Linda L. Dannison

Food, Culture, and Family: Exploring the Coordinated Management of Meaning Regarding Childhood Obesity

Increased rates of childhood obesity combined with more accessible information about the relationship between diet, physical activity and inactivity, and chronic diseases suggest the need for analyzing the complex process of receiving and transmitting messages related to child feeding practices. This study examined the perceptions of childhood obesity within 1 multiethnic community, the Commonwealth of the Northern Mariana Islands. In particular, through the use of focus groups, individuals indicated that sociocultural, familial, and official nutritional messages were most influential to their health care behaviors. The coordinated management of meaning (CMM) theory was used to gain insight into how individuals negotiate competing messages occurring at different levels of meaning. Given its focus on cultural influences (parallel to the concepts of archetypes), CMM proved especially relevant for understanding child feeding beliefs, values, attitudes, and practices in diverse ethnic populations. Implications for future health communication research that might draw from a CMM approach were identified, as well as pragmatic endeavors that focus on the development, implementation, and evaluation of culturally appropriate interventions in the prevention of childhood obesity.

Prevention of childhood obesity: Sociocultural and familial factors

This study examined sociocultural and familial factors related to the prevention of childhood obesity. Primary caregivers of 6- to 10-year-old children representing several ethnic populations in Saipan participated in 4 focus groups (N=32). Trained moderators used semi-structured interviews and qualitative methods were used in data analysis. A central theme with several related factors emerged. The theme was a conflict expressed by the primary caregiver between sociocultural values, family expectations, traditional dietary beliefs and attitudes, and knowledge about food and disease. These findings have important implications for designing culturally sensitive interventions for prevention of childhood obesity.

Childhood obesity prevention: an intervention targeting primary caregivers of school children.

Community‐based participatory research (CBPR) was used to design and evaluate the effectiveness of a culturally relevant, science‐based intervention for the prevention of childhood obesity in the Commonwealth of the Northern Mariana Islands (CNMI), a US Commonwealth in the western Pacific. This cognitive behavioral lifestyle intervention, Project Familia Giya Marianas (PFGM), was offered during the 2005–2007 school years in all CNMI public elementary schools over eight sessions to primary caregivers of 3rd grade children (N = 407). A crossover design was utilized with half of the schools offering the intervention in the Fall term, while the other half delivered the sessions in the Spring term. The primary outcome measure was change in BMI z‐score. There was an intervention‐dependent effect on BMI z‐score, with program impact being a function of baseline BMI and the number of lessons attended. This effect was most apparent in students whose baseline BMI z‐score was in healthy range (≥5 to <85 percentile). In both Asian and Pacific Island groups, children whose caregivers completed 5–8 lessons experienced a significant change in BMI z‐score as compared to those with 0 lessons (P < 0.05). Research that integrates multidisciplinary and multimethod approaches is effective in identifying and/or devising solutions to address a complex condition such as childhood obesity. PFGM demonstrated that community participation can be successfully utilized in the development and implementation of childhood obesity prevention programs.

Grandparents raising grandchildren: A psychoeducational group approach

Abstract This article presents results from a study exploring the use of a psychoeducational group format specifically developed for grandparents who are raising their grandchildren. The 8-week group sessions covered topics such as parenting skills, personal well-being, relationships, managing finances, and exploring legal issues. Group facilitators noted grandparents consistently met objectives of the content areas, with increased mastery as sessions progressed. Custodial grandparents rated the group experience as positive, indicating a high degree of interest and enjoyment from the psychoeducational format, with no differences reported across session topics.

Grandparent-Headed Families in the United States: Programming to Meet Unique Needs.

Abstract Grandparents are returning to the role of parents in ever-increasing numbers. Custodial grandparents often find themselves isolated from sources of support as they face unique emotional, physical, and financial challenges on a daily basis. Nearly half are grandparents without partners and the majority are caring for two or more young children. Children in the care of grandparents are more likely to experience cognitive, emotional, and physical challenges. Their early traumatic experiences may lead to difficulties in communication and forming attachments. The Parent Topics Questionnaire is a standardized assessment measure designed to provide parent education group facilitators with specific information about needs, desires, and expectations of participants. Administration of this instrument to four parent groups revealed a high readiness for information among the custodial grandparent population. Based on information obtained from this measure, a holistic program was developed which simultaneously provided services to care-giving grandparents, their young grandchildren, and educational professionals. Grandparent and grandchildrens groups met weekly and emphasized topics and activities aimed at meeting common needs within these populations. Educational professionals participated in a series of inservice meetings aimed at increasing awareness of needs and strengths of grandparent-headed families, modifying curriculum to more effectively meet grandchildrens needs, and enhancing knowledge of existing resources. Pre- and post-test analysis demonstrate significant positive effects for all involved populations. Grandparents were found to increase in parenting knowledge, perceived levels of social support, willingness to utilize existing resources, and enjoyment of time with their grandchildren. Levels of isolation and perceived depression were decreased. Participating grandchildren demonstrated increased abilities to interact effectively with peers and adults and perceived their interactions with grandparents more positively. Educational professionals reported feeling more informed about custodial grandparent family issues, more confident about interacting with grandparents, and more knowledgeable about existing resources.

Skipped Generation Parents: Building Collaborative Partnerships to Support Custodial Grandparents

Social service caseworkers observed a significant number of custodial grandparents who appeared isolated from typical community support networks. These grandparents, for one reason or another, were actively involved in parenting their children’s children. Many issues of re-parenting were of significant concern. Some grandparents presented poor parenting skills and others were frustrated with their circumstances. Resources typically available to support foster care families were not available to these families. These observations were numerous enough to bring the matter to the attention of others, including supervisors and other caseworkers.