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1.
J Infect Dis ; 2024 Mar 05.
Article in English | MEDLINE | ID: mdl-38442331

ABSTRACT

Detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections is challenging with current serology assays and is further complicated by the marked decrease in routine viral testing practices as viral transmission increased during Omicron. Here, we provide proof-of-principle that high-avidity anti-nucleocapsid (N) antibodies detects reinfections after a single infection with higher specificity (85%; 95% confidence interval [95% CI], 80%-90%) compared to anti-N antibody levels (72%; 95% CI, 66%-79%) in a vaccinated cohort. This method could be used to retroactively investigate the epidemiology and incremental long-term health consequences of SARS-CoV-2 reinfections.

2.
BMJ Open ; 13(6): e071228, 2023 06 12.
Article in English | MEDLINE | ID: mdl-37308276

ABSTRACT

OBJECTIVE: To determine the SARS-CoV-2 seroprevalence among school workers within the Greater Vancouver area, British Columbia, Canada, after the first Omicron wave. DESIGN: Cross-sectional study by online questionnaire, with blood serology testing. SETTING: Three main school districts (Vancouver, Richmond and Delta) in the Vancouver metropolitan area. PARTICIPANTS: Active school staff enrolled from January to April 2022, with serology testing between 27 January and 8 April 2022. Seroprevalence estimates were compared with data obtained from Canadian blood donors weighted over the same sampling period, age, sex and postal code distribution. PRIMARY AND SECONDARY OUTCOMES: SARS-CoV-2 nucleocapsid antibody testing results adjusted for test sensitivity and specificity, and regional variation across school districts using Bayesian models. RESULTS: Of 1850 school staff enrolled, 65.8% (1214/1845) reported close contact with a COVID-19 case outside the household. Of those close contacts, 51.5% (625/1214) were a student and 54.9% (666/1214) were a coworker. Cumulative incidence of COVID-19 positive testing by self-reported nucleic acid or rapid antigen testing since the beginning of the pandemic was 15.8% (291/1845). In a representative sample of 1620 school staff who completed serology testing (87.6%), the adjusted seroprevalence was 26.5% (95% CrI 23.9% to 29.3%), compared with 32.4% (95% CrI 30.6% to 34.5%) among 7164 blood donors. CONCLUSION: Despite frequent COVID-19 exposures reported, SARS-CoV-2 seroprevalence among school staff in this setting remained no greater than the community reference group. Results are consistent with the premise that many infections were acquired outside the school setting, even with Omicron.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , British Columbia , Cross-Sectional Studies , Bayes Theorem , Seroepidemiologic Studies , Antibodies, Viral
3.
Microbiol Spectr ; 10(4): e0062222, 2022 08 31.
Article in English | MEDLINE | ID: mdl-35862938

ABSTRACT

We prospectively studied SARS-CoV-2 transmission at schools in an era of variants of concern, offering all close contacts serial viral asymptomatic testing up to 14 days. From the 69 primary cases detected in schools, 392 close contacts were identified and offered asymptomatic testing. A total of 229 (58%) were close school contacts, and of these, 3 tested positive (1.3%), 2 of which were detected through asymptomatic testing. This is in contrast to the 117 household contacts, where 43 (37%) went on to become secondary cases. Routine asymptomatic testing of close contacts should be examined in the context of local testing rates, preventive measures, programmatic costs, and health impacts of asymptomatic transmission. IMPORTANCE There is concern that schools may be a setting where asymptomatic infections might result in significant "silent" transmission of SARS-CoV-2, particularly after the emergence of more transmissible variants of concern. After the programmatic implementation of a strategy of asymptomatic testing of close COVID-19 contacts as part of contact tracing in the school setting, the majority of the secondary cases were still found to have occurred in home or social contacts. However, for the 6.2% of secondary cases that occurred in close school contacts, the majority were detected through asymptomatic testing. The potential added yield of this approach needs to be considered within the overall setting, including consideration of the local epidemiology, ongoing goals of case and contact management, additional costs, logistical challenges for families, and possible health impacts of asymptomatic transmission.


