Assessing sleep behaviors in Latino children and adolescents: what is known, what are we missing, and how do we move forward?

PURPOSE OF REVIEW: Sleep health is a commonly overlooked component of pediatric cardiometabolic risk. Disparities in sleep duration and meeting of pediatric sleep guidelines have been well documented among at-risk populations in the United States, including Latinos. However, sleep research often fails to describe or account for contextual and cultural factors impacting the ability for Latino families to meet guidelines. The current review focuses on recent findings related to measurement of sleep duration, understanding of contextual factors that impact sleep hygiene, and interventions designed to increase sleep duration and quality among U.S. Latino families with infants, young children, and adolescents. RECENT FINDINGS: Ten studies focusing on sleep health in U.S. Latino children, using different study designs were identified. Overall, cross-sectional studies confirmed inadequate sleep among Latino children, intervention studies demonstrated promise of culturally-sensitive health behavior education for improving sleep in early childhood, and qualitative studies highlighted neighborhood and cultural factors that impact sleep quality. IMPLICATIONS FOR CLINICAL PRACTICE AND RESEARCH: Rather than new prevalence studies on adherence to sleep recommendations among Latino families, research focusing on adapting clinical guidelines to accommodate the realities of many Latino families (e.g., co-sleeping and bedsharing) will advance our knowledge. A shift towards objective measurement of the 24-h period as well as evaluating specific contextual barriers that make It challenging to meet sleep guidelines for Latino children is needed.

Adolescent sedentary behavior and body composition in early adulthood: results from a cohort study.

BACKGROUND: This study investigates the cross-sectional and prospective associations between accelerometer-measured sedentary behavior and body composition from adolescence to early adulthood. METHODS: Data from the Santiago Longitudinal Study were analyzed (n = 212). Sedentary time was measured at age 16 years, and body composition (body mass index [BMI], waist circumference, waist-to-height ratio [WHtR], fat mass percentage, and lean mass percentage) was examined at both age 16 and 23 years. Adjusted linear regression models estimated associations between sedentary time, sedentary bout duration, and body composition, overall and by sex. RESULTS: In all analyses, mean sedentary bout duration was not associated with body composition. In cross-sectional analyses, more sedentary time during adolescence was significantly associated with lower BMI, waist circumference, WHtR, fat mass percentage, and higher lean mass percentage (p < 0.05). One standard deviation increase in daily sedentary time was prospectively associated with lower body mass index (ß = -1.22 kg/m2, 95% CI: -2.02, -0.42), waist circumference (ß = -2.39 cm, 95% CI: -4.03, -0.75), and WHtR (ß = -0.014, 95% CI: -0.024, -0.004). Sedentary time at 16 years was not associated with changes in body composition from 16 to 23 years. CONCLUSIONS: Sedentary behavior in adolescence is not adversely associated with body composition profiles in early adulthood. IMPACT: Little is known about the effect of device-measured sedentary behavior on body composition during the transition from adolescence to early adulthood. Among participants in the Santiago Longitudinal Study, more accelerometer-measured sedentary time during adolescence was associated with lower BMI, waist circumference, and waist-to-height ratio in early adulthood though point estimates were generally small in magnitude. Sedentary behavior in adolescence was not detrimentally associated with healthy body composition profiles in early adulthood. Public health interventions aimed at reducing obesity rates could consider other behaviors, such as physical activity and healthy diet, instead of sitting time.

Screen-related discord and dismay in low-income Mexican American families with toddlers: A qualitative study.

