Kathryn Brogan

A Pilot Study of Motivational Interviewing Targeting Weight-Related Behaviors in Overweight or Obese African American Adolescents

PURPOSE To pilot motivational interviewing (MI) targeting weight-related behaviors in African American adolescents with body mass index ≥85th percentile. METHODS A total of 44 adolescents were randomly assigned to MI or nutrition counseling with baseline and 3-month assessment. RESULTS MI group reported improved eating behaviors and activity motivation. CONCLUSION Brief clinic-based MI interventions merit further study in this population.

A Randomized Pilot Study of Multisystemic Therapy Targeting Obesity in African-American Adolescents

Adolescents with obesity (N = 48) and their caregivers were randomized to Multisystemic Therapy (MST) or a group weight-loss intervention. MST adolescents significantly reduced percents overweight and body fat, while control adolescents did not. Treatments such as MST that can intervene in the multiple systems that influence weight are worthy of further study.

Cardiovascular disease risk factors are elevated in urban minority children enrolled in head start.

BACKGROUND The prevalence of obesity and overweight persists in the preschool population, despite some prevention and treatment advances, particularly in minorities. Investigating the prevalence of dyslipidemia and the effect of family health may also guide the focus of intervention efforts. METHODS Anthropometric data were collected from urban minority preschool children (n=161; 42% female) enrolled in USDA Head Start. Blood was collected by finger prick and analyzed with the Cholestech LDX Analyzer (Cholestech Corporation, Hayward, CA). Caregivers provided a self-reported family health history for cardiovascular diseases (CVDs). RESULTS By BMI percentile, 8% of the children were underweight (UW), 54% healthy weight (HW), 10% overweight (OW), and 28% obese (OB). One of every 5 children had borderline or high-risk levels for total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides based on the National Cholesterol Education Program categories. In OW/OB children only, BMI was positively correlated with TC (r(61)=0.428; p=0.001) and LDL (r(58)=0.395; p=0.005). Child BMI was also associated with family comorbid diseases (r(159)=0.177; p=0.025). UW/HW children with a family history of CVD had significantly higher LDL than UW/HW children without a family history of CVD (p=0.001). Step-wise regression analysis revealed that BMI (p=0.005) plus family history of heart attack (p=0.018) were significant predictors of blood TC levels. CONCLUSION Continued efforts to treat and prevent elevated weight are urgently needed for minority preschoolers. Attention to CVD screening may be an important target in school, community, and healthcare arenas for minority populations regardless of weight status.

Factors Associated with Weight Resilience in Obesogenic Environments in Female African-American Adolescents

This study used a descriptive, cross-sectional analysis to examine a social ecological model of obesity among African-American female adolescents residing in obesogenic environments. The goal was to identify factors that promote weight resilience, defined as maintaining a healthy body weight despite living in an environment that encourages inactivity and undermines healthy weight behaviors. During 2005 to 2008, weight-resilient (n=32) and obese (n=35) African-American female adolescents (12 to 17 years) living in Detroit, MI, and their caregivers completed measures of individual, family, and extrafamilial weight-resilience factors. Variables related to weight resilience in bivariate analyses were subjected to multivariate analysis using logistic regression to test the hypothesis that these factors independently predicted adolescent membership into the weight-resilient or obese group. As hypothesized, the odds of an adolescent being weight resilient were predicted by lower caregiver body mass index (calculated as kg/m(2)) (odds ratio [OR]=0.790; 95% confidence interval [CI]: 0.642 to 0.973), lower caregiver distress (OR=0.796; 95% CI: 0.635 to 0.998), higher caregiver monitoring and supervision of exercise (OR=5.746; 95% CI: 1.435 to 23.004), more frequent full-service grocery store shopping (OR=5.147; 95% CI: 1.137 to 23.298), and more peer support for eating (OR=0.656; 95% CI: 0.445 to 0.969). Contrary to prediction, lower eating self-efficacy (OR=0.597; 95% CI: 0.369 to 0.965) also predicted weight resilience. The model correctly classified 92.5% of all cases. Findings suggest that increasing psychosocial weight-resilience factors across multiple systems might be an important intervention strategy for obese African-American female adolescents residing in obesogenic environments.

African American Preschool Children's Physical Activity Levels in Head Start

The purpose of this study was to describe the physical activity levels of urban inner city preschoolers while attending Head Start, the federally funded preschool program for children from low-income families. Participants were 158 African American children. Their physical activity during Head Start days was measured using programmed RT-3 accelerometers. Results revealed that the children spent the most time in sedentary and light physical activity, while their participation in moderate-to-vigorous physical activities was low. Given the sedentary class format and limited physical space for the Head Start programs observed, we suggest adding a structured physical activity component to Head Start schools to fight the overweight and obesity crisis.

Dietary Vitamin D Intake Among High-Risk Adolescents With Insulin Dependent Diabetes

Purpose The purpose of the present study was to describe the dietary intake of vitamin D in an urban, low income, predominantly African American sample of adolescents with insulin dependent diabetes. Methods Participants were 99 adolescents diagnosed with insulin dependent diabetes. Vitamin D intake was estimated from dietary recall data. Blood glucose levels were also assessed. Results The average daily vitamin D intake estimated from dietary recall data was 102 IUs (SD = 64.4) with 70% of adolescents consuming less than 50 IUs of vitamin D in their day. Level of vitamin D intake was a significant predictor of HbA1c levels in the current sample. Conclusions Results indicate a need for the assessment of vitamin D levels in this at-risk population, as supplementation may be indicated.