Christel Hyden

Is overweight at 12 months associated with differences in eating behaviour or dietary intake among children selected for inappropriate bottle use

Bottle feeding beyond the recommended weaning age of 12 months is a risk factor for childhood obesity. This paper describes a sample of toddlers at high risk for obesity: prolonged bottle users from a low-income multi-ethnic community. We report here baseline mealtime and feeding behaviour, 24 h dietary recall and bottle intake data for Feeding Young Children Study (FYCS) participants, by overweight (≥85% weight-for-length) status. FYCS enrolled 12-13-month-olds from urban nutrition programmes for low-income families in the United States who were consuming ≥2 bottles per day. Our sample was predominately Hispanic (62%), 44% of mothers were born outside of the United States and 48% were male. Overall, 35% were overweight. Overweight status was not associated with mealtime/feeding behaviours, bottle use or dietary intake. Most (90%) children ate enough, were easily satisfied and did not exhibit negative (e.g. crying, screaming) mealtime behaviours, per parent report. The samples median consumption of 4 bottles per day accounted for 50% of their total calories; each bottle averaged 7 ounces and contained 120 calories. Mean daily energy intake, 1098.3 kcal day(-1) (standard deviation = 346.1), did not differ by weight status, nor did intake of fat, saturated fat, protein or carbohydrates. Whole milk intake, primarily consumed via bottles, did not differ by weight status. Thus, overweight 12-13-month-olds in FYCS were remarkably similar to their non-overweight peers in terms of several obesity risk factors. Findings lend support to the set-point theory and prior work finding that weight and intake patterns in the first year of life alter subsequent obesity risk.

Bottle-weaning intervention tools: the "how" and "why" of a WIC-based educational flipchart, parent brochure, and website.

Objective. This article describes the development of educational materials for a Women, Infants, and Children (WIC)–based randomized controlled trial of an intervention encouraging timely bottle weaning. Method. Following a systematic process to develop of patient education materials, messages were first tested in 4 focus groups with 26 caregivers of WIC toddlers aged 7 to 36 months of age at the 2 study sites. Following review and revision, the materials were retested in one-on-one nutritional counseling sessions with 10 clients at the WIC sites who met the study’s eligibility criteria. Results. Materials development was an iterative process requiring several levels of input, review, and revision. Use of a systematic process guided by steps adapted from the health education literature was crucial in ensuring continuous feedback from stakeholders, experts, and priority populations and to develop an intervention instrument that met the needs and expectations of all groups. Conclusions and implications. The content, theoretical orientation, and format of the materials were influenced at every turn by feedback from frontline WIC nutritionists, WIC policy staff at the state level, and WIC clients. Development of effective, easy to use materials requires constant input from key stakeholders.

Getting the Most Out of Professional Associations

In this commentary, three public health professionals working in diverse career settings share their perspectives on how to get the most out of professional associations. This article demonstrates how you can benefit from active involvement in your membership in professional associations and attending professional conferences. Methods to participate actively in your association include volunteering for one-time opportunities or standing committees, mentoring, and reviewing publications and manuscripts. Being active in professional organizations, such as the Society for Public Health Education, offers personal career development skill-building and opportunities for leadership and mentoring across all career stages. Experiences on how participation in professional organizations helped shape the authors’ careers are shared.

Addition of Solids and Sweeteners in Toddler Bottles and Sippy Cups

Serving cereal and other foods by baby bottle is a common infant feeding practice, yet little research explores how this practice may continue beyond the first year of life or following transition from the bottle to sippy cups. This article describes the addition of solids and sweeteners into bottles and sippy cups of milk, formula, or nondairy milk among children aged 1 to 2 years in an urban Women, Infants, and Children clinic. This observational study recruited n = 299 low-income nutrition program clients whose 12-month-olds consumed ≥2 nonwater bottles per day. Dietary recall data were extracted for the 3105 servings of milk, formula, or nondairy milk in bottles or sippy cups and analyzed for vessel, content, addition of solids or sweeteners (eg, cereals or syrups), calories, and added grams of sugar. Sixty-one percent of children had a solid or sweetener added to their beverage at least once. Solids or sweeteners were added to 38% of baby bottles and 21% of sippy cups. Presence of solids and sweetene...

