Nicole Mareno

Parental perception of child weight: a concept analysis.

AIM This article is a report of an analysis of the concept of parental perception of child weight. BACKGROUND Perception is commonly studied, but lacks a strong conceptual definition. Concept analysis is important in providing a conceptual definition of parental perception of child weight. DESIGN Rodgerss evolutionary view of concept analysis guided this enquiry. DATA SOURCES A search of multiple nursing and social sciences databases was undertaken, including CINAHL, Academic Search Complete, Science Direct, ProQuest, PsychINFO, Medline and SocINDEX. REVIEW METHODS Data from 2000-2012 related to the concept of interest were reviewed. Fifty-eight articles meeting the inclusion criteria were included. Key attributes, antecedent occurrences and consequences of the concepts use were identified. Thematic analysis revealed common themes related to the concept attributes, antecedents and consequences. RESULTS Five attributes were identified including: parental recognition of body size, physical appearance, functional abilities, psychosocial effects and health effects related to body weight. Antecedents of this concept are parental beliefs and values about body weight, fatalism, societal normalization of overweight, parental weight status and parental mental health status. The consequences of this concept are parental concern, increased knowledge about obesity-related health risks, motivation to make changes and family lifestyle changes. The ultimate goal is a healthy weight for the child. CONCLUSIONS A middle-range explanatory theory of parental perception of child weight was proposed. Parents who recognize child weight issues may be motivated to initiate lifestyle changes, resulting in a healthy weight for the child.

Cultural Competency among Nurses with Undergraduate and Graduate Degrees: Implications for Nursing Education

AIM To compare the level of cultural awareness, knowledge, skills, and comfort of nurses with undergraduate and graduate degrees when encountering patients from diverse populations. BACKGROUND Cultural competency is a core curriculum standard in undergraduate and graduate nursing programs. Assessing cultural awareness, knowledge, skills, and comfort among nurses can help identify areas to strengthen in nursing curricula. METHOD A prospective, cross‐sectional, descriptive study design was used. Two thousand surveys were sent to nurses in a southeastern state; 365 nurses participated. RESULTS Undergraduate‐degree nurses scored lower than graduate‐degree nurses on cultural knowledge. Scores on cultural awareness, skills, and comfort with patient encounters did not vary between groups. Both groups of nurses reported little cultural diversity training in the workplace or in professional continuing education. CONCLUSION The findings of this study indicate areas of need for undergraduate and graduate nursing education.

Overweight and obesity among White, Black, and Mexican American children: implications for when to intervene.

PURPOSE The study sought to determine if race/ethnicity, age, gender, and poverty index influence the development of overweight (OW) or obesity (OB) in children 6-11 years of age and whether a desirable time to intervene could be established. METHODS A descriptive and comparative analysis was conducted using data from the 1999-2008 National Health and Nutrition Examination Survey. RESULTS Advancing age was the single largest predictor of OW or OB followed by race/ethnicity. PRACTICE IMPLICATIONS Culturally sensitive interventions targeting children in their early elementary school years could reduce the consequences of OW and OB in childhood.

Ways to Enhance Children's Activity and Nutrition (WE CAN) - a pilot project with Latina mothers.

PURPOSE This article presents the feasibility and acceptability of the 4-week Ways to Enhance Childrens Activities and Nutrition (WE CAN) program. DESIGN AND METHOD Mixed methods were utilized. Quantitative data were collected from Latina mothers using self-administered surveys. RESULTS The program was positively received, although attrition was a concern. Mothers were concerned about their childrens weight and were receptive to being key role models for being more active, limiting screen time, buying less junk food, and increasing consumption of fruits and vegetables. PRACTICE IMPLICATIONS Findings provide nurses with knowledge on how mothers view appropriate nutrition and activity as important to their childrens health.

Replication and Extension of the Weight Loss For Life Community-Based Treatment Protocol

ABSTRACT Maintaining weight-loss beyond 6–9 months within behavioral treatments has been problematic. However, a social cognitive theory-driven, community-based curriculum emphasizing the generalization of physical activity-related self-regulation, to eating-related self-regulation (phase 1 treatment; n = 55), demonstrated success at both inducing lost weight over its initial 6 months, and maintaining that loss through month 24. The present replication study contrasted those outcomes with a phase 2 version of the year-long treatment (n = 74) that added a follow-up component during year 2 consisting of 5 brief phone interactions to reinforce self-regulatory skills. Participants were all women with obesity (body mass index 30–40 kg/m2; mean age = 48 years). In phase 2, the mean weight loss of 6.3% during baseline-month 6, and regain of 0.7% through month 24, did not significantly differ from phase 1. However, phase 2 methods were associated with significantly better retention of improvements in self-regulation, fruit/vegetable intake, and physical activity. For phase 2 results, second-year change in fruit/vegetable consumption completely mediated the significant relationship between self-regulation and weight change, and change in physical activity completely mediated the significant relationship between self-regulation and weight change, over the 2-year study. Findings suggest the importance of moderate physical activity and more intensive follow-up focused on self-regulation processes.