PURPOSE: Understanding parental experiences with managing their toddler's screen use is important to inform the design of interventions addressing early childhood screen use, yet current evidence is limited. To enhance our understanding of the context of toddler screen use, this study characterizes the screen-related discord and dismay parents experience in families with toddlers. DESIGN AND METHODS: In-depth interviews were conducted to explore everyday experiences with screen use among low-income Mexican American caregivers of toddlers (21 mothers, 10 fathers, 1 grandmother). Transcripts were content analyzed to identify prominent themes. RESULTS: Three themes were identified. Experiences of screen-related discord and dismay arose (1) between parent and child, (2) between parents, and (3) surfaced as parental internal dissonance about toddler screen use. Parent-child discord resulted from parental limit setting and child reactions to parental screen use, which often included tantrums. Parent-partner discord included patterns of agreeing to disagree and direct disagreement between partners. Parents also reported their own feelings of ambivalence and dismay as they struggled to reconcile their preferences against their toddler's actual screen use, while living in a screen-saturated world. CONCLUSIONS: Findings offer insight into types of screen-related discord and dismay low-income Mexican American parents experience as they attempt to manage their toddler's screen use. PRACTICE IMPLICATIONS: Although discord in families is normal, the screen-specific discord reported by participants warrants consideration in efforts promoting healthy screen use in families. Providers can tailor their counseling to consider the range of screen-related discord families of toddlers may experience.

Household and social characteristics associated with COVID-19 vaccine intent among Latino families in the San Francisco Bay Area.

BACKGROUND: Latinos have had higher case counts, hospitalization rates and deaths during the COVID-19 pandemic nationally and in the state of California. Meanwhile, Latino vaccination rates remain lower than those of non-Hispanic Whites. COVID-19 vaccine nonintent, defined as intent to not vaccinate against COVID-19, among Latino individuals continues to be an issue in the state of California. METHODS: Families from three Latino longitudinal mother-child cohorts previously recruited in the San Francisco Bay Area were surveyed telephonically from February to June 2021 to assess attitudes towards vaccination against COVID-19 and prior vaccination, in general, for themselves and their children. Risk for vaccine nonintent was assessed using the Mann-Whitney rank sum non-parametric test for continuous predictors and chi-squared tests for categorical ones. RESULTS: Three hundred and nineteen families were surveyed from the Telomere at Birth (TAB), Hispanic Eating and Nutrition (HEN) and Latino Eating and Diabetes Cohort (LEAD). Approximately 36% from TAB and 28% from HEN/LEAD indicated COVID-19 vaccine nonintent for themselves and/or their children. Risk factors for vaccine nonintent included lower maternal age (p = 0.01), concern about vaccine side effects (p < 0.01) and prior history of a household members being infected with SARS-CoV-2 (p < 0.01) and indexes of household crowding including number of people sharing a bathroom (p = 0.048). Vaccine intent was also associated with receiving vaccine input from friends (p = 0.03), family (p < 0.01) and/or coworkers (p = 0.02) compared with those who were not planning on getting vaccinated against COVID-19. CONCLUSIONS: Latino families living in crowded living situations who may not have received any COVID-19 advice from family, coworkers or friends are at particular risk for nonintent for vaccinatation against COVID-19. Community-based grassroots or promotor/a based interventions centered on trusted individuals with close community ties and counseling concerning vaccination against COVID-19 could help boost vaccination rates in this population group.

Style of meal service and feeding practices among Mexican American fathers and mothers: An analysis of video-recorded children's evening mealtime at home.

The aim of this study was to examine video-recorded observations of evening family mealtime at home among Mexican American children to help elucidate style of meal service, fathers' and mothers' feeding practices and child's eating behavior. Consistent with guidelines for coding behaviors, we analyzed observational data of evening mealtimes of 71 Mexican American children aged eight to 10 years. Regarding style of meal service, in almost all cases (96%), parents plated the child's food, with more available on the table or counter in 40% of the observations. Mothers almost always served the child (94%). Regarding parental feeding practices, parents used positive involvement in meals (80%), pressure to eat (42%) and restriction of food (9%). Using food as a reward to control behavior was never used by either parent. The majority (75%) of children requested or negotiated to eat less food, or only eat certain items. In Mexican American families, both mothers and fathers play a role in family mealtimes and both use positive involvement in child's meals, and to a lesser extent pressure to eat, with their children aged eight to 10 years. To help reduce the obesity epidemic, intervention strategies are needed, which integrate the family, a plating style of meal and parental feeding practices that promote healthy eating in the home. To reduce obesity among Mexican American children, interventions that focus on parental positive involvement in child's meal and maintenance of home cooked meals could have a positive impact on the entire family.

