From the Lunch Table, to the Family Table: A Grounded Theory Approach to Understanding Urban Adolescents' Experiences of Food Culture Mismatch between School and Home Environments.

Based on a participatory action research project in New York City from 2012 to 2014, our study compares the experience of black and Latino adolescents between their school and home food environments. Following a photovoice approach, adolescents participated in a "food justice" curriculum, photographed foodscapes, and conducted photo-elicited interviews. Using a grounded theory approach, we found that adolescents had mismatched experiences between school and home food environments under two conditions: sensory-emotional and sociopolitical. Mismatch suggested psychological and behavioral consequences, including skipping or wasting school lunch entrées and consuming energy-dense, nutrient-poor snack foods. We named this middle-range substantive theory food culture mismatch.

Inclusion of Sleep Promotion in Family-Based Interventions To Prevent Childhood Obesity.

Sleep promotion in childhood may reduce the risk of obesity, but little is known of its inclusion in family-based interventions. This study examines the proportion and context of family-based interventions to prevent childhood obesity that promote child sleep. We drew on data from a recent systematic review and content analysis of family-based interventions for childhood obesity prevention published between 2008 and 2015, coupled with new data on sleep promotion strategies, designs, and measures. Out of 119 eligible family-based interventions to prevent childhood obesity, 24 (20%) promoted child sleep. In contrast, 106 (89%) interventions targeted diet, 97 (82%) targeted physical activity, and 63 (53%) targeted media use in children. Most interventions that promoted sleep were implemented in clinics (50%) and home-based settings (38%), conducted in the United States (57%), and included children 2-5 years of age (75%). While most interventions utilized a randomized controlled design (70%), only two examined the promotion of sleep independent of other energy-balance behaviors in a separate study arm. Sleep was predominately promoted by educating parents on sleep hygiene (e.g., age-appropriate sleep duration), followed by instructing parents on responsive feeding practices and limiting media use. One intervention promoted sleep by way of physical activity. A large number promoted sleep by way of bedtime routines. Most interventions measured children's sleep by parent report. Results demonstrate that sleep promotion is underrepresented and variable in family-based childhood obesity interventions. While opportunities exist for increasing its integration, researchers should consider harmonizing and being more explicit about their approach to sleep promotion.

Feasibility and Reliability of the System for Observing Play and Leisure Activity in Youth (SOPLAY) for Measuring Moderate to Vigorous Physical Activity in Children Visiting an Interactive Children's Museum Exhibition.

PURPOSE: To test the feasibility and reliability of a direct observation method for measuring moderate to vigorous physical activity (MVPA) in children visiting an interactive children's museum exhibition. DESIGN: Direct observation was used to assess MVPA in children visiting an interactive children's museum exhibition on 2 weekend days in winter 2013. SETTING: The Children's Museum of Manhattan's EatSleepPlay™: Building Health Every Day exhibition. PARTICIPANTS: Children (group level) visiting the museum exhibition. MEASURES: System for Observing Play and Leisure Activity in Youth (SOPLAY). ANALYSES: Interobserver reliability was analyzed for MVPA and activity type. Two-group analyses were conducted using a series of Wilcoxon rank sum tests. RESULTS: A total of 545 children were observed over 288 observations. No significant differences were found between observers for MVPA ( r = .91, P = .6804) or activity type (κ = .90, P = .6334). Children participated in MVPA during 35.2% of all observations. No significant differences were found for participation in MVPA between boys (37.6%) and girls (32.8%, P = .1589). CONCLUSION: The SOPLAY may be a useful tool for measuring MVPA in interactive children's museum exhibitions. Research with multiple museum settings and diverse groups of children over longer periods of time is warranted to further establish the feasibility and reliability of the SOPLAY for measuring MVPA in this novel setting.

Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis.

BACKGROUND: A wide range of interventions has been implemented and tested to prevent obesity in children. Given parents' influence and control over children's energy-balance behaviors, including diet, physical activity, media use, and sleep, family interventions are a key strategy in this effort. The objective of this study was to profile the field of recent family-based childhood obesity prevention interventions by employing systematic review and quantitative content analysis methods to identify gaps in the knowledge base. METHODS: Using a comprehensive search