Barriers to healthy behaviors: perspectives from teens with comorbid Type 1 diabetes and overweight/obesity, caregivers, and pediatric endocrinologists.

Objectives: This study aimed to understand barriers to engagement in healthy lifestyle behaviors among adolescents with comorbid Type 1 diabetes (T1D) and overweight/obesity (n = 12), their caregivers (n = 12), and pediatric endocrinologists (n = 9).

Methods: Participants (n = 33) completed individual, semi-structured interviews. Interviews were transcribed verbatim, and applied thematic analysis was used to analyze the interview data.

Earlier Bedtimes Mediate the Effect of a Brief Behavioral Sleep Intervention on Children's Weight Status.

Whether the effect of a brief behavioral sleep intervention on child weight status resulted from observed differences in sleep duration and/or bedtimes was assessed. Findings demonstrate that the intervention's beneficial effect on weight status was due to earlier bedtimes, suggesting the potential importance of earlier bedtimes for obesity prevention.

Systematic review and meta analysis of psychological interventions to prevent or treat pediatric chronic disease in rural communities.

Objective: The purpose of this systematic review and meta-analysis was to examine the effectiveness of psychological interventions at improving physical or mental health outcomes for youth living in rural communities who have, or are at-risk for, any chronic medical condition in comparison to control interventions conducted in rural communities.

Methods: Following prospective registration (OSF.IO/7TDQJ), 7 databases were searched through July 1, 2023.

Maternal depressive symptom trajectories and associations with child feeding.

Background: Responsive feeding, when caregivers attend to children's signals of hunger and satiation and respond in an emotionally supportive and developmentally appropriate way, is associated with the development of healthy eating behaviors, improved diet quality, and healthy weight status for children. However, gaps in the literature remain on how factors, such as maternal depressive symptoms and child temperament, influence feeding interactions.

Methods: This longitudinal secondary data analysis explored the association between maternal depressive symptom trajectory and child temperament with maternal feeding practices in women with obesity who participated in a prenatal lifestyle intervention trial.

Scaling and sustaining research tested interventions: Lessons learned from Rhode Island Childhood Obesity Research Demonstration 3.0.

Childhood obesity is a significant health problem associated with negative physical and mental health outcomes. Although evidence-based family healthy weight programs (FHWPs), such as JOIN for ME, have been developed, there is a significant lag before these are disseminated more broadly. This study outlines the process of participating in the Speeding Research-tested Interventions (SPRINT) program, highlighting lessons learned, to increase the reach of a previously tested and efficacious FHWP, JOIN for ME.

Child routines moderate a brief behavioral intervention to enhance sleep in school-aged children.

Objective: To examine whether child routines (the consistency or variation in children's daily routines, household responsibilities, discipline routines, and homework routines) moderated the effectiveness of a brief behavioral intervention to enhance sleep in school-aged children.

Methods: Secondary analysis was conducted with a subset of 66 families with short sleeping (≤9.5 hr/day) children, 8-11 years old (female = 68%; mean age = 9.

Leveraging seasonality and timing to optimize pediatric weight management interventions: Novel directions for future research.

National estimates suggest that more than 35% of American children, ages 2-19 years, are overweight or obese, which increases their risk for weight-related comorbidities including diabetes, cancer, cardiovascular disease risk factors, depression, and anxiety. While obesity prevention is most cost-effective, for youth with existing obesity, the United States Preventive Services Task Force recommends ≥26 h of comprehensive lifestyle intervention over 6-12 months. This include standard behavioral therapy, dietary counseling, and an emphasis on physical activity.

Referral to Adolescent Weight Management Interventions: Qualitative Perspectives From Providers.

Objective: Current guidelines for treatment of obesity in adolescence include screening and referring youth with obesity to appropriate weight management (WM) care. However, prior work has not explored the referral process to adolescent WM programs, especially for youth from lower-income backgrounds, who are at increased risk of obesity and related negative health outcomes. This qualitative study sought to understand pediatricians' current practices regarding referrals to adolescent WM interventions with a focus on adolescents from lower-income backgrounds.

Family asthma management and physical activity among urban children.

Introduction: Urban, low-income, and Black and Latino children with asthma experience higher morbidity and poorer outcomes compared to their suburban, higher-income, and non-Latino White counterparts. This risk is further compounded by higher rates of co-occurring overweight or obesity. Physical activity contributes to both asthma and overweight/obesity status, however, little is known about factors that may promote/limit physical activity among youth from low-income, urban, and racial/ethnic backgrounds.

Formative Development of a Weight Management Intervention for Adolescents with Type 1 Diabetes Mellitus and Obesity.

The prevalence of overweight and obesity in youth with type 1 diabetes mellitus (T1D) now exceeds that of youth without T1D. Comorbid T1D and excess adiposity are associated with multiple serious negative health outcomes. Unfortunately, youth with T1D are often excluded from and/or not referred to standard behavioral lifestyle interventions.

The buffering effect of family support on the association between weight-based teasing and adolescent weight management outcomes.

Weight-based victimization (WBV) is associated with poor weight-related outcomes in adolescence. Family support may be one protective factor against the negative impact of WBV. The goal of this study is to examine the moderating effect of family support on the association between WBV and early weight loss for adolescents in a clinical weight management program.

