scholarly journals Quantifying parent engagement in the randomized Fuel for Fun impact study identified design considerations and BMI relationships

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Lohse ◽  
Leslie Cunningham-Sabo
Keyword(s):  
Repeated Measures ◽  
Parent Engagement ◽  
Parent Participation ◽  
Positive Deviance ◽  
Impact Study ◽  
Linear Modeling ◽  
Obese Youth ◽  
Northern Colorado ◽  
Activity Types ◽  
Family Based

Abstract Background Parent participation in children’s health interventions is insufficiently defined and measured. This project quantified parent participation to enable future examination with outcomes in an intervention focused on 4th graders, aged 9–11 years, and their families living in northern Colorado. Methods Indices were developed to measure type (Parent Participation Profile; PPP) and intensity (Parent Engagement Intensity; PEI) of engagement in Fuel for Fun (FFF), an asymmetric school-and family-based intervention for 4th graders. Study arm-specific participation opportunities were catalogued and summed to calculate the PPP. An algorithm considered frequency, effort, convenience, and invasiveness of each activity to calculate PEI. Indices were standardized (0–100%) using study arm-specific divisors to address asymmetric engagement opportunities. Parents who completed ≥75% of the PPP were defined as Positive Deviants. Youth height and weight were measured. Youth BMI percentile change was compared with parent Positive Deviant status using general linear modeling with repeated measures that included the participation indices. Results Of 1435 youth, 777 (54%) had parent participation in at least one activity. Standardized means were 41.5 ± 25.4% for PPP and 27.6 ± 20.9% for PEI. Demographics, behaviors or baseline FFF outcomes did not differ between the Positive Deviant parent (n = 105) and non-Positive Deviant parents (n = 672); but more Positive Deviant parents followed an indulgent feeding style (p = 0.015). Standardized intensity was greater for Positive Deviant parents; 66.9 ± 20.6% vs 21.5 ± 12.7% (p < 0.001) and differences with non-Positive Deviant parents were related to activity type (p ≤0.01 for six of eight activities). Standardized participation intensity was associated with engagement in a greater number of standardized activity types. Among participating parents, standardized intensity and breadth of activity were inversely related to the youth BMI percentile (n = 739; PEI r = −0.39, p < 0.001; PPP r = −0.34, p < 0.001). Parent engagement was not associated with parent BMI change. Conclusions An activity-specific intensity schema operationalized measurement of parent engagement in a complex, unbalanced research design and can serve as a template for more sensitive assessment of parent engagement. Positive deviance in parent engagement was not a function of personal, but rather activity characteristics. PPP and PEI increased with fewer requirements and convenient, novel, and personalized activities. Parent engagement indices affirmed lower engagement by parents of overweight/obese youth and concerns about target reach.

scholarly journals Quantifying Parent Engagement in Fuel for Fun Identified Design Considerations and BMI Relationships

2021 ◽  
Author(s):  
Barbara Lohse ◽  
Leslie Cunningham-Sabo
Keyword(s):  
Repeated Measures ◽  
Parent Engagement ◽  
Parent Participation ◽  
Positive Deviance ◽  
Health Interventions ◽  
Activity Type ◽  
Linear Modeling ◽  
Obese Youth ◽  
Activity Types ◽  
Family Based

