Parental Feeding Style, Parenting Stress, and Child Mealtime Behaviors in Cystic Fibrosis.

OBJECTIVE: Nutrition and weight gain significantly contribute to overall health outcomes in children with cystic fibrosis (CF). Strong emphasis is placed on these entities by the CF team, which can cause stress for parents and impact parent and child mealtime behaviors. The current study sought to investigate the relationship between parental feeding style, parenting stress, and parent and child mealtime behaviors in families of children with CF. METHODS: Forty-five parents of a child with CF between the ages of 2 and 10 years were recruited during a CF clinic appointment. They completed surveys assessing child mealtime behaviors, parental feeding style, and parental stress. Medical data including body mass index (BMI) were collected from the medical record. RESULTS: There was a significant difference in behavioral feeding scores based on feeding style (F3,41 = 13.48, p <.001), with authoritarian parents reporting significantly greater mealtime behavior problems than all other parents. There was also a significant difference in parenting stress based on parental feeding style (F3,41=4.11, p <.05), with authoritarian parents showing more stress than authoritative parents (Mdiff=23.70, p <.05). Correlation analyses showed a positive relationship between behavioral feeding problems and parent stress, r(45)=0.403; p <.01. CONCLUSIONS: Data suggest parents using an authoritarian feeding style experience more stress and behavioral feeding problems than other parents. More feeding problems were also associated with more stress. Findings help determine how pediatric psychologists can intervene to support positive parenting behaviors that reduce children's mealtime behavior problems and parental stress, thus improving health outcomes in this vulnerable population.

Parental Feeding Style and Pediatric Obesity in Latino Families.

INTRODUCTION: Pediatric obesity has become an epidemic in the United States. Previous research has shown that parenting factors related to feeding style affect child weight and that Latino families are especially at risk for pediatric obesity. The goal of the current study was to evaluate the relationship between parental feeding style and child body mass index (BMI) in Latino families. METHOD: Latino parents of children between the ages of 2 and 8 ( N = 124) completed a survey on parental feeding styles, acculturation, and demographics. The outcome variable was child BMI. RESULTS: Among respondents, 89% were mothers, 72% were overweight or obese, and 40% reported an indulgent feeding style. Children had a mean age of 59 months ( SD = 23.8) and a mean BMI z score of 0.77 ( SD = 1.14). A demanding parental feeding style was associated with lower child BMI z score, r = -.179, p < .05, and higher acculturation level, r = .213, p < .05. CONCLUSIONS: Findings from the current study can be used to inform health care practitioners of the need to use culturally sensitive interventions that consider parents' feeding behaviors. Future research is warranted in the area of ethnic variations of parenting and how these affect feeding and obesity in this highly vulnerable population.

Development and feasibility of a community-partnered nutrition intervention targeting rural migrant communities in the Dominican Republic.

OBJECTIVE: Research on health initiatives for rural batey communities in the Dominican Republic is needed. DESIGN AND SAMPLE: This study utilized a pretest-posttest design to examine the feasibility and acceptability of a nutritional intervention targeting rural migrant sugarcane families. Participants (N = 310) were primarily female (61%) and ranged in age from 13 to 64 years (M = 25.9; SD = 10.4). A convenience sample was recruited from six rural bateyes in the southern region of the Dominican Republic. INTERVENTION: The intervention was developed for the target population in partnership with a grass-roots organization. The intervention consisted of a short video in the participant's preferred language (Spanish or Creole) describing the importance of consuming a diverse diet. Participants then completed an interactive meal-planning activity to enhance skills learned in the video. The main outcome variable was knowledge and a secondary outcome was participants' performance on the interactive activity. RESULTS: Results showed that the intervention was well received by the target population and participants demonstrated a significant increase in nutrition knowledge (p < .001). Higher postintervention knowledge scores were positively correlated with higher activity skills scores. CONCLUSION: This novel intervention may have promise as a practical program to enhance the nutritional status of a vulnerable population of migrant sugarcane workers.

The Interactive Effect of Diabetes Family Conflict and Depression on Insulin Bolusing Behaviors for Youth.

