Reframing the early childhood obesity prevention narrative through an equitable nurturing approach.

High-quality mother-child interactions during the first 2,000 days, from conception to age 5 years, are considered crucial for preventing obesity development during early life stages. However, mother-child dyads interact within and are influenced by broader socio-ecological contexts involved in shaping child development outcomes, including nutrition. Hence, the coexistence of both undernutrition and obesity has been noted in inequitable social conditions, with drivers of undernutrition and overnutrition in children sharing common elements, such as poverty and food insecurity. To date, a holistic life-course approach to childhood obesity prevention that includes an equitable developmental perspective has not emerged. The World Health Organization (WHO) Nurturing Care Framework provides the foundation for reframing the narrative to understand childhood obesity through the lens of an equitable nurturing care approach to child development from a life-course perspective. In this perspective, we outline our rationale for reframing the childhood narrative by integrating an equitable nurturing care approach to childhood obesity prevention. Four key elements of reframing the narrative include: (a) extending the focus from the current 1,000 to 2,000 days (conception to 5 years); (b) highlighting the importance of nurturing mutually responsive child-caregiver connections to age 5; (c) recognition of racism and related stressors, not solely race/ethnicity, as part of adverse child experiences and social determinants of obesity; and (d) addressing equity by codesigning interventions with socially marginalized families and communities. An equitable, asset-based engagement of families and communities could drive the transformation of policies, systems and social conditions to prevent childhood obesity.

Heart Healthy Routines in Young Children With Sesame Workshop: A Qualitative Study of Latina Mothers With Economic Hardship.

OBJECTIVE: To explore how Sesame Workshop resources are perceived by Latino families with economic hardship and to highlight approaches for early heart healthy routine promotion. METHODS: We performed a purposive sampling of Latina mothers (n = 40) with young children experiencing economic hardship. Using an interview guide informed by the Consolidated Framework for Implementation Research, we recorded Spanish and English semistructured interviews, which were translated and transcribed verbatim. Partnering with Sesame Workshop, we iteratively incorporated Sesame Resources into interviews to query for acceptability. Using reflexive thematic analysis, we coded transcripts through textual analysis until saturation, prioritizing in vivo coding to capture participant voices. RESULTS: We constructed 3 themes. Parents connected with resources that 1) Reflect lived and multicultural experiences containing recognizable family scenes that can serve as tools to transfer a parent's own early routines or cultural rituals to their child. They appreciated resources that 2) Engage caregivers and children together, featuring elements for both children and adult caregivers with activities to highlight important caregivers and encourage shared play. Participants also reflected on how 3) Routines amplify family strengths and foster resilient reactions with feelings of decreased stress when daily practices become routines, promoting resilient reactions and supporting long-term goals when facing setbacks. CONCLUSIONS: An interdisciplinary partnership leveraged strengths of pediatric practitioners and Sesame Workshop to align future initiatives with the values and priorities of mothers of young children at risk for early obesity. Resultant themes inform strategies to promote heart healthy routines and relational health in young children with economic hardship.

Sesame Street and School Nurses Join in a "Circle of Care".

Collaboration with community school health partners is a valuable tool assisting school nurses with a strategy referred to as developing a "circle of care." The strategy involves surrounding children with nurturing adults in their lives, individuals in schools and communities who regularly support children with comfort and care. One example of a school health partner contributing to providing a "circle of care" is the program titled "Sesame Street in Communities." The program has three main priorities-military and veteran families, supporting children with autism, and supporting resiliency in young children undergoing trauma. The following article is an interview with the authors discussing the application of this resource for school nurses working with an early childhood population.