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1.

Objective

Investigate associations between perceived parental/peer support for a healthy diet and adolescent dietary behaviors using data from the 2009–2011 School Physical Activity and Nutrition (SPAN) survey.

Design

A secondary analysis of SPAN, a cross-sectional statewide study using a validated self-administered questionnaire, assessed obesity-related behaviors.

Setting

Probability-based sample of Texas 8th- and 11th-grade students.

Participants

A total of 6,716 8th- and 11th-grade students.

Main Outcome Measures

Obtained by self-report and included sugary beverage consumption, fruit and vegetable intake, and SPAN healthy eating score.

Analysis

Multiple logistic regression and linear regression were used to determine associations, controlling for demographic variables.

Results

For every 1-point increase in parental support (range, 0–12), adolescents had 1.19 times higher odds of consuming ≥1 fruits or vegetables/d (P < .001) and 1.1 times lower odds of consuming ≥2 sugary beverages/d (P < .05), and had a SPAN healthy eating score (range, –100 to 100) that was 1.6 points higher (P < .001). For every 1-point increase in peer support, adolescents had 1.14 times higher odds of consuming ≥1 fruits and vegetables/d (P < .001) and a higher SPAN healthy eating score (P < .05).

Conclusions and Implications

Parental/peer support was associated with healthier dietary behaviors. Future research could conduct pre-post intervention studies to determine whether an increase in parental/peer support is associated with positive changes in healthier eating.  相似文献   

2.
3.

Objective

Assess the impact of a web-based gamification program on nutrition literacy of families and explore differences in impact by socioeconomic status.

Design

Quasi-experimental.

Setting

Thirty-seven kindergartens from Portugal.

Participants

Eight hundred seventy-seven families.

Intervention

Web-based social network of participants' interactions, educational materials, apps and nutritional challenges, focused on fruit, vegetables, sugar, and salt.

Main Outcome Measures

Parental nutrition literacy (self-reported survey – 4 dimensions: Nutrients, Food portions, Portuguese food wheel groups, Food labeling).

Analysis

General linear model – Repeated measures was used to analyze the effect on the nutrition literacy score.

Results

Families uploaded 1267 items (recipes, photographs of challenges) and educators uploaded 327 items (photographs, videos) onto the interactive platform. For the intervention group (n?=?106), the final mean (SD) score of nutrition literacy was significantly higher than the baseline: 78.8% (15.6) vs 72.7% (16.2); P < .001, regardless of parental education and perceived income status. No significant differences in the scores of the control group (n?=?83) were observed (final 67.8% [16.1] vs initial 66.4% [15.6]; P?=?.364).

Conclusions and Implications

Gamified digital interactive platform seems to be a useful, easily adapted educational tool for the healthy eating learning process. Future implementations of the program will benefit from longer time intervention and assessment of the eating habits of families before and after intervention.  相似文献   

4.

Purpose

Extreme weight loss behaviors (EWLBs) pose a serious health risk to adolescents. Studies suggest a link between EWLBs and other health-compromising behaviors. Extending these findings, this study examines correlates of EWLB in a predominantly minority adolescent population.

Methods

A secondary analysis of EWLB data from adolescents in an inner city pediatric emergency department was conducted. The sample (n?=?3,876) included 60% African-American, 20% Hispanic, 16% Caucasian, and 4% Asian-Pacific Islander individuals. Comparative analyses and multivariate logistic regressions were applied.

Results

Fifteen percent of the sample endorsed use of EWLBs; endorsement did not differ between minority and Caucasian groups, or among minority subgroups. EWLB correlates included female gender, hopelessness, abuse history, current smoking, and alcohol use.

Conclusions

Endorsement of EWLBs is not different between minority and Caucasian adolescents surveyed in an emergency department. Identified correlates are potential targets for prevention and early intervention.  相似文献   

5.

Objective

This study investigated variables that may mediate the relationship between advertising susceptibility and adolescent preference for and consumption of sugar-sweetened beverages (SSBs), with the goal of informing inoculation-based mitigation approaches grounded in media literacy and messaging resistance.