Abstract BackgroundParent participation in children’s health interventions is insufficiently defined and measured. This project quantified and examined parent participation and its association with outcomes in an intervention focused on 4th graders and their families.MethodsIndices were developed to measure type (Parent Participation Profile; PPP) and intensity (Parent Engagement Intensity; PEI) of engagement in Fuel for Fun (FFF), an asymmetric school-and family-based intervention for 4th graders. Study arm-specific participation opportunities were catalogued and summed to calculate the PPP. An algorithm considered frequency, effort, convenience, and invasiveness of each activity to calculate PEI. Indices were standardized (0-100%) using study arm-specific divisors to address asymmetric engagement opportunities. Parents who completed \(\ge\)75% of the PPP were defined as Positive Deviants. Youth height and weight were measured. Youth BMI percentile change was compared with parent Positive Deviant status using general linear modeling with repeated measures that included the participation indices.ResultsOf 1435 youth, 777 (54%) had parent participation in at least one activity. Standardized means were 41.5 ± 25.4% for PPP and 27.6 ± 20.9% for PEI. Demographics, behaviors or baseline FFF outcomes did not differ between the Positive Deviant parent (n = 105) and non-Positive Deviant parents (n = 672); but more Positive Deviant parents followed an indulgent feeding style (p = 0.015). Standardized intensity was greater for Positive Deviant parents; 66.9 ± 20.6% vs 21.5 ± 12.7% (p < 0.001) and differences with non-Positive Deviant parents were related to activity type (p \(\le\)0.01 for six of eight activities). Standardized participation intensity was associated with engagement in a greater number of standardized activity types. Among participating parents, standardized intensity and breadth of activity were inversely related to the youth BMI percentile (n=739; PEI r= -0.39, p < 0.001; PPP r= -0.34, p < 0.001). Parent engagement was not associated with parent BMI changeConclusionsPositive deviance in parent engagement was not a function of personal, but rather activity characteristics. PPP and PEI increased with fewer requirements and convenient, novel, and personalized activities. Parent engagement indices affirmed lower engagement by parents of overweight/obese youth and concerns about target reach.Trial RegistrationClinicaltrials.gov NCT02491294. Registered 8 July, 2015.

scholarly journals Consider BMI Change When Evaluating Nutrition Intervention Impact on Eating Competence: Findings from an Intervention with Eating Competence Constructs for Adults

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1326-1326
Author(s):  
Barbara Lohse ◽  
Leslie Cunningham-Sabo
Keyword(s):  
Physical Activity ◽  
Nutrition Education ◽  
Repeated Measures ◽  
Online Survey ◽  
Physical Activity Intervention ◽  
Pearson Correlation ◽  
Nutrition Intervention ◽  
Linear Modeling ◽  
Post Intervention ◽  
Eating Competence

Abstract Objectives Examine change in adult eating competence (EC) over a 12 month period following participation in a controlled 7-month nutrition education intervention with EC constructs. Methods Parents of 4th grade youth in a cluster randomized impact assessment of a 7 month school-based culinary and physical activity intervention were assigned to 1 of 4 incrementally complex treatments that included components congruent with EC tenets. An online survey included validated measures of EC (ecSI 2.0TM), physical activity, stress, diet quality, healthful modeling, self-efficacy (SE) to offer fruits and vegetables to youth, and self-reported height/weight. EC was defined as ecSI 2.0TM ≥32. Measures were completed at baseline (BL), post-intervention (FU) and 5 months later (FU2). SPSS 24.0 analyses included repeated measures general linear modeling, means testing, chi square, Pearson correlation. Results Mean age of the mostly female (86%) sample (n = 418) was 39.1 ± 6.0 y; at FU2 126 were intervention and 96 control parents. BL analyses supported EC tenets with greater ecSI 2.0TM scores associated with less stress, lower BMI, less overweight/obesity, greater physical activity, greater SE and modeling behaviors (all P &lt; 0.01). These relationships persisted at FU (n = 220) and FU2 (n = 221) for BMI, SE, modeling, and stress measures (all P &lt; 0.01) and physical activity (P = 0.001 FU and 0.09 FU2). EC was denoted for 53% and 57% at BL and FU2 respectively. BL to FU2 ecSI 2.0TM change was not significant when controlling for changes in stress or physical activity. However, compared to those with increased FU2 BMI, ecSI 2.0TM tended (P = 0.06) to increase when BMI was decreased or unchanged, even when controlling for BL BMI. BL to FU2 ecSI 2.0 change was inversely related to BMI change (P = 0.01). ecSI 2.0TM tended to decrease for control, but increase for intervention parents (P = 0.07; –0.34 vs. 1.05), but not when controlling for BMI change. Conclusions An intervention with attention to EC congruent tenets showed modest effect on ecSI 2.0TM suggesting that successful programs require attributes that directly align with EC, which may be uniquely different from traditional nutrition education. Accurate EC intervention assessment required consideration of BMI change. Funding Sources USDA, NIFA.