Subject(s)
COVID-19 , SARS-CoV-2 , British Columbia/epidemiology , COVID-19/epidemiology , COVID-19 Testing , Contact Tracing , Humans
4.
Front Public Health ; 10: 832444, 2022.
Article in English | MEDLINE | ID: mdl-35570951

ABSTRACT

Background: The purpose of this study was to explore factors associated with COVID-19 vaccine intentions among school staff as high vaccine uptake is essential to ensure schools return to normal activities. Methods: Staff (e.g., teachers, administrators, student support workers) from three urban school districts in the Greater Vancouver Area of British Columbia, Canada completed a survey between February and June 2021 (n = 2,393) on COVID-19 vaccine intentions and perceptions (i.e., acceptance of routine vaccines, benefits and risks of vaccination, susceptibility to, and severity of COVID-19, recommendation by authority figures, information mistrust and conspiracy beliefs) as part of a COVID-19 seroprevalence study. Confirmatory factor analysis followed by multiple logistic regression models adjusting for relevant covariates were used to identify vaccine perceptions uniquely associated with (a) intention to get the COVID-19 vaccine (intention), and (b) intention to get vaccinated right away (urgency). Results: In total, 95.4% of participants of the seroprevalence study completed the vaccine questionnaire, corresponding to 17.7% of the target population. Vaccine intention was associated with staff who valued expert recommendations (AOR = 10.5, 95% CI = 7.39-14.90) accepted routine vaccines (AOR = 1.94, 95% CI = 1.26-2.98) and perceived higher benefits (AOR = 1.29, 95% CI = 1.01-1.65) and lower safety risks of vaccination (AOR = 0.40, 95% CI = 0.29-0.54). Comparable associations were found with vaccine urgency. Perceived susceptibility to the COVID-19 virus was uniquely associated with vaccine urgency (AOR = 1.30, 95% CI = 1.05-1.61). A significant interaction effect (p = 0.01) revealed that staff who expressed mistrust in COVID-19 information intended to get vaccinated only if they also perceived high benefits of vaccination. Conclusions: Education about the risks and benefits of COVID-19 vaccines from a trusted source had the strongest relationship with vaccine intentions among this occupational group. Notably, those who expressed mistrust in information still intended to get vaccinated if they also perceived strong benefits of the vaccine.


Subject(s)
COVID-19 , Vaccines , British Columbia , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Intention , Schools , Seroepidemiologic Studies
5.
BMJ Open ; 12(4): e057846, 2022 04 05.
Article in English | MEDLINE | ID: mdl-35383082

ABSTRACT

OBJECTIVES: Few studies reported COVID-19 cases in schools during the 2020/21 academic year in a setting of uninterrupted in-person schooling. The main objective was to determine the SARS-CoV-2 seroprevalence among school staff in Vancouver public schools. DESIGN: Cumulative incident COVID-19 cases among all students and school staff based on public health data, with an embedded cross-sectional serosurvey among a school staff sample that was compared to period, age, sex and geographical location-weighted data from blood donors. SETTING: Vancouver School District (British Columbia, Canada) from kindergarten to grade 12. PARTICIPANTS: Active school staff enrolled from 3 February to 23 April 2021 with serology testing from 10 February to 15 May 2021. MAIN OUTCOME MEASURES: SARS-CoV-2 seroprevalence among school staff, based on spike (S)-based (unvaccinated staff) or N-based serology testing (vaccinated staff). RESULTS: Public health data showed the cumulative incidence of COVID-19 among students attending in-person was 9.8 per 1000 students (n=47 280), and 13 per 1000 among school staff (n=7071). In a representative sample of 1689 school staff, 78.2% had classroom responsibilities, and spent a median of 17.6 hours in class per week (IQR: 5.0-25 hours). Although 21.5% (363/1686) of surveyed staff self-reported close contact with a COVID-19 case outside of their household (16.5% contacts were school-based), 5 cases likely acquired the infection at school based on viral testing. Sensitivity/Specificity-adjusted seroprevalence in 1556/1689 staff (92.1%) was 2.3% (95% CI: 1.6% to 3.2%), comparable to a sex, age, date and residency area-weighted seroprevalence of 2.6% (95% CI: 2.2% to 3.1%) among 5417 blood donors. CONCLUSION: Seroprevalence among staff was comparable to a reference group of blood donors from the same community. These data show that in-person schooling could be safely maintained during the 2020/21 school year with mitigation measures, in a large school district in Vancouver, Canada.


