Latina mothers as agents of change in children's eating habits: findings from the randomized controlled trial Entre Familia: Reflejos de Salud.

BACKGROUND: Few children consume sufficient servings of fruits and vegetables. Interventions aiming to improve children's dietary intake often target parent level factors, but limited research has examined the mediating role of parental factors on children's dietary intake. This study examined 10-month follow up data from the Entre Familia: Reflejos de Salud (Within the Family: Reflections of Health) trial to investigate (1) intervention effects on children's dietary intake, both sustained and new changes, and (2) whether changes in mothers' dietary intake, her parenting strategies, and behavioral strategies to promoting healthy eating in the home mediated changes in children's dietary intake. METHODS: Participants were 361 Mexican-origin families living in Imperial County, California. Families were randomly assigned to a 4-month dietary intervention or a delayed treatment control group. The intervention was delivered by promotoras (community health workers) via home visits and telephone calls. Assessments occurred at baseline, and 4- and 10-months post-baseline. RESULTS: At 10-months post-baseline, sustained intervention effects were observed on children's reported intake of varieties of vegetables, with differences getting larger over time. However, differential intervention effects on fast food were not sustained due to significant reductions in the control group compared with smaller changes in the intervention group. New intervention effects were observed on servings of sugar-sweetened beverages. However, the intervention continued to have no effect on children's reported fruit and vegetable servings, and varieties of fruits consumed. Mother-reported behavioral strategies to increase fiber and lower fat mediated the relationship between the intervention and children's intake of varieties of vegetables. Mothers' percent energy from fat and behavioral strategies to lower fat were mediators of children's daily servings of sugar-sweetened beverages. CONCLUSIONS: This study suggests that a promotora-led family based intervention can provide mothers with skills to promote modest changes in children's diet. Examining the parent related mechanisms of change will inform future interventions on important targets for improving children's diet. TRIAL REGISTRATION: https://clinicaltrials.gov/ . NCT02441049 . Retrospectively registered 05.06.2015.

Putting Youth in Charge: Exploring a Multi-Year Interagency Community Engagement Experiential Programme for Youth with Disabilities and Their Families.

This paper outlines a qualitative exploration of the experiences of Youth in Charge (YiC), a 3-year pilot programme. YiC was designed to promote early, immersive community participation for students with physical disabilities, and was co-developed/co-hosted by three agencies (hospital, community rehabilitation, school board). To better understand the experiences of the youth, parents, and staff involved in this broad intervention, observation of 10 programme sessions and annual semi-structured interviews with youth (n = 5), parents (n = 4) and staff (n = 6) were undertaken. Qualitative results comprise six themes based in the two major thematic areas of participation-related experiences and programme considerations. Results indicate the need for community-based experiences, measured risk-taking, long-term engagement, parental involvement, and greater interagency collaboration and integration.

Results of a multi-level intervention to prevent and control childhood obesity among Latino children: the Aventuras Para Niños Study.

BACKGROUND: Community-based interventions are needed to reduce the burden of childhood obesity. PURPOSE: To evaluate the impact of a multi-level promotora-based (Community Health Advisor) intervention to promote healthy eating and physical activity and prevent excess weight gain among Latino children. METHODS: Thirteen elementary schools were randomized to one of four intervention conditions: individual/family level (Family-only), school/community level (Community-only), combined (Family + Community), or a measurement-only condition. Participants were 808 Latino parents and their children enrolled in kindergarten through 2(nd) grade. Measures included parent and child body mass index (BMI) and a self-administered parent survey that assessed several parent and child behaviors. RESULTS: There were no significant intervention effects on children's BMI z-score. The family intervention changed several obesity-related child behaviors (e.g., fruit/vegetable consumption) and these were mediated by changes in parenting variables (e.g., parent monitoring). CONCLUSION: A promotora-based behavioral intervention was efficacious at changing parental factors and child obesity-related health behaviors.

Examining Mexican-Heritage Mothers' Perceptions of Their Children's Weight: Comparison of Silhouette and Categorical Survey Methods.