Indirect effects of exercise on emotional eating through psychological predictors of weight loss in women.

An improved understanding of how weight-loss interventions might be tailored to improve emotional eating is required. This study aimed to assess mediation of the relationship between increased exercise and decreased emotional eating so that behavioral treatments might be optimized. After randomization, women with obesity (N = 108; mean age = 48 years) were assigned to either a previously tested treatment of manual-based self-help for nutrition and exercise plus brief phone follow-ups, or a new protocol of cognitive-behavioral methods of exercise support intended to carry-over psychological improvements to better controlled eating and weight loss. A community-based field setting was incorporated. Validated self-report measures were administered over 6 months. Significant overall improvements in exercise outputs, emotional eating, mood, and self-regulation and self-efficacy for controlled eating were found. The newly developed treatment protocol demonstrated significantly greater improvements in exercise outputs and self-regulation. In a multiple mediation analysis, changes in self-regulation, self-efficacy, and mood significantly mediated the relationship between changes in exercise and emotional eating. Changes in self-efficacy and mood were significant independent mediators. Within follow-up analyses, the substitution of emotional eating subscales that addressed specific moods, and a subscale of self-efficacy for controlled eating that addressed that factor specifically in the presence of negative emotions, yielded results generally consistent with those of the multiple mediation analysis. Results suggested a psychological pathway of exercises association with emotional eating changes in women with obesity. Guided by the present findings, tailoring exercise support and leveraging it to induce specific psychological improvements might reduce emotional eating and improve weight-management outcomes.

Treatment-Associated Changes in Body Composition, Health Behaviors, and Mood as Predictors of Change in Body Satisfaction in Obese Women Effects of Age and Race/Ethnicity

A lack of satisfaction with one’s body is common among women with obesity, often prompting unhealthy “dieting.” Beyond typically slow improvements in weight and body composition, behavioral factors might also affect change in body satisfaction. Age and race/ethnicity (African American vs. White) might moderate such change. Obese women (N = 246; Mage = 43 years; MBMI = 39 kg/m2) initiating a 6-month cognitive-behaviorally based physical activity and nutrition treatment were assessed on possible predictors of body satisfaction change. At baseline, African American and younger women had significantly higher body satisfaction. The treatment was associated with significant within-group improvements in mood, health behaviors (physical activity and fruit/vegetable intake), and body composition (waist circumference). A multiple regression analysis indicated that mood, health behavior, and body composition changes explained a significant 27% of the variance in body satisfaction change. Of these predictors, changes in mood (β = −.36, p < .001) and health behaviors (β = .18, p = .01) made significant, unique contributions to the variance in change in body satisfaction that was accounted for, while only the measure of actual physiological change (body composition) did not. Neither age nor race/ethnicity was a significant moderator when each was entered separately into the multiple regression equation. Practical implications for leveraging manageable changes in behavioral factors for improving body satisfaction were discussed.

Psychometric Validation of the Revised Clinical Cultural Competency Questionnaire

Background and Purpose: Growing diversity in health care requires culturally competent care. Assessing nurses’ cultural competence is the first step in designing cultural competency education. The Clinical Cultural Competency Questionnaire (CCCQ) is one instrument to assess nurses’ cultural competence. Methods: The psychometric properties and factor structure of the revised CCCQ-PRE (CCCQ-PRE-R) for nurses was examined. Results: A 1-factor solution was noted for the knowledge and skills subscales. A 2-factor solution was discovered for the comfort and awareness subscales: differentiating between comfort in dealing with positive and negative cross-cultural encounters/situations, and differentiating between importance awareness and self-awareness. Cronbach’s alpha coefficients were high for all subscales. Conclusions: The findings support the use of the revised CCCQ-PRE-R with nurses. Further testing in larger, more diverse nursing populations is warranted.

Psychometric properties of the Clinical Decision-Making Self-Confidence Scale.

Background and Purpose: Nurses’ self-confidence in handling acute patient deterioration events may influence decision-making capabilities and implementation of lifesaving interventions during such events. The study purpose is to provide further psychometric testing of the Clinical Decision-Making Self-Confidence Scale (CDMSCS). Methods: The psychometric properties and factor structure of the CDMSCS was examined. Results: A two-factor solution was discovered for the CDMSCS. Construct validity was further supported by statistically significant differences between registered nurses and nursing students’ self-confidence level in handling deterioration events. Cronbach’s alpha coefficients were acceptable for the subscales and instrument. Conclusion: The CDMSCS is a valid and reliable instrument. Future studies should focus on establishing test–retest reliability and to determine factor loadings of subscale items to retain or delete cross-loading items.

Effects of the Youth Fit 4 Life physical activity/nutrition protocol on body mass index, fitness and targeted social cognitive theory variables in 9‐ to 12‐year‐olds during after‐school care

Childhood overweight and obesity is unacceptably high in industrialised nations. School‐based interventions have largely been atheoretical and ineffective. This study aimed to test a new theory‐based protocol for its effects on measures of fitness and body mass index (BMI), and its proposed psychosocial mediators, during elementary after‐school (out‐of‐school hours) care.