Change in health-related quality of life in the context of pediatric obesity interventions: A meta-analytic review.

Objective: To quantitatively characterize change in health-related quality of life (HRQoL) in the context of behavioral (n = 16), surgical (n = 5), and pharmacological (n = 1) interventions for pediatric overweight and obesity. A secondary goal was to examine the relationship between change in HRQoL and change in body mass index (ΔBMI) by treatment type. The amount of weight loss necessary to observe a minimally clinically important difference (MCID) in HRQoL was determined.

College students as facilitators in reducing adolescent obesity disparity in Southern Appalachia: Team Up for Healthy Living.

The proportion of obese adolescents in Southern Appalachia is among the highest in the nation. Through funding from the National Institute on Minority Health and Health Disparities--National Institutes of Health, the Team Up for Healthy Living project was a cluster-randomized trial targeting obesity prevention in adolescents through a cross-peer intervention. The specific aims of the project were to: 1) develop a peer-based health education program focusing on establishing positive peer norms towards healthy eating and physical activity (PA) among high school students, 2) test program efficacy, and 3) explore mechanisms underlying the program.

Examining General Versus Condition-Specific Health-Related Quality of Life Across Weight Categories in an Adolescent Sample.

This study examined health-related quality of life (HRQoL) across weight categories in adolescents using both a general and a condition-specific measure sensitive to fatigue symptoms. Participants (N = 918) completed the Pediatric Quality of Life (PedsQL) Inventory and PedsQL Multidimensional Fatigue Scale measures. Actual height and weight were used to calculate body mass index for age and sex percentiles and assign weight categories.

Reflections from an Undergraduate Student Peer Facilitator in the Team Up for Healthy Living School-Based Obesity Prevention Project.

was a cluster-randomized trial to evaluate a cross-peer school-based obesity prevention program in Southern Appalachia. Undergraduate students from the disciplines of Kinesiology, Nutrition, and Public Health were trained as peer facilitators to deliver an 8-week curriculum in high school classes. The focus of the curriculum was on improving diet and physical activity with an additional emphasis on enhancing leadership and communication skills.

Weight status misperception as related to selected health risk behaviors among middle school students.

Background: Weight misperception has been documented among children although the impact on health risk behaviors is less understood, particularly among middle school students. The goals of this study were to describe sociodemographic differences in actual and perceived weight, correspondence between actual and perceived weight, and weight-related health risk behaviors, as well as to examine weight misperception and interactions with sociodemographic variables in explaining weight-related health risk behaviors.

Methods: Participants were recruited at 11 public school districts participating in the Tennessee Coordinated School Health (CSH) pilot program.

Improving the accuracy of weight status assessment in infancy research.

Both researchers and primary care providers vary in their methods for assessing weight status in infants. The purpose of the present investigation was to compare standing-height-derived to recumbent-length-derived weight-for-length standardized (WLZ) scores, using the WHO growth curves, in a convenience sample of infants who visited the lab at 18 and 21 months of age. Fifty-eight primarily White, middle class infants (25 girls) from a semi-rural region of southern Appalachia visited the lab at 18 months, with 45 infants returning 3 months later.

Parent report of child's health-related quality of life after a primary-care-based weight management program.

Background: Health-related quality of life (HRQoL) has been recognized as an important target and health outcome in obesity research. The current study aimed to examine HRQoL in overweight or obese children after a 10-week primary-care-based weight management program, Parent-Led Activity and Nutrition for Healthy Living, in southern Appalachia.

Methods: Sixty-seven children (ages 5-12 years) and their caregivers were recruited from four primary care clinics, two of which were randomized to receive the intervention.

Home food environment, dietary intake, and weight among overweight and obese children in Southern Appalachia.

Objectives: This study examined the relation of multiple aspects of the home food environment to dietary intake and body weight among overweight and obese children in southern Appalachia.

Methods: The study used baseline data from a cluster-randomized controlled trial, Parent-Led Activity and Nutrition for Healthy Living, evaluating a parent-mediated approach to treating child overweight and obesity in the primary care setting in southern Appalachia. Sixty-seven children ages 5 to 11 years were recruited from four primary care clinics.

Weight concerns, body image, and smoking continuation in pregnant women in rural Appalachia.

Objective: To examine the relationship between pre-pregnancy weight and body image concerns and smoking status in late pregnancy.

Methods: Participants included 172 pregnant smokers. Pre-pregnancy weight and body image concerns were assessed during first trimester via the Weight Concern Scale and Body Image Concern Inventory.

Go Slow Whoa meal patterns: cafeteria staff and teacher perceptions of effectiveness in winning with wellness schools.

Background: School-based interventions hold promise for child obesity prevention. Implemented as a part of the Winning With Wellness obesity prevention project, the "Go Slow Whoa" meal pattern (GSW) was designed to promote healthier foods in school cafeterias. This investigation determined perceived program effectiveness and impact on student's food purchases.

Integration of behavioral health services in a primary care clinic serving rural Appalachia: reflections on a clinical experience.

In the past few decades, there has been a move toward integrating behavioral health and medical services. This can be particularly beneficial for rural residents, as integration can increase access to mental healthcare in areas where there are shortages of mental health providers. Southern Appalachia is characterized by isolated areas that have shortages of both mental health and medical providers.

Parent-Led Activity and Nutrition (PLAN) for healthy living: design and methods.

