Obesity-related parenting practices, styles, and family functioning: A natural experiment comparing pandemic and nonpandemic data.

The COVID-19 pandemic resulted in substantial changes to family life. This study examined associations between pandemic conditions and mothers' and fathers' food, physical activity, and media parenting practices and whether these associations were moderated by parenting styles and family functioning. Two independent samples of Canadian parents (nonpandemic n = 270; pandemic n = 357) self-reported their obesity-related parenting practices, styles, and family functioning. Covariate-adjusted regression models compared parenting practices between the samples. Interactions tested the moderating effects of family functioning and parenting styles on mothers' and fathers' parenting practices separately. Compared to nonpandemic mothers, pandemic mothers reported more frequent family meals, more screen time negotiation, and lower modeling of healthy screen time. Both pandemic mothers and fathers reported lower physical activity facilitation than nonpandemic parents. Parenting styles moderated some of these associations; for example, pandemic authoritative parents used less physical activity monitoring (mothers) and screen time negotiation (fathers) as opposed to uninvolved and permissive parents who reported higher use of these practices. The association between pandemic and parenting practices was also moderated by family functioning, especially among fathers. Among high-functioning families, pandemic fathers reported greater engagement in food monitoring, emotional feeding, coercive feeding, healthy screen time modeling, and emotional compensation with screens than nonpandemic fathers and low-functioning family fathers. Pandemic conditions may have negatively affected obesity-related parenting practices, but most associations were moderated by the familial context. The extent to which this will have long-lasting effects on adolescents' health needs to be further explored. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Patterns of Physical Activity Parenting Practices and Their Association With Children's Physical Activity Behaviors.

Background: Little is known about how parents combine multiple physical activity (PA) parenting practices (PAPP) and their relationship with their child's activity level. This study examined patterns of PAPP and their associations with sociodemographic characteristics and children's PA. Methods: Parents of 5- to 12-year-olds (n = 618) completed the 65-items PAPP item-bank assessing their use of structured, autonomy promoting, and controlling PAPP, and reported their child's PA. Latent class analysis was used to uncover similar groups of parents based on their use of nine PAPP. Regression analyses evaluated associations between the latent classes, sociodemographic factors, and children's PA. Results: Four latent classes emerged: (1) Indifferent (30%)-parents who were unlikely to use any of the PAPP examined; (2) Coercive (23%)-parents using primarily controlling PAPP; (3) Involved (19%)-parents using most PAPP examined; and (4) Supportive (28%)-parents using primarily structured and autonomy promoting PAPP. Involved parents were younger than Indifferent and Supportive parents. Supportive parents reported the highest level of children's PA compared with all other groups, whereas Coercive parents reported the lowest level of children's PA. Conclusions: Our findings showed that different latent classes exist among Canadian parents and that the combination of structured and autonomy promoting PAPP, when used without control, was associated with the highest PA level among children. The emergent latent classes are novel, theoretically meaningful, and key to inform family-based PA interventions.

Efficacy of the Aim2Be Intervention in Changing Lifestyle Behaviors Among Adolescents With Overweight and Obesity: Randomized Controlled Trial.

BACKGROUND: Aim2Be is a gamified lifestyle app designed to promote lifestyle behavior changes among Canadian adolescents and their families. OBJECTIVE: The primary aim was to test the efficacy of the Aim2Be app with support from a live coach to reduce weight outcomes (BMI Z score [zBMI]) and improve lifestyle behaviors among adolescents with overweight and obesity and their parents versus a waitlist control group over 3 months. The secondary aim was to compare health trajectories among waitlist control participants over 6 months (before and after receiving access to the app), assess whether support from a live coach enhanced intervention impact, and evaluate whether the app use influenced changes among intervention participants. METHODS: A 2-arm parallel randomized controlled trial was conducted from November 2018 to June 2020. Adolescents aged 10 to 17 years with overweight or obesity and their parents were randomized into an intervention group (Aim2Be with a live coach for 6 months) or a waitlist control group (Aim2Be with no live coach; accessed after 3 months). Adolescents' assessments at baseline and at 3 and 6 months included measured height and weight, 24-hour dietary recalls, and daily step counts measured with a Fitbit. Data on self-reported physical activity, screen time, fruit and vegetable intake, and sugary beverage intake of adolescents and parents were also collected. RESULTS: A total of 214 parent-child participants were randomized. In our primary analyses, there were no significant differences in zBMI or any of the health behaviors between the intervention and control groups at 3 months. In our secondary analyses, among waitlist control participants, zBMI (P=.02), discretionary calories (P=.03), and physical activity outside of school (P=.001) declined, whereas daily screen time increased (P<.001) after receiving access to the app compared with before receiving app access. Adolescents randomized to Aim2Be with live coaching reported more time being active outside of school compared with adolescents who used Aim2Be with no coaching over 3 months (P=.001). App use did not modify any changes in outcomes among adolescents in the intervention group. CONCLUSIONS: The Aim2Be intervention did not improve zBMI and lifestyle behaviors in adolescents with overweight and obesity compared with the waitlist control group over 3 months. Future studies should explore the potential mediators of changes in zBMI and lifestyle behaviors as well as predictors of engagement. TRIAL REGISTRATION: ClinicalTrials.gov NCT03651284; https://clinicaltrials.gov/ct2/show/study/NCT03651284. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-020-4080-2.

The Aim2Be mHealth Intervention for Children With Overweight or Obesity and Their Parents: Person-Centered Analyses to Uncover Digital Phenotypes.

