Comparison of height, weight, and body mass index data from state-mandated school physical fitness testing and a districtwide surveillance project.

Background: Approximately one third of California school-age children are overweight or obese. Legislative approaches to assessing obesity have focused on school-based data collection. During 2010-2011, the Chula Vista Elementary School District conducted districtwide surveillance and state-mandated physical fitness testing (PFT) among fifth grade students.

San Diego Healthy Weight Collaborative: a systems approach to address childhood obesity.

A collaborative approach to identify opportunities for interactions between multiple systems is an important model for childhood obesity prevention. This paper describes a process aligning multiple partners in primary care, public health, university research, schools, and community organizations. Jointly implemented strategies in a Latino underserved community included: (1) building an effective and sustainable collaborative team; (2) disseminating a healthy weight message across sectors; (3) assessing weight status and healthy weight plans in primary care, school, and early childhood settings; and (4) implementing policy changes to support healthy eating and physical activity.

A culturally appropriate intervention to improve health behaviors in Hispanic mother-child dyads.

Background: Obesity interventions targeting Hispanic preschool children are still nascent, and few are culturally appropriate. We evaluated the feasibility of a culturally relevant 9-month intervention program to improve health behaviors in low-income Mexican mothers with 3- to 5-year-old children.

Methods: A community engagement approach was used to culturally and linguistically tailor an intervention program that was pilot tested with 33 mother-child dyads enrolled from a large California urban health center.

Next steps in obesity prevention: altering early life systems to support healthy parents, infants, and toddlers.

There is an urgent need for effective, sustainable child obesity prevention strategies. Progress toward this goal requires strengthening current approaches to add a component that addresses pregnancy onward. Altering early-life systems that promote intergenerational transmission of obesity holds promise for interrupting the continuing cycle of the obesity epidemic.

Learning from state surveillance of childhood obesity.

Data on childhood obesity collected by the Centers for Disease Control and Prevention helped reveal the nation's epidemic of overweight and obese children. But more information is needed. Collecting body mass index (BMI)-the widely accepted measurement of childhood weight status-at the state and local levels can be instrumental in identifying and tracking obesity trends, designing interventions to help overweight children, and guiding broader policy solutions.

The relationship between body mass index and behavior in children.

Objective: To examine reciprocal relationships between body mass index (BMI) and internalizing and externalizing problems from infancy through middle childhood, with a focus on sex and history of overweight.

Study Design: Data from 1254 children in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were used to conduct longitudinal analyses of the relationship between BMI and scores on the Child Behavior Checklist from age 2 years through the 6th grade.

Results: BMI and behavior problems demonstrated stability across the 7 measurement occasions.

Moderate-to-vigorous physical activity from ages 9 to 15 years.

Context: Decreased physical activity plays a critical role in the increase in childhood obesity. Although at least 60 minutes per day of moderate-to-vigorous physical activity (MVPA) is recommended, few longitudinal studies have determined the recent patterns of physical activity of youth.

Objective: To determine the patterns and determinants of MVPA of youth followed from ages 9 to 15 years.

Association of neighborhood design and recreation environment variables with physical activity and body mass index in adolescents.

Purpose: To examine associations of neighborhood walkability and recreation environment variables with physical activity in adolescents.

Methods: The cross-sectional study was conducted with 98 white or Mexican-American adolescents (mean age = 16.2 years).

Evaluation of residency training in the delivery of culturally effective care.

Objective: To augment resident training in the delivery of culturally effective care in order to improve clinician capacity to effectively care for patients from diverse backgrounds.

Methods: Residents from the Naval Medical Center San Diego and the University of California San Diego participated in experiential learning and service activities. Programme evaluation assessed aspects of the delivery of culturally effective care in community settings.

Identifying risk for obesity in early childhood.

Objectives: Our aim with this study was to assist clinicians by estimating the predictive value of earlier levels of BMI status on later risk of overweight and obesity during the middle childhood and early adolescent years.

Methods: We present growth data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, a longitudinal sample of 1042 healthy US children in 10 locations. Born in 1991, their growth reflects the secular trend of increasing overweight/obesity in the population.

Acculturation, parent-child acculturation differential, and chronic disease risk factors in a Mexican-American population.

Acculturation is typically defined in terms of individual responses to a dominant culture. In the present study, we examined the effects of different levels of acculturation among family members. Specifically, we looked at the health and risk behavior in Mexican-American children as related to a variety of psychosocial predictors, especially the differences in orientation toward Mexican- and Anglo-American cultures between them and their parents.

School-based health education programs can be maintained over time: results from the CATCH Institutionalization study.

Background: Developing and evaluating interventions to influence students' opportunities for healthful choices has been a focus of school-based health promotion research; however, few studies have examined the sustainability of these programs and viability of continued organizational implementation.

Methods: The purpose of this study was to determine the maintenance of Child and Adolescent Trial for Cardiovascular Health (CATCH) school-level changes in former intervention (n = 56) and former comparison (n = 20) schools 5 years post-intervention. Twelve schools unexposed to CATCH were measured as controls.

A prenatal intervention study to improve timeliness of immunization initiation in Latino infants.

