Katherine R. Arlinghaus

Engaging Fathers in the Promotion of Healthy Lifestyle Behaviors

Parental engagement is an important component in lifestyle behavior change interventions for children as parents are uniquely positioned to establish a healthy environment and model healthy eating and physical activity habits for their children. Despite both mothers and fathers being important agents of behavioral change for their children, fathers are typically underrepresented in programming interventions. Physical activity may be an important strategy for fathers to become involved in lifestyle change with their children as, compared to mothers, fathers traditionally tend to be comfortable engaging in physical activity with their children.

Authoritative parent feeding style is associated with better child dietary quality at dinner among low-income minority families

Abstract Background Parent feeding styles have been linked to child weight status across multiple studies. However, to our knowledge, the link between feeding styles and childrens dietary quality, a more proximal outcome, has not been investigated. Objective The purpose of this study was to examine the relation between parent feeding styles and dietary quality of Head Start preschoolers’ dinner meals. Design The amount of food served and consumed by children was measured by using a standardized digital photography method during 3 in-home dinner observations of low-income minority families in Houston, Texas. Trained dietitians entered food served and consumed into the Nutrient Data System for Research 2009 for nutrient analysis. Overall dietary quality of the food served and consumed at dinner was evaluated by using the Healthy Eating Index 2010 (HEI-2010). Parent feeding style was assessed with the use of the Caregivers Feeding Style Questionnaire (CFSQ). On the basis of a parents level of demandingness and responsiveness to his or her child during feeding, the CFSQ categorizes parent feeding into 4 styles: authoritative (high demandingness and high responsiveness), authoritarian (high demandingness and low responsiveness), indulgent (low demandingness and high responsiveness), or uninvolved (low demandingness and low responsiveness). Results For the overall sample, the mean ± SD HEI score for dinner served was 44.2 ± 8.4, and the mean ± SD HEI score for dinner consumed was 43.4 ± 7.0. In the fully adjusted model, ANCOVA indicated that the authoritative parent feeding style was associated with significantly higher child dietary quality compared with the authoritarian feeding style (mean ± SEE HEI consumed—authoritative 45.5 ± 0.9; authoritarian: 41.9 ± 0.7; P = 0.001). Conclusions Parent feeding style contributes to the overall dietary quality of children, and among low-income minority preschoolers an authoritative feeding style was associated with the highest dietary quality of the 4 feeding styles. Interventions to promote feeding practices that contribute to authoritative feeding are needed to improve the dietary quality of preschool children at dinner. This trial was registered at https://clinicaltrials.gov as NCT02696278.

Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults

While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460) on sexually active homeless adults from a cross-sectional study of participants (n = 610) recruited from homeless service locations, such as shelters and drop-in centers, in an understudied region of the southwest. Covariate-adjusted logistic regressions were used to assess the impact of age at homelessness onset, current age, age at first sex, and HIV risk perceptions on having condomless sex, new sexual partner(s), and multiple sexual partners (≥4 sexual partners) in the past 12 months. Individuals who first experienced homelessness by age 24 were significantly more likely to report condomless sex and multiple sexual partners in the past year than those who had a later onset of their first episode of homelessness. Individuals who were currently 24 years or younger were more likely to have had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months than those who were 25 years or older. Those who had low perceived HIV risk had lower odds of all three sexual risk behaviors. Social service and healthcare providers should consider a younger age at homelessness onset when targeting HIV prevention services to youth experiencing homelessness.

An Intergenerational Approach to Break the Cycle of Malnutrition

Purpose of ReviewThis article examines how nutritional status is treated throughout the lifecycle. In doing so, the review identifies promising life stages during which intervention may improve nutritional status of future generations.Recent FindingsA life course perspective suggests that nutritional changes are most likely to be sustained when they occur during times of developmental transition, such as pregnancy or adolescence. Adolescence is a unique period in which malnutrition in future generations may be addressed because it is the first life stage at which pregnancy becomes feasible and individuals seek independence from parents.SummaryA need exists to begin investigating not just how nutrition changes are sustained throughout the lifespan, but how nutritional intervention in one generation impacts the next. This intergenerational approach should be undertaken with cross-discipline collaboration to have the best chance at impacting underlying determinants of malnutrition like poverty and women’s education.

Integrating Physical Activity Into Clinical Cancer Care

Physical activity is an important target for improving health and well-being among cancer survivors. Cancer clinicians are uniquely positioned to promote physical activity among survivors through follow-up visits for treatment planning and surveillance. Providers should prioritize assessment of guideline-concordant physical activity and facilitate achievement of physical activity guidelines through exercise prescription, goal setting, addressing barriers, and capitalizing on support systems.

Advocating for Behavior Change With Education

Education is ubiquitous with clinical care. However, not all education supports behavioral change. Education is a broad term that encompasses the process of obtaining general knowledge, personal awareness, and skills training. Although not sufficient, education is a necessary component for behavior change. This article outlines the role of education in behavior change and offers practical suggestions for how clinicians can provide education to their patients to help them change behavior.

The Potential Contribution of Current Health Care Zeitgeists to the Success of Health and Wellness Coaches

Chronic disease is challenging to treat because treatment often requires lifestyle behavior changes. In recent years the use of health and wellness coaches (HWC) has emerged as a way to support patients making behavioral changes. The use of HWCs has resulted in improved management of chronic disease for many patients. The success of HWCs is often thought to be due to the extended care they provide and the behavioral modification techniques they promote such as goal setting and self-monitoring. This article describes how HWC’s conformity to the current health care zeitgeist of personalized, holistic care may be another reason for their success.

Reducing Anxiety to Increase Exercise in Individuals With Decreased Lung Capacity

The management of chronic disease is complex. For many diseases, the treatment for the disease may mimic disease symptoms. For example, exercise training is recommended as part of the treatment of chronic obstructive pulmonary disease (COPD). Individuals may confuse the physiological experiences related to exercise with COPD symptoms. This type of association between treatment and disease can cause anxiety. For health care practitioners to successfully motivate their patients to make the necessary behavior changes for disease treatment, anxiety must also be addressed.

The Issue of Aversion in Lifestyle Treatments

Increasing evidence suggests that vigorous physical activity (PA) is more beneficial than moderate PA for reducing adiposity and improving bone health in youth. However, beginning a vigorous PA program is not an easy behavior adjustment and the change is likely to be aversive for some individuals. In order to benefit from vigorous PA, health care providers need to help individuals increase self-efficacy.