Design

The study utilized data from a nationally representative sample of US adolescents (ages 12–17 years, n?=?1,657) from the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating survey.

Main Outcome Measure

Variables of interest were SSB preference and consumption, advertising susceptibility, perceived self-efficacy to make good nutritional choices, perceived SSB consumption by peers, and attitude toward SSBs. Exposure to obesogenic environments was examined as a moderator.

Analysis

Direct and mediated associations between advertising susceptibility and SSB preference were estimated through a series of regression and mediation analyses.

Results

Advertising susceptibility was a strong predictor of SSB preference (unstandardized B?=?.29, SE?=?.026, P < .001), which, in turn, was a strong predictor of consumption (unstandardized B?=?.10, SE?=?.01, P < .001), controlling for potential mediators. The only statistically significant mediator of this association was perceived peer consumption (unstandardized B?=?.38, SE?=?.08, P < .001), which was stronger for adolescents with higher exposure to obesogenic environments.

Conclusions and Implications

This study offers developers of inoculation-based strategies additional insight into levers that could be targeted for building adolescent resistance to advertising effects.  相似文献   

6.

Objective

To evaluate behavior modification of diet and parent feeding practices in childhood obesity interventions.

Design

Secondary analysis of randomized, controlled trial comparing Mind, Exercise, Nutrition … Do It! (MEND2-5 and MEND/Coordinated Approach to Child Health [CATCH6-12]) vs Next Steps at baseline and 3 and 12 months.

Setting

Austin and Houston, TX.

Participants

A total of 549 Hispanic and black children randomized to programs by age groups (2–5, 6–8, and 9–12 years)

Interventions

Twelve-month MEND2-5 and MEND/CATCH6-12 vs Next Steps.

Main Outcome Measure(s)

Diet (MEND-friendly/unfriendly food groups and Healthy Eating Index-2010) and parent feeding practices (parental overt control, discipline, limit setting, monitoring, reinforcement, modeling, and covert control; and food neophobia).

Analysis

Mixed-effects linear regression.

Results

Changes in diet quality, consumption of MEND-unfriendly foods, and parent feeding practices did not differ between programs. In both interventions, MEND-unfriendly vegetables, grains, dairy and protein, added fat and desserts/sugar-sweetened beverages declined in 2–5- and 6–8-year-olds (P < .001). Healthy Eating Index-2010 improved in 2–5- (treatment; P?=?.002) and 6–8-year-olds (P?=?.001). Parental overt control decreased and limit setting, discipline, monitoring, reinforcement, and covert control increased with both interventions in 2–5- and 6–8-year-olds (P < 0.01–0.001).

Conclusions

Diet quality, consumption of MEND-unfriendly foods, and parent feeding practices were altered constructively in 2 pediatric obesity interventions, especially in 2–5- and 6–8-year-olds.  相似文献   

7.

Purpose

Little is known about whether parents and adolescents agree in their attitudes towards preventive care, private time, and confidentiality for adolescent care.

Methods

We surveyed a nationally representative sample of 1,209 13–18 year-old U.S. adolescents and their parents. Parent and adolescents attitudes towards preventive services, private time, and confidentiality were compared. Parent-youth dyad agreement was measured using Cohen's kappa and Spearman coefficients and modeled for association with demographic variables.

Results

Parents are more likely than adolescents to think preventive services are important (71% vs. 48%; p < .001). Parent-youth attitudes were weakly to moderately correlated (Cohen's kappa coefficient?=?.22; p < .001). Parents and adolescents report similar ages for when teens should start having private time (median 16 years for both) and many think this age should be at 18, the legal age of adulthood). Fewer than half believe confidentiality should be provided for 10 services, ranging from routine care to abortion care (parents range: 12.8%–52.3%; adolescents: 24.0%–58.8%). While most adolescents agreed with their parents, teens were more likely to report wanting confidential access than parents. Older age, Hispanic ethnicity, having divorced parents and higher family income were associated with both adolescent/parent and adolescent endorsement of confidentiality.

Conclusions

Adolescents and parents generally agree about the importance of preventive services, private time, confidentiality, and what should and should not be confidential. On average, parents value clinical preventive services more than youth, and youth value confidentiality more than parents. Both believe private time should start at ages older than those recommended in clinical guidelines.  相似文献   

8.
9.