scholarly journals Beyond Just the Average Effect: Variation in Head Start Treatment Effects on Parenting Behavior

AERA Open ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. 233285842096969
Author(s):  
Christina M. Padilla
Keyword(s):  
Head Start ◽  
Treatment Effects ◽  
Parent Engagement ◽  
Parenting Behaviors ◽  
Parenting Behavior ◽  
Local Alternatives ◽  
Impact Study ◽  
Random Assignment ◽  
Average Effect ◽  
Head Start Programs

Parent engagement has been a cornerstone of Head Start since its inception in 1965. Prior studies have found evidence for small to moderate impacts of Head Start on parenting behaviors but have not considered the possibility that individual Head Start programs might vary meaningfully in their effectiveness at improving parenting outcomes. The present study uses the Head Start Impact Study to examine the average effect of random assignment to and participation in Head Start on parenting outcomes as well as variation in that effect across Head Start programs. Findings reveal that Head Start is effective on average at promoting parents’ daily reading and overall literacy and math activities with children but that effects vary significantly for parents’ literacy and math activities, with some programs much more and some much less effective than their local alternatives. Findings also demonstrate that Head Start has consistent near-zero impacts across centers on parents’ disciplinary interactions with children.

scholarly journals Assessing Fidelity to Family-Based Treatment: An Exploratory Examination of Expert, Therapist, Parent, and Peer Ratings

2021 ◽  
Author(s):  
Jennifer Couturier ◽  
Melissa Kimber ◽  
Melanie Barwick ◽  
Gail McVey ◽  
Sheri Findlay ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Phase 1 ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
The Other ◽  
Peer Ratings ◽  
Fidelity Assessment ◽  
Scale Scores ◽  
Family Based Treatment ◽  
Family Based

Abstract Introduction: Fidelity is an essential component for evaluating the clinical and implementation outcomes related to delivery of evidence-based practices (EBPs). Effective measurement of fidelity requires clinical buy-in, and as such, requires a process that is not burdensome for clinicians and managers. As part of a larger implementation study, we examined fidelity to Family-Based Treatment (FBT) measured by several different raters including an expert, a peer, therapists themselves, and parents, with a goal of determining a pragmatic, reliable and efficient method to capture treatment fidelity to FBT. Methods: Each therapist audio-recorded at least one FBT case and submitted recordings from session 1, 2, and 3 from phase 1, plus one additional session from phase 1, two sessions from phase 2, and one session from phase 3. These submitted files were rated by an expert and a peer rater using a validated FBT fidelity measure. As well, therapists and parents rated fidelity immediately following each session and submitted ratings to the research team. Inter-observer reliability was calculated for each item using the intraclass correlation coefficient (ICC), comparing the expert ratings to ratings from each of the other raters (parents, therapists, and peer). Mean scale scores were compared using repeated measures ANOVA.Results: Intraclass correlation coefficients revealed that agreement was the best between expert and peer, with excellent, good, or fair agreement in 7 of 13 items from session 1, 2 and 3. There were only four such values when comparing expert to parent agreement, and two such values comparing expert to therapist ratings. The rest of the ICC values indicated poor agreement. Scale level analysis indicated that expert fidelity ratings for phase 1 treatment sessions scores were significantly higher than the peer ratings and, that parent fidelity ratings tended to be significantly higher than the other raters across all three treatment phases. There were no significant differences between expert and therapist mean scores.Conclusions: There may be challenges inherent in parents rating fidelity accurately. Peer rating or therapist self-rating may be considered pragmatic, efficient, and reliable approaches to fidelity assessment for real-world clinical settings.

scholarly journals Study of Phenomenology: The Experience of Meeting Nutritional Needs of Infants With Low Birth Weight (LBW) in Positive Deviance Families

2021 ◽  
Vol 15 (1) ◽  
pp. 39
Author(s):  
Daevi Khairunisa ◽  
Yanti Yanti ◽  
Ismarwati Ismarwati
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Role Models ◽  
Sampling Technique ◽  
Ideal Body Weight ◽  
Phenomenological Approach ◽  
Positive Deviance ◽  
History Of ◽  
Nutritional Needs ◽  
Family Based

