Monique Reed

Eating Behaviors Among Early Adolescent African American Girls and Their Mothers

African American (AA) girls aged 10–12 living in urban communities designated as food deserts have a significantly greater prevalence of overweight and obesity than girls that age in the general population. The purpose of our study was (a) to examine the agreement in nutritional intake between AA girls aged 10–12 and their mothers and (b) to determine if the girls’ weight categories were associated with their or their mothers demographic characteristics, eating behaviors, nutritional intake, and health problem. A cross-sectional descriptive study was conducted in predominantly low-income AA communities in Chicago. Forty-three dyads of early adolescent AA girls and their mothers responded to food frequency and eating habits questionnaires. There was a strong and significant correlation between mother’s and daughter’s kilocalories consumed (r = .61). Our study suggests that interventions aimed at improving eating behaviors in early adolescent AA girls should include their mothers.

Identification, Prevention, and Management of Childhood Overweight and Obesity in a Pediatric Primary Care Center

Background. In the United States, overweight/obesity among youth has reached epidemic proportions. The purpose of this project was to (1) examine primary care provider adherence to American Academy of Pediatrics guidelines; (2) compare adherence based on patients’ weight classification, age, race, and gender; and (3) identify areas for improvement in health care delivery. Methods. A retrospective chart audit and feedback quality improvement project was conducted with a stratified random sample of 175 charts of 6- to 19-year-olds seen for well-child visits. Frequencies of provider adherence were reported. χ2 Analyses of weight classification, age, race, or gender influence on adherence was calculated. Results. After discussion with the primary care providers, 5 areas were identified as priorities for change (diagnosis based on BMI, parental history of obesity, sleep assessment, endocrine assessment, and attendance of patients at the follow-up visit). Conclusion. Cost-efficient, feasible strategies to improve provider adherence to recommendations for identification, prevention and management of childhood overweight and obesity were identified.

Determinants of Obesity in the Hispanic Preschool Population: An Integrative Review

OBJECTIVE(S) The purpose of this integrative review was to identify factors associated with obesity in Hispanic preschool children. DESIGN AND SAMPLE Integrative research review based on strategies described by Whittemore and Knafl. Thirty-five research reports using qualitative and/or quantitative methods and including a majority of participants (parents or preschool-aged children) of Hispanic ethnicity. MEASURES Data were analyzed using the Matrix Method. RESULTS Decreased physical activity of the child and increased maternal body mass index were found as contributors to obesity in the preschool, Hispanic population. The relationship between maternal feeding practices and beliefs, food choices and childhood obesity are widely studied with little consistency in findings across studies. CONCLUSIONS Public health nurses can work with communities to promote physical activity and safe outdoor places for exercise. In addition, they can advocate for the availability of healthy food choices in neighborhood schools. Maternal feeding practices, acculturation, and the childs environment require further research.

Creating a community-physical therapy partnership to increase physical activity in urban African-American adults

Background: Racial disparities in health across the United States remain, and in some cities have worsened despite increased focus at federal and local levels. One approach to addressing health inequity is community-based participatory research (CBPR). Objectives: The purpose of this paper is to describe the develop ment of an ongoing community–physical therapy partnership focused on physical activity (PA), which aims to improve the health of African-American community members and engage physical therapist (PT) students in CBPR. Methods: Three main research projects that resulted from an initial partnership-building seed grant include (1) community focus groups, (2) training of community PA promoters, and (3) pilot investigation of PA promoter effectiveness. Lessons Learned: Results from each project informed the next. Focus groups findings led to development of a PA pro moter training curriculum. PA promoters were accepted by the community, with potential to increase PA. Focus on the community issue of PA fostered and sustained the partnership. Conclusions: Community and academic partners benefitted from funding, structure, and time to create meaningful, trusting, and sustainable relationships committed to improving health. Engaging PT students with community residents provided learning opportunities that promote respect and appreciation of the social, economic, and environmental context of future patients.