Research Approaches of Education, Applied Psychology, and Behavioral Science and Their Application to Behavioral Medicine

This chapter describes the range of different research strategies, designs, and methods derived from education, applied psychology, and behavioral science that are used in behavioral medicine. Section one examines seven key questions that are typically addressed in behavioral medicine and illustrates how the research and program evaluation methods, including qualitative, quantitative, and mixed methods, are utilized in answering each of these questions. Section two discusses community engagement in the research process as an integral element of conducting research and evaluation in behavioral medicine, including both the basic concepts and principles of community-based participatory research. Section three explores the concepts and issues in the translation of research into practice, a topic of growing interest as a next-generation challenge to those working in both the public health and behavioral medicine communities. The chapter concludes with a discussion of the emerging challenges of conducting behavioral medicine research and their implications for the future.

Student Partnerships to Build Organizational Capacity

Public health organizations—whether community-based nonprofits, centers affiliated with a university, or some other entity—can benefit greatly from partnering with students to build capacity and grow in a variety of ways. However, there are many issues to consider before taking on students as interns or volunteers. These include realistic considerations of supervisory time and effort, determining if you can actually match student skills with organizational programming not to mention legal requirements based on federal and state laws. This article provides a detailed overview of steps that organizations interested in partnering with students should follow once determining that taking on a student or multiple students is viable. These include issues around time lines, scheduling, the student selection process, supervising, ongoing mentoring, as well as expectations after the practicum or volunteer experience has ended.

Bottle and sippy cup use is associated with diet and energy intake in toddlers

The second year of life incorporates a continued shift from a liquid- to solid-based diet. Little is known about the prevalence and dietary impact of bottle and sippy cup use. This paper describes associations between percent of energy consumed via drinking containers (bottles and sippy cups combined) and dietary outcomes, between 1 and 2 years of age. This observational study recruited n = 299 low-income, nutrition programme clients from the Bronx, NY, whose 12 month olds consumed ≥ 2 non-water bottles per day. The main exposure variable was percent of energy intake via drinking containers (PEDC), dichotomized at the median into low-percent-energy-from-drinking-containers (LOW-C) and high-percent-energy-from-drinking-containers (HIGH-C) groups, assessed quarterly, for 1 year. We report 24-hour dietary recall nutrient and food serving data by LOW-C vs. HIGH-C. We employed linear mixed models to study associations between PEDC and nutrient intake. PEDC decreased from 52% to 33% between 1 and 2 years of age in both groups. The LOW-C group had higher intake of energy, dietary fibre, iron and sodium, grains, protein-rich foods and sweets. Conversely, LOW-C group had lower intake of Vitamin D and calcium vs. the HIGH-C group. PEDC was inversely associated with total energy intake in a model controlling for baseline age, baseline-weight-for-length and gender (β = -5.8, P = 0.029, 95% confidence interval (-10.96, -0.6). Lower bottle and sippy cup use had significant, albeit mixed association with diet quality in the second year of life, and was associated with higher energy intake. Evidence-based guidelines are needed to determine the appropriate use of those feeding methods.

Identifying and Applying for Professional Development Funding

Participation in ongoing professional development can be critical for maintaining up-to-date knowledge in your field, as well as preparing for promotions and job changes. Career development activities may include formal classroom education, web-based courses, on-the-job training, workshops and seminars, professional conferences, and self-study programs. Developing a career development plan, cultivating a team to support your goals, and actively pursuing continuing education and skill-building opportunities are important across all career stages. However, the financial cost of these opportunities can often place them beyond reach. In this commentary, we summarize several potential sources for career development funding as well as best practices for completing the application process.