Babies born with Low Birth Weight (LBW) are more prone to experiencing malnutrition problems. Efforts to prevent malnutrition in infants and toddlers can be done through the Positive Deviance approach. Positive Deviance is an individual or group (family) based approach by identifying positive behaviors that allow them to find better solutions to their problems. The purpose of this study was to determine the experience of fulfilling the nutritional needs of infants with a history of LBW in Positive Deviance families. The research design employed in this study was qualitative with a phenomenological approach. The main informants were Positive Deviance mothers, and the supporting informants consisted of Positive Deviance families, non-Positive Deviance mothers, and village midwives. The sampling technique used was purposive sampling. Data collection was carried out through in-depth interviews and documentation studies. The results of this study reveal the experiences of families in fulfilling the nutritional needs of infants with a history of LBW including positive maternal behaviors. For example, Early Initiation of Breastfeeding (IMD), breastfeeding after childbirth, application of breastfeeding correct way to LBW babies, exclusive breastfeeding, complementary breastfeeding, and other efforts if the baby does not have an appetite. Thus, this study implies that positive habits of mothers and families can meet the nutritional needs of infants, especially in increasing the weight of LBW babies to achieve ideal body weight. Therefore, it is necessary to make efforts to make mothers and their Positive Deviance family role models in order to transmit positive habits to other families with babies in preventing malnutrition in infants with LBW history.

scholarly journals Longitudinal associations between family conflict, parent engagement, and metabolic control in children with recent-onset type 1 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e002461
Author(s):  
Hannah Case ◽  
David D Williams ◽  
Shideh Majidi ◽  
Diana Ferro ◽  
Mark Allen Clements ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Family Conflict ◽  
Mixed Models ◽  
Repeated Measures ◽  
Parent Engagement ◽  
Linear Mixed Models ◽  
Initial Study ◽  
School Age Children ◽  
Related Family

IntroductionWe prospectively investigated the associations between diabetes-related family conflict, parent engagement in child type 1 diabetes (T1D) care, and child glycated hemoglobin (HbA1c) in 127 families of school-age children who we recruited within the first year of their T1D diagnosis.Research design and methodsParents completed the Diabetes Family Conflict Scale-Revised (DFCS-R) to assess for diabetes-related family conflict and the Diabetes Self-Management Questionnaire-Brief (DSMQ-Brief) to assess parent engagement in child T1D care at the initial study visit (T1) and at 12 (T2) and 27 (T3) months later. We also collected child HbA1c at these time points. Our analyses included Pearson correlations and repeated measures linear mixed models controlling for child age, sex, and T1D duration at T1.ResultsParents’ DFCS-R scores negatively correlated with DSMQ-Brief scores (r=−0.13, p<0.05) and positively correlated with children’s HbA1c (r=0.26, p<0.001). In our linear mixed models, parents’ DSMQ-Brief scores were unchanged at T2 (β=−0.71, 95% CI −1.59 to 0.16) and higher at T3 (β=8.01, 95% CI 6.89 to 9.13) compared with T1, and there was an association between increasing DFCS-R and decreasing DSMQ-Brief scores (β=−0.14, 95% CI −0.21 to −0.06). Child HbA1c values were significantly higher at T2 (β=0.66, 95% CI 0.38 to 0.94) and T3 (β=0.95, 95% CI 0.63 to 1.27) compared with T1, and there was an association between increasing DFCS-R scores and increasing child HbA1c (β=0.04, 95% CI 0.02 to 0.06).ConclusionsIncreasing diabetes-specific family conflict early in T1D may associate with decreasing parent engagement in child T1D care and increasing child HbA1c, suggesting a need to assess and intervene on diabetes-specific family conflict.Trial registration numberNCT03698708.

