Height and Weight Measurement and Communication With Families in Head Start: Developing a Toolkit and Establishing Best Practices.

Background: Head start (HS) programs are required to collect children's height and weight data. Programs also communicate these results to families. However, no standardized protocol exists to guide measurements or communicate results. The purpose of this article was to describe the development of a measurement toolkit and best practices for communication. Methods: HS programs contributed to the development and pilot testing of a toolkit for HS staff to guide child measurement. We used a three-phase iterative approach and qualitative methods to develop and test the toolkit, which included a video and handout. In addition, we convened an advisory group to draft best practices for communication. Results: HS program staff appreciated the toolkit materials for their simplicity and content. The advisory group highlighted the importance of weight stigma and the need to be cautious in the way that information is communicated to families. The group underscored the role of emphasizing health behavior change, instead of focusing solely on BMI. Best practices were organized into (1) Policies and procedures for communicating screening results, (2) training for HS program staff to improve communication related to screening and health behaviors, and (3) other best practices to promote health behaviors and coordinate data systems. Conclusions: Our toolkit can improve anthropometric measurements of HS to ensure that potential surveillance data are accurate. Advisory group best practices highlight opportunities for HS to develop and implement policies, procedures, and trainings across the country to improve communication with HS families. Future research should test the implementation of these best practices within HS.

Head Start Health and Nutrition Managers' Perceptions of the Process of Measuring BMI and Communicating Preschooler's Weight Status.

Body mass index (BMI) screenings are conducted as part of Head Start's (HS) health and nutrition assessments. Weight status classifications, which rely on the accuracy of the BMI measurements, are communicated to caregivers to engage them in health behavior change. Limited qualitative research has been conducted on the procedures for BMI measurement and reporting in HS programs. Interviews (n=28) were conducted with HS health/nutrition managers in Ohio and North Carolina to understand the processes used to conduct BMI screenings and disseminate reports and identify related needs. Themes included Personnel, Equipment, and Training for BMI Measurements; Classifying and Communicating BMI and Referrals; Professional Development Opportunities; and Resource, Training/Policy Needs to Support BMI Practices. Programs need additional resources to implement BMI measurement training and improve data accuracy and entry. Clarification of the referral/follow-up process and training around communicating with caregivers is also needed to better support families in implementing behavior change.

Communicating With Head Start Families About Children's Weight Status: A Phenomenological Approach.

BACKGROUND: To support the early identification of childhood obesity, Head Start (HS) implemented a body mass index screening program. This program provides opportunities for HS to communicate with families about children's weight status. Limited research is available describing the methods used to communicate this information. OBJECTIVE: Explore common experiences of HS health/nutrition managers (HNM) when communicating information to families about children's weight status. STUDY DESIGN, SETTINGS, AND PARTICIPANTS: Twenty-eight in-depth telephone interviews with HNM across North Carolina (n = 15) and Ohio (n = 13). STUDY DESIGN/ANALYSIS: Phenomenology guided the study design and analysis. The themes focused on HNM's lived experiences with their body mass index screening program. Interviews were recorded and transcribed verbatim. RESULTS: Four emergent themes identified: (1) strategies for communicating weight status to families; (2) family response to communication strategies; (3) educational, staff support, and counseling opportunities for families; and (4) challenges engaging families in childhood obesity prevention efforts. CONCLUSIONS AND IMPLICATIONS: Head Start programs acknowledged the importance of communicating children's weight status; however, there are inconsistencies in methods used and information communicated across programs. Head Start programs have community partners who support obesity prevention efforts; however, these partnerships may be underused. More research is needed to explore effective and sensitive communication methods for HS families regarding children's weight status.

Beverage behaviors and correlates among Head Start preschooler-parent dyads.