Purpose

To synthesize evidence on the prevalences of stages of change (Transtheoretical Model) for smoking cessation in adolescents and associated factors.

Methods

A systematic search of Web of Science (Thomson Reuters), SCOPUS (Elsevier), MEDLINE/PubMed, CINAHL (EBSCO) and PsycINFO (APA) was conducted to identify eligible studies. Two calibrated reviewers selected studies independently, extracted data, and appraised studies. A qualitative synthesis of the findings and meta-analysis of the prevalences of the stages of change for smoking cessation were carried out. A quality effects model was used to estimate the pooled prevalences.

Results

Eleven studies (N?=?6469 adolescents) from five middle- to high-income countries were included in the review. Precontemplators accounted for 41% of smokers in earlier stages of change (95%CI: 34%–49%). In such a group, a lowered decisional balance, the lowest self-efficacy, and highest nicotine dependence were found (p < .05).

Conclusions

A higher overall prevalence of adolescents in precontemplation stage for smoking cessation was observed. Such group displayed more unfavorable smoking-related behaviors and characteristics than adolescents in other stages. The evidence is limited due to the lack of studies in adolescents living in low-income countries.  相似文献   

10.

Objective

To investigate (1) how perceived parental control, perceived parental modeling, and parent–teen co–decision making are associated with teenagers’ consumption of fruits and vegetables as well as sugary drinks and less healthful food; and (2) whether self-efficacy mediates this relationship.

Design

Cross-sectional survey.

Participants

A total of 1,657 adolescents aged 12–17years.

Main Outcome Measure(s)

Perceived parental control, perceived parental modeling, parent–teen co–decision making, self-efficacy, and consumption of fruits and vegetables as well as sugary drinks and less healthful food.

Analysis

Ordinary least-squares regressions and mediation analyses.

Results

After controlling for teenagers’ self-efficacy, perceived parental control was not significantly associated with teenagers’ fruit and vegetable consumption but it was negatively related to teenagers’ consumption of sugary drinks and less nutrient-dense food. Perceived parental modeling had a positive correlation to teenagers’ fruit and vegetable consumption and a negative relationship to their consumption of sugary drinks and less healthful food. Parent–teen co–decision making regarding teenagers’ food consumption emerged as a positive predictor for teenagers’ fruit and vegetable consumption but not for that of sugary drinks and foods with little nutritional value after controlling for self-efficacy.

Conclusions and Implications

Findings from this study demonstrated that perceived parental behaviors were related to teenagers’ nutrition intakes. Not exerting too much control and having teenagers participate in the decision-making process could help teenagers eat more healthily. Furthermore, providing a positive role model for teenagers can be an effective strategy to encourage teenagers to eat better.  相似文献   

11.

Purpose

This article presents a systematic review of the prevalence of violence against adolescents in the 22 countries of the Arab League.

Methods

Data on physical and emotional child maltreatment, sexual abuse, bullying and fighting, violence in schools, and intimate partner violence against adolescent girls were retrieved using: (1) a systematic search for peer-reviewed journal articles using Medline and the Social Sciences Citation Index; and (2) a search for nationally-representative, population-based surveys.

Results

Published evidence suggests that physical, sexual, and emotional violence against adolescents is widespread in the Arab region. In many studies, prevalence rates exceeded other regional or global estimates, including rates of violent discipline, fighting, and intimate partner violence against adolescent girls. Data on certain forms of violence (e.g. violent discipline) are available from many Arab countries; but data on other forms, e.g., sexual abuse, are scarce. Most peer-reviewed journal articles are based on small studies with diverse operational definitions and methods, making comparisons challenging.

Conclusions

High rates of violence against adolescents in the region merit greater attention from policy makers concerned with determinants of adolescent health. There is also a need to expand and improve the quality of quantitative and qualitative research on violence against adolescents in the region.  相似文献   

12.

Objective

Describe fruit and vegetable (FV) preferences and other factors that may influence participation in community-supported agriculture (CSA).

Design

In-depth, semi-structured interviews.