Mechanisms linking childhood weight status to metabolic risk in adolescence.

BACKGROUND: Obesity is a risk factor for insulin resistance (IR) and metabolic disease. OBJECTIVE: To examine potential metabolic pathways linking childhood weight status to adolescent IR and metabolic risk. METHODS: Participants were 600 low- to middle-income Chilean adolescents from a cohort studied since infancy as part of an iron deficiency anemia preventive trial and follow-up study. We examined body mass index z-score at 10 y (BMIz-10y) and blood pressure, total fat, and fasting glucose, adiponectin to leptin ratio (A:L), ghrelin, and HOMA-IR at 16 y. A total count for metabolic risk factors (MRF) was calculated using the International Diabetes Federation criteria. We used path analysis to estimate pathways and model indirect effects from BMIz-10y, controlling for child age and sex and maternal body mass index (BMI). RESULTS: Participants were 54% male; mean BMIz-10y of 0.53 (SD = 1.02); mean MRF of 1.3 (SD = 0.9); mean HOMA-IR of 1.8 (SD = 1.3). Path analysis showed that BMIz-10y directly and indirectly related to increased MRF via A:L and HOMA-IR. Ghrelin was not in the metabolic pathway from BMIz-10y to MRF but was related to MRF via HOMA-IR. CONCLUSION: These results elucidate metabolic pathways involving child weight status, IR and metabolic risk in adolescents. Childhood BMI was an indirect risk factor for adolescent cardiometabolic risk via several pathways that involved BMI, appetite hormones, markers of inflammation, and insulin resistance during adolescence. Findings illustrate the adverse effect that childhood obesity has on adolescent health outcomes, which sets precedence for health outcomes over the life course.

Sleep duration in Mexican American children: Do mothers' and fathers' parenting and family practices play a role?

This study examined parenting styles, parenting practices and family practices that may be associated with weeknight sleep duration among 8- to 10-year-old Mexican American (MA) children. This cross-sectional study of MA children used baseline data from a 2-year cohort study of mother-child pairs (n = 308) with additional data on fathers (n = 166). Children's weeknight sleep duration was accelerometer estimated and averaged for 2 weeknights. Parents reported on their parenting styles and practices regarding food and family food-related practices. Multivariable linear regression analysis was used to examine sleep duration with parenting styles and practices, and family practices, and adjusting for child gender and body mass index. Model 1 included mothers' parenting styles and practices; Model 2 included both mothers' and fathers' parenting styles and practices. Children's average sleep duration was 9.5 (SD = 0.8) hr. Mothers who used pressure to encourage their children to eat and those who used food to control behavior had children with longer sleep duration (ß = 0.21, p < 0.01; ß = 0.15, p = 0.03, respectively). Mothers who reported their children ate dinner with the TV on and those who valued eating dinner as a family had children with shorter sleep duration (ß = -0.16, p = 0.01; ß = -0.18, p = 0.01, respectively). Fathers who restricted the amount of food their children ate had children with shorter sleep duration (ß = -0.27, p = 0.01). Mothers' and fathers' feeding practices, the child's eating dinner with the TV on, and valuing family dinners, played a role in children's weeknight sleep duration among Mexican American families. Parental feeding practices and family mealtime contexts may have an effect on children's weeknight sleep duration.

Latino mothers' beliefs about child weight and family health.