OBJECTIVES: To describe beverage behaviors among preschooler-parent dyads and explore correlates with preschooler's beverage behaviors. METHODS: This exploratory, cross-sectional study includes a convenience sample of 202 parents of preschoolers surveyed from four Head Start programs in Virginia and Ohio. Measurements included parent-child beverage behaviors, parent beverage perceptions, parent beverage rules, home beverage availability, and demographics. Analyses included descriptive statistics, correlations, Kruskal-Wallis test, and Quade's non-parametric ANCOVA tests. RESULTS: Mean sugar-sweetened beverage (SSB; i.e., regular soda, sweetened fruit drinks, sports/energy drinks, and coffee/tea with sugar) intake was 1.3 (SD = 1.4) and 2.3 (SD = 2.0) times/day for preschoolers and parents, respectively. When considering all sugary drink sources [i.e., summing SSB with flavored milk and 100% fruit juice (FJ)], the mean frequency increased to 3.2 (SD = 2.1) and 3.6 (SD = 2.4) times/day, respectively, for preschoolers and parents. A significant positive correlation was observed between preschooler-parent dyads for SSB (r = 0.406, p < 0.001) and for all sugary drinks (r = 0.572, p < 0.001). Parents who were younger, single, less educated, and with lower income had preschoolers with significantly higher SSB and all sugary drink intake (all p < 0.05). Significant correlates with preschoolers' beverage behaviors also included parent perceived behavioral control (SSB: p = 0.003, 100% FJ: p = 0.008, water: p < 0.0001), parenting practices (SSB: p = 0.022), and home availability (SSB: p = 0.011, 100% FJ: p < 0.001, water: p < 0.001). CONCLUSIONS: This study highlights excessive SSB and all sugary drink consumption among Head Start preschooler-parent dyads. Also, intervention targets to improve preschooler's beverage behaviors are identified, including efforts to improve parent's beverage behaviors, perceived behavioral control, parenting practices, and the home environment.

Potential health benefits of edible insects.

Animal-based foods have traditionally been viewed as dietary staples because they provide many essential nutrients; however, edible insects have the potential to serve as healthy, sustainable alternatives to these because of their nutrient contents. Edible insects may have superior health benefits due to their high levels of vitamin B12, iron, zinc, fiber, essential amino acids, omega-3 and omega-6 fatty acids, and antioxidants. The addition of edible insects such as crickets to the human diet could offer a myriad of environmental and nutritional benefits including an overall reduction in greenhouse gas emissions, decreased agricultural use of land and water, improved prevention and management of chronic diseases like diabetes, cancer, and cardiovascular disease, and enhanced immune function. Future research should aim to understand the beneficial effects of whole insects or insect isolates in comparison to traditional animal- and plant-based foodstuffs. Ultimately, insects have the potential to be used as meat substitutes or dietary supplements, resulting in human health and environmental benefits. The purpose of this review is to provide additional insight on the nutrient composition of edible insects, their potential use as meat substitutes or dietary supplements, the associated health and wellness benefits, and their potential role in exercise performance.

Perceptions of Weight Loss in Older Adults Following a 6-Month Weight Loss Program: A Qualitative Research Study.

BACKGROUND: Obesity in older adults contributes to increasing comorbidities and decreased quality of life. There is limited research that includes older adults' perspectives on weight loss. OBJECTIVE: The purpose of this qualitative study was to gain a better understanding of older adults' perceptions and experiences related to weight loss immediately after a 6-month weight loss intervention. DESIGN: A qualitative research design using semi-structured interviews conducted as part of a larger research study exploring weight loss and/or aerobic exercise on muscle inflammation. PARTICIPANTS/SETTING: A sample of community-based older adults (n = 11) in Southwestern Ohio were recruited from September 2018 through August 2019 after completion of a 6-month weight loss intervention. Eligible participants were older than 58 years, with a body mass index (calculated as kg/m2) >27, and sedentary with no cognitive deficits. Exclusions included cancer, heart disease, diabetes, and tobacco use. ANALYSIS: Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis. Descriptive statistics were used for demographic data. RESULTS: Three emergent themes included barriers and challenges to weight loss, which included caregiving roles, challenges with increasing protein intake, and ambivalence to change; personal strategies for success (eg, portion control and meal flexibility); and external strategies for success (eg, visual graphs as feedback measures, alternate measures of success, and social support). CONCLUSIONS: The results of this qualitative study provide insight into older adults' experiences with weight loss, which may be considered when designing weight management interventions. However, more research is needed to examine strategies to address the challenges identified by participants in this research study. Future qualitative research should also focus on weight loss perspectives of older adults in other racial and ethnic groups.

