Gavin Abbott

A Parent-Focused Intervention to Reduce Infant Obesity Risk Behaviors: A Randomized Trial

OBJECTIVE: To assess the effectiveness of a parent-focused intervention on infants’ obesity-risk behaviors and BMI. METHODS: This cluster randomized controlled trial recruited 542 parents and their infants (mean age 3.8 months at baseline) from 62 first-time parent groups. Parents were offered six 2-hour dietitian-delivered sessions over 15 months focusing on parental knowledge, skills, and social support around infant feeding, diet, physical activity, and television viewing. Control group parents received 6 newsletters on nonobesity-focused themes; all parents received usual care from child health nurses. The primary outcomes of interest were child diet (3 × 24-hour diet recalls), child physical activity (accelerometry), and child TV viewing (parent report). Secondary outcomes included BMI z-scores (measured). Data were collected when children were 4, 9, and 20 months of age. RESULTS: Unadjusted analyses showed that, compared with controls, intervention group children consumed fewer grams of noncore drinks (mean difference = –4.45; 95% confidence interval [CI]: –7.92 to –0.99; P = .01) and were less likely to consume any noncore drinks (odds ratio = 0.48; 95% CI: 0.24 to 0.95; P = .034) midintervention (mean age 9 months). At intervention conclusion (mean age 19.8 months), intervention group children consumed fewer grams of sweet snacks (mean difference = –3.69; 95% CI: –6.41 to –0.96; P = .008) and viewed fewer daily minutes of television (mean difference = –15.97: 95% CI: –25.97 to –5.96; P = .002). There was little statistical evidence of differences in fruit, vegetable, savory snack, or water consumption or in BMI z-scores or physical activity. CONCLUSIONS: This intervention resulted in reductions in sweet snack consumption and television viewing in 20-month-old children.

Is healthy behavior contagious: associations of social norms with physical activity and healthy eating

BackgroundSocial norms are theoretically hypothesized to influence health-related behaviors such as physical activity and eating behaviors. However, empirical evidence relating social norms to these behaviors, independently of other more commonly-investigated social constructs such as social support, is scarce and findings equivocal, perhaps due to limitations in the ways in which social norms have been conceptualized and assessed. This study investigated associations between clearly-defined social norms and a range of physical activity and eating behaviors amongst women, adjusting for the effects of social support.MethodsSelf-report survey data about particular physical activity (leisure-time moderate-vigorous activity; volitional walking; cycling for transport) and eating behaviors (fast food, soft drink and fruit and vegetable consumption), and social norms and support for these, were provided by 3,610 women aged 18-46 years living in socioeconomically disadvantaged neighborhoods in Victoria, Australia.ResultsResults of regression analyses showed that social norms for physical activity and eating behaviors predicted these respective behaviors relatively consistently; these associations generally remained significant after adjustment for social support.ConclusionsAcknowledging the cross-sectional study design, these data confirm theoretical accounts of the importance of social norms for physical activity and eating behaviors, and suggest that this is independent from social support. Intervention strategies aimed at promoting physical activity and healthy eating could incorporate strategies aimed at modifying social norms relating to these behaviors.

Park improvements and park activity: a natural experiment.

BACKGROUND Parks are an important setting for leisure-time physical activity. Understanding how to attract residents to parks and encourage park users to be physically active is an important public health initiative. Natural experiments are a research priority for investigating whether changes to the physical environment affect physical activity; however, natural experiments involving parks have rarely been conducted. PURPOSE This natural experiment examined whether improvements to a park in Victoria, Australia, increased its use and park-based physical activity of users. METHODS Observational data were collected on park use and park-based activity among park users at the intervention park and a control park at three time points; baseline (T1, August 2009); post-improvement (T2, March 2010); and 12 months after baseline (T3, August 2010). At each time point, observations were undertaken during three 1.5-hour periods each day on 9 days. Analyses were conducted in 2011. RESULTS In the intervention park, there were significant increases from pre- to post-improvement in the number of park users (T1=235, T3=985) and the number of people observed walking (T1=155, T3=369) and being vigorously active (T1=38, T3=257). At the control park, counts of usage decreased over the same period and no differences in walking or vigorous activity were observed. CONCLUSIONS Improving the features of a local neighborhood park may lead to increased usage and physical activity.