Child obesity has become an important public health concern, especially in rural areas. Primary care providers are well positioned to intervene with children and their parents, but encounter many barriers to addressing child overweight and obesity. This paper describes the design and methods of a cluster-randomized controlled trial to evaluate a parent-mediated approach utilizing physician's brief motivational interviewing and parent group sessions to treat child (ages 5-11 years) overweight and obesity in the primary care setting in Southern Appalachia.

Family context as it relates to weight-related behaviors in preadolescent African American girls.

Objective: To examine family context in relation to body image, weight concerns, and weight control behaviors in preadolescent African American girls.

Methods: Cross-sectional baseline data were analyzed from 303 African American girls 8 to 10 years old and a caregiver in the Girls health Enrichment Multi-site Studies Phase 2(GEMS), an obesity prevention intervention trial.

Results: Fruit, juice, and vegetable accessibility and family support for healthy eating and physical activity were significantly related to girls' body image and weight control behaviors.

Treatment of eating disorders in primary care: a systematic review.

This review evaluated psychological treatments for Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder conducted in primary care. Five studies met inclusion criteria. Guided self-help cognitive-behavioral therapy via a self-help book may be a beneficial, first-line treatment for reducing binging and purging symptoms.

The Winning with Wellness pilot project: rural Appalachian elementary student physical activity and eating behaviors and program implementation 4 years later.

School-based efforts to promote physical activity and healthier eating are a potentially effective approach to decreasing child obesity in rural populations. This article describes follow-up data on student activity and eating behaviors 4 years after implementation of the Winning with Wellness obesity prevention initiative. This project was based on the Centers for Disease Control and Prevention's coordinated school health model and used a community-based participatory research approach to address health behaviors in rural Appalachian elementary students.

The prevalence of emotional and behavior problems in pediatric primary care serving rural children.

Objectives: To examine the prevalence of parent-reported emotional and behavior problems in pediatric primary care clinics serving rural Appalachia using methods commensurate with studies of broader samples.

Methods: Parents presenting to pediatric primary care clinics completed a rating scale (Pediatric Symptom Checklist) of psychosocial problems for their child.

Results: Approximately 21% of all rating scales were in the clinically significant range.

Health behaviors and health-related quality of life among middle school children in Southern Appalachia: data from the winning with wellness project.

Unlabelled: Health-related quality of life (HRQoL) is linked to health status in a variety of conditions. Less is known about the relation between quality of life and modifiable health behaviors, especially among medically underserved populations.

Objective: The purpose of the current study was to examine HRQoL as it relates to physical activity, sedentary behavior, and eating patterns in youth residing in Southern Appalachia.

Primary care practice addressing child overweight and obesity: a survey of primary care physicians at four clinics in southern Appalachia.

Objective: The prevalence of childhood overweight and obesity in southern Appalachia is among the highest in the United States (US). Primary care providers are in a unique position to address the problem; however, little is known about attitudes and practices in these settings.

Methods: A 61-item healthcare provider questionnaire assessing current practices, attitudes, perceived barriers, and skill levels in managing childhood overweight and obesity was distributed to physicians in four primary care clinics.

Family functioning and children's response to primary care treatment for overweight: a preliminary study.

Objective: The aim of this study was to assess the relation between family functioning and children's response to treatment for overweight in a primary care setting.

Methods: Sixty predominantly African American (72%) parents of children who are overweight were recruited from a pediatric outpatient clinic to provide information about family functioning. Children's success in treatment was tracked through medical chart review.

Joint effects of child temperament and maternal sensitivity on the development of childhood obesity.

The interplay between child characteristics and parenting is increasingly implicated as crucial to child health outcomes. This study assessed the joint effects of children's temperamental characteristics and maternal sensitivity on children's weight status. Data from the National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development were utilized.

Lifestyle interventions for youth who are overweight: a meta-analytic review.

Objective: Clear evidence suggests that lifestyle interventions can be helpful in the treatment of youth who are overweight, but translational research is needed to address the gap between treatment research and clinical care.

Design: This meta-analysis integrated the results of 66 treatment-control comparisons and 59 alternate treatment comparisons evaluating lifestyle interventions for children and adolescents who were overweight.

Main Outcome Measures: Between-groups differences in weight-related outcomes and other health-related behaviors at the end of treatment.

Developing a coordinated school health approach to child obesity prevention in rural Appalachia: results of focus groups with teachers, parents, and students.

Introduction: High prevalence rates of obesity, particularly among those residing in US rural areas, and associated physical and psychosocial health consequences, direct attention to the need for effective prevention programs. The current study describes an initial step in developing a school-based obesity prevention program in rural Appalachia, USA. The program, modeled on the Centers for Disease Control and Prevention Coordinated School Health (CSH) Program, includes a community-based participatory research approach to addressing the health needs specific to this region.

Gender, smoking status, and risk behavior attitudes explain adolescents' patterns of nicotine replacement therapy use.

Treatment studies provide minimal support for nicotine replacement therapy (NRT) with youth; however, survey studies suggest that adolescents use NRT, and may engage in inappropriate use. The current study sought to examine patterns of NRT use and risk factors for use to further aid smoking cessation efforts including prevention of potential misuse. In-school surveys assessing socio-demographic and behavioral factors associated with NRT use, gum or patch, were completed by 4078, predominantly African American, high school students.