Setting

Eight rural/micropolitan communities in 4 US states.

Participants

There were 41 caregivers and 20 children (8–12 years of age) from low-income, English-speaking households.

Phenomena of Interest

Knowledge, attitudes, and behaviors regarding FVs; perceived barriers to CSA participation.

Analysis

Transcribed verbatim and iteratively coded.

Results

Caregivers and children believed FVs were important to health, yet FVs were not featured in dinners or snacks and consumption was challenged by limited preferences and neophobia. Few caregivers and children knew about the seasonality of FV. Most caregivers were unfamiliar with CSA and had concerns about CSA cost, accessibility, produce quality, and selection.

Conclusions and Implications

These qualitative data support improvements in: 1) CSA distribution practices to offer flexible payment and pick-up options, more fruits, and self-selection of FV; 2) public awareness of produce seasonality and the CSA distribution model as necessary precursors to participation, and lower cost for low-income families who highlighted this barrier; and 3) capacity to prepare FV by enhancing skills and providing time-saving kitchen tools. Approaches to aligning CSA practices with the needs and preferences of low-income families warrant further research.  相似文献   

13.

Objective

Restrictive food avoidance behavior among Chinese cancer patients is common. Yet, to the authors’ knowledge, no study has investigated factors associated with such behavior. This study attempted to validate a new measurement tool, the Cancer Patients Food Avoidance Behaviors Scale (CPFAB), that assessed cancer patients’ belief regarding 5 perceived benefits of practicing food avoidance, and to test its applicability.

Design

Cross-sectional face-to-face interviews.

Setting

Two outpatient oncology clinics in 2 different districts of Hong Kong.

Participants

A total of 245 patients with nasopharyngeal and colorectal cancer.

Main Outcome Measures

Assessment of psychometric properties of the CPFAB.

Analysis

Principal components method with oblique (Promax) rotations was performed to investigate the factor structure of the CPFAB.

Results

Psychometric properties, which included test-retest intraclass correlations (mean?=?0.72; SD?=?0.12), Cronbach α (.88–.94), floor (0.4% to 5.7%) and ceiling (0% to 7.3%) effects, and item-subscale (0.67–0.79) and subscale-total (0.68–0.89) correlations, were satisfactory.

Conclusions and Implications

The CPFAB, a new instrument used to assess food avoidance, was developed and validated. It showed satisfactory psychometric properties and can be used to evaluate interventions that seek to modify food avoidance attitudes among cancer patients.  相似文献   

14.

Objective

To evaluate the effects of a supermarket meal bundling and electronic reminder intervention on food choices of families with children.

Design

Quasi-experimental (meal bundling) and randomized, controlled trial (electronic reminders).

Setting

Large supermarket in Maine during 40-week baseline and 16-week intervention periods in 2015–2016.

Participants

English-speaking adults living with at least 1 child aged ≤18 years (n?=?300) with 25% of households participating in the Supplemental Nutrition Assistance Program.

Intervention(s)

(1) Four bundles of ingredients needed to make 8 low-cost healthful meals were promoted in the store through displays and point-of-purchase messaging for 4 weeks each; (2) weekly electronic messages based on principles from behavioral psychology were sent to study participants reminding them to look for meal bundles in the store.

Main Outcome Measures

(1) Difference in storewide sales and individual purchases of bundled items (measured using supermarket loyalty card data) from baseline to intervention in intervention vs control groups.

Analysis

Regressions controlling for total food spending and accounting for repeated measures.

Results

There were no differences in spending on bundled items resulting from the meal bundling intervention or the electronic reminders.

Conclusions and Implications

Overall, there was little impact of healthful meal bundles and electronic reminders on storewide sales or purchases of promoted items in a large supermarket.  相似文献   

15.

Purpose

Research on parental incarceration and the health of offspring is relatively scarce despite studies linking childhood adverse experiences to a range of physical and mental health conditions. This study aimed to estimate the associations between parental incarceration and sexual risk outcomes (early sexual onset, inconsistent condom use, and sexually transmitted infections [STIs]) in young adulthood.