Associations Between Technology Use, Responsive Feeding, and Child Temperament Among Prior Prenatal Intervention Participants.

Objectives: The primary objective was to examine associations between mothers' television and mobile device (TV/MD) use and responsive feeding during an observed mother-toddler mealtime interaction. The secondary objective was to assess whether dimensions of child temperament were associated with mothers' TV/MD use.

Methods: Participants from a prenatal lifestyle intervention trial to prevent excess gestational weight gain among women with overweight and obesity (N = 77) were observed during a dinner-time meal when their children were aged 19.

Engaging Stakeholders to Adapt an Evidence-Based Family Healthy Weight Program.

Childhood obesity is associated with negative physical and psychosocial outcomes, especially for children from low-income backgrounds. It is critical to adapt evidence-based family healthy weight programs to meet the needs of this population. The Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions was used to describe the process of using qualitative data from community and intervention stakeholders, children with overweight or obesity from low-income backgrounds, and caregivers to guide adaptations to the JOIN for ME pediatric weight management intervention.

Weight Management Engagement for Teens From Low-Income Backgrounds: Qualitative Perspectives From Adolescents and Caregivers.

Objective: Adolescents from low-income backgrounds are at increased risk for obesity and related negative health outcomes. Furthermore, these adolescents have less access to, and success in, weight management (WM) programs. This qualitative study sought to better understand engagement in a hospital-based WM program from the perspective of adolescents and caregivers at different levels of program initiation and engagement.

Randomized controlled trial of prepregnancy lifestyle intervention to reduce recurrence of gestational diabetes mellitus.

Background: Preconception lifestyle intervention holds potential for reducing gestational diabetes mellitus, but clinical trial data are lacking.

Objective: This study aimed to determine the effects of a prepregnancy weight loss intervention on gestational diabetes mellitus recurrence in women with overweight/obesity and previous gestational diabetes mellitus.

Study Design: A 2-site, randomized controlled trial comparing a prepregnancy lifestyle intervention with educational control was conducted between December 2017 and February 2022.

Effectiveness of a Scalable mHealth Intervention for Children With Overweight and Obesity.

Multicomponent interventions are the first line of treatment for pediatric obesity, but are challenging to access. Mobile health (mHealth) interventions hold promise as they address commonly cited barriers for attending in person programs and have potential for wide scale dissemination. This retrospective cohort study examined data from youth who enrolled in the program, which includes personal health coaching and a mobile app.

Asthma-related lung function and physical activity patterns among children living in urban neighborhoods.

Objective: Black and Latino American children residing in urban environments are at increased risk for comorbid asthma and obesity. Physical activity (PA) is a modifiable behavior known to contribute to the asthma-obesity phenotype. While research has indicated links between optimal asthma status and high PA among children, little is documented about whether this group may display other asthma and PA patterns that warrant clinical attention and tailored interventions.

Maternal responsiveness and toddler body mass index z-score: Prospective analysis of maternal and child mealtime interactions.

Responsive feeding, where parents are guided by children's hunger and satiation cues and provide appropriate structure and support for eating, is believed to promote healthier weight status. However, few studies have assessed prospective associations between observed parental feeding and toddler growth. We characterized toddler growth from 18 to 36 months and, in a subset of families, examined whether observed maternal responsiveness to toddler satiation cues and encouraging prompts to eat at 18 and 24 months were associated with toddler body mass index z-score (BMIz) from 18 to 36 months.

Persistent, High Levels of Social Jetlag Predict Poor Weight Outcomes in a Weight Gain Prevention Study for Young adults.

Introduction: Social jetlag (SJL), the discrepancy in sleep timing between weekdays and weekends, is associated with higher BMI and cardiometabolic risk and is common in young adults. We examined whether chronic SJL impacts weight gain in young adults participating in a weight gain prevention trial.

Methods: Young adults (n = 599, age 18-35; BMI: 21.

Effect of changes in children's bedtime and sleep period on targeted eating behaviors and timing of caloric intake.

Short sleep is associated with obesity risk. Experimental studies with adults and observational studies with children demonstrate that changes in eating, including increased caloric intake from energy-dense foods and sugar-sweetened beverages as well as increased caloric intake in the evening, may partially account for this increased risk. We therefore examined whether experimental changes in children's sleep period lead to changes in reported caloric intake from energy-dense snack foods and sugar-sweetened beverages, and in the evening.

Design of a clinical trial to isolate the experience of food insecurity and elucidate the biological mechanisms of risk for childhood health outcomes.

Background: Food insecurity affects one in seven households with children in the United States, disproportionately impacts households headed by women and minorities, and is associated with childhood comorbidities, including obesity. While food insecurity likely contributes to poor health through its effect on diet, such a simplistic understanding likely obscures the effects of poverty-related stress and other Adverse Childhood Experiences, on metabolic health.

Methods: Over two summers, 100 children, ages 8-12 years, will be recruited from low-income households in an urban, Rhode Island community, to participate in an 8-week trial designed to isolate the experience of food insecurity.

Randomized controlled trial to enhance children's sleep, eating, and weight.

Background: The present study assessed the efficacy of a behavioral intervention to enhance children's sleep and reduce caloric intake and body mass index (BMI) change.

Methods: Seventy-eight children 8-11 years old who slept 9.5 h/night or less were randomized to the sleep intervention or to no treatment control.