School Nutrition Personnel Perceptions of School Salad Bars before and after COVID-19.

Many schools have salad bars as a means to increase students' fruit and vegetable intake. School nutrition programs experienced drastic changes to the school food environment due to COVID-19. The aim of the current study was to understand cafeteria personnel's experiences related to salad bar implementation before the COVID-19 pandemic and in the current school environment to inform efforts to enhance salad bar sustainability. Seven elementary schools (N = 30 personnel) installed salad bars prior to COVID-19; three of these schools (n = 13 personnel) re-opened salad bars after COVID-19. Cafeteria personnel completed surveys assessing their experiences with salad bars at both time points. Satisfaction with salad bar implementation and training was high pre- and post-COVID-19. Most agreed that salad bars increased students' fruit and vegetable intake, yet had concerns about cleanliness and waste. Perceived job difficulty increased post-COVID-19 (p = 0.01), and satisfaction with student salad bar training decreased (p = 0.001). Additional staff support and greater student training were needed post-COVID-19. Overall, salad bars were viewed favorably; however, more challenges and lower satisfaction were reported following COVID-19. Increasing support for cafeteria personnel is needed for salad bar sustainability and improving the school food environment.

Infant Obesity Prevention Programs for Underrepresented Mothers in a Home Visiting Program: A Qualitative and Community-Engaged Needs Assessment.

A qualitative, community-engaged assessment was conducted to identify needs and priorities for infant obesity prevention programs among mothers participating in home visiting programs. Thirty-two stakeholders (i.e., community partners, mothers, home visitors) affiliated with a home visiting program serving low-income families during the prenatal to age three period participated in group level assessment sessions or individual qualitative interviews. Results indicated families face many challenges to obesity prevention particularly in terms of healthy eating. An obesity prevention program can address these challenges by offering realistic feeding options and non-judgmental peer support, improving access to resources, and tailoring program content to individual family needs and preferences. Informational needs, family factors in healthy eating outcomes, and the importance of access and awareness of programs were also noted. To ensure the cultural- and contextual-relevance of infant obesity prevention programs for underserved populations, needs and preferences among community stakeholders and the focal population should be used as a roadmap for intervention development.

Maternal Feeding Beliefs and Behaviors Relate to Infant Diet and Appetite.

INTRODUCTION: Maternal feeding practices may be linked to infant obesogenic outcomes, but research to date has focused primarily on infant growth as an outcome of maternal feeding practices rather than exploring additional obesogenic outcomes like infant appetite and diet. Therefore, the current study examined the association between maternal feeding practices and beliefs and infant growth, diet, and appetite simultaneously at a critical timepoint for obesity risk development (i.e., 3-months-old). METHODS: Thirty-two 3-month-old infants and their mothers participated in this cross-sectional study. Infant anthropometrics were collected by trained staff and mothers completed questionnaires regarding maternal feeding practices and beliefs and infant diet and appetite. The data were analyzed by Spearman correlations. RESULTS: Statistically significant correlations were identified between maternal feeding practices (e.g., using food to calm, concern about infant weight) and infant satiety, appetite, food responsiveness, slow eating, and kilocalories consumed. Infant weight-for-length was related to maternal concern about infant underweight and mother-infant social interaction during feeding. DISCUSSION: These findings highlight the importance of the mother-infant feeding relationship and how these associations may influence responsive feeding practices and infant weight-related outcomes.

Weight change predicts college adjustment and depressive symptoms among first-year college students.

ObjectiveWeight change is common during the first year of college and may be related to different outcomes for men and women. This study examined the moderating effects of gender on the association between weight change and college adjustment and depressive symptoms. Participants: One-hundred and eighty-one 18-19-year-old college freshmen (56.9% female; 84.5% Caucasian). Methods: Students completed a one-time survey about demographics, weight, college adjustment, and depressive symptoms during their second semester of college. Results: Increased weight change was associated with fewer depressive symptoms for both men and women (p < .04). For men, increased weight change was associated with better overall college adjustment, more positivity about college, less negativity about college, and less homesickness (all p < .02). Conclusions: Universities could target men and women differently in regard to weight, college adjustment, and mental health to promote a positive college experience and optimal mental health.

Family Functioning in Pediatric Functional Gastrointestinal Disorders: A Systematic Review.

OBJECTIVE: Children with some chronic health conditions experience family functioning difficulties. However, research examining family functioning in youth with functional gastrointestinal disorders (FGIDs) has produced mixed results. Therefore, the current review critically synthesized the literature on family functioning among youth with FGIDs. METHODS: A systematic search using pediatric, family functioning, and FGID search terms was conducted in PubMed, PsycInfo, and ProQuest. Out of the 586 articles initially identified, 17 studies met inclusion criteria. Studies were included if they presented original research in English, assessed family functioning, and the study sample consisted of children (0-18 years) diagnosed with a FGID. Quality assessment ratings were conducted for each included study based on a previously developed scientific merit 3-point rating system. RESULTS: The majority of studies (n = 13) examined family functioning between youth with FGIDs and comparison groups. The remaining studies explored associations between family functioning and study variables (e.g., child psychosocial functioning and sociodemographic factors) and examined family functioning clusters among children with FGIDs. In general, children with FGIDs demonstrated poorer family functioning compared to healthy counterparts. Findings also suggested that child psychosocial functioning, disease characteristics, and sociodemographic factors were related to family functioning among youth with FGIDs. The average quality of studies was moderate (M = 2.3). CONCLUSIONS: Maintaining healthy family functioning appears to be challenging for some families of children with FGIDs. Future research should explore the directionality of the relationship between family functioning and child physical and psychosocial outcomes to advance the understanding and treatment of pediatric FGIDs.