Background: Failure to recognize children's overweight status by parents may contribute to children's risk for obesity. We examined two methods of measuring mothers' perceptions of children's weight and factors associated with weight perception inaccuracy. Methods: Cross-sectional analyses of clinical and self-report data from 287 Mexican-heritage mother-child dyads. Mothers identified their child's weight category using a scale (e.g., "normal/overweight/obese") and a visual silhouette scale (11 child gender-specific weight-varying images). Children's height and weight were measured to calculate body mass index (BMI). Chi-square tests examined associations between categorical, silhouette, and BMI percentile categories of children's weight. Bivariate logistic regression analyses examined factors associated with mothers' inaccuracy of their children's weight. Results: Only 13% of mothers accurately classified their child as obese using the categorical scale, while 78% accurately classified their child as obese using the silhouette scale. Mothers were more likely to underestimate their child's weight using BMI categories (62%) compared to using the silhouette scale (23%). Predictors of mothers' underestimation using the categorical method were child sex [female] (adjusted odds ratio [AOR] = 1.99; 95% CI: 1.02-3.86), child age [younger age] (AOR = 10.39; 95% CI: 4.16-25.92 for ages 5-6 years), and mother's weight status (overweight AOR = 2.99; 95% CI: 1.05-8.51; obese AOR = 5.19; 95% CI: 1.89-14.18). Child BMI was the only predictor of mothers' overestimation (AOR = 0.89; 95% CI: 0.85-0.94) using the silhouette method. Conclusions: Using silhouette scales to identify children's body weight may be a more accurate tool for clinicians and interventionists to activate parents' awareness of unhealthy weight in children compared to using traditional categorical weight-labeling methods.

Evaluating psychosocial and behavioral mechanisms of change in a tailored communication intervention.

This study examined the impact of a tailored nutrition intervention at 3 and 6 months postintervention. In all, 357 Latinas were randomly assigned to one of three conditions: (1) a control condition comprised of previously developed Spanish language targeted materials, (2) tailored print materials, or (3) tailored print materials accompanied by personalized dietary counseling via lay heath advisors (promotoras). At 6 months postintervention, significant group by time interactions were observed on the dietary behavioral strategies scales. The promotora condition resulted in significant behavior change initially; however, receipt of tailored and control materials was instrumental in continued behavior change after intervention activities had ceased. Group main effects suggested that the promotora condition was superior at reducing barriers and improving family interactions supporting healthy behaviors. The promotora model is an effective method for changing important dietary behaviors and psychosocial determinants, but longer term behavior change is achievable with less expensive intervention methods.

Validation of a Shortened Version of the Children's Eating Behavior Questionnaire and Associations with BMI in a Clinical Sample of Latino Children.

OBJECTIVE: To examine the validity of the Children's Eating Behavior Questionnaire (CEBQ) through the associations of its 3 subscale scores (food responsiveness, slowness in eating, and satiety responsiveness) with body mass index (BMI). DESIGN: Cross-sectional study of baseline data from a clinic-based obesity prevention and control randomized controlled trial. PARTICIPANTS: Latino pediatric patients (n = 295) aged 5-11 years from a federally qualified health center in San Diego County, CA, with BMI percentiles ranging from 75.5 to 99.0. MAIN OUTCOME MEASURE: Child BMI-for-age percentile computed using the standardized program for the 2000 Centers for Disease Control and Prevention growth charts. ANALYSIS: Principal components analysis and multivariate linear regressions. RESULTS: Principal components analysis showed a factor structure relatively similar to that of the original 3 CEBQ subscales, with acceptable internal consistency and between-subscale correlations. Analyses demonstrated the validity of the 3 subscales: child BMI was positively associated with food responsiveness (ß = .336; P ≤ .001) and negatively associated with slowness in eating (ß = -.209; P ≤ .001) and satiety responsiveness (ß = -.211; P ≤ .001). CONCLUSIONS AND IMPLICATIONS: The 14-item CEBQ scale may be useful for assessing obesogenic eating behaviors of Latino children. Further study is needed to replicate these findings.

Applying an ecological framework to understand transition pathways to post-secondary education for youth with physical disabilities.