Subject(s)
COVID-19 , SARS-CoV-2 , British Columbia/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Seroepidemiologic Studies
6.
Am J Orthopsychiatry ; 91(1): 109-119, 2021.
Article in English | MEDLINE | ID: mdl-33151733

ABSTRACT

Research addressing the linkages between acculturation and markers of adolescent well-being across multiple ethnic minority groups is limited in scope and breadth, even though children of immigrant origin are the fastest growing population. We examined cross-sectional relationships between acculturation and substance use, socioemotional well-being, and academic achievement. Somali, Latino, and Hmong adolescents in Minnesota provided data as part of the EAT 2010 (Eating and Activity in Teens) cohort study (N = 1,066). Acculturation was based on nativity, language usually spoken at home, and length of residence in the United States. Chi-square, ANOVA, and regression models were used to test for differences in adolescent well-being by acculturation and ethnic group, and interaction terms were added to models to test effect modification by ethnicity. Hmong adolescents had the highest mean acculturation scores (4.4 ± 1.5), whereas Somali adolescents (2.2 ± 1.8) were the least acculturated. Independent of ethnicity, acculturation was positively associated with marijuana (OR: 1.38; CI [1.25, 1.53]) and alcohol use (OR: 1.12; CI [1.02, 1.22]), and was negatively associated with academic achievement, based on grade point average (ß = -0.07; CI [-0.12, -0.03]). Interaction effects indicated significant differences by ethnicity only for academic achievement; significant associations between acculturation and academic achievement were evident only for Somali and Latino youth. Prevention programming should include supports for multilingual and multicultural learners and account for cultural assets within immigrant origin families that maintain and nurture protective factors as adolescents acculturate and transition into young adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Acculturation , Ethnicity , Adolescent , Adult , Child , Cohort Studies , Hispanic or Latino , Humans , Language , Minority Groups , Somalia , United States , Young Adult
7.
Body Image ; 27: 156-168, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30292082

ABSTRACT

This study explored the perceived impact of yoga on body image. Young adults (n= 34 female, 12 male; Mage = 30.6 [SD = 1.6]) practicing yoga were interviewed and data were analyzed for emerging themes across weight status. In general, participants discussed the positive impact of yoga on their body image, but some described both a positive and negative impact. Yoga was perceived as having a positive impact on body image via perceived physical changes, gratitude for one's body, a sense of accomplishment within one's yoga practice, self-confidence, and witnessing different types of bodies practicing yoga. Yoga was perceived to have a negative impact on body image via comparative critique (e.g., upward comparisons with others) and inner critique (e.g., negative self-talk). Themes were generally similar across weight status; exceptions were that participants at higher weight status were more likely than those at lower weight status to discuss accomplishment within one's yoga practice as a positive impact on body image and comparative critique as a negative impact on body image. Yoga studios and instructors can take steps to further enhance the positive impact of yoga and to provide environments that are inclusive of participants with diverse body shapes and sizes.


Subject(s)
Body Image/psychology , Self Concept , Yoga/psychology , Adult , Body Weight , Female , Humans , Male , Meditation
8.
Eat Behav ; 30: 42-48, 2018 08.
Article in English | MEDLINE | ID: mdl-29777969

ABSTRACT

PURPOSE: To examine personal, home, peer, school, neighborhood, and media correlates of sugar-sweetened beverage (SSB) intake in a diverse sample of adolescents. METHODS: Cross-sectional, population-based study (EAT 2010: Eating and Activity in Teens) of 2793 adolescents (54% female, mean age [SD] = 14.5 [2.0], 80% nonwhite) attending public secondary schools in Minneapolis-St. Paul, Minnesota. Adolescents completed a food frequency questionnaire and answered survey questions about their diet/health perceptions and behaviors. Socio-environmental data were collected from parents/caregivers, peers, school personnel, Geographic Information Systems (e.g., distance to food outlet), and a content analysis of favorite TV shows. Individual and mutually adjusted mixed-effects regression models examined associations between multi-contextual factors and estimated daily servings of SSB, controlling for relevant covariates. RESULTS: The contextual factors examined accounted for 24% of the variance in adolescents' SSB consumption. The proportion of variance explained by each context was 13% personal, 16% home/family, 3% peer, 1% school, 0.1% media, and 0% neighborhood. The strongest correlate of SSB intake was home soda availability (adjusted for covariates: ß = 0.26, p < 0.01; adjusted for all multi-contextual factors: ß = 0.18, p < 0.01). Other significant correlates of SSB intake included personal behaviors (e.g., fast food intake, sleep), home/family factors (e.g., parent modeling) and peer influences (e.g., friends' SSB intake). CONCLUSIONS: Public health policies and programs to reduce adolescent SSB intake should target personal behaviors (e.g., limit fast food, encourage adequate sleep), address the home setting (e.g., help parents to reduce SSB availability and model healthy eating habits) and involve peers (e.g., identify and enable peers to model healthy eating behaviors).