Parent engagement and involvement in education for children and young people’s online, relationship, and sexual safety : A rapid evidence assessment and implications for child sexual abuse prevention education

2021 ◽  
Author(s):  
Sebastian Trew ◽  
◽  
Daryl Higgins ◽  
Douglas Russell ◽  
Kerryann Walsh ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Parent Engagement ◽  
Parent Participation ◽  
Educational Programs ◽  
Sexual Abuse Prevention ◽  
Prevention Education ◽  
School Based ◽  
Child Sexual Abuse Prevention ◽  
Evidence Review

[Excerpt] We recently conducted a rapid evidence review on educational programs that focus on child sexual abuse (CSA) prevention (Trew et al., 2021). In that review, we learned that child-focused CSA prevention education could be enhanced by looking at how to improve the parent engagement or involvement. We know from a previous review (Hunt & Walsh, 2011), that parents’ views about CSA prevention education are important. But further evidence is needed to develop concrete strategies for strengthening parent engagement in appropriate and effective ways. As identified in the above-mentioned review (Trew et al., 2021), prominent researchers in the CSA prevention field have noted that if prevention efforts are to be successful, it is imperative to include parents (Hunter, 2011; Mendelson & Letourneau, 2015; J. Rudolph & M.J. Zimmer-Gembeck, 2018; Wurtele & Kenny, 2012). This research focuses on two complementary aspects of parent engagement in CSA prevention: (i) parent participation in parent-focused CSA prevention (ii) parent participation in school-based or child-focused CSA prevention.

Family-Based Intervention Improves Maternal Psychological Well-being and Feeding Interaction of Preterm Infants

PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 241-246 ◽  
Author(s):  
Elaine C. Meyer ◽  
Cynthia T. Garcia Coll ◽  
Barry M. Lester ◽  
C. F. Zachariah Boukydis ◽  
Susan M. McDonough ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Family Environment ◽  
Repeated Measures ◽  
Well Being ◽  
Bottle Feeding ◽  
Physical Contact ◽  
Infant Behavior ◽  
Significant Group ◽  
Family Based ◽  
Feeding Interactions

Objective. To determine the efficacy of an individualized, family-based intervention with preterm infants and their families. Design. Randomized, repeated measures intervention outcome study. Setting. Level III neonatal intensive care nursery. Patients. Random sample of 34 preterm infants ≤1500 g and their families. Interventions. Individualized, family-based intervention during the hospitalization and transition to home addressed problems identified by parents in four domains including: infant behavior and characteristics, family organization and functioning, caregiving environment, and home discharge and community resources. Measurements and Main Results. Standardized questionnaires were administered at baseline and discharge to mothers, and predischarge bottle-feeding interactions were videotaped and coded by two blinded observers. Results were in favor of intervention (Int) versus control (Con) mothers (baseline; discharge) (P &lt; .05) on the Parental Stressor Scale Sights and Sounds subscale (Int 2.4 ± 1.0; 2.0 ± 0.8 vs Con 2.4 ± 0.9; 2.6 ± 0.8); Child's Appearance and Behavior subscale (Int 2.8 ± 1.0; 2.5 ± 1.1 vs Con 2.8 ± 0.8; 3.1 ± 0.6); and Total Stressor Score (Int 93.9 ± 36.6; 72.3 ± 41.8 vs Con 87.5 ± 26.7; 87.8 ± 26.2). On the Beck Depression Inventory, intervention mothers had significant decreases in depressive symptoms (39%; 11%) vs control mothers (31%; 44%). Maternal self-esteem in both groups improved over time. There were no significant group differences in family environment. During feeding interactions, intervention infants grimaced (P &lt; .001) and gagged (P &lt; .05) less than controls. Intervention mothers less frequently interrupted feedings (P &lt; .001); less frequently stimulated infant sucking (P &lt; .01); smiled more (P &lt; .001); vocalized more (P &lt; .01); demonstrated greater sensitivity to infant behavior (P &lt; .001), better quality of physical contact (P &lt; .001), and more positive affect (P &lt; .01). Conclusions. Individualized, family-based intervention appears to reduce maternal stress and depression, and to enhance early mother-infant feeding interactions. Further research is needed to determine whether these short-term beneficial effects persist beyond the newborn period.

scholarly journals The Effect of 12-Week Passive Aquatic Bodywork on Sympathovagal Balance of Obese Youth