PURPOSE: The purpose of this study was to explore the experiences of youth with physical disabilities and clinicians who support them in their transition to post-secondary education (PSE). Most research on transition to PSE has focused on youth with intellectual disabilities while there is a lack of research on youth with physical disabilities. METHODS: This study drew on 30 interviews with 20 youth with disabilities and 10 clinicians. We used Bronfrenbrenner's ecological framework to inform our analysis. RESULTS: Our results showed that there are several important individual skills that youth need to be successful in transitioning to PSE. Youth with disabilities experienced supports from peers and family that influence their transition to PSE. Several disability-specific issues (e.g., coping, self-care, disclosure, and accommodations) were often a barrier to transitioning to PSE. Clinicians and youth both reported that improved inter-professional collaboration and inter-agency partnerships were needed to enhance the transition experience. Societal attitudes (stigma and discrimination), policies, and the timing of transitions also influence youth's transition. CONCLUSION: Applying an ecological approach helped to provide a more holistic perspective of the PSE transitions and emphasizes the need to consider more than just preparing individuals but also where they are transitioned. Implications for rehabilitation Clinicians and educators should continue to promote the development of relevant life skills (e.g., self-advocacy, disclosure, and navigating public transportation) that youth need to succeed in post-secondary education. Clinicians should continue to educate and support youth regarding the process for disclosing their condition and how to request and set up accommodations in PSE. Clinicians should connect youth with disabilities to appropriate resources that can support them and continue to help them to set career goals and develop career plans. There is a critical need for improved inter-professional collaboration among clinicians providing transition services and inter-agency partnerships among high schools, disability organizations, and PSEs to enhance transition experiences for youth with disabilities.

Family restaurant choices are associated with child and adult overweight status in Mexican-American families.

Increasing evidence links restaurant food with overweight, but little is known about the relative roles of different types of restaurants, or the effects among Latinos. Using baseline data from an intervention trial, this study tested whether the type of restaurant a family reports visiting most often is associated with the body mass index (BMI; calculated as kg/m(2)) of children and adults. Children, ages 4 to 7, and one primary caregiver for each child (94% mothers), were recruited through public elementary schools in southern San Diego County, CA, with at least 70% Latino enrollment. Weight and height measurements and survey information assessing family restaurant patronage were collected from 223 pairs of children and adults. Logistic regression results showed that children were most likely to be at risk of overweight (BMI >or=85th percentile) in families who ate most often at fast-food chains (odds ratio: 2.2; 95% confidence interval: 1.2 to 4.3). Parent overweight (BMI >or=25) was associated with eating at American restaurants, primarily buffets (odds ratio: 2.8; 95% confidence interval: 1.3 to 6.2). Both child and parent BMI were lowest in families selecting Mexican restaurants. Eating at fast-food chains and other Anglo-oriented restaurants may contribute to higher obesity rates linked to acculturation among Mexican Americans.

Association between family variables and Mexican American children's dietary behaviors.

OBJECTIVE: To examine the association between family variables and children's diets. DESIGN: Cross-sectional study with households sampled using random-digit dialing. Children completed a one-time, self-administered survey, and mothers participated in a face-to-face structured interview. SETTING: Data collection occurred in southern San Diego County on the U.S.-Mexico border. PARTICIPANTS: One hundred sixty-seven Mexican American children between 8 and 18 years of age and their mothers. MAIN OUTCOME MEASURES: Diet: number of snacks, candies and sweets, and sodas consumed daily; dietary fat and fiber; and money spent weekly on fast food and snacks. Family variables: household size, family support for healthful eating, number of meals eaten together, availability of fast food in the home, food ads seen on television, and parent purchasing food products that children saw advertised on television. DATA ANALYSES: Regression analyses were used to examine the independent contributions of family variables on dietary intake. Statistical significance was set at P < .05. RESULTS: Greater family support for healthful eating was associated with fewer snacks and more fiber consumed. Children of parents who purchased food products that their children had seen advertised on television reported consuming more snacks and more fat, and they spent more money on fast food and snacks. CONCLUSIONS AND IMPLICATIONS: Family-based interventions are needed to moderate the potential influence of television-advertised food products on children's requests for these food products.

Long-term effects of a communication intervention for Spanish-dominant Latinas.

BACKGROUND: Few studies compare the influence of different types of dietary interventions on the dietary practices of Latinas in the short and long term. The present study examined the 1-year impact of two innovative behavior-change approaches to reduce dietary fat and increase fiber. DESIGN: Three-group randomized controlled trial: (1) personalized dietary counseling via lay heath advisors (promotoras) plus tailored print materials delivered via the mail, (2) tailored mailed print materials only, and (3) targeted mailed "off-the-shelf" materials. SETTING/PARTICIPANTS: A total of 357 Latinas were randomly assigned to the three aforementioned conditions. INTERVENTION: Promotora and tailored print materials. MAIN OUTCOME MEASURES: Fat intake (total grams of fat and percent calories from dietary fat) and number of grams of dietary fiber. RESULTS: Earlier work reported that at immediate post-intervention the promotora group achieved significantly lower levels of total fat grams, and lower levels of energy intake, total saturated fat, total carbohydrates, glucose, and fructose than the targeted group. However, the present longitudinal analyses suggest that the effects achieved by the promotoras dissipated over the 12-month follow-up period while the effects of the tailored group concurrently improved. CONCLUSIONS: The high interactivity (i.e., calls, visits) of the promotora condition may have been the most salient reinforcer and may have led to further tailoring, making this type of intervention more effective than the comparison groups in the short term. Further research should explore whether booster sessions involving promotoras help to maintain the impact over time.