OBJECTIVE: There is a need to address cultural beliefs and parenting practices regarding childhood obesity to design effective weight-control programmes for overweight/obese US Latino children. The purpose of the current study was to explore cultural beliefs about children's weight, understand parent perceptions on feeding their children, and explore barriers that interfere with a healthy lifestyle. DESIGN: Four focus groups were conducted in Spanish with forty-one Latino mothers of elementary school-age children from San Diego County, California between April and May 2011. Cultural viewpoints about overweight status among children and barriers to leading a healthy lifestyle were explored. Focus group discussions were analysed based on a priori and emergent themes. RESULTS: Three themes were identified: (i) mothers' cultural beliefs about health that are barriers to family health; (ii) mothers as primary caretakers of their family's health; and (iii) attitudes about targeting children's weight. Mothers acknowledged the idea that 'chubby is better' is a misperception, yet having a 'chubby' child was preferred and even accepted. Mothers described fatalistic beliefs that contradicted existing knowledge of chronic disease and daily demands of Western culture as barriers to practising healthy behaviours in the home as the family caretaker. CONCLUSIONS: These findings may be used to inform more culturally appropriate research to address US Latino health. Increasing awareness of cultural beliefs and daily circumstance could help to address obesity more directly and thereby overcome some of the potential underlying barriers that might exist when involving the Latino immigrant families in obesity treatment and prevention.

Fathers' feeding practices and children's weight status in Mexican American families.

Mothers' feeding practices are associated with their children's weight status, but little is known about the associations between fathers' feeding practices and children's weight status. Moreover, there is a dearth of research on Latino fathers' feeding practices and children's weight status, even though Latino children suffer some of the highest obesity rates in the U.S. We examined the associations between fathers' feeding practices and child weight status, conditional on mothers' feeding practices, within 174 Mexican American families with children aged 8-10 years. Parents completed the Parental Feeding Practices Questionnaire, which consists of four subscales: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. To assess child weight status, body mass index (BMI) was calculated and converted to age- and gender-specific percentile scores (BMI z-score). We fit four sets of regression models, one set for each of the four parental feeding practices subscales, with child BMI z-score as the outcome variable. Fathers' pressure to eat (b = -0.20, p = 0.04; 95% CI: -0.39, -0.01) and use of food to control behavior (b = -0.36, p = 0.02; 95% CI: -0.65, -0.07) were associated with lower child BMI z-score, and restriction of amount of food (b = 0.56, p < 0.001; 95% CI: 0.27, 0.84) was associated with higher child BMI z-score, after accounting for mothers' feeding practices. Fathers' positive involvement in child eating was not associated with child BMI z-score. These findings provide empirical evidence that fathers' feeding practices are independently associated with children's weight status, even when mothers' feeding practices are taken into account, and suggest that fathers' feeding practices also matter in regard to children's weight status.

Preferred Child Body Size and Parental Underestimation of Child Weight in Mexican-American Families.

Objective To determine whether parents who prefer a heavier child would underestimate their child's weight more than those who prefer a leaner child. Methods Participants were Mexican-American families (312 mothers, 173 fathers, and 312 children ages 8-10) who were interviewed and had height and weight measurements. Parents reported their preferred child body size and their perceptions of their child's weight. Parents' underestimation of their child's weight was calculated as the standardized difference between parent's perception of their child's weight and the child's body mass index (BMI) z-score. Demographic factors and parental BMI were also assessed. Results Although 50 % of children were overweight or obese, only 11 % of mothers and 10 % of fathers perceived their children as being somewhat or very overweight. Multiple regressions controlling for covariates (parental BMI and child age) showed that parents who preferred a heavier child body size underestimated their children's weight more, compared to those who preferred a leaner child (ß for mothers = .13, p < .03; ß for fathers = .17, p < .03). Conclusions for Practice Parents who preferred a heavier child body size underestimated their child's weight to a greater degree than parents who preferred a leaner child. Attempts by pediatricians to correct parents' misperceptions about child weight may damage rapport and ultimately fail if the misperception is actually a reflection of parents' preferences, which may not be readily amenable to change. Future research should address optimal methods of communication about child overweight which take into account parent preferences.

Parental feeding practices and child weight status in Mexican American families: a longitudinal analysis.