Children's appraisals of threat in pediatric cancer☆.

PURPOSE: Although many children with cancer cope well with challenges, some experience distress that results in poor adjustment. Children's perceptions of threat may be one explanation for heterogeneity in outcomes, but relatively little is known about what children find threatening. This study aimed to describe the threats that children report. METHOD: Youth (4-18 years old) newly diagnosed with cancer and their primary/parent caregivers (PC) participated in a multi-method study. Appraisals of threat were assessed via self-report and a narrative technique at two weeks post-diagnosis. PCs reported children's anxiety and depressive symptoms three months post-diagnosis and children reported their quality of life (QOL) six months post-diagnosis. RESULTS: Youth reported various types of threatening events (e.g., receiving the cancer diagnosis, fear or pain of procedures) across multiple domains (e.g., threat to self, physical threat, threat of loss). Adolescents tended to report threat to life (e.g., the seriousness of the diagnosis itself) whereas younger children reported other threats (e.g., procedural pain). Children with high perceived threat to self had higher subsequent anxiety symptoms and lower QOL compared to those with low appraisals of threat to self. There was also a significant mean difference between high and low appraisals of threat of loss in child reported QOL. CONCLUSIONS: Youths' reported threats, as well as how threat appraisals related to adjustment outcomes in distinct ways, underscores the developmental nature of how youth interpret medically stressful events and the utility of developmentally sensitive assessment. Understanding perceived threat could ultimately inform efforts to foster positive long-term adaptation for youth with cancer.

Factor structure of the Intuitive Eating Scale-2 among a low-income and racial minority population.

Intuitive eating, where an individual relies on one's own physiologic hunger and satiety cues instead of situational and emotional cues, is associated with healthier lifestyle choices, lower body-mass index (BMI), and positive psychological well-being. Despite the importance of this construct, no assessment measure of intuitive eating has been validated for use in a low-income Black population, who have an elevated risk for poor health outcomes. The aim of this study was to evaluate the factor structure of the Intuitive Eating Scale-2 (IES-2) in a predominately low-income Black population. A confirmatory factor analysis (CFA) followed by an exploratory factor analysis (EFA) were conducted using data from 204 adult participants. A large majority (71%) identified as Black and 89% had public insurance. The relationship between scores on the IES-2, BMI, and body-image dissatisfaction scores were also evaluated. A CFA of the previously used IES-2 structure demonstrated less than optimal fit. An EFA supported a six-factor, twenty-three item measure with the following names set for subscales: Avoiding Forbidden Foods (3 items), Permission to Eat (3 items), Avoiding Emotional Eating (4 items), Avoiding Food-Related Coping Strategies (4 items), Reliance on Hunger and Satiety Cues (6 items), and Body-Food Choice Congruence (3 items). The modified IES-2 scores were negatively associated with BMI and body-image dissatisfaction scores. A modified factor structure of the IES-2 may be a better measure of intuitive eating in low-income Black populations.

Predictors of victimization among youth who are overweight in a national sample.

OBJECTIVES: The current cross-sectional study examined whether children who are overweight experience greater levels of parent-reported bullying behaviors and victimization using a national sample. Additionally, the relations among child (mental health), family (parent-child sharing of information), and contextual factors (neighborhood safety, school engagement) and risk of victimization in children who are overweight were assessed. METHODS: Caregivers provided data via the 2016 National Survey of Children's Health. A series of multinomial logistic regressions were conducted with the subsample of children aged 10 to 17 years (N = 26 094). RESULTS: Youth who were overweight were more likely to be victimized, but not more likely to bully. Being engaged in school and neighborhood safety were protective factors among youth who were overweight, while living in families where information is shared and difficulty making friends were risk factors. CONCLUSIONS: Children who were overweight were more likely to be victims, rather than perpetrators, of bullying. Health professionals should assess family and contextual factors in relation to victimization status when developing interventions.

Do Parent-Adolescent Discrepancies Predict Deviant Peer Affiliation and Subsequent Substance Use?

Recent evidence suggests parent-adolescent discrepancies regarding adolescent disclosure can provide insight into parent-child relations and adolescent adjustment. However, pathways linking discrepancies to adjustment are not well known. We tested a model linking parent-adolescent discrepancies in disclosure to adolescent substance use through affiliation with deviant peers. Using three annual waves of data from a community-based study (N = 357; 91% African American; 53% female; Mage = 13.13 years, SD = 1.62 years at baseline), findings revealed that adolescent-reported secrecy and deviant peer affiliation were positively associated with substance use one and two years later, respectively, but there was no evidence of mediation. The results highlight associations of adolescent secrecy and adjustment, and the role peers play in adolescent substance use behaviors.