Association of a traditional vs shared meal decision-making and preparation style with eating behavior of Hispanic women in San Diego County.

OBJECTIVE: To examine the influence of meal decision-making and preparation on Hispanic women's dietary practices. DESIGN: One-on-one structured interviews were conducted, assessing meal decision-making and preparation practices, barriers, and behavioral strategies to eating low-fat and high-fiber diets, fat and fiber intake, demographic, and other psychosocial factors. SUBJECTS/SETTING: The study population included 357 Hispanic women living in the southern or central regions of San Diego County. Participants were recruited via random-digit dialing to a tailored nutrition communication intervention. MAIN OUTCOME MEASURE: Household decision-making style (alone vs with family) by household activity (decides meals, prepares meals, and decides snacks). STATISTICAL ANALYSES PERFORMED: Multiple logistic regressions were used to evaluate associations between the predictors and dependent variable. All models included adjustments for potential confounders, such as marital status, education, employment, age, and acculturation. RESULTS: A positive statistical association between Hispanic women's acculturation level and shared decision-making style was found. Also, Hispanic women in shared decision-making households faced greater psychosocial barriers to healthful eating and reported less healthful eating compared with Hispanic women in traditional households. Women in shared decision-making households were more likely to eat at fast-food restaurants, less likely to engage in behavioral strategies promoting fiber consumption, eat more saturated fat, and encounter more barriers to reduce dietary fat as compared with Hispanic women in traditional households. Acculturation did not attenuate differences in psychosocial and dietary practices between shared decision-making and traditional households. CONCLUSIONS: Study findings suggest intervention efforts should focus on different aspects of healthful eating among Hispanic women in shared-decision, compared with traditional, households.

Interpersonal and print nutrition communication for a Spanish-dominant Latino population: Secretos de la Buena Vida.

Participants (N=357) were randomly assigned to 1 of 3 conditions: lay health advisor (promotora) plus tailored print materials, tailored print materials only (tailored), or off-the-shelf print materials (control). The primary outcomes were calories from fat and daily grams of fiber. Secondary outcomes included total energy intake, total and saturated fat intake, and total carbohydrates. Adjusted for baseline values, calories from fat were 29%, 30%, and 30% for the promotora, tailored, and control conditions, respectively, and grams of fiber consumed were 16 g, 17 g, and 16 g. Significant Condition X Time interactions were not observed between baseline and 12-weeks postintervention. The LHA condition achieved significantly lower levels of energy intake, total fat and saturated fat, and total carbohydrates. The relative superiority of the promotora condition may derive from the personal touch achieved in the face-to-face interactions or from the women's use of print materials under the promotora's guidance.

Restaurant and food shopping selections among Latino women in Southern California.

OBJECTIVE: This study describes and examines determinants of restaurant and food store selections in a sample of Latino women. DESIGN: Data were collected at the baseline home-based interview from women involved in a randomized community trial to improve dietary behaviors. The interview consisted of both a structured interview and the measurements of height, weight, and waist-to-hip ratio. SUBJECTS/SETTING: Participants included 357 Latino women recruited via random-digit dial in the Southern and Central areas of San Diego County, California. Women were included if they were between 18 and 67 years of age, not currently pregnant, and Spanish-language dominant; women were excluded if a family member was on a special diet or was planning to leave the area during the study. STATISTICAL ANALYSES PERFORMED: Means and frequencies were used to describe preference for various types of restaurants and food stores based on the North American Industry Classification System (NAICS). Independent samples t tests examined differences in levels of importance for preferring fast-food vs other restaurants and supermarkets/produce markets vs other grocery stores. Logistic regression models examined correlates of preferring fast-food restaurants vs all other restaurants and preferring supermarkets/produce markets vs all other grocery stores. RESULTS: More women reported eating at fast-food restaurants, followed by full-service restaurants and cafeterias. Younger women, employed women, women living in higher income households, and women living in the United States for a greater number of years preferred fast food. Supermarkets; grocery stores; and discount, bulk-purchase stores were equally represented as the primary food store. Women who lived in smaller households, had a smaller measured body mass, were married, and were more acculturated to the Anglo culture were more likely to shop at supermarkets compared with women who shopped at other grocery stores. CONCLUSIONS: Our findings suggest specific recommendations for targeting dietary interventions for the growing Latino population that take into account differences in levels of acculturation. For example, young Latino women who more closely identify with the Anglo culture and/or who report living in the United States for a longer period of time may benefit from targeted information on healthy restaurant behavior. On the other hand, traditional Latino women may benefit from instrumental support interventions such as tours to large supermarkets.

