Beth DeGrace

Frequency of family meals and 6-11-year-old children's social behaviors

Family meals are regarded as an opportunity to promote healthy child development. In this brief report, we examined the relationship between frequency of family meals and childrens social behaviors in 6-11-year-olds. The 2007 U.S. National Survey of Childrens Health (NSCH) provided data on the frequency of family meals in a sample of 6-11-year-old children (N = 24,167). The following social behavior indicators were examined: child positive social skills, child problematic social behaviors, child engagement in school, and parental aggravation with the child. Individual logistic regression analyses were calculated in unadjusted and adjusted models. On average, families had 5.3 meals together per week. In adjusted models, more frequent family meals increased the odds of child positive social skills (OR = 1.08, 95% CI [1.02, 1.16]) and child engagement in school (OR = 1.11, 95% CI [1.06, 1.15]), and decreased the likelihood of child problematic social behaviors (OR = 0.92, 95% CI [0.87, 0.98]). There was no association between frequency of family meals and parental aggravation with the child (OR = 0.98, 95% CI [0.93, 1.04]). Findings support the promotion of family meals to benefit childrens development of healthy social behaviors.

Obesogenic environments in tribally-affiliated childcare centers and corresponding obesity rates in preschool children.

Background: Determine the relationship between obesogenic characteristics of childcare and child adiposity in tribally-affiliated centers in Oklahoma. Methods: The two-day Environment and Policy Assessment and Observation (EPAO) included a total environment (TE), nutrition (N), and physical activity (PA) score and took place in 11 centers across Oklahoma. Eighty-two preschool children (3-5 years) participated. Child height and weight were measured and overweight status (≥ 85th percentile for age and sex) was determined. Regression models, fit using Generalized Estimating Equations methodology to account for clustering by center were used and adjusted for center characteristics. Results: Participants were 3.8 (0.8) years old, 55% male, 67% American Indian (AI) and 38% overweight. A healthier TE and PA was associated with a reduced odds of overweight, which remained significant after adjusting for some center characteristics, but not all. A healthier TE, N, and PA was associated with lower BMI percentile, which remained significant after some center-level adjustments, but not all. Lower sedentary opportunity and sedentary time were no longer associated with reduced odds of overweight following adjustment. Lower opportunity for high sugar and high fat foods and minutes of active play were associated with reduced odds of overweight in some adjusted models. Conclusions: Collectively unadjusted and adjusted models demonstrate that some aspects of a healthier childcare center environment are associated with reduced odds of overweight and lower BMI percentile in preschool children attending tribally-affiliated childcare in Oklahoma. Future research should examine the association of childcare and health behaviors and further explore the role of potential confounders.

Families' Experiences and Occupations Following the Diagnosis of Autism

The unrelenting and persistent behaviors often demonstrated by children with autism, together with the uncertainty surrounding diagnosis and intervention options, pose a significant threat to the occupations of the family system. The purpose of this study was to explicate the experiences of living everyday life following the diagnosis of autism. Seven families were interviewed and using grounded theory methodology the research team investigated family experiences following a diagnosis of autism. Results informed the development of the preliminary Family Experience and Occupation Following the Diagnosis of Autism Model that explicitly framed family experience, the element of family occupation, and factors that mediate both experiences and occupation. By looking at family occupations from the time of diagnosis of a child, this work transcends the individual. It captures the co-constructed interplay of doing as families organize and seek ways to maintain everyday family functions.

Differences in preschool-age children's dietary intake between meals consumed at childcare and at home

Preschool children need optimal nutrition, including a variety of nutrient-dense foods, for growth and development. The purpose of this study was to determine differences in foods and nutrients consumed at childcare and home environments. Children ages 3-to-5 years (n = 90, 3.8 ± 0.7 years; 56% female) from 16 childcare centers participated in this cross-sectional study from 2011 to 2014. Lunches at childcare were observed for two days; three days of dinners at home were reported by caregivers. Nutrient-dense and energy-dense foods were counted and nutrient content of meals was determined using FoodWorks®. More servings of fruit (0.92 ± 0.82 vs. 0.15 ± 0.26; p ≤ 0.0001), vegetables (1.47 ± 1.43 vs. 0.62 ± 0.60; p ≤ 0.0001), and low-fat dairy (0.83 ± 0.32 vs. 0.07 ± 0.19; p ≤ 0.0001) were consumed at childcare than at home. More servings of high-fat, high-sugar foods (0.08 ± 0.18 vs. 0.43 ± 0.39, p ≤ 0.0001) and sugary drinks (0.22 ± 0.41 vs. 0.39 ± 0.35. p ≤ 0.001) were consumed at home than at childcare. There were no differences between environments in whole-grains, high-fat meats, or high-fat high-sugar condiments consumed. On average, children consumed 333.0 ± 180.3 kcal at childcare and 454.7 ± 175.3 at home (p ≤ 0.0001). There were no differences in macronutrient profiles or in iron, zinc, folate, or vitamin B6 intake. More calcium (86.2 ± 44.6 vs. 44.6 ± 22.2 mg/kcal, p ≤ 0.0001) and vitamin A/kcal (56.1 ± 36.9 vs. 26.5 ± 24.2 RAE/kcal, p ≤ 0.0001) were consumed at childcare than at home. Preschool children are consuming more nutrient-dense foods and a more servings of fruit and vegetables at childcare during lunch than at home during dinner. Childcare and parents should work together to provide early and consistent exposure to nutrient-rich foods to ensure optimal nutrition for developing children.