Methods

We used logistic regression to estimate associations of sexual risk taking behaviors with parental incarceration during childhood in a sample of 3,972 participants in The National Longitudinal Study of Adolescent to Adult Health (Add Health) between 2001 and 2009.

Results

Parental incarceration was associated with early sexual onset (adjusted odds ratio [AOR]?=?1.4, 95% confidence interval [CI]?=?1.03–2.03) and STIs (AOR =2.0, 95% CI?=?1.3–3.2). Maternal incarceration was associated with increased odds of early sexual onset (AOR?=?3.6, 95% CI?=?1.9–6.7), inconsistent condom use (AOR?=?3.4, 95% CI?=?1.3–8.9), and STIs (AOR?=?5.5, 95% CI?=?1.7–17.6). Additionally, paternal incarceration and parental incarceration occurring before age 10 were associated with STIs (AOR?=?1.7, 95% CI?=?1.1–2.8; AOR?=?2.0, 95% CI?=?1.1–3.7).

Conclusions

Parental incarceration, especially maternal imprisonment, is associated with risky sexual behavior and sexually transmitted infections in young adults in the United States. Intervening during or prior to the adolescent developmental period may ameliorate risky sexual behaviors and related health outcomes among children of incarceration parents.  相似文献   

16.

Objective

To evaluate the effectiveness of nutrition counseling for patients with hypertension, provided in a grocery store setting.

Design

Single-arm pretest–posttest design implementing a 12-week dietary intervention.

Setting

Grocery store.

Participants

Thirty adults with hypertension recruited from a primary care practice.

Intervention

Registered dietitian nutritionists provided counseling based on the Dietary Approaches to Stop Hypertension diet.

Main Outcome Measures

Dietary intake patterns and Healthy Eating Index-2010 (HEI-2010) scores measured via food-frequency questionnaire. Change in systolic blood pressure (SBP) was a secondary outcome.

Analysis

Paired t tests were used to test for differences between HEI-2010 scores, intake of key food pattern components, and SBP at baseline compared with follow-up. Statistical significance was established at P ≤ .05.

Results

Eight HEI-2010 component scores increased significantly from baseline to follow-up (a change toward a more desirable eating pattern): total fruit, whole fruit, greens and beans, whole grains, fatty acids, refined grains, and empty calories. Sodium (P < .001), saturated fat (P < .001), discretionary solid fat (P < .001), added sugars (P?=?.01), and total fat (P < .001) all decreased significantly. The change in SBP was not significant.

Conclusions and Implications

Grocery store–based counseling for patients with hypertension may be an effective strategy to provide lifestyle counseling that is not typically available within primary care.  相似文献   

17.

Objective

To conduct a comprehensive process evaluation of a policy, systems, and environmental (PSE) change intervention.

Design

Quasi-experimental, mixed methods.

Setting

Low-income urban school district.

Participants

Fifth-grade students in 4 schools assigned to 2 intervention and 2 comparison schools (intervention, n?=?142; comparison, n?=?170).

Intervention

Both groups received a nutrition curriculum delivered by classroom teachers. Intervention schools also received 10 PSE lessons taught by paraprofessional educators.

Main Outcome Measures

Quantitative data were obtained from fidelity and observation checklists, grading rubrics and self-reported student surveys. Focus group and interviews provided qualitative data. Quantitative measures included assessments of PSE and fruit and vegetable knowledge, as well as assessment of times fruits and vegetables (FV) were consumed yesterday.

Analyses

Qualitative data were analyzed using inductive content analysis. Quantitative data were analyzed using repeated measures analysis of variance and analysis of co-variance.

Results

Fidelity, dose, reach, and acceptance of PSE intervention were high; students felt more empowered, although PSE lessons were considered lengthy and complicated. Intervention PSE and FV knowledge scores were significantly higher than comparison scores (F37.56, P < .001; and F3.94, P < .05, respectively). However, issues in communication were identified between school staff and researchers.

Conclusions and Implications

Policy, systems, and environmental classroom interventions commented on the differences between quantitative and qualitative assessments, and this suggests the need for more sensitive quantitative assessments. Future research should look at long-term outcomes as this study only looked at short-term outcomes.  相似文献   

18.