BACKGROUND: Parental feeding practices are thought to influence children's weight status, through children's eating behavior and nutritional intake. However, because most studies have been cross-sectional, the direction of influence is unclear. Moreover, although obesity rates are high among Latino children, few studies of parental feeding practices have focused on this population. METHODS: This 2-year longitudinal study examined mutual influences over time between parental feeding practices and children's weight status, in Mexican American families with children 18 years old at baseline. Mothers (n = 322) and fathers (n = 182) reported on their feeding practices at baseline, 1-year follow-up, and 2-year follow-up. Weight status, defined by waist-height ratio (WHtR) and body mass index (BMI), was ascertained at all assessments. Cross-lagged panel models were used to examine the mutual influences of parental feeding practices and child weight status over time, controlling for covariates. RESULTS: Both mothers' and fathers' restriction of food predicted higher subsequent child weight status at Year 1, and for fathers this effect was also found at Year 2. Mothers' and fathers' pressure to eat predicted lower weight status among boys, but not girls, at Year 1. Child weight status also predicted some parental feeding practices: boys' heavier weight predicted mothers' less pressure to eat at Year 1, less use of food to control behavior at Year 2, and greater restriction at Year 2; and girls' heavier weight at Year 1 predicted fathers' less pressure to eat and less positive involvement in child eating at Year 2. CONCLUSIONS: This study provides longitudinal evidence that some parental feeding practices influence Mexican American children's weight status, and that children's weight status also influences some parental feeding practices. Feeding practices of both mothers and fathers were related to children's weight status, underscoring the importance of including fathers in research on parental feeding practices and child obesity.

Mother-reported sleep, accelerometer-estimated sleep and weight status in Mexican American children: sleep duration is associated with increased adiposity and risk for overweight/obese status.

We know of no studies comparing parent-reported sleep with accelerometer-estimated sleep in their relation to paediatric adiposity. We examined: (i) the reliability of mother-reported sleep compared with accelerometer-estimated sleep; and (ii) the relationship between both sleep measures and child adiposity. The current cross-sectional study included 303 Mexican American mother-child pairs recruited from Kaiser Permanente Northern California. We measured sleep duration using maternal report and accelerometry and child anthropometrics. Concordance between sleep measures was evaluated using the Bland-Altman method. We conducted zero-ordered correlations between mother-reported sleep, accelerometer-estimated sleep and child BMI z-scores (BMIz). Using linear regression, we examined three models to assess child BMIz with mother-reported sleep (model 1), accelerometer-estimated sleep (model 2) and both sleep measures (model 3). Children had an average age of 8.86 years (SD = 0.82). Mothers reported that their child slept 9.81 ± 0.74 h [95% confidence interval (CI): 9.72, 9.89], compared to 9.58 ± 0.71 h (95% CI: 9.50, 9.66) based on accelerometry. Mother-reported sleep and accelerometer-estimated sleep were correlated (r = 0.33, P < 0.001). BMIz outcomes were associated negatively with mother-reported sleep duration (model 1: ß = -0.13; P = 0.02) and accelerometer-estimated sleep duration (model 2: ß = -0.17; P < 0.01). Accounting for both sleep measures, only accelerometer-measured sleep was related to BMIz (model 3: ß = -0.14, P = 0.02). Each sleep measure was related significantly to adiposity, independent of covariates. Accelerometry appeared to be a more reliable measure of children's sleep than maternal report, yet maternal report may be sufficient to examine the sleep-adiposity relationship when resources are limited.

Longitudinal effects of parental, child and neighborhood factors on moderate-vigorous physical activity and sedentary time in Latino children.