Tribally Affiliated Child-Care Center Environment and Obesogenic Behaviors in Young Children

BACKGROUND Child-care centers are an integral part of life for many families with young children. American Indian children are at elevated health risk because of higher levels of obesity and associated health behaviors. OBJECTIVE Our aim was to assess the child-care environment and childrens physical activity (PA) and dietary intake in young children attending tribally affiliated child care. DESIGN We conducted a cross-sectional study. PARTICIPANTS/SETTING Participants were from 11 tribally affiliated child-care centers across Oklahoma and included 82 children aged 3 to 5 years old. MAIN OUTCOME MEASURES Classroom observations were conducted using the Environmental and Policy Assessment Observation to measure PA and nutrition environments. Children wore an ActiGraph GT3X accelerometer and lunchtime plate waste was observed. STATISTICAL ANALYSES Descriptive statistics, including mean±standard deviation and frequencies, were calculated for the childrens behaviors and environment. RESULTS The total environment score was 23.9±5.2 (maximum=43). The nutrition score was 12.5±3.1 (maximum=21). The PA score was 11.7±2.2 (maximum=22). The participants were 3.8±0.1 years old, 55% were male, 67% were American Indian, and 38% were overweight or obese. Accelerometers were worn for 5.9±1.7 hours, excluding naptime. Children accumulated 4.3±2.2 min/h of moderate to vigorous PA, 4,294±1,883 steps/day, and 12.1±3.7 steps/min. At lunch, children were served 510±241 kcal, and consumed 387±239 kcal. Lunches consisted of 47% carbohydrate, 20% protein, and 33% fat. Total number of F/V served was 2.9±1.9 and consumed was 2.3±1.8, while whole grains served and consumed were 0.3±0.4 and 0.2±0.4, respectively, and lean proteins served and consumed were 0.3±0.4 and 0.2±0.4, respectively. CONCLUSIONS This study describes obesogenic aspects of the child-care environment and identifies areas for improvement. Children did not accumulate adequate PA or consume calories or fat excessively. Children consumed multiple F/V; however, more whole grains and lean proteins could be provided. Future research might investigate how the healthfulness of the child-care environment can be improved by counseling providers on nutrition and PA strategies to prevent obesity.

Benefits of Family Meals for Children With Special Therapeutic and Behavioral Needs.

Frequency of family meals (FMs) is associated with favorable child outcomes; however, no study to date has examined the relationship between frequency of FMs and outcomes for children with disabilities. Data from the 2007 National Survey of Childrens Health for children with disabilities (N = 4,336) were used. Logistic regression for each dependent variable was completed using frequency of FMs and covariates of age, gender, race, family structure, and poverty level. Each day per week increase in the frequency of FMs increased the likelihood for positive social skills (odds ratio [OR] = 1.09, 95% confidence interval [CI] [1.01, 1.19]) and engagement in school (OR = 1.09, 95% CI [1.02, 1.16]). Frequency of FMs was not associated with problematic social behaviors or parental aggravation with child. Our findings suggest that children with disabilities whose families participate in frequent FMs have a greater likelihood of positive social and family health outcomes.

Early childrearing practices and their relationship to academic performance in Mexican American children.

Purpose: To examine whether parenting behaviors and childrearing practices in the first 3 years of life among Mexican American (MA) families predict childrens academic performance at school age. Methods: Thirty-six children were assessed using the Parent Behavior Checklist, Nursing Child Assessment Teaching Scale, Home Observation for Measurement of the Environment Inventory, and Bayley Scales of Infant Development II. Academic performance was measured with the Illinois Standards Achievement Test during third grade. Results: Correlation between parents’ developmental expectations, nurturing behaviors, discipline, and academic performance were statistically significant (P < .05). Developmental expectations and discipline strategies predicted 30% of the variance in the Illinois Standards Achievement Test of reading. Conclusions: The results of this study suggest that early developmental expectations that MA parents have for their children, and the nurturing and discipline behaviors they engage in, are related to how well the children perform on academic tests at school age.

Exploring families’ experiences of health: contributions to a model of family health

Abstract Child health and developmental outcomes are influenced by the health of the family and the context created. Research suggests symptoms of poor family health (e.g. suboptimal family interactions, parenting stress) yet there is limited understanding of the factors which contribute to robust family health which may unveil opportunities for targeted intervention and family health promotion. The present study examined families’ experiences of family health and factors contributing to family health. We performed a qualitative study using constructivist grounded theory methods to guide our understanding of family health for families with typically developing children aged 5–18. Interviews were conducted in family homes and all members were invited to participate. Data from interviews were transcribed, coded, thematically analyzed, and verified with select families. Ten families, including 10 mothers, 8 fathers, and 15 children participated in the study. Participants described family health as a process of balance, living purposefully, and sharing experiences together in alignment with family identity. Mediating family health were processes of awareness and reflection, and adapting, adjusting, and changing in response to family life including external stress factors. Results highlight the possibility for healthcare practitioners to facilitate families’ self-reflection and awareness about their health in order to mediate family health development.