Do mothers' play behaviors moderate the associations between socioeconomic status and 24-month neurocognitive outcomes of toddlers born preterm or with low birth weight?

OBJECTIVE: We examined whether neonatal risks and maternal scaffolding (i.e., task changes and flexibility) during a 16-month post-term play interaction moderated the association between socioeconomic status (SES), visual-spatial processing and emerging working memory assessed at 24 months post-term among 75 toddlers born preterm or low birth weight. METHOD: SES and neonatal risk data were collected at hospital discharge and mother-child play interactions were observed at 16-month post-term. General cognitive abilities, verbal/nonverbal working memory and visual-spatial processing data were collected at 24 months. RESULTS: Neonatal risks did not moderate the associations between SES and 24-month outcomes. However, lower mother-initiated task changes were related to better 24-month visual-spatial processing among children living in higher SES homes. Mothers' flexible responses to child initiated task changes similarly moderated the impact of SES on 24-month visual-spatial processing. CONCLUSION: Our results suggest that mothers' play behaviors differentially relate to child outcomes depending on household SES.

Maternal scaffolding and preterm toddlers' visual-spatial processing and emerging working memory.

OBJECTIVE: We examined longitudinal associations among neonatal and socioeconomic risks, maternal scaffolding behaviors, and 24-month visual-spatial processing and working memory in a sample of 73 toddlers born preterm or low birthweight (PT LBW). METHODS: Risk data were collected at hospital discharge and dyadic play interactions were observed at 16-months postterm. Abbreviated IQ scores, verbal/nonverbal working memory, and verbal/nonverbal visual-spatial processing data were collected at 24-months postterm. RESULTS: Higher attention scaffolding and lower emotion scaffolding during 16-month play were associated with 24-month verbal working memory scores. A joint significance test revealed that maternal attention and emotion scaffolding during 16-month play mediated the relationship between socioeconomic risk and 24-month verbal working memory. CONCLUSIONS: These findings suggest areas for future research and intervention with children born PT LBW who also experience high socioeconomic risk.

Community-Led Collaborative Action to Prevent Obesity.

At the population level, turning the tide on obesity requires not only health education and promotion programs, but also systemic changes in our society. However, few of these changes can be implemented by single agencies or organizations acting in isolation. Broader community-driven efforts are needed to advance and maintain systematic changes across multiple settings. We introduce 2 promising approaches for local action to achieve changes: coalition action and community organizing. Understanding differences between the two approaches makes it clear that while each has distinct advantages, there are also possibilities for synergies between them. We also clarify how community-driven efforts can be catalyzed and supported, and describe our efforts as part of the Wisconsin Obesity Prevention Initiative to identify and implement best practices for building and sustaining the necessary local community capacity to carry out systematic changes. We are working with communities to launch initiatives in which residents are engaged through grassroots organizing, and local agencies, businesses, and other institutions are engaged in pursuit of collective impact on obesity prevention. This will allow us not only to compare the effectiveness of the 2 types of initiatives for driving local changes, but also to explore the potential for the two to work together in pursuit of systemic changes for preventing obesity.