BACKGROUND: Moderate-vigorous physical activity (%MVPA) confers beneficial effects on child musculoskeletal health, cardiovascular fitness, and psychosocial well-being; in contrast, sedentary time (%SED) is emerging as a risk factor for health. This study aimed to identify parental, child and neighborhood factors influencing longitudinal assessments of body mass index (BMI) and activity patterns among Latino children, and to estimate lagged and cross-lagged effects between child BMI, %MVPA and %SED. METHODS: A longitudinal design with assessments at baseline, 1 and 2 years follow-up (FU) was used to evaluate the effects of maternal and paternal factors (BMI, age, education level, acculturation, household income and household size), child factors (gender, age, BMI, pubertal status) and neighborhood factors (disorder, victimization) on child BMI, %MVPA and %SED, expressed as a percent of awake time, in 282 Latino children ages 8-10 y and their parents. This study was restricted to families with a mother and biological father or father figure in the child's life. RESULTS: Across time, total daily accelerometer counts (p = 0.04) and steps decreased (p = 0.0001), %SED increased (p = 0.0001), and %MVPA decreased (p = 0.02). Moderate lagged effects or tracking was seen for %MVPA and %SED (p = 0.001). %MVPA varied by gender (5.5% higher in boys than girls, p = 0.0001); child age (-0.4% per year, p = 0.03), and child BMI in boys only (-0.22%, p = 0.0002). Negative effects of paternal age, maternal education and maternal changes in BMI on %MVPA also were seen. %SED increased with child age (2.5% higher per year, p = 0.0001). Positive effects of paternal acculturation, maternal change in BMI, paternal age, and negative effects of household size on %SED were observed. A cross-lagged positive effect of BMI at FU1 on %SED at FU2 was observed for boys and girls (p = 0.03). Neighborhood disorder and victimization were not significant predictors of child BMI, %MVPA or %SED. CONCLUSION: The major child determinants of physical activity (age, gender and BMI) and minor parental influences (maternal BMI and education, paternal age and acculturation) should be considered in designing interventions to promote %MVPA and reduce %SED among Latino children as they approach adolescence.

SNAP Student Rules Are Not So Snappy: Lessons Learned From a Qualitative Study of California County Agency Workers.

OBJECTIVE: To examine the college student Supplemental Nutrition Assistance Program (SNAP) application process from the perspective of county agency workers. DESIGN: A qualitative study that included semistructured individual and group interviews (n = 14) between February and December, 2021. SETTING: Nine California counties with a University of California campus. PARTICIPANTS: A total of 24 county agency workers who regularly process or advise on college student SNAP applications. PHENOMENON OF INTEREST: Facilitators and barriers to processing student SNAP applications. ANALYSIS: Interviews were recorded, transcribed, and coded using thematic analysis. RESULTS: Five themes were identified regarding student applications: (1) a need for more consistency in policy dissemination and program administration, (2) student exemptions and the application process are perceived as challenging for students, (3) facilitators of successfully processing student applications, (4) tracking policy changes is burdensome, and (5) eliminate the student rules. CONCLUSION AND IMPLICATIONS: County agency workers perceived that students experience unnecessary barriers to accessing SNAP benefits and that implementing the student rules was taxing. Expanding SNAP access to low-income college students could be an equitable solution to mitigate the risk of student hunger while they pursue their degrees.

Campus Food Pantry Use May Improve Daily Frequency of Fruit and Vegetable Intake Among California University Students Experiencing Food Insecurity.

BACKGROUND: University students are at increased risk for both food insecurity and suboptimal fruit and vegetable (F/V) intake. Campus food pantries (CFP) have been a common intervention in response to student food insecurity, but there have been few evaluations of the effectiveness of this strategy on improving students' dietary intake. OBJECTIVE: To examine differences in the frequency of F/V intake by food security status, and whether the number of monthly CFP visits was associated with frequency of F/V intake among university students who were CFP clients. DESIGN: Cross-sectional PARTICIPANTS: The study population included 1,188 university students across the 10-campus University of California system who had accessed their CFP or Basic Needs Center. MAIN MEASURES: United States Department of Agriculture (USDA) 6-item short food security module, monthly CFP visits, and self-reported frequency of F/V intake (daily). STATISTICAL ANALYSES PERFORMED: T-tests were performed to compare differences in mean daily frequency of F/V intake by food security status. Generalized linear models were used to examine associations between monthly CFP visits and mean daily frequency of F/V intake. Using a post hoc Wald test, an interaction term (monthly CFP visits × food security status) was included to the models to determine whether food security status modified associations. RESULTS: Students experiencing food insecurity consumed total F/V 0.48 fewer times per day compared with students who were food secure (2.64 ± 2.11 vs 3.12 ± 2.01; P < .001). Among students experiencing food insecurity, each monthly CFP visit was associated with higher daily frequencies of intake for total F/V (ß = 0.06), whole fruit (ß = 0.03), 100% fruit juice (ß = 0.01), and leafy greens (ß = 0.01); however, no associations were found among the food-secure group. CONCLUSIONS: Findings suggest that CFPs may be supporting students in need of nutritional assistance increase their daily frequency of F/V intake. Future studies are needed to validate these findings to inform investment in campus food pantries and support university students in need of nutritional assistance.

