Laura Bellows

Formative Research and Strategic Development of a Physical Activity Component to a Social Marketing Campaign for Obesity Prevention in Preschoolers

The prevalence of overweight in childhood, including preschoolers, continues to rise. While efforts focusing on school-aged children are encouraging, obesity prevention programs to address nutrition and physical activity in the child care center are lacking. Food Friends® is a successfully evaluated nutrition program aimed at enhancing preschoolers’ food choices, the addition of a physical activity program would improve the programs overall efforts to establish healthful habits early in life. This study describes the formative research conducted with secondary influencers of preschoolers—teachers and parents—for the development of a physical activity program. Key informant interviews and focus group discussions were conducted with preschool teachers and parents, respectively, to examine current physical activity practices, as well as attitudes, opinions, and desired wants and needs for physical activity materials. Findings illustrate that teachers provided physical activity; however, most did not use a structured program. Teachers identified time, space and equipment as barriers to providing activity in their classroom. Focus group findings identified activities of preschoolers’, parents’ perceptions of the adequacy of activity levels, and items to help parents engage their children in more physical activity. Barriers were also identified by parents and included time, safety, inclement weather, and lack of knowledge and self-efficacy. Findings from this formative research were used to develop a marketing strategy to guide the development of a physical activity component, Food Friends Get Movin’ with Mighty MovesTM, as part of a larger social marketing campaign aimed to decrease the risk for obesity in low-income preschoolers.

Making New Foods Fun for Kids

The “Food Friends: Making New Foods Fun For Kids” program is a uniquely creative and effective method for educators to address nutrition and eating habits with preschool children. To date, over 50 preschool and Head Start classrooms have used the program. It continually undergoes refinement based on feedback from teachers, children, and nutrition educators. In addition, a parent component is currently under development. Anyone interested in more information about the program is encouraged to contact the authors or visit the Colorado Nutrition Networks Web site at www.cahs.colostate.edu/fshn/nep .

Home food and activity assessment. Development and validation of an instrument for diverse families of young children

The purpose of this study was to refine and psychometrically test an instrument measuring the home food and activity environment of geographically and economically diverse families of preschool aged children. Caregivers of preschool aged children (n = 83) completed a modified self-report questionnaire. Reliably trained researchers conducted independent observations on 25 randomly selected homes. Agreement statistics were conducted at the item level (154 total items) to determine reliability. Frequency counts were calculated to identify item availability. Results showed Kappa statistics were high (.67-1.00) between independent researchers but varied between researchers and parents resulting in 85 items achieving criterion validity (Kappa >.60). Analyses of reliable items revealed the presence in the home of a high frequency of unhealthy snack foods, high fat milk and low frequency of availability of fruits/vegetables and low fat milk. Fifty-two percent of the homes were arranged with a television in the preschool childs bedroom. Physical Activity devices also were found to have high frequency availability. Families reporting lower education reported higher levels of sugar sweetened beverages and less low-fat dairy (p < .05) compared with higher education families. Low-income families (<

Parental Perception on the Efficacy of a Physical Activity Program for Preschoolers

27K per year) reported significantly fewer Physical Activity devices (p < .001) compared with higher income families. Hispanic families reported significantly higher numbers of Sedentary Devices (p < .05) compared with non-Hispanic families. There were no significant differences between demographic comparisons on available fruits/vegetables, meats, whole grains, and regular fat dairy. A modified home food and activity instrument was found to reliably identify foods and activity devices with geographically and economically diverse families.

Young Children’s Food Neophobia Characteristics and Sensory Behaviors Are Related to Their Food Intake

Childhood obesity is among the leading health concerns in the United States. The relationship between unmet physical activity needs in young children is of particular interest as the trend in childhood obesity continues to rise and unmet physical activity needs are identified. The preschool years are an influential time in promoting healthful lifestyle habits and early childhood interventions may help establish lifelong healthful behaviors which could help prevent obesity later in life. The Food Friends®: Get Movin’ with Mighty Moves® is a preschool physical activity program which aims to improve children’s gross motor skills and physical activity levels. The home environment and parental modeling are critical factors related to child physical activity in this population. The parent component, Mighty Moves®: Fun Ways to Keep Families Active and Healthy, was designed to address barriers in the home environment that lead to unmet physical activity needs in preschoolers and their families. The program and materials were designed based on Social Marketing tenets and Social Learning Theory principles. Four Colorado Head Start centers were assigned to an experimental group as part of the Mighty Moves® group randomized trial. Quantitative and qualitative evaluation methods were used to determine what messages and materials reached and motivated the target audience to increase physical activity levels. Results of the study indicated the program’s materials helped families and children to be more physically active. Additionally, materials and material dissemination were revised to enhance program goals.