BMI Data Collection and Communication Practices in a Multistate Sample of Head Start Programs.

Background: Although there is a federal mandate to collect anthropometric data in Head Start (HS), little is currently known about the processes used to collect the height and weight measurements across programs and how the results are communicated to parents/guardians. The goal of this study was to understand anthropometric data collection and dissemination procedures in a sample of HS programs serving children 3-5 years. Methods: A convenience sample of HS Health or Nutrition managers were recruited via personal contacts and HS state directors to complete an electronic survey. Quantitative data were analyzed using descriptive statistics (means, standard deviations and frequencies). Open-ended questions were coded using thematic analysis. All protocols and procedures were approved by the Institutional Review Board at Miami University. Results: Approximately half of the programs reported that they have a protocol in place to guide measurements (57.1%) and those measurements are primarily taken by HS staff (64.5%). Most programs explain measurements to parents (82.3%) and report that collecting height/weight data is helpful in supporting children's health (76.0%). Most programs (80.3%) provide resources to parents of children with overweight or obesity. Four themes emerged from open-ended responses: (1) Role of Community Partners (e.g., providing information that conflicts with others); (2) Communicating Children's Weight Status with Families (e.g., using sensitive communication methods); (3) Challenges Measuring Children's Weight Status (e.g., accuracy of data, children's awareness); and (4) Family Reaction to Weight Status Communication (e.g., positive or negative experiences). Conclusion: Opportunities for quality improvement include wider use of standardized, written protocols and policies on data collection and enhanced communication practices to share information with parents.

Comparing Delivery Methods of an Introductory Nutrition Course Using the Community of Inquiry.

OBJECTIVE: To compare student perceptions and final grades of online vs face-to-face nutrition courses using the community of inquiry (COI) framework. METHODS: Using a cross-sectional research design, students in 3 courses completed the 34-item COI questionnaire. One-way ANOVA compared the COI and final grades. RESULTS: One hundred eight students participated. There were no significant differences in the perception of teaching presence (F[2,103] = 0.214, P = .81), social presence (F[2,103] = 0.393, P = .68), cognitive presence (F[2,103] = 0.428, P = .65), and final grades (F[2,140] = 0.846, P =.43). CONCLUSIONS AND IMPLICATIONS: Online courses may provide similar perceptions of connection to the course content, peers, and the instructor similar to face-to-face courses and may result in similar grades. Instructor professional development may be warranted to ensure the use of instructional strategies that enhance connections and facilitate higher-level learning. Additional research is needed to replicate these findings with multiple instructors and a larger sample size.

Exploration of Sugar-Sweetened Beverage Intake in a Latinx Population.

