Rachel W. Gow

Preventing weight gain in first year college students: an online intervention to prevent the "freshman fifteen".

The transition to college has been identified as a critical period for increases in overweight status. Overweight college students are at-risk of becoming obese adults, and, thus prevention efforts targeting college age individuals are key to reducing adult obesity rates. The current study evaluated an Internet intervention with first year college students (N=170) randomly assigned to one of four treatment conditions: 1) no treatment, 2) 6-week online intervention 3) 6-week weight and caloric feedback only (via email), and 4) 6-week combined feedback and online intervention. The combined intervention group had lower BMIs at post-testing than the other three groups. This study demonstrated the effectiveness and feasibility of an online intervention to prevent weight gain among college students.

An Evaluation of the Reliability and Construct Validity of Eating Disorder Measures in White and Black Women.

Most measures of eating disorder symptoms and risk factors were developed in predominantly White female samples. Yet eating disorders affect individuals of all racial and ethnic backgrounds. Black women appear more vulnerable to certain forms of eating pathology, such as binge eating, and less susceptible to other eating disorder symptoms and risk factors, such as body dissatisfaction, compared with their White peers. Despite concern that extant measures do not adequately assess eating concerns among Black women, the construct validity of scores on most of these measures has not been adequately examined within this population. This study included 2,208 Black and White women who completed the following: the Binge Eating Scale (BES), the Eating Disorder Diagnostic Scale (EDDS), the Eating Attitudes Test-26 (EAT-26), the Eating Disorder Inventory Body Dissatisfaction and Drive for Thinness subscales, the Bulimia Test-Revised (BULIT-R), the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MBSRQ-AE), and the Objectified Body Consciousness Scale (OBCS). Most measures yielded internally consistent scores in both races. Confirmatory factor analyses indicated that loadings for some measures, including the EAT-26 and EDDS, were not invariant across groups and thus do not assess equivalent constructs in White and Black women. However, others, including the BULIT-R, BES, OBCS, and MBSRQ-AE, exhibited factorial invariance in both races. Results suggest scores are likely not equivalent across races for several popular measures of eating disorder symptoms and risk factors. Thus, it is recommended that researchers and clinicians obtain additional information regarding racial/cultural factors when using these instruments with Black women.

Nourishing Our Understanding of Role Modeling to Improve Support and Health (NOURISH): Design and methods

Pediatric overweight is associated with numerous physical and psychological health risks, and overweight children are at significant risk for obesity in adulthood. African-American children are at particularly high risk for obesity and related health complications. However, this racial group has traditionally had limited access to obesity treatment and relatively few studies have included sufficient numbers of lower-SES, African American participants. Further, although parental involvement in treatment for pediatric overweight has been found to be beneficial, few studies have examined the efficacy of offering treatment exclusively to parents, a potentially cost-effective approach which could benefit the entire family. This pilot project will evaluate the efficacy of an intensive parenting intervention, (NOURISH; Nourishing Our Understanding of Role modeling to Improve Support and Health), targeting racially diverse parents of overweight children (ages 6-11). NOURISH addresses several urgent research priorities by targeting the underserved and addressing the significant disparity in obesity treatment services. Parents meeting study criteria (having a child between the ages of 6 and 11 with a BMI ≥ the 85th percentile) will be offered participation in the randomized trial comparing NOURISH with a control group. We hypothesize that children whose parents participate in NOURISH will manifest greater decreases in BMI, and greater improvements in dietary intake, and quality of life compared to children whose parents do not participate. This study is designed explicitly to gather preliminary feasibility, acceptability, and effectiveness data to inform a subsequent larger randomized controlled trial.