Is the Neighbourhood Environment Associated with Sedentary Behaviour Outside of School Hours Among Children

BackgroundLittle is known about neighbourhood environments and children’s sedentary behaviour outside school hours.PurposeThis study aims to examine the associations between public open spaces (POS), parent perceptions of the neighbourhood and children’s sedentary behaviours.MethodsParents reported their child’s television viewing and computer/electronic game time and their perceptions of the physical and social neighbourhood. Children’s sedentary time was objectively assessed. The closest POS was audited.ResultsCross-sectionally, living near a POS with a water feature and greater parental satisfaction with POS quality were negatively associated with computer/e-games; greater POS area was negatively associated with TV viewing. Longitudinally, living in a cul-de-sac and greater satisfaction with POS quality were negatively associated with computer/e-games and TV viewing, respectively. A walking path in the POS was positively associated with computer/e-games.ConclusionNeighbourhood features appear to positively and negatively influence children’s sedentary behaviours, highlighting the complexity of urban planning on behaviour. Further age- and context-specific studies are required.

Resilience to obesity among socioeconomically disadvantaged women: the READI study

Objective:This cross-sectional study aimed to identify sociodemographic and behavioural characteristics of ‘overweight-resilient’ women, that is, women who were in a healthy body weight range, despite living in socioeconomically disadvantaged neighbourhoods that place them at increased risk of obesity. The study also aimed to test a comprehensive theoretically derived model of the associations between intrapersonal, social and environmental factors and obesity among this target group.Participants:A total of 3235 women aged 18–45 years from 80 urban and rural neighbourhoods throughout Victoria, Australia, participated in the Resilience for Eating and Activity Despite Inequality study.Measurements:Women reported height, weight, sociodemographic characteristics, leisure-time physical activity, dietary behaviours and a range of theoretically derived cognitive, social and neighbourhood environmental characteristics hypothesized to influence obesity risk. A theoretical model predicting body mass index (BMI) was tested using structural equation models.Results:Women classified as ‘resilient’ to obesity tended to be younger, born overseas, more highly educated, unmarried and to have higher or undisclosed household incomes. They engaged in more leisure-time physical activity and consumed less fast foods and soft drinks than overweight/obese women. Neighbourhood characteristics, social characteristics and cognitive characteristics all contributed to explaining variation in BMI in the hypothesized directions.Conclusions:These results demonstrate several characteristics of women appearing ‘resilient’ to obesity, despite their increased risk conferred by residing in socioeconomically disadvantaged neighbourhoods. Acknowledging the cross-sectional study design, the results advance theoretical frameworks aimed at investigating obesity risk by providing evidence in support of a comprehensive model of direct and indirect effects on obesity of neighbourhood, as well as social, cognitive and behavioural characteristics.

Influence of price discounts and skill-building strategies on purchase and consumption of healthy food and beverages: outcomes of the Supermarket Healthy Eating for Life randomized controlled trial

BACKGROUND Fiscal strategies are increasingly considered upstream nutrition promotion measures. However, few trials have investigated the effectiveness or cost effectiveness of pricing manipulations on diet in real-world settings. OBJECTIVE We assessed the effects on fruit, vegetable, and beverage purchasing and consumption of a 20% price-reduction intervention, a tailored skills-based behavior-change intervention, and a combined intervention compared with a control condition. DESIGN The Supermarket Healthy Eating for Life trial was a randomized controlled trial conducted over 3 mo [baseline (time 1) to postintervention (time 2) with a 6-mo follow-up (time 3)]. Female primary household shoppers in Melbourne, Australia, were randomly assigned to a 1) skill-building (n = 160), 2) price-reduction (n = 161), 3) combined skill-building and price-reduction (n = 160), or 4) control (n = 161) group. Supermarket transaction data and surveys were used to measure the following study outcomes: fruit, vegetable, and beverage purchases and self-reported fruit and vegetable consumption at each time point. RESULTS At 3 mo (time 2), price reduction-alone participants purchased more total vegetables and frozen vegetables than did controls. Price reduction-alone and price reduction-plus-skill-building participants purchased more fruit than did controls. Relative to controls, in the price-reduction group, total vegetable consumption increased by 233 g/wk (3.1 servings or 15% more than at baseline), and fruit purchases increased by 364 g/wk (2.4 servings; 35% more than at baseline). Increases were not maintained 6 mo postintervention (time 3). Price reduction-alone participants showed a tendency for a slight increase in fruit consumption at time 2 (P = 0.09) that was maintained at time 3 (P = 0.014). No intervention improved purchases of bottled water or low-calorie beverages. CONCLUSIONS A 20% price reduction in fruit and vegetables resulted in increased purchasing per household of 35% for fruit and 15% for vegetables over the price-reduction period. These findings show that price modifications can directly increase produce purchases. The Supermarket Healthy Eating for Life trial was registered at Current Controlled Trials Registration as ISRCTN39432901.