OBJECTIVE: The purpose was to explore contributing factors of sugar-sweetened beverage (SSB) intake in Latinx residing in Southwest Ohio to inform the development of future interventions. DESIGN: This was a qualitative study utilizing focus groups. PARTICIPANTS AND SETTING: Latinx participants were recruited from local churches, community centers, and universities to participate in 1 of 6 focus groups (n = 43). PHENOMENON OF INTEREST: Individual, relational, community, and sociocultural factors related to SSB consumption. ANALYSIS: Constant comparative analysis of focused, axial, and selective coding to develop themes. Memo writing assisted with conceptualization of the data. Themes mirrored the Socioecological Model. RESULTS: SSB consumption is rooted in cultural identity and social norms. Other factors include availability, taste, and energy. Suggestions for change consisted of finding acceptable substitutions, creating socially appropriate support networks, developing community and workplace policies, and countering the impact of advertising. CONCLUSION AND IMPLICATIONS: This study highlights factors across the ecological model that contribute to Latinx SSB consumption in Southwest Ohio. Similar studies in other geographical areas in the US are warranted to confirm these findings. Individual, intrapersonal, community, and societal factors may be utilized in tailoring SSB interventions for Latinx adults to enhance cultural capital and create behavior change. Future interventions may explore and test these factors using the Model of Cultural Change.

Parents' Perceptions of 5210 Nutrition Messaging and Child Weight Status.

OBJECTIVE: To explore parent perceptions of child weight status and 5210 nutrition messaging recommendations, including daily consumption of 5 fruits and vegetables, limiting child screen time to ≤2 hours, incorporating 1 hour of daily physical activity, and no consumption of sugary, sweetened beverages. METHODS: Using the Convergence Model of Communication as a framework, qualitative focus groups (n = 5) were conducted at 4 Head Start sites across 1 Ohio County. Twenty-eight parents aged 20-60 years comprised the groups. A deductive analysis technique with respondent validation was used. RESULTS: Parents have limited understanding of 5210 messages delivered by the program. Parent food preferences, family finances, and children's picky eating were identified as barriers to integrating healthy eating habits at home. Parents prefer practical strategies regarding how to integrate healthy eating habits into the home environment. Participants expressed concern about children's psychological health and happiness vs weight status. CONCLUSIONS AND IMPLICATIONS: Understanding parental perceptions of 5210 messaging and program-reported weight status may assist Head Start programs in addressing childhood obesity through focused parent education and support.

"What's Cooking?": Qualitative Evaluation of a Head Start Parent-Child Pilot Cooking Program.

Providing access to nutritious foods is crucial for low-income populations, but increasing nutrition-related skills and attitudes such as food preparation, feeding practices, and positive perceptions around healthy foods to establish sustainable behavior change are paramount for the development of healthy lifestyles. This qualitative study was designed to evaluate the What's Cooking pilot program. A total of 15 participants were recruited from two Head Start schools through flyers, text messages, and e-mails. Two focus group sessions were audiotaped to obtain information related to the program implementation and perceived outcomes and behavior change. Recordings of the sessions were transcribed and analyzed using constant comparative analysis. Resulting themes included children's asking behavior for healthy foods, family connection, parent comfort in cooking, and development of child attitude, knowledge, and skills. The qualitative analysis provided foundational information for the development of a framework for other nutrition program providers to understand the role of the child in a cooking class as a mediator for lifestyle change. The What's Cooking program increased the implementation of sustainable food practices and healthy nutrition behaviors through educating families on how to involve their children in positive mealtime practices.

Achieving a shared vision for girls' health in a low-income community.

In response to a lack of information related to girls' health in a low-income community, an initiative was developed to create a community-wide vision for girls' health. A forum was conducted following a photovoice project to generate sustainable action steps. Forty-four participants attended the forum. Key action steps included decreasing barriers to participation in girls' programs, offering leadership roles and interpersonal communication skills for girls in the community, and engaging girls in community organizations. Integral to the forum's success were the initial photos, which provided a bridge from understanding the issues of girls' health to the development of the action steps.

Effects of porous polystyrene resin parameters on Candida antarctica lipase B adsorption, distribution, and polyester synthesis activity.

Polystyrene resins with varied particle sizes (35 to 350-600 microm) and pore diameters (300-1000 A) were employed to study the effects of immobilization resin particle size and pore diameter on Candida antarctica Lipase B (CALB) loading, distribution within resins, fraction of active sites, and catalytic properties for polyester synthesis. CALB adsorbed rapidly (saturation time