Lessons learned from implementing a diversity, equity, and inclusion curriculum for health research professionals at a large academic research institution.

Objective: Despite advances in incorporating diversity and structural competency into medical education curriculum, there is limited curriculum for public health research professionals. We developed and implemented a four-part diversity, equity, and inclusion (DEI) training series tailored for academic health research professionals to increase foundational knowledge of core diversity concepts and improve skills. Methods: We analyzed close- and open-ended attendee survey data to evaluate within- and between-session changes in DEI knowledge and perceived skills. Results: Over the four sessions, workshop attendance ranged from 45 to 82 attendees from our 250-person academic department and represented a mix of staff (64%), faculty (25%), and trainees (11%). Most identified as female (74%), 28% as a member of an underrepresented racial and ethnic minority (URM) group, and 17% as LGBTQI. During all four sessions, attendees increased their level of DEI knowledge, and within sessions two through four, attendees' perception of DEI skills increased. We observed increased situational DEI awareness as higher proportions of attendees noted disparities in mentoring and opportunities for advancement/promotion. An increase in a perceived lack of DEI in the workplace as a problem was observed; but only statistically significant among URM attendees. Discussion: Developing applied curricula yielded measurable improvements in knowledge and skills for a diverse health research department of faculty, staff, and students. Nesting this training within a more extensive program of departmental activities to improve climate and address systematic exclusion likely contributed to the series' success. Additional research is underway to understand the series' longer-term impact on applying skills for behavior change.

The 7-day Beverage Intake Questionnaire for Latino Children: Validation of a Culturally Tailored Tool.

OBJECTIVE: To validate a culturally tailored 7-day beverage intake questionnaire for Latino children (BIQ-L). DESIGN: Cross-sectional. SETTING: Federally qualified health center in San Francisco, CA. PARTICIPANTS: Latino parents and their children aged 1-5 years (n = 105). VARIABLES MEASURED: Parents completed the BIQ-L for each child and three 24-hour dietary recalls. Participants' height and weight were measured. ANALYSIS: Correlations between the mean intake of beverages in 4 categories as determined by the BIQ-L and three 24-hour dietary recalls were assessed. Multivariable linear regression examined the association between sugar-sweetened beverages (SSB) servings as determined by the BIQ-L and child body mass index z-score. RESULTS: Mean daily intake of SSB (r = 0.52, P < 0.001), 100% fruit juice (r = 0.45, P < 0.001), flavored milk (r = 0.7, P < 0.001), and unflavored milk (r = 0.7, P < 0.001) from the BIQ-L were correlated with intake assessed via three 24-hour dietary recalls. In the multivariable model, weekly servings of SSBs were associated with child body mass index z-score (ß = 0.15, P = 0.02). Culturally specific beverages comprised 38% of the SSB intake reported on the BIQ-L. CONCLUSIONS AND IMPLICATIONS: The BIQ-L is a valid tool for assessing beverage intake among Latino children aged 1-5 years. The inclusion of culturally specific beverages is critical for accurately assessing beverage intake among Latino children.

Breastfeeding Duration and Timing of Bottle Supplementation: Associations with Body Mass Index from Childhood to Young-Adulthood.