Subject(s)
Beverages , Dietary Sugars/administration & dosage , Feeding Behavior , Sweetening Agents , Adolescent , Cross-Sectional Studies , Female , Humans , Male , Minnesota , Multivariate Analysis , Risk Factors , Social Environment , Surveys and Questionnaires
9.
Int J Behav Nutr Phys Act ; 15(1): 42, 2018 05 02.
Article in English | MEDLINE | ID: mdl-29720214

ABSTRACT

BACKGROUND: A regular yoga practice may have benefits for young adult health, however, there is limited evidence available to guide yoga interventions targeting weight-related health. The present study explored the relationship between participation in yoga, healthy eating behaviors and physical activity among young adults. METHODS: The present mixed-methods study used data collected as part of wave 4 of Project EAT (Eating and Activity in Teens and Young Adults), a population-based cohort study in Minneapolis-St. Paul, Minnesota. Young adults (n = 1820) completed the Project EAT survey and a food frequency questionnaire, and a subset who reported practicing yoga additionally participated in semi-structured interviews (n = 46). Analyses of survey data were used to examine cross-sectional associations between the frequency of yoga practice, dietary behaviors (servings of fruits and vegetables (FV), sugar-sweetened beverages (SSBs) and snack foods and frequency of fast food consumption), and moderate-to-vigorous physical activity (MVPA). Thematic analysis of interview discussions further explored yoga's perceived influence on eating and activity behaviors among interview participants. RESULTS: Regular yoga practice was associated with more servings of FV, fewer servings of SSBs and snack foods, less frequent fast food consumption, and more hours of MVPA. Interviews revealed that yoga supported healthy eating through motivation to eat healthfully, greater mindfulness, management of emotional eating, more healthy food cravings, and the influence of the yoga community. Yoga supported physical activity through activity as part of yoga practice, motivation to do other forms of activity, increased capacity to be active, and by complementing an active lifestyle. CONCLUSIONS: Young adult yoga practitioners reported healthier eating behaviors and higher levels of physical activity than non-practitioners. Yoga should be investigated as an intervention for young adult health promotion and healthy weight management.


Subject(s)
Diet, Healthy , Exercise , Feeding Behavior , Health Behavior , Health Promotion/methods , Meditation , Yoga , Adult , Body Weight , Cohort Studies , Craving , Cross-Sectional Studies , Emotions , Fast Foods , Feeding Behavior/psychology , Female , Humans , Life Style , Male , Mindfulness , Minnesota , Motivation , Social Environment , Surveys and Questionnaires
10.
Body Image ; 24: 69-75, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29288970

ABSTRACT

This study explored the potential for yoga to promote body satisfaction in a general population of young adults. The sample included 1664 participants (M age: 31.1, SD=1.6years) in Project EAT, a 15-year longitudinal study. Data from the third and fourth waves (EAT-III and EAT-IV), collected five years apart, were utilized. Practicing yoga (≥30min/week) was reported by 16.2% of young adults. After adjusting for EAT-III body satisfaction and body mass index, yoga practitioners had higher concurrent body satisfaction at EAT-IV than those not practicing yoga (difference: 1.5 units [95% CI: 0.1-2.8], p=.03). Among participants within the lowest quartile of prior (EAT-III) body satisfaction, there was preliminary evidence that body satisfaction at EAT-IV was higher among yoga practitioners than in other young adults. Findings suggest that yoga may be associated with improved body satisfaction, particularly among young adults with low prior body satisfaction.


Subject(s)
Body Image/psychology , Body Mass Index , Personal Satisfaction , Yoga/psychology , Adult , Female , Humans , Longitudinal Studies , Male
11.
BMC Nutr ; 4: 3, 2018.
Article in English | MEDLINE | ID: mdl-32153867

