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Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34210069


The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.

Adaptação Psicológica , Comportamento do Adolescente/psicologia , Afro-Americanos/psicologia , Obesidade Pediátrica/psicologia , Estresse Psicológico/psicologia , Adolescente , Terapia Comportamental , Criança , Dieta/psicologia , Família/psicologia , Relações Familiares/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Humanos , Masculino , Obesidade Pediátrica/terapia , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Programas de Redução de Peso
Nutrients ; 13(6)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34063799


Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial (n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child's weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness (p = 0.018) and demandingness (p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent's weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents.

Terapia Familiar/métodos , Refeições/psicologia , Poder Familiar/psicologia , Obesidade Pediátrica/terapia , Programas de Redução de Peso/métodos , Adolescente , Adulto , Afro-Americanos/psicologia , Dieta Saudável/etnologia , Dieta Saudável/psicologia , Comportamento Alimentar/etnologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Refeições/etnologia , Pessoa de Meia-Idade , Motivação , Análise Multinível , Relações Pais-Filho/etnologia , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/psicologia , Avaliação de Programas e Projetos de Saúde
J Behav Med ; 44(4): 541-550, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33751355


This study evaluated the associations between parenting factors and adolescent weight related outcomes in African American adolescents with overweight and obesity. Baseline heights and weights were collected from 241 African American adolescents (11-16 years) with overweight and obesity. Self-reported adolescent perceptions of caregiver's parenting style (responsiveness, demandingness), parental feeding practices (monitoring, responsibility, weight related concerns, pressure-to-eat, and restriction), and their own dietary self-efficacy for healthy eating were assessed. Results demonstrated that greater parental responsiveness was significantly associated with lower adolescent body mass index (BMI) and higher adolescent dietary self-efficacy. In contrast, parental concern about adolescent weight was significantly associated with greater adolescent BMI, while greater parental responsibility for foods was associated with lower adolescent BMI. Although parental pressure-to-eat was significantly associated with higher dietary self-efficacy, greater parental restriction was associated with lower dietary self-efficacy. The results of this study highlight the importance of parental responsiveness and responsibility in understanding obesity related outcomes in African American adolescents with overweight and obesity.

Afro-Americanos , Poder Familiar , Adolescente , Índice de Massa Corporal , Comportamento Alimentar , Humanos , Obesidade , Sobrepeso , Relações Pais-Filho , Inquéritos e Questionários
Int J Behav Nutr Phys Act ; 16(1): 47, 2019 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-31126345


BACKGROUND: Although weight loss is an important primary outcome in obesity interventions, family-based interventions may have cascading ripple effects that extend to other aspects of health and well-being. Identifying these secondary benefits may be useful for understanding how to best engage underserved African American families in weight loss. The present research examines whether African American adolescents and parents perceive secondary benefits from participating in a family-based weight-loss intervention, including secondary health, social, or cognitive benefits. METHODS: Qualitative data were obtained from families participating in the group-based intervention of the Families Improving Together (FIT) for Weight Loss trial. During the final week of the face-to-face motivational and family-based intervention program, families completed a guided open-ended group discussion about changes they experienced from participating (14 groups, N = 41 adolescents and 41 parents). Sessions were audiotaped, transcribed, and coded by independent pairs of raters using both inductive and deductive approaches. Guided by the multi-theoretical framework for the FIT trial, some themes were determined prior to coding using a deductive approach, including: (a) health outcomes (e.g., monitoring strategies for diet and physical activity), (b) social outcomes (e.g., involvement in family support, group support, autonomy support, family bonding, positive communication) and (c) cognitive outcomes (e.g., expression of self-confidence through self-efficacy, self-regulation, establishment of long-term goals). In addition to these pre-determined themes, the coding process included an inductive assessment, allowing for unexpected themes to surface as well around positive self-talk, relapse prevention, and monitoring strategies for different types of weight-related behaviors. RESULTS: Across both adolescents and parents, the cognitive outcomes were the most frequently discussed outcomes, including self-regulation, monitoring strategies for diet, establishing long-term goals, and ultimate relapse prevention. Parents made a greater number of comments about the social outcomes, including family support, group support, self-efficacy, and family connectedness, whereas adolescents made a greater number of comments about positive family communication. CONCLUSIONS: The results provide preliminary support for the positive secondary effects of weight loss programs on improving both cognitive and social well-being in underserved African American adolescents. TRIAL REGISTRATION: # NCT01796067. The trial was registered on February 21, 2013 and the first participant was enrolled July 12, 2013.

Afro-Americanos/psicologia , Família/psicologia , Perda de Peso/fisiologia , Programas de Redução de Peso , Adolescente , Humanos , Autoeficácia , Apoio Social