Report of an EU–US Symposium on Understanding Nutrition-Related Consumer Behavior: Strategies to Promote a Lifetime of Healthy Food Choices

BACKGROUND Food neophobia in children has been associated with poor dietary variety and nutrient intakes. Underlying characteristics that may predispose a child to neophobia have not been widely studied. OBJECTIVE We investigated the associations between childrens food neophobia, sensory sensitivity, and dietary intake in a diverse sample of typically developing preschoolers. METHODS Caregiver reports of childrens food neophobia and sensory behaviors (SBs) as measured by the Food Neophobia Scale and the Sensory Profile, childrens observed weight outcome [body mass index z score (BMIz)], and childrens food intake as estimated from the Block Kids Food Screener were collected at baseline in the Colorado LEAP (Longitudinal Eating and Physical Activity Study) study of childhood obesity. Preschool-aged children (n = 249; 136 girls, 113 boys; aged 55.6 ± 4.7 mo; BMIz = 0.54 ± 1.14) and caregivers [n = 180; 57 Hispanic, 119 non-Hispanic white (NHW), 4 unknown] participated. Data were analyzed by Pearson correlations and multivariate hierarchical linear regression analyses. RESULTS Lower scores for childrens oral sensory characteristics (i.e., more atypical) were related to higher neophobia ratings (r = -0.53, P < 0.001), and neophobia was negatively associated with reported vegetable intake (r = -0.31, P = 0.001) and dietary variety (r = -0.22, P < 0.001). Hispanic caregivers reported more atypical child SB scores (46.2 ± 8.8) than did NHW caregivers (50.5 ± 7.6; P = 0.006); however, no differences were noted for neophobia and SB scores by parent income and education or child sex. Neophobia was negatively associated with vegetable intake and dietary variety (P < 0.001 for both). SBs were associated with childrens energy intake from sugar-sweetened beverages in bivariate analyses (r = -0.18, P < 0.05); however, in regression models, only ethnicity was significantly associated with energy from sugar-sweetened beverages (P < 0.001). Hispanic ethnicity was positively associated with sugar-sweetened beverage consumption (P < 0.001). CONCLUSIONS Childrens neophobia and sensory sensitivity may be important in understanding underlying issues related to limited food acceptance in typically developing young children and for helping caregivers facilitate healthy dietary intake patterns for their children. This trial was registered at clinicaltrials.gov as NCT01937481.

Children's Challenging Eating Behaviors: Picky Eating, Food Neophobia, and Food Selectivity

This report summarizes an EU-US Task Force on Biotechnology Research symposium on healthy food choices and nutrition-related purchasing behaviors. This meeting was unique in its transdisciplinary approach to obesity and in bringing together scientists from academia, government, and industry. Discussion relevant to funders and researchers centered on (1) increased use of public-private partnerships, (2) the complexity of food behaviors and obesity risk and multilevel aspects that must be considered, and (3) the importance of transatlantic cooperation and collaboration that could accelerate advances in this field. A call to action stressed these points along with a commitment to enhanced communication strategies.

Are Family Routines Modifiable Determinants of Preschool Children’s Eating, Dietary Intake, and Growth? A Review of Intervention Studies

Abstract Picky eating, food neophobia, and food selectivity are challenging eating behaviors that emerge during early childhood. Although these behaviors are highly interrelated, they differ in prevalence and scope. In this chapter, we define each of the behaviors and explore their similarities and differences in terms of measurement, antecedents, and consequences. All three behaviors appear to have both genetic and environmental components that impact the severity and degree to which the behaviors are expressed. Additionally, each of the behaviors is associated with important nutrition, health, and growth outcomes. To date, the majority of data related to these behaviors has been collected through cross-sectional studies, and thus it is difficult to make conclusions regarding the developmental trajectory of these behaviors or recommendations for treatment in severe clinical cases. Consistent definitions and measurement approaches are needed to better understand antecedents and to develop effective interventions for each behavior.

Barriers and Facilitators to Healthy Eating and Activity in Head Start Staff: An Opportunity for Worksite Wellness.

Purpose of ReviewChildren’s eating behaviors are critical determinants of their dietary intake and, hence, childhood growth. Nutritional interventions among families with young children are focused on parents as agents of change, with interventions increasingly targeting family routines as drivers of children’s eating and health outcomes. This review describes studies that have acted on family routines in the context of preschoolers’ eating and growth, summarizes their findings, and discusses the limitations of current approaches to studying family routines and the implications for future research.Recent FindingsWe found that food availability and parental offering of foods have been modified by several interventions and linked to positive changes in child outcomes. Parent interventions have had success in reducing controlling feeding practices and improving self-efficacy related to child feeding, but these have not been associated with long-term change in child outcomes.SummaryWe conclude that opportunities exist to strengthen the definition, operationalization, and measurement of family routine variables. Improvements in fidelity and process evaluation measures will be important for more efficacious intervention development and dissemination.

The Healthy Weight Disparity Index: Why We Need It to Solve the Obesity Crisis

Background: Head Start (HS) staff are ideally positioned to promote healthy behaviors to over one million low-income children each year, however little is understood about their own health. Purpose: To conduct a needs assessment with HS staff to: 1) understand perceptions, barriers and motivators to healthful behaviors; and 2) ascertain interest in a worksite wellness program. Methods: Surveys (n = 154) and telephone interviews (n = 25) were conducted with HS staff from eight Colorado HS centers (4 rural, 4 urban). Results: Findings indicate that 56% of teachers were overweight or obese, 89% wanted to be more active, and 86.6% desired wellness programming. Motivators consisted of relief of stress, health, and weight control; barriers included time, fatigue, and money; desired topics included nutrition, exercise, and stress management. Motivators, barriers and interest topics were consistent across surveys and interviews. Discussion and Translation to Health Education Practice: HS staff want and need comprehensive wellness programming. Wellness programming should be tailored to include nutrition, physical activity and stress reduction strategies utilizing multifaceted modes of delivery. Improved staff wellness and increased comfort with health and wellness topics could impact the school environment and young childrens health.