BACKGROUND: Despite the growing number of mobile health (mHealth) interventions targeting childhood obesity, few studies have characterized user typologies derived from individuals' patterns of interactions with specific app features (digital phenotypes). OBJECTIVE: This study aims to identify digital phenotypes among 214 parent-child dyads who used the Aim2Be mHealth app as part of a randomized controlled trial conducted between 2019 and 2020, and explores whether participants' characteristics and health outcomes differed across phenotypes. METHODS: Latent class analysis was used to identify distinct parent and child phenotypes based on their use of the app's behavioral, gamified, and social features over 3 months. Multinomial logistic regression models were used to assess whether the phenotypes differed by demographic characteristics. Covariate-adjusted mixed-effect models evaluated changes in BMI z scores (zBMI), diet, physical activity, and screen time across phenotypes. RESULTS: Among parents, 5 digital phenotypes were identified: socially engaged (35/214, 16.3%), independently engaged (18/214, 8.4%) (socially and independently engaged parents are those who used mainly the social or the behavioral features of the app, respectively), fully engaged (26/214, 12.1%), partially engaged (32/214, 15%), and unengaged (103/214, 48.1%) users. Married parents were more likely to be fullyengaged than independently engaged (P=.02) or unengaged (P=.01) users. Socially engaged parents were older than fullyengaged (P=.02) and unengaged (P=.01) parents. The latent class analysis revealed 4 phenotypes among children: fully engaged (32/214, 15%), partially engaged (61/214, 28.5%), dabblers (42/214, 19.6%), and unengaged (79/214, 36.9%) users. Fully engaged children were younger than dabblers (P=.04) and unengaged (P=.003) children. Dabblers lived in higher-income households than fully and partiallyengaged children (P=.03 and P=.047, respectively). Fully engaged children were more likely to have fully engaged (P<.001) and partiallyengaged (P<.001) parents than unengaged children. Compared with unengaged children, fully and partiallyengaged children had decreased total sugar (P=.006 and P=.004, respectively) and energy intake (P=.03 and P=.04, respectively) after 3 months of app use. Partially engaged children also had decreased sugary beverage intake compared with unengaged children (P=.03). Similarly, children with fully engaged parents had decreased zBMI, whereas children with unengaged parents had increased zBMI over time (P=.005). Finally, children with independently engaged parents had decreased caloric intake, whereas children with unengaged parents had increased caloric intake over time (P=.02). CONCLUSIONS: Full parent-child engagement is critical for the success of mHealth interventions. Further research is needed to understand program design elements that can affect participants' engagement in supporting behavior change. TRIAL REGISTRATION: ClinicalTrials.gov NCT03651284; https://clinicaltrials.gov/ct2/show/NCT03651284. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-020-4080-2.

Don't take the context out of the picture: Contextually shaped parents' and children's obesogenic behaviors in a marginalized area of Mexico City.

Santa Fe Gully zone is a marginalized area of Mexico City where nearly 39% of children live with either overweight or obesity. Despite the extensive research on obesogenic behaviors, studies frequently overlook the contexts where such behaviors occur. This qualitative study described individual and familial obesogenic behaviors among children with obesity from Santa Fe Gully, and explained how these behaviors might be contextually shaped. We used a grounded theory approach to investigate the process of development/maintenance of obesity in our sample. Fifteen participants (seven 10-year-olds with overweight or obesity and their parents) participated in nine art-based focus groups, and parents completed individual semi-structured interviews. Data were analyzed using a structured thematic content analysis. Results showed children's weight status was part of their identity, providing children with a familial 'fitting' sense while increasing psychosocial difficulties, leading to emotional overeating as a coping strategy. Parents' use of controlling and low-structured parenting practices reinforced children's emotional overeating and failed to regulate children's dietary and physical activity behaviors. Some low-structured parenting practices were guilt-motivated or fostered by socioeconomic and cultural factors (e.g., limited food access, unhealthy food exposure, community unsafety). Future interventions in Santa Fe Gully aimed at modifying obesogenic behaviors should incorporate systemic and ecological approaches to help participants navigate through contextual obstacles, as their behaviors should be analized considering the context where they occur.

Are fathers' and mothers' food parenting practices differentially associated with children's eating behaviors?

Little is known about how fathers' food parenting practices (FPP) are linked with children's eating behaviors and whether these associations differ from mothers. This study examined associations between paternal and maternal FPP and eating behaviors among children aged 5-12 years. A sample of 565 parents (53% fathers) completed: 1) the FPP item bank, which measured 11 FPP constructs from three domains of parenting (control, autonomy promotion, and structure) and 2) the Children's Eating Behavior Questionnaire (CEBQ), to assess four constructs (emotional overeating, food responsiveness, satiety responsiveness and food fussiness). Multivariable linear regressions evaluated associations between FPP and CEBQ constructs, and models were run separately for fathers and mothers. Similarities emerged between fathers and mothers: 1) use of restriction for weight practices were positively associated with emotional overeating and food responsiveness; 2) use of practices to accommodate the child around food and use of practices to involve the child were positively and negatively associated, respectively, with food fussiness; and 3) use of practices to accommodate the child, or coercive controlling practices, was positively associated with emotional overeating. Differences emerged between fathers and mothers in terms of FPP associated with children's food and satiety responsiveness, with a greater number of fathers' FPP predictive of these behaviors. Although similarities exist between mothers and fathers, these findings suggest that fathers likely exert a unique influence on their children's eating behaviors and stress the need for interventions to account for the role each parent plays promoting healthy eating habits.