This was a prospective randomized cohort study to assess the effectiveness of an educational immunization intervention with pregnant Latinas on timely initiation of infant immunization. Study participants were recruited from two community clinics in north San Diego County. A total of three hundred and fifty-two Latinas in the third trimester of pregnancy were recruited and randomly assigned to intervention or control groups.

Two national surveys on pediatric training and activities in school health: 1991 and 2001.

Objective: To determine from 2 surveys, in 1991 and 2001, 1) the proportion of pediatricians and which pediatricians report doing school health, 2) which school health activities are most commonly engaged in and whether this has changed, 3) whether training/education during residency influences doing school health later in practice, and 4) whether the amount or nature of residency training in school health (as reported by practicing pediatricians) increased over time, as recommended by various task forces.

Methods: Surveys were mailed to a 10% randomly selected group of the voting membership of the American Academy of Pediatrics.

Results: An estimated 50% to 70% of pediatricians report doing school health, and a consistent 20% report having had training in school health.

Retaining school children and families in community research: lessons from the Study of Children's Activity and Nutrition (SCAN).

Retaining school-aged study participants poses a major challenge in any longitudinal research study. Dropouts produce bias in the remaining sample and this loss may affect study findings and their interpretation. Dominant factors that influence retention in pediatric research studies include family versus individual participation, patient management strategies of study personnel, knowledge about the condition or therapy, age and gender factors, credibility within the community, monetary incentives, and altruism.

Frequency and intensity of activity of third-grade children in physical education.

Background: Health recommendations are for preadolescent children to have daily school physical education (PE) classes that engage children in moderate to vigorous physical activity at least 50% of class time.

Objective: To observe activity of children in PE classes in third grades across 10 different sites.

Design: Observational study.

Childhood movement skills: predictors of physical activity in Anglo American and Mexican American adolescents?

We assessed the relationship between young children's movement skills and their physical activity in early adolescence. Balance, agility, eye-hand coordination, and skinfold thicknesses in 207 Mexican American and Anglo American children (104 boys, 103 girls) were measured at ages 4, 5, and 6 years. Habitual physical activity was assessed at the age of 12 years by two interviewer-administered 7-day recalls.

Maintenance of lightweight correlates with decreased cardiovascular risk factors in early adolescence.

Purpose: To describe predictors of lightweight in 11-year-olds and how weight changes between ages 9-11 years affected selected cardiovascular risk factors.

Methods: Cohort study among an ethnically and geographically diverse group of 5098 nine-year-olds who participated in the Child and Adolescent Trial for Cardiovascular Health (CATCH) and were followed from 1991 to 1994 until age 11 years. Lightweight (body mass index [BMI] <15th percentile) was defined from gender- and age-adjusted data on the total population in the National Health and Nutrition Examination Survey I of 1971 to 1973.

Home environmental influences on children's television watching from early to middle childhood.

Identifying correlates of children's television (TV) watching could help identify strategies to reduce children's TV watching and impact children's weight status. Children's TV time and home environment factors were assessed longitudinally among 169 families with children followed from 6 to 12 years of age. TV watching increased with age, as did the number of in-home TVs and the presence of videocassette recorders (VCRs), the frequency of meal eating while watching TV, and the percentage of children with bedroom TVs.

Tracking dietary intake in white and Mexican-American children from age 4 to 12 years.

Objective: To examine the tracking (ie, the stability over time) of dietary intake in Mexican-American and white children aged 4 to 12 years.

Subjects: Children 4 years of age (n=351) were assessed at baseline and 65% (n=228) completed the 8-year study.

Design: Cardiovascular disease-related dietary intake was defined as energy, percent of energy from fat, and sodium (mg/1,000 kcal).

Serum cholesterol levels in children are associated with dietary fat and fatty acid intake.

Background: Recent studies in adults suggest that individual dietary fatty acids differ markedly in their effects on serum lipids and lipoprotein levels. However, these associations have rarely been studied in children.

Objective: To assess, using regression procedures, the associations in children between specific fatty acids and nonfasting serum lipids and cholesterol after controlling for total energy and total fat intake,

Subjects: The sample consisted of 1,182 children who participated in the Child and Adolescent Trial for Cardiovascular Health.

Provider-staff discrepancies in reported immunization knowledge and practices.

Background: The purpose of the study was to compare immunization-relevant knowledge, certainty about knowledge, self-efficacy, vested interest, and reported practices of providers and clinical staff in the same clinics.

Methods: A valid and reliable instrument measuring the aforementioned issues was developed and administered to a sample of 50 providers and 60 members of the clinical staff.

Results: Providers were significantly more knowledgeable than staff (P < 0.

Tracking of physical and physiological risk variables among ethnic subgroups from third to eighth grade: the Child and Adolescent Trial for Cardiovascular Health cohort study.

Background: The Child and Adolescent Trial for Cardiovascular Health (CATCH), a multisite field trial, tested the effectiveness of multiple interventions for cardiovascular disease risk behaviors in children in third through fifth grades. This paper reports the tracking of physiologic variables through eighth grade.

Methods: The cohort began with 5,106 third grade students from diverse ethnic backgrounds: 69% Caucasian, 14% Hispanic, 13% African American, and 4% other.