Is church attendance associated with Latinas' health practices and self-reported health?

OBJECTIVES: To evaluate (a) the relation between frequency of church attendance, self-rated health, and health behaviors controlling for potential confounders and (b) the influence of acculturation on church attendance and health behaviors. METHODS: Physical activity and dietary patterns, demographics, and acculturation levels were compared among Latinas who attended church frequently, infrequently, and not at all. RESULTS: Church attendance was independently and positively associated with healthier dietary and physical activity behaviors, but not with self-rated health. Acculturation attenuated the relation between physical activity and church attendance. CONCLUSION: Latinas' health behaviors and self-rated health may be related to other variables that explain the salutary effects of church attendance.

Some methodologic issues in analyzing data from a randomized adolescent tobacco and alcohol use prevention trial.

Three issues concerning the design and analysis of randomized behavioral intervention studies are illustrated and discussed within the framework of a tobacco and alcohol prevention trial among migrant Latino adolescents. The first issue arises when subjects are randomized in clusters rather than individually. Because subject observations cannot be assumed to be independent, information pertaining to the degree of clustering must be reported, and analyses must take the clustering into account. The second issue concerns the impact of compliance to the intervention and the importance of measuring compliance in the experimental and attention-control groups. A compliance analysis should control for participant contact with study personnel. Investigators must consider ways of constructing a compliance measure that is common to both conditions. Third, because outcomes are measured repeatedly over time, we illustrate the importance of assessing the impact of missing-data patterns on outcomes and the extent to which the patterns may modify the treatment effect.

Tobacco and alcohol use-prevention program for Hispanic migrant adolescents.

OBJECTIVE: Evaluate a community-based tobacco/alcohol use-prevention program group compared with an attention-control condition (first aid/home safety) group. METHODS: A total of 660 adolescents and 1 adult caregiver for each were recruited through the Migrant Education Program to participate in an 8-week intervention. Random assignment to the two groups occurred in 22 schools. Seventy 8-week intervention groups (37 tobacco/alcohol and 33 attention-control) were conducted. Assessments occurred at baseline, immediate post-intervention, and 1- and 2-year follow-ups. Susceptibility to smoking and alcohol as well as smoking and drinking over the past 30 days were the primary outcomes of interest. RESULTS: Following intervention, no between-group differences in smoking or drinking were significant. Thirty-day smoking started and remained at very low levels, with the highest group prevalence at any measurement period being 4.7% and the lowest 2.5%. Those considered susceptible to smoking dropped by nearly 40% in the attention-control group and by 50% in the intervention group from baseline to the final follow-up. (The overall reduction from post-test to final follow-up was statistically significant.) Less-acculturated children were less likely to report drinking in the past 30 days. CONCLUSIONS: The current intervention was not demonstrated to be effective in preventing cigarette or alcohol consumption. This perhaps is due to very low baseline levels of smoking and drinking in the migrant youth participants.

Correlates of body mass index and waist-to-hip ratio among Mexican women in the United States: implications for intervention development.

INTRODUCTION: This study contributes to our understanding of acculturation and obesity by examining the association between several measures of acculturation, including a bidimensional scale of acculturation, body mass index (BMI), and waist-to-hip ratio (WHR). METHODS: Exploratory analyses were performed using baseline data from 357 Mexican women recruited into a Spanish-language randomized community trial. The women were randomly sampled by telephone and interviewed in their homes. Women's height, weight, waist, and hip were measured to obtain estimates of their BMI and WHR. A face-to-face interview collected data on dietary intake, physical activity, acculturation, and other demographic and psychosocial variables. RESULTS: Less than a quarter of the women were normal weight (39% overweight and 41% obese). Univariate analyses revealed that more years living in the United States and less integration into the Anglo culture were associated with a larger BMI and WHR. However, in the multivariate analyses, significant correlates of a larger BMI were less moderate physical activity and unemployment. There were trends linking a larger BMI with older age, no vigorous physical activity, more energy intake, and less integration into the Anglo culture. These same variables plus less household income were associated with a higher WHR. Exploratory analyses on acculturation revealed that bicultural Mexican-American women were more educated, more likely to be employed, reported a higher household income, and perceived fewer barriers to a healthy diet compared with traditional Mexican women. CONCLUSIONS: Intervention designed to prevent overweight/obesity should consider promoting maintenance of Mexican cultural practices, as well as teach women how to effectively integrate into the Anglo culture.