Parent skills training to enhance weight loss in overweight children: Evaluation of NOURISH

OBJECTIVE Although there is general agreement that parents should be involved in pediatric obesity treatment, few studies have investigated the effectiveness of interventions that target parents exclusively. Moreover, the effectiveness of this approach has not been adequately assessed with racially diverse families, particularly African Americans(AA), a group at high risk for elevated Body Mass Index (BMI). METHODS NOURISH (Nourishing Our Understanding of Role modeling to Improve Support and Health) is a culturally-sensitive parenting intervention targeting overweight (AA) children (ages 6-11; MBMI = 98.0%ile). Families (N = 84; 61% AA, 37% White) were randomly assigned to NOURISH or a control group. RESULTS NOURISH families significantly improved on child BMI from pre- to post-testing after adjustment for random effects, baseline BMI, and child race. NOURISH parents were very satisfied with the intervention and would recommend it to other parents; 91% strongly or moderately agreed that NOURISH helped them eat in a healthier manner. CONCLUSIONS These pilot data suggest that NOURISH is acceptable and, with refinement, offers promise for reducing pediatric BMI. Outcomes, lessons learned, and parent feedback will inform a larger randomized controlled trial.

Messages about appearance, food, weight and exercise in “tween” television

Tweens (children ages ~8-14years) are a relatively recently defined age group, increasingly targeted by marketers. Individuals in this age group are particularly vulnerable to opinions and behaviors presented in media messages, given their level of cognitive and social development. However, little research has examined messages about appearance, food, weight, and exercise in television specifically targeting tweens, despite the popularity of this media type among this age group. This study used a content analytic approach to explore these messages in the five most popular television shows for tweens on the Disney Channel (as of 2015). Using a multiple-pass approach, relevant content in episodes from the most recently completed seasons of each show was coded. Appearance related incidents occurred in every episode; these most frequently mentioned attractiveness/beauty. Food related incidents were also present in every episode; typically, these situations were appearance and weight neutral. Exercise related incidents occurred in 53.3% of episodes; the majority expressed resistance to exercise. Weight related incidents occurred in 40.0% of the episodes; the majority praised the muscular ideal. Women were more likely to initiate appearance incidents, and men were more likely to initiate exercise incidents. These results suggest that programs specifically marketed to tweens reinforce appearance ideals, including stereotypes about female attractiveness and male athleticism, two constructs linked to eating pathology and body dissatisfaction. Given the developmental vulnerability of the target group, these findings are concerning, and highlight potential foci for prevention programming, including media literacy, for tweens.

Development and preliminary effectiveness of an innovative treatment for binge eating in racially diverse adolescent girls.

INTRODUCTION Binge and loss of control (LOC) eating are significant concerns among many adolescents and are associated with poor physical, social, and psychological functioning. Black girls appear to be particularly vulnerable to binge and LOC eating. Yet, empirically validated, culturally sensitive treatments for these disordered eating behaviors are not well established. This investigation examined satisfaction, feasibility, and preliminary outcomes of a binge eating intervention for ethnically diverse adolescent girls. METHODS Participants were 45 girls (age 13-17years; 44.4% white, 42.2% black) randomized into a dialectical behavior therapy (DBT)-based intervention (Linking Individuals Being Emotionally Real, LIBER8) or a weight management group (2BFit). Following each meeting, participants completed satisfaction measures, and therapists assessed intervention feasibility. Participants also completed assessments of eating behavior and related psychological constructs at baseline, immediately following the intervention, and at 3-month follow-up. RESULTS Descriptive statistics indicated that LIBER8 was feasible, and participants were highly satisfied with this intervention. Significant reductions in eating disorder cognitions, dietary restraint, and eating in response to negative affect were observed for participants in both groups, with no differences between LIBER8 and 2BFit. DISCUSSION The acceptability and feasibility of LIBER8 and associated reductions in emotional eating show promise in ameliorating binge eating and provide insight into multiple options for treating this challenging eating concern.

Evaluation of parent-reported feeding practices in a racially diverse, treatment-seeking child overweight/obesity sample

ABSTRACT This study examined psychometric properties and baseline/post-treatment racial differences in the Child Feeding Questionnaire (CFQ) in parents of overweight/obese children in a randomized controlled obesity trial. Participants were 302 (n = 285 mothers, n = 17 fathers) diverse (n = 207 Black, n = 80 White), treatment-seeking parents of children (5–11 years) with overweight/obesity. CFQ data fit the established Anderson factor structure in the full sample and subsample of Black parents. Black parents had higher scores than White parents on only Pressure to Eat. The CFQ yields reliable and valid scores in a racially diverse treatment-seeking sample, suggesting its utility in culturally-sensitive pediatric obesity treatment.