Evidence for the association between breastfeeding (BF) duration and later body mass index (BMI) is inconsistent. We explored how BF duration and BF type (exclusive or partial) related to BMI from childhood to young adulthood in a Chilean cohort. Infants were recruited at 6 months between 1994 and 1996 in Santiago, Chile (n = 821). Mothers reported date of first bottle and last BF; anthropometry was measured at 1, 5, 10, 16, and 23 years. We tested whether: (1) type of BF at 6 months (none, partial, exclusive) and (2) duration of exclusive BF (<1 month, 1 to <3 months, 3 to <6 months, and ≥6 months) related to BMI. At 6 months, 35% received both breastmilk and formula ("partial BF") and 38% were exclusively breastfed. We found some evidence of an association between longer BF and lower BMI z-scores at young ages but observed null effects for later BMI. Specifically, BF for 3 to <6 months compared to <1 month related to lower BMI z-scores at 1 and 5 years (both p < 0.05). Our results are in partial accordance with others who have not found a protective effect of longer BF for lower BMI.

Understanding the Role of CalFresh Participation and Food Insecurity on Academic Outcomes among College Students during the COVID-19 Pandemic.

Food insecurity (FI) is associated with many adverse outcomes in college students. The Supplemental Nutrition Assistance Program (SNAP, known as CalFresh in California) has been observed to alleviate FI; however, on college campuses, the benefits of food assistance programs are not well understood. This study investigated whether college students benefit from CalFresh participation. It was hypothesized that students would experience increased FI over time and that CalFresh participation would moderate the effect of FI on grade point average (GPA). A comprehensive FI and CalFresh questionnaires were distributed during the 2020-2021 academic year to 849 students. The chi-square test of independence assessed differences between FI and student factors. A Friedman test assessed differences in FI during the three quarters. Moderation analysis assessed whether CalFresh participation moderated FI's effect on GPA. Differences were observed among food security scores in Winter 2021 (median = 1.69) and Fall 2020 (median = 2.14; p = 0.013) and Spring 2020 (median = 2.17; p = 0.009). In the moderation model, the interaction of FI score and CalFresh participation was positively correlated with GPA (B = 0.11; p = 0.002). These results indicate that SNAP/CalFresh participation was particularly beneficial for mitigating the negative effects of FI on GPA. Given these benefits, encouraging SNAP/CalFresh enrollment should be a priority for university administrators.

COVID-19-related stressors exacerbate food insecurity and depressive symptoms among graduate students receiving campus basic needs services: Cross-sectional findings from seven California public universities.

Prior to the COVID-19 pandemic, food insecurity and depression were growing public health concerns among graduate students. Yet, little is known about how COVID-19-related stressors exacerbated these health outcomes among graduate students. To address this research gap, this study examined two types of COVID-19-related stressors, anticipated concerns about remote learning and challenges interfering with academic and research responsibilities, in relation to food insecurity and depressive symptoms among public university graduate students. Between August and October 2020, 631 graduate students who utilised basic needs services from seven University of California campuses completed an online survey assessing the effects of COVID-19 on their academic experiences, mental health, and basic needs security. Regression analyses examined associations of COVID-19-related concerns and COVID-19-related challenges with food insecurity as well as COVID-19-related concerns and COVID-19-related challenges in relation to depressive symptoms. All four models were adjusted for age, sex, race and ethnicity, campus affiliation, and living with a partner. Models examining food security status as the dependent variable were adjusted for depressive symptoms and vice versa. Graduate students concerned about delayed graduation, post-graduate employment, isolation from faculty and not having access to healthcare reported higher counts of depressive symptoms. Challenges associated with higher counts of depressive symptoms included caring for family more than usual, spending more time on errands and not paying for utilities in full. Students concerned about accessing healthcare had higher odds of experiencing food insecurity. Challenges associated with food insecurity included spending more time on errands, being unable to afford housing and sending money to family members during the pandemic. Our findings illuminate the pandemic's deleterious consequences on graduate students' mental health and food security, underscoring the need for strong academic and basic needs programs and policies.