Longitudinal intervention effects on parenting of the Aventuras para Niños study.

BACKGROUND: Parenting interventions have achieved changes in factors associated with childhood obesity but few have tested the effects on multiple parental influences. PURPOSE: This study examined the efficacy of an intervention aimed at improving several dimensions of parenting related to childhood obesity. DESIGN: The study used a 2 x 2 factorial design. SETTING/PARTICIPANTS: In 2003, a sample of 13 Southern California schools was randomized to one of four conditions: micro-environment only, macro-environment only, micro-plus-macro-environment, and no treatment control condition. Participants included 811 predominantly Mexican immigrant/Mexican-American mothers with children in kindergarten through second grade. INTERVENTION: In both micro conditions, participants received monthly home visits by a promotora over a 7-month period plus monthly mailed newsletters. MAIN OUTCOME MEASURES: In 2008, intervention effects were examined on (1) parenting strategies, including limit setting, monitoring, discipline, control, and reinforcement related to children's diet and physical activity; (2) parental support for physical activity; (3) parent-mediated family behaviors such as family meals eaten together and TV watching during family dinners; and (4) perceived barriers and other parent cognitions related to children's eating and activity. RESULTS: At the 2-year follow-up, significant improvements were observed in three of five parenting strategies, parental support, and two of four parent-mediated family behaviors among parents receiving the micro intervention (i.e., those who received promotora visits and monthly newsletters), as compared with those in the macro-only and control conditions. CONCLUSIONS: Aspects of parenting related to children's risk for obesity and related health outcomes are modifiable with the support of a promotora and print media.

Individual, family, and community environmental correlates of obesity in Latino elementary school children.

BACKGROUND: The prevalence of overweight children has reached epidemic proportions, and affects Latinos youth more than other subgroups in the United States. Given the prevalence of obesity and its economic consequences, community health initiatives have shifted toward primary prevention at younger ages. METHODS: Data representing all levels of the ecological systems theory were collected using diverse methods. Participants were children enrolled in K-2nd grade and their parents. RESULTS: Overweight children were less active compared to normal weight children. The parents of overweight children provided less instrumental support to engage in activity and set fewer limits on their child's activities. Similarly, parents of overweight children were less likely to control, but more likely to set limits on their child's diet compared to parents of normal weight children. Parents who rated their health more positively and were less acculturated were more likely to have children who were overweight. School and community level variables were not significantly correlated with children's weight. Adjusting for the aforementioned variables, parents' weight status was positively associated with children's weight. CONCLUSIONS: Social and structural environments in which Hispanic children are reared may play an important role in determining their risk for obesity and related behaviors. Parents' weight was among the strongest correlate of child weight; however, the extent to which this influence functions primarily through biological or social/structural influences is not entirely clear. The role of school and community factors on child's health practices and body mass index needs to be further examined.

Family history of diabetes, parental body mass index predict obesity in Latino children.

PURPOSE: The purpose of this study is to examine the association between family history of diabetes (FHD), body mass index (BMI), and acculturation with children's BMI status. METHODS: Baseline data from a randomized community intervention trial promoting healthy eating and physical activity were collected in children living in San Diego, California. A self-administered survey was completed by primary caregivers at each school assessing maternal diabetes, BMI, acculturation, and socioeconomic status (SES). Anthropometric data (height, weight, and BMI) from mothers and children were also collected. RESULTS: A total of 812 caregivers completed the baseline survey. Adjusting for maternal age, marital status, and socioeconomic level, women who had been diagnosed with diabetes or gestational diabetes or who received diabetes treatment were significantly more likely to have overweight children. Maternal BMI was also associated with children's weight. Maternal acculturation level was marginally associated with children's BMI. CONCLUSIONS: FHD, gestational diabetes, and BMI were associated with children's overweight status. More comprehensive interventions are needed to prevent obesity in Latino children and adults.