2018 ◽  
Vol 6 (2) ◽  
pp. 166 ◽  
Author(s):  
Ertan Tufekcioglu ◽  
Mustafa Sait Erzeybek ◽  
Fatih Kaya ◽  
Goksel Ozan
Keyword(s):  
Repeated Measures ◽  
Controlled Trial ◽  
Inverse Correlation ◽  
Therapeutic Interventions ◽  
Control Group ◽  
Global Epidemic ◽  
Bonferroni Adjustment ◽  
Obese Youth ◽  
Negative Effect ◽  
Rate Sensor

Background:  Obesity has been identified as a global epidemic that is associated with numerous comorbidities such as type 2 diabetes, hypertension, cancer, cardiovascular disease. We have investigated the effects of Watsu® therapy and Immersion on HRV parameters of obese male subjects. Methods and Results: Volunteer 34 obese subjects with BMI above 30 without any other chronic health issues were included (age, 18.30±.31, height, 166.02±29.60, BMI, 36.54±5.96). Randomized controlled trial was conducted with Watsu and Immersion protocols whereas control group received no therapy in water or on land for 12 weeks. A baseline HRV was recorded 5 minutes in four different circumstances. Polar H7 heart rate sensor and digital standardized HRV signal processing software were used to record the R-R intervals in millisecond. The repeated measures were used to compare the conditions between the therapies. The HRV analyses were performed using three-way Mixed ANOVA. Multiple comparisons were done with a Bonferroni adjustment of the alpha level (0.05). The collective results of HF showed significant negative effect (13.01±1.36, 9.99±1.11) and HF laying supine value (20.62±2.22) was the highest (p<0.05). Conclusion: A significant inverse correlation was found between HRV values and both therapeutic interventions. Counterintuitively, 12-week of watsu and immersion therapies decreased LF and HF.

Abstract P257: The Association of Metabolic Risk and Physical Activity Trajectories: CARDIA

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Sarah M Camhi ◽  
Peter T Katzmarzyk ◽  
Stephanie Broyles ◽  
Timothy S Church ◽  
Arlene L Hankinson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Black Women ◽  
Black Men ◽  
Repeated Measures ◽  
White Women ◽  
Smoking Status ◽  
White Men ◽  
Metabolic Risk ◽  
Linear Modeling

Purpose: To determine whether baseline metabolic risk in young adults is associated with physical activity (PA) trajectories over 20 years. Methods: The sample included young adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study, baseline ages 18–30 years (n= 4161). PA was determined from self-reported questionnaire at baseline and at years 2,5,7,10,15 and 20 of follow-up. Baseline metabolic risk was calculated using age-adjusted principal components analysis (elevated=top 10% of first factor), within sex-by-race groups, from mean arterial pressure (1/3(SBP-DBP)+DBP), glucose, waist circumference, triglycerides, and high-density lipoprotein cholesterol. Repeated measures general linear modeling was used to generate PA trajectories over 20 years, separately in black men, white men, black women and white women, adjusting for age and smoking status. Time by metabolic risk interaction terms did not contribute significantly to any model for any sex-by-race group and were therefore not included in final models. Results: In black men, white men, and white women, PA (in exercise units) at baseline was significantly lower among those with elevated metabolic risk (elevated risk vs. normal risk: black men 473.0 ± 27.0 vs. 572.0 ± 22.7; white men: 498.0 ±20.6 vs. 568.7 ± 17.3; white women: 402.4 ± 17.0 vs. 481.1 ± 14.3), and these differences persisted over 20 years (black men: −98.9 ± 16.4, white men: −70.8 ± 12.5 , white women: −78.7 ± 10.2; all p<0.0001). There were no significant differences in PA by metabolic risk in black women (307.2 ± 15.5 vs. 317.4 ± 13.1, difference: −10.1 ± 9.3, p =0.27). Conclusion: Elevated metabolic risk is associated with lower levels of PA in early adulthood, and these differences persist over 20 years. Despite these lower levels at baseline, the PA trajectory declines at similar rates for those with and without elevated metabolic risk. Young adults with elevated metabolic risk are important to identify early, in order to prevent PA level gap which remains over 20 years between those with and without elevated metabolic risk.

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