Objectives

To describe (1) the use of a diet goal-setting tool in a self-directed online intervention aimed at promoting a healthy lifestyle, and (2) the association of tool use with gestational weight gain (GWG).

Design

Cross-sectional analysis of data from the intervention group in a randomized effectiveness trial.

Setting

An urban county in the northeastern US.

Participants

A total of 898 healthy pregnant women aged 18–35 years with body mass indexes of (BMI) ≥18.5 and <35; 39.1% were low-income.

Main Outcome Measures

Physical, sociodemographic, and psychosocial characteristics; use of tool features; and GWG.

Analysis

Frequencies, chi-square tests of independence, and regression analysis.

Results

Use of the online dietary tool was 45.1% completed the assessment, 35.3% set a goal, and 22.6% engaged in self-monitoring. Among women with normal BMI, setting ≥2 goals and engaging in self-monitoring were significantly (P < .05) associated with less GWG. Among women with higher BMI, setting ≥2 goals was significantly associated with greater GWG.

Conclusions and Implications

Although online diet goal setting is a potentially effective weight management tool for pregnant women with normal BMI, findings suggest that it may not be for higher-BMI women. Additional research is needed to explain this finding.  相似文献   

19.

Objective

Early childhood is a crucial time for the development of eating behaviors and food preferences. With increased labor force participation by Australian mothers of young children, grandparents are acting as the main informal carers of grandchildren. Therefore, grandparents have the capacity to influence the feeding of young children and thus their eating behaviors.

Design

Eleven semistructured qualitative interviews.

Setting

Suburban Adelaide, South Australia.

Participants

Grandparents (n?=?11; 9 grandmothers and 2 grandfathers).

Phenomenon of Interest

To gain insight into grandparental perspectives, beliefs, and opinions regarding the feeding of grandchildren aged 1–5 years.

Analysis

Interviews were manually transcribed and coded, and codes were synthesized into common themes.

Results

Four major themes emerged: (1) intergenerational differences (between grandparents and parents); (2) maintaining familial relationships; (3) treating grandchildren with food, and (4) nutritional efficacy. Grandparents thoughtfully managed familial relations, including intergenerational differences, in relation to feeding grandchildren. They showed some cognitive dissonance with regard to provision of treat foods (defined as discretionary foods) in which grandparents simultaneously prioritized healthy foods and treats.

Conclusions and Implications

Grandparents’ social role in the complex psychosocial space of child feeding warrants serious recognition and deeper understanding to engage them fully as stakeholders in children's nutritional health.  相似文献   

20.

Objective

To examine the trends in breastfeeding disparities across Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) eligibility and participation statuses in the last 2 decades.

Design

Secondary analyses from multiple cross-sectional surveys.

Setting

United States.

Participants

The National Health and Nutrition Examination Survey 1999–2014 included 10,696 children younger than 60 months. Birth cohorts in 4-year increments were created from 1994 to 2014.

Main Outcome Measures

Ever-breastfed status and breastfed-at-6-months status.

Analysis

The prevalence rates of ever-breastfed and breastfed at 6 months were estimated between WIC-eligible vs non-eligible children and WIC-eligible participants vs eligible nonparticipants. Prevalence rates and their 95% confidence intervals were plotted across birth cohorts. Log-binomial regression was conducted to test the trends of breastfeeding in each subgroup.

Results

Ever-breastfeeding rates increased from 52% (WIC participants) vs 57% (WIC-eligible nonparticipants) in the 1994–1997 birth cohort to 71% vs 77% in the 2010–2014 birth cohort—a 36% vs 34% relative increase for participants vs eligible nonparticipants, respectively (P < .001). Breastfeeding-at-6-month rates increased from 28% (participants) vs 30% (eligible nonparticipants) to 34% vs 49% in the same time period—a 21% vs 66% relative increase, respectively (P < .001).

Conclusion and Implications

To meet the Healthy People 2020's goal for breastfeeding at 6 months, sustainable postpartum breastfeeding education and interventions may be needed among WIC participants. Future research focusing on identification of the causal relationship between WIC participation and breastfeeding outcomes is warranted.  相似文献   

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