic attitudes toward cancer than do non-Latino Whites. Knowledge of cancer prevention is also lower among racial/ethnic minorities. Moreover, low knowledge about cancer risk factors is often associated with fatalistic beliefs. Our study examined fatalism and cancer knowledge by race/ethnicity and explored whether race/ethnicity moderate the association of fatalism with knowledge of cancer prevention and risk factors. We analyzed data from the Health Information National Trends Survey (2008), a national probability survey, to calculate population estimates of the associations among race/ethnicity, fatalistic beliefs, and knowledge about cancer from multivariable logistic regression. Racial/ethnic minorities had higher odds of holding fatalistic beliefs and lower odds of having knowledge of cancer risk factors than non-Hispanic Whites, and important differences by acculturation among Latinos were observed. Limited evidence of the moderating effect of race/ethnicity on the relationship between fatalistic beliefs and cancer risk factor knowledge was observed. Knowledge of cancer risk factors is low among all race/ethnicities, while fatalistic beliefs about cancer are higher among racial/ethnic minorities compared with non-Hispanic Whites. Implications for cancer education efforts are discussed.

The FLASHE Study: Survey Development, Dyadic Perspectives, and Participant Characteristics

The National Cancer Institute developed the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study to examine multiple cancer preventive behaviors within parent-adolescent dyads. The purpose of creating FLASHE was to enable the examination of physical activity, diet, and other cancer preventive behaviors and potential correlates among parent-adolescent dyads. FLASHE surveys were developed from a process involving literature reviews, scientific input from experts in the field, cognitive testing, and usability testing. This cross-sectional, web-based study of parents and their adolescent children (aged 12-17 years) was administered between April and October 2014. The nationwide sample consisted of 1,573 parent-adolescent dyads (1,699 parents and 1,581 adolescents) who returned all FLASHE surveys. FLASHE assessed parent and adolescent reports of several intrapersonal and interpersonal domains (including psychosocial variables, parenting, and the community and home environments). On a subset of example FLASHE items across these domains, responses of parents and adolescents within the same dyads were positively and significantly correlated (r =0.32-0.63). Analyses were run in 2015-2016. FLASHE data present multiple opportunities for studying research questions among individuals or dyads, including the ability to examine similarity between parents and adolescents on many constructs relevant to cancer preventive behaviors. FLASHE data are publicly available for researchers and practitioners to help advance research on cancer preventive health behaviors.

Recruitment, Enrollment, and Response of Parent–Adolescent Dyads in the FLASHE Study

INTRODUCTION In 2014, the National Cancer Institute conducted the Family Life, Activity, Sun, Health, and Eating Study (FLASHE). This parent and adolescent survey examines psychosocial; generational (parent-adolescent); and environmental (home and neighborhood) correlates of cancer-preventive behaviors, with a particular emphasis on diet and physical activity. This paper describes the FLASHE data collection methods and enrollment and response rates. METHODS FLASHE data collection methods included web-based surveys delivered to dyads of parents and their adolescent children, and deployment of accelerometers to a subset of adolescents, to achieve study goals in a nationwide study sample. The National Cancer Institute contracted with Westat, Inc. to recruit, enroll, and collect the data using a consumer opinion panel. RESULTS A total of 5,027 dyads were screened for eligibility, and 1,945 (38.7%) enrolled. Of fully enrolled dyads, 85.6% of those in the Survey-Only group completed all four surveys, and 58.7% of dyads in the Motion Study group completed all surveys and were compliant with the accelerometer protocol for adolescents. The overall study response rate was 29.4%; 1,479 dyads completed all study procedures. The majority of parents were female, whereas the adolescent sample was gender balanced. Data were analyzed in 2015-2016. CONCLUSIONS FLASHE recruited a large sample of parent-adolescent dyads. Although challenges for research in parent-adolescent dyads include enrolling a diverse sample and having multistep enrollment and consent processes, study completion rate was high among fully enrolled dyads. Future panel studies may consider approaches used in FLASHE to encourage study enrollment and completion.

Promoting family meals: a review of existing interventions and opportunities for future research

Evidence suggests that regular family meals protect against unhealthy eating and obesity during childhood and adolescence. However, there is limited information on ways to promote family meals as part of health promotion and obesity prevention efforts. The primary aim of this review was to synthesize the literature on strategies to promote family meals among families with school-aged children and adolescents. First, we reviewed interventions that assess family meals as an outcome and summarized strategies that have been used in these interventions. Second, we reviewed correlates and barriers to family meals to identify focal populations and target constructs for consideration in new interventions. During May 26–27, 2014, PubMed and PsycInfo databases were searched to identify literature on family meals published between January 1, 2000 and May 27, 2014. Two reviewers coded 2,115 titles/abstracts, yielding a sample of 139 articles for full-text review. Six interventions and 43 other studies presenting data on correlates of or barriers to family meals were included in the review. Four interventions resulted in greater family meal frequency. Although there were a small number of interventions, intervention settings were diverse and included the home, community, medical settings, the workplace, and the Internet. Common strategies were goal setting and interactive group activities, and intervention targets included cooking and food preparation, cost, shopping, and adolescent influence. Although methodological nuances may contribute to mixed findings, key correlates of family meals were employment, socioeconomic and demographic factors, family structure, and psychosocial constructs. Barriers to consider in future interventions include time and scheduling challenges, cost, and food preferences. Increasing youth involvement in mealtime, tailoring interventions to family characteristics, and providing support for families experiencing time-related barriers are suggested strategies for future research.

The association between motivation and fruit and vegetable intake: The moderating role of social support

Despite knowing that fruit and vegetable (FV) intake promotes health and well-being, few U.S. adults meet current guidelines. Thus, understanding peoples motivation for FV intake is important for predicting dietary behavior. Applying self-determination theory, the goal of this study was to examine the role of social support as a potential moderator of the link between autonomous and controlled motivations and FV intake. Cross-sectional data from 2959 adults in the United States were analyzed. Autonomous motivation and perceived social support were positively associated with FV intake, while controlled motivation was negatively associated with FV intake. Additionally, there was evidence that the negative association between controlled motivation and FV intake was attenuated by higher levels of perceived social support. Findings suggest the need for a more comprehensive approach to understanding the role of motivation in health behaviors like FV intake and the potential roles played by friends and family in these motivational processes.