Childhood Obesity Policy Implications for African American Girls and a Nursing Ecological Model

In the United States there is a prevalence of obesity among ethnic groups, especially African American girls. The author in this column examines through an ecological lens selected American federal, state, and city policies and program interventions aimed at reducing obesity. Specifically, the eating behavior of African American girls is discussed as a population subset for which significant gaps are present in current obesity policy and implementation. Policy recommendations should include parents as research has shown a significant relationship in the eating behaviors of African American girls and their parents. Opportunities for nurses in practice and research to test the effectiveness of family and community level policy and program initiatives that address the ecological perspectives of the adolescent environment are discussed.

Parent and African American Daughter Obesity Prevention Interventions: An Integrative Review

Background. In the U.S., overweight/obesity among African American (AA) girls has become epidemic. Since parental factors may be associated with improved weight status, it is important to understand the empirical evidence for including parents in obesity prevention interventions with AA girls. The purpose of this integrative review was to identify effectiveness and characteristics of obesity prevention interventions for AA girls (6–17 years) and their parent. Methods. Included interventions addressed physical activity (PA), dietary/eating behaviors, and body composition. Results. Of 708 studies published through March 2014, eight met inclusion criteria. Though effects were in the intended direction for most, statistically significant effects were found only for dietary intake and eating behavior. Discussion. Interventions were characterized by exclusion of girls ages 13–17, failure to link parent involvement to child outcomes, the absence of family systems theory, and modest effects. Further research is needed to ascertain the effectiveness of daughter/parent obesity prevention interventions.

Child Temperament, Maternal Feeding Practices, and Parenting Styles and Their Influence on Obesogenic Behaviors in Hispanic Preschool Children

Although obesogenic behaviors (physical activity and/or sedentary behavior and dietary intake) are known predictors of childhood weight status, little is known about mother and child behaviors contributing to obesogenic behaviors and obesity in Hispanic preschool children, whose obesity rate is higher than in non-Hispanic Whites and non-Hispanic Blacks. The purpose of this cross-sectional, descriptive study was to examine relationships among child temperament, maternal behaviors (feeding practices and parenting style), child obesogenic behaviors, and child weight status in 100 Hispanic preschool children. Results showed that higher scores on the negative affectivity dimension of child temperament were associated with higher scores on the dimension of permissive parenting, and permissive parenting was associated with less time spent in sedentary behaviors (B = −3.53, confidence interval [−7.52, −0.90]). Findings can guide school nurses in developing interventions that consider child temperament and parenting style to promote nonobesogenic behavior in Hispanic preschoolers.

The Chronic Care Model to Improve Management of Childhood Obesity

One-third of children in the United States are overweight or obese. Comorbidities continue into adulthood if a healthy weight is not established. While expert guidelines for management of this condition are recognized, provider adherence to guidelines is lacking. The purpose of this quality improvement project was to evaluate the effectiveness of the chronic care model (CCM) on improving primary care provider identification, prevention, and management of childhood overweight and obesity. A pre- and postintervention chart audit was completed to evaluate documentation of 20 assessment measures included in expert guidelines. A chi-square analysis was conducted to assess differences. Statistically significant improvements were found in documentation of parental obesity, family medical history, sleep assessment, endocrine assessment, and weight classification as a diagnosis. Use of the CCM had a positive impact on provider adherence to expert guidelines. Furthermore, not all aspects of the CCM must be used to see statistically significant improvements.

Beyond the Manuscript: Podcast Interview Transcript

In each volume of the Journal, the editors select one article for our Beyond the Manuscript post-study interview with the authors. Beyond the Manuscript provides the authors the opportunity to tell listeners what they would want to know about the project beyond what went into the final manuscript. The associate editors who handled the articles conduct our Beyond the Manuscript interviews. This edition of Beyond the Manuscript features Maryann Mason, Darby Morhardt, Ben Rucker, Monique Reed, Gina Curry, Jen Brown and Bill Haley, authors of “I Know What CBPR Is, Now What Do I do? . . . ” Community Perspectives on CBPR Capacity Building, and special issue Guest Editor Elmer Freeman.