OBJECTIVE: Adherence to type 1 diabetes management declines as children enter adolescence. For youth, psychosocial variables including mood and interpersonal relationships play a large role in diabetes maintenance. The current study assessed the unique and interactive roles diabetes family conflict and depression have on insulin bolusing behaviors for youth ages 10-16 years. METHODS: Ninety-one youth-parent dyads completed a survey assessing family conflict and depression. Mean daily blood glucose levels, mealtime insulin bolus scores ( BOLUS), and glycated hemoglobin (HbA1c) were collected from the medical record as outcome variables. RESULTS: Parent-reported diabetes-related family conflict and youths' endorsed depression both significantly predicted insulin bolusing behavior, R2 = .13, F(2, 88) = 6.66, P < .05. The interaction of diabetes family conflict and youth depression played a significant role in youths' bolusing behaviors, above and beyond that which was predicted by conflict and depression separately, R2 = .18, Fchange(1, 87) = 4.63, P < .05. BOLUS was negatively related to youths' hemoglobin A1c, r = -.556, P < .001 and mean daily blood glucose levels, r = -.428, P < .001. CONCLUSIONS: Among depressed youth, mealtime insulin BOLUS scores declined with greater diabetes-related family conflict, while there was no change in BOLUS scores among depressed youth living in families reporting less conflict. Findings underscore the importance of screening for depression and family conflict in youth experiencing or at risk for poor adherence to mealtime insulin and higher HbA1c levels.

Outcomes of a weight management clinic for children with special needs.

OBJECTIVE: Rates of obesity are elevated among children with special needs (e.g., autism spectrum disorder, Down syndrome, or developmental disabilities). The objective of this study was to evaluate the effectiveness of a multidisciplinary tailored intervention to treat obesity among youth with special needs. METHOD: Seventy-six children aged 2 to 19 years participated in a multidisciplinary weight management clinic adapted for children with special needs. A description of the patients presenting for specialized clinical services is provided, and the impact of the intervention on child body mass index (BMI) and food variety was examined for a subset (n = 30) of children. Descriptive statistics of the patient population at baseline were calculated and a series of t tests, correlations, and analysis of variance models examined change in BMI z-scores (BMIz) and diet variety. Factors related to treatment outcomes were also explored. RESULTS: BMIz decreased significantly by the 6-month follow-up (M = 2.43 to M = 2.36, p < .01). There were significant increases in the variety of fruits, vegetables, and grains that children ate (t(16) = 3.18, p < .01; t(16) = 2.63, p = .02; t(16) = 2.37, p = .03, respectively). CONCLUSION: A multidisciplinary clinic-based intervention was effective in reducing BMIz over a 6-month period and increasing the variety of foods that children were eating. These results have implications for providing tailored weight management interventions for youth with obesity and special needs.

Providing adolescent sexual health care in the pediatric emergency department: views of health care providers.

OBJECTIVES: The purpose of this study was to explore health care providers' (HCPs') attitudes and beliefs about adolescent sexual health care provision in the emergency department (ED) and to identify barriers to a health educator-based intervention. METHODS: We conducted focused, semistructured interviews of HCPs from the ED and adolescent clinic of a children's hospital. The interview guide was based on the theory of planned behavior and its constructs: attitudes, subjective norms, perceived behavioral control, and intention to facilitate care. We used purposive sampling and enrollment continued until themes were saturated. Interviews were recorded and transcribed. Transcripts were analyzed using directed content analysis. RESULTS: Twenty-nine interviews were required for saturation. Participants were 12 physicians, 12 nurses, 3 nurse practitioners, and 2 social workers; the majority (83%) were female. Intention to facilitate care was influenced by HCP perception of (1) their professional role, (2) the role of the ED (focused vs expanded care), and (3) need for patient safety. Health care providers identified 3 practice referents: patients/families, peers and administrators, and professional organizations. Health care providers perceived limited behavioral control over care delivery because of time constraints, confidentiality issues, and comfort level. There was overall support for a health educator, and many felt the educator could help overcome barriers to care. CONCLUSIONS: Despite challenges unique to the ED, HCPs were supportive of the intervention and perceived the health educator as a resource to improve adolescent care and services. Future research should evaluate efficacy and costs of a health educator in this setting.

Writing approaches of nursing students.

Over the past 20years, research has focused on the writing processes of college students, however, despite recent support for writing as a tool of reflection in nursing education, little is known about how it is that nursing students go about writing papers and assignments as part of their professional education. In order to determine the writing processes of nursing students, the Inventory of Processes in College Composition, a self-response questionnaire, was administered to 169 nursing students. Results support the independence of the writing approaches that nursing students use and similarity to the writing approaches of a general college student population.