ABSTRACT

BACKGROUND: The home food environment may be an important target for addressing adolescent obesity. The aim of this study was to investigate associations between aspects of the home food environment and the diets of adolescents who present for obesity treatment. METHODS: Cross-sectional baseline data were collected from 167 overweight/obese adolescent-parent pairs participating in an e-health lifestyle modification intervention. Adolescent intake of specific foods (fruit and vegetables, total fat, sugar-sweetened beverages, desserts/treats, and snacking occasions) was assessed by three 24-h dietary recalls, while household factors were collected from adolescent and parent questionnaires. Structural Equation Modeling, controlling for relevant covariates, was used to examine the relationship between adolescent diet and the following household factors: parent modeling, parenting style, family meal practices, and home food/beverage availability. RESULTS: Findings reveal that few characteristics of the home food environment were associated with adolescent dietary intake. Greater home availability of high-fat foods was moderately associated with adolescent snack intake (ß = 0.27, p < .001). Associations with fruit/vegetables and fat intake were small and some were in unexpected directions. Parent modeling of healthful food choices and healthier family meal practices were associated with lower availability of high-fat foods and treats in the home, but were not directly associated with adolescent diets. CONCLUSIONS: Parent modeling of healthy foods and positive mealtime routines might contribute to the healthfulness of foods offered in the homes of adolescents who are overweight/obese. Additional research is needed to better characterize the complex aspects of the household environment that influence adolescent diet.

12.
Int J Behav Nutr Phys Act ; 14(1): 122, 2017 09 11.
Article in English | MEDLINE | ID: mdl-28893273

ABSTRACT

BACKGROUND: Parents are an important influence on children's dietary intake and eating behaviors. However, the lack of a conceptual framework and inconsistent assessment of food parenting practices limits our understanding of which food parenting practices are most influential on children. The aim of this study was to develop a food parenting practice conceptual framework using systematic approaches of literature reviews and expert input. METHOD: A previously completed systematic review of food parenting practice instruments and a qualitative study of parents informed the development of a food parenting practice item bank consisting of 3632 food parenting practice items. The original item bank was further reduced to 110 key food parenting concepts using binning and winnowing techniques. A panel of 32 experts in parenting and nutrition were invited to sort the food parenting practice concepts into categories that reflected their perceptions of a food parenting practice conceptual framework. Multi-dimensional scaling produced a point map of the sorted concepts and hierarchical cluster analysis identified potential solutions. Subjective modifications were used to identify two potential solutions, with additional feedback from the expert panel requested. RESULTS: The experts came from 8 countries and 25 participated in the sorting and 23 provided additional feedback. A parsimonious and a comprehensive concept map were developed based on the clustering of the food parenting practice constructs. The parsimonious concept map contained 7 constructs, while the comprehensive concept map contained 17 constructs and was informed by a previously published content map for food parenting practices. Most of the experts (52%) preferred the comprehensive concept map, while 35% preferred to present both solutions. CONCLUSION: The comprehensive food parenting practice conceptual map will provide the basis for developing a calibrated Item Response Modeling (IRM) item bank that can be used with computerized adaptive testing. Such an item bank will allow for more consistency in measuring food parenting practices across studies to better assess the impact of food parenting practices on child outcomes and the effect of interventions that target parents as agents of change.


Subject(s)
Diet, Healthy/psychology , Diet/psychology , Parent-Child Relations , Parenting/psychology , Child , Child Behavior/psychology , Child, Preschool , Evaluation Studies as Topic , Health Behavior , Humans , Nutritional Status , Surveys and Questionnaires
13.
J Phys Act Health ; 14(12): 905-912, 2017 12 01.
Article in English | MEDLINE | ID: mdl-28682698

ABSTRACT

BACKGROUND: Yoga may provide a strategy for healthy weight management in young adults. This study examined prevalence and characteristics of young adults' yoga practice and associations with changes in body mass index. METHODS: Surveys were completed by 1830 young adults (31.1 ± 1.6 y) participating in Project EAT-IV. Cross-sectional and 5-year longitudinal analyses were conducted stratified by initial weight status. RESULTS: Two-thirds (66.5%) of nonoverweight women and 48.9% of overweight women reported ever doing yoga, while 27.2% of nonoverweight women and 16.4% of overweight women practiced regularly (≥30 min/wk). Fewer men practiced yoga. Among young adults practicing regularly (n = 294), differences were identified in intensity, type, and location of yoga practice across weight status. Young adults who were overweight and practiced yoga regularly showed a nonsignificant 5-year decrease in their body mass index (-0.60 kg/m2; P = .49), whereas those not practicing regularly had significant increases in their body mass index (+1.37 kg/m2; P < .01). Frequency of yoga was inversely associated with weight gain among both overweight and nonoverweight young adults practicing yoga regularly. CONCLUSIONS: Young adults of different body sizes practice yoga. Yoga was associated with less weight gain over time, particularly in overweight young adults. Practicing yoga on a regular basis may help with weight gain prevention.