Are associations between the perceived home and neighbourhood environment and children's physical activity and sedentary behaviour moderated by urban/rural location?

Associations between parental perceived home and neighbourhood environments and childrens physical activity (PA), and sedentary time (ST) and screen time and moderating effects according to urban/rural location were examined. Data were collected (2007-2008) from a cohort of women (aged 18-45 years) and their children (5-12 years) participating in the Resilience for Eating and Activity Despite Inequality (READI) study. A total of 613 children (47% boys; mean age 9.4±2.2 years) and their mothers were included in the study. Urban children had higher screen time than rural children. Mothers in rural areas reported greater access to physical activity equipment in the home, higher levels of descriptive norms for physical activity, greater knowledge of the neighbourhood, a stronger social network, and higher personal safety than urban mothers. There were five significant interactions between the home and neighbourhood environment and PA/ST according to urban/rural location. Among urban children, the importance of doing PA together as a family was positively associated with ST. Interventions targeting PA and ST may need to target different factors according to urban/rural location.

Home and neighbourhood correlates of BMI among children living in socioeconomically disadvantaged neighbourhoods

A detailed understanding of the underlying drivers of obesity-risk behaviours is needed to inform prevention initiatives, particularly for individuals of low socioeconomic position who are at increased risk of unhealthy weight gain. However, few studies have concurrently considered factors in the home and local neighbourhood environments, and little research has examined determinants among children from low socioeconomic backgrounds. The present study examined home, social and neighbourhood correlates of BMI (kg/m2) in children living in disadvantaged neighbourhoods. Cross-sectional data were collected from 491 women with children aged 5-12 years living in forty urban and forty rural socioeconomically disadvantaged areas (suburbs) of Victoria, Australia in 2007 and 2008. Mothers completed questionnaires about the home environment (maternal efficacy, perceived importance/beliefs, rewards, rules and access to equipment), social norms and perceived neighbourhood environment in relation to physical activity, healthy eating and sedentary behaviour. Childrens height and weight were measured at school or home. Linear regression analyses controlled for child sex and age. In multivariable analyses, children whose mothers had higher efficacy for them doing physical activity tended to have lower BMI z scores (B = - 0·04, 95 % CI - 0·06, - 0·02), and children who had a television (TV) in their bedroom (B = 0·24, 95 % CI 0·04, 0·44) and whose mothers made greater use of food as a reward for good behaviour (B = 0·05, 95 % CI 0·01, 0·09) tended to have higher BMI z scores. Increasing efficacy among mothers to promote physical activity, limiting use of food as a reward and not placing TV in childrens bedrooms may be important targets for future obesity prevention initiatives in disadvantaged communities.

Sociodemographic and behavioural correlates of weight status among women with children living in socioeconomically disadvantaged neighbourhoods.

Objective:To investigate sociodemographic and behavioural characteristics associated with weight status among women with children living in socioeconomically disadvantaged neighbourhoods.Methods and procedures:A total of 1680 women aged 18–46 years, living in socioeconomically disadvantaged neighbourhoods with dependent children (aged 0–18 years), provided self-report data on height and weight and a range of sociodemographic and behavioural (for example, dietary intake, physical activity and time spent sitting) characteristics.Results:Half of the women were classified as having a healthy weight (body mass index=18.5–25). Bivariable ordinal logistic regression analyses indicated that a healthy weight status was associated with a range of sociodemographic and behavioural characteristics. In a multivariable model, a healthy weight status among women was associated with being younger and unmarried, speaking a language other than English at home, having a medium or high level of education, and a partner with a high level of education, having a high household income, spending more time engaged in leisure-time physical activity and less time spent sitting, and having a lower consumption of soft drink.Discussion:The present findings highlight that a considerable proportion of women with children living in disadvantaged neighbourhoods manage to maintain a healthy weight. Acknowledging the cross-sectional nature of this study, strategies aimed at helping women with children in socioeconomically disadvantaged areas to maintain their weight should focus on increasing physical activity, and reducing sitting time and soft drink consumption.

Facial affect recognition and schizotypal personality characteristics

Aim: Deficits in facial affect recognition are well established in schizophrenia, yet relatively little research has examined facial affect recognition in hypothetically psychosis‐prone or ‘schizotypal’ individuals. Those studies that have examined social cognition in psychosis‐prone individuals have paid little attention to the association between facial emotion recognition and particular schizotypal personality features. The present study therefore sought to investigate relationships between facial emotion recognition and the different aspects of schizotypy.