Subject(s)
Body Weight/physiology , Obesity/therapy , Yoga/psychology , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Obesity/epidemiology , Young Adult
14.
Can J Diet Pract Res ; 78(4): 166-171, 2017 12 01.
Article in English | MEDLINE | ID: mdl-28537092

ABSTRACT

PURPOSE: To examine the influence of peers and the source of meals and snacks on the dietary quality of adolescents seeking obesity treatment. METHODS: Baseline surveys were completed by 173 adolescents with overweight or obesity (11-16 years old) enrolled in an e-health intervention in Vancouver, British Columbia. Dietary quality was assessed with three 24-h dietary recalls used to compute a Healthy Eating Index adapted to the Canadian context (HEI-C). Multiple linear regression examined associations between HEI-C scores and the frequency of: (i) meals prepared away from home, (ii) purchasing snacks from vending machines or stores, (iii) eating out with friends, and (iv) peers modeling healthy eating. RESULTS: Adolescents reported eating approximately 3 lunch or dinner meals prepared away from home and half purchased snacks from vending machines or stores per week. After adjusting for socio-demographics, less frequent purchases of snacks from vending machines or stores (b = -3.00, P = 0.03) was associated with higher HEI-C scores. More frequent dinner meals prepared away from home and eating out with friends were only associated with lower HEI-C scores in unadjusted models. CONCLUSIONS: Snack purchasing was associated with lower dietary quality among obesity treatment-seeking adolescents. Improving the healthfulness of foods obtained away from home may contribute to healthier diets among these adolescents.


Subject(s)
Diet, Healthy , Feeding Behavior , Obesity , Overweight , Adolescent , British Columbia/epidemiology , Child , Cross-Sectional Studies , Female , Food Dispensers, Automatic , Health Behavior , Health Surveys , Humans , Life Style , Male , Meals , Mental Recall , Nutrition Surveys , Restaurants
15.
BMC Public Health ; 17(1): 352, 2017 04 24.
Article in English | MEDLINE | ID: mdl-28438202

ABSTRACT

BACKGROUND: Few studies have evaluated the effect of adherence to a lifestyle intervention on adolescent health outcomes. The objective of this study was to determine whether adolescent and parental adherence to components of an e-health intervention resulted in change in adolescent body mass index (BMI) and waist circumference (WC) z-scores in a sample of overweight/obese adolescents. METHODS: In total, 159 overweight/obese adolescents and their parents participated in an 8-month e-health lifestyle intervention. Each week, adolescents and their parents were asked to login to their respective website and to monitor their dietary, physical activity, and sedentary behaviours. We examined participation (percentage of webpages viewed [adolescents]; number of weeks logged in [parents]) and self-monitoring (number of weeks behaviors were tracked) rates. Linear mixed models and multiple regressions were used to examine change in adolescent BMI and WC z-scores and predictors of adolescent participation and self-monitoring, respectively. RESULTS: Adolescents and parents completed 28% and 23%, respectively, of the online component of the intervention. Higher adolescent participation rate was associated with a decrease in the slope of BMI z-score but not with change in WC z-score. No association was found between self-monitoring rate and change in adolescent BMI or WC z-scores. Parent participation was not found to moderate the relationship between adolescent participation and weight outcomes. CONCLUSIONS: Developing strategies for engaging and promoting supportive interactions between adolescents and parents are needed in the e-health context. Findings demonstrate that improving adolescents' adherence to e-health lifestyle intervention can effectively alter the weight trajectory of overweight/obese adolescents.


Subject(s)
Life Style , Obesity/therapy , Parents , Patient Education as Topic/methods , Telemedicine/methods , Adolescent , Behavior Therapy , Body Mass Index , Child , Diet , Exercise , Female , Humans , Internet , Male , Patient Compliance , Waist Circumference , Weight Loss
16.
Appetite ; 112: 23-34, 2017 05 01.
Article in English | MEDLINE | ID: mdl-28082196

ABSTRACT

Frequent consumption of energy-dense, nutrient-poor snack foods is an eating behavior of public health concern. This study was designed to inform strategies for reducing adolescent intake of energy-dense snack foods by identifying individual and environmental influences. Surveys were completed in 2009-2010 by 2540 adolescents (54% females, mean age = 14.5 ± 2.0, 80% nonwhite) in Minneapolis-St. Paul, Minnesota schools. Daily servings of energy-dense snack food was assessed using a food frequency questionnaire that asked about consumption of 21 common snack food items, such as potato chips, cookies, and candy. Data representing characteristics of adolescents' environments were collected from parents/caregivers, friends, school personnel, Geographic Information System sources, and a content analysis of favorite television shows. Linear regression was used to examine relationships between each individual or environmental characteristic and snack food consumption in separate models and also to examine relationships in a model including all of the characteristics simultaneously. The factors found to be significantly associated with higher energy-dense snack food intake represented individual attitudes/behaviors (e.g., snacking while watching television) and characteristics of home/family (e.g., home unhealthy food availability), peer (friends' energy-dense snack food consumption), and school (e.g., student snack consumption norms) environments. In total, 25.5% of the variance in adolescents' energy-dense snack food consumption was explained when factors from within each context were examined together. The results suggest that the design of interventions targeting improvement in the dietary quality of adolescents' snack food choices should address relevant individual factors (e.g., eating while watching television) along with characteristics of their home/family (e.g., limiting the availability of unhealthy foods), peer (e.g., guiding the efforts of a peer leader in making healthy choices), and school environments (e.g., establishing student norms for selecting nutrient-dense snack foods).


Subject(s)
Adolescent Behavior , Attitude , Energy Intake , Feeding Behavior , Snacks , Social Environment , Adolescent , Cross-Sectional Studies , Diet , Diet Surveys , Eating , Family , Female , Food Supply , Friends , Humans , Male , Minnesota , Models, Biological , Obesity/prevention & control , Peer Group , Schools
17.
J Acad Nutr Diet ; 117(5): 707-714, 2017 May.
Article in English | MEDLINE | ID: mdl-27989447

ABSTRACT

BACKGROUND: Despite research linking family meals to healthier diets, some families are unable to have regular meals together. These families need guidance about other ways to promote healthy eating among adolescents. OBJECTIVE: Our aim was to examine the association between various parenting practices and adolescent fruit and vegetable (F/V) intake at different levels of family meal frequency. DESIGN: We conducted a cross-sectional, population-based survey of influences on adolescent weight-related behaviors using Project EAT (Eating and Activity in Teens) 2010. PARTICIPANTS/SETTING: Participants were 2,491 adolescents recruited from middle/high schools in Minneapolis/St Paul, MN. MEASURES: Adolescent F/V intake was ascertained with a food frequency questionnaire. Survey items assessed frequency of family meals and F/V parenting practices (availability, accessibility, parent modeling, parent encouragement, and family communication). STATISTICAL ANALYSES: Linear regression models were used to examine associations with and interactions among family meals and parenting practices. Models were adjusted for age, sex, socioeconomic status, race/ethnicity, and energy intake (kilocalories per day). RESULTS: Family meals, F/V availability, F/V accessibility, F/V modeling, and encouragement to eat healthy foods were independently associated with higher F/V intake. Of the 949 (34%) adolescents who reported infrequent family meals (≤2 days/wk), mean F/V intake was 3.6 servings/day for those with high home F/V availability vs 3.0 servings/day for those with low home F/V availability. Similar differences in mean F/V intake (0.3 to 0.6 servings/day) were found for high vs low F/V accessibility, parental modeling, and parent encouragement for healthy eating. Frequent family meals in addition to more favorable parenting practices were associated with the highest F/V intakes. CONCLUSIONS: Food parenting practices and family meals are associated with greater adolescent F/V intake. Longitudinal and intervention studies are needed to determine which combination of parenting practices will lead to improvements in adolescent diets.


Subject(s)
Diet , Family , Fruit , Meals , Vegetables , Adolescent , Adolescent Behavior , Adolescent Nutritional Physiological Phenomena , Body Weight , Cross-Sectional Studies , Diet/psychology , Diet Surveys , Diet, Healthy/psychology , Energy Intake , Family/psychology , Female , Humans , Male , Meals/psychology , Parent-Child Relations , Parenting/psychology
18.
Int J Eat Disord ; 50(6): 665-671, 2017 06.
Article in English | MEDLINE | ID: mdl-27987207

ABSTRACT

High rates of disordered eating exist among adolescents with overweight and among ethnic/racial minority adolescents. Given the lack of research examining how eating disorder risk is moderated by both overweight and ethnicity/race, this study aimed to explore interactions between ethnicity/race and overweight status on disordered eating behaviors in a population-based adolescent sample. Cross-sectional data from adolescents (n = 2,271; 52% females) of White (23%), Black (34%), Hispanic (20%), and Asian (23%; 82% Hmong) ethnicity/race participating in the EAT 2010 study were used to examine associations between overweight status and disordered eating behaviors across ethnic/racial groups. Disordered eating behaviors occurred more frequently among adolescents with overweight compared with those without overweight across all ethnic/racial groups. Although some differences in the prevalence of disordered eating were found by ethnicity/race, particularly in girls, no consistent patterns of interaction emerged. Overweight White and Hispanic girls reported the highest risk for dieting, while the highest risk for unhealthy weight control behaviors was among overweight Black girls, and for overeating among overweight White and Asian girls. Within a society in which thinness is highly valued and being overweight is stigmatized, across diverse cultural groups, adolescents with overweight are at risk for disordered eating.


Subject(s)
Feeding and Eating Disorders/epidemiology , Overweight/epidemiology , Adolescent , Cross-Sectional Studies , Ethnicity , Female , Humans , Male , Minority Groups
19.
J Phys Act Health ; 13(10): 1070-1078, 2016 10.
Article in English | MEDLINE | ID: mdl-27253269

ABSTRACT

BACKGROUND: The purpose of this study was to compare the physical activity parenting practices (PAPPs) parents report using with the PAPPs incorporated in the published literature. METHODS: PAPPs in the literature were identified by reviewing the content of 74 published PAPP measures obtained from current systematic reviews supplemented with a literature search. The types of PAPPs used by parents were identified by surveying a stratified sample of 134 Canadian and US parents of 5- to 12 year-old children. Items from the literature and parent responses were coded using the same coding scheme. Differences between the PAPPs emphasized by the parents and the literature were examined. RESULTS: Parents significantly emphasized different issues than what is measured in the literature (P < .001). Parents emphasized more control (13.6% vs. 6.9%), modeling and teaching (13.2% vs. 9.2%), and structural strategies (32.2% vs. 28.6%) and less autonomy support (11.8% vs. 14.0%), logistical support (9.9% vs. 12.8%), and responsiveness strategies (19.3% vs. 28.5%). CONCLUSIONS: Physical activity practices most often employed by parents are not the ones emphasized in current measures. The extent to which putting more emphasis on the areas identified by parents will increase the predictive validity of the measures warrants further examination.


Subject(s)
Exercise , Health Promotion/methods , Parenting , Attitude to Health , Canada , Child , Humans , Social Support , Surveys and Questionnaires , United States
20.
J Nutr ; 146(7): 1348-55, 2016 07.
Article in English | MEDLINE | ID: mdl-27281807

ABSTRACT

BACKGROUND: Most adolescents consume ≥1 snack/d; exploring the relevance of snacking patterns for overall diet and weight status is important to guide dietary counseling and public health strategies for obesity prevention. OBJECTIVE: This study examined intake of common energy-dense snack foods, total number of snacks consumed, frequency of consuming snacks prepared away from home, and frequency of snacking while watching television in adolescents and how these behaviors may be linked to diet and weight status. Relations were examined with attention to potential confounders that may help explain the mixed findings of previous research. METHODS: Survey measures of snacking behavior, a food-frequency questionnaire, and anthropometric measurements were completed by 2793 adolescents (53.2% girls, mean age = 14.4 y) in Minneapolis-St. Paul school classrooms in 2009-2010. Linear regression was used to examine associations with adjustment for sociodemographic characteristics and other potential confounding factors, such as meal skipping, underreporting energy intake, dieting to lose weight, and physical activity. RESULTS: Adolescents reported consuming a mean of 2.2 energy-dense snack food servings/d and 4.3 snacks/d and purchasing snacks prepared away from home on 3.2 occasions/wk. More than two-thirds of adolescents reported that they sometimes, usually, or always consumed a snack while watching television. The measures of snacking were directly associated (P < 0.01) with higher energy, lower fruit/vegetable, higher sugar-sweetened beverage, and more frequent fast-food intakes in all models except for one: energy-dense snack food servings were not related to sugar-sweetened beverage intake. A direct relation between daily servings of energy-dense snack foods and body mass index (BMI) z score was found; however, the snacking behaviors were inversely related to BMI z score (P < 0.01). CONCLUSIONS: The observed cross-sectional associations suggest that snack consumption is a risk factor for poor diet, but unless energy-dense foods are consumed, snacking does not consistently contribute to overweight in US adolescents.


Subject(s)
Body Weight , Eating , Adolescent , Adolescent Behavior , Adolescent Nutritional Physiological Phenomena , Diet Surveys , Female , Food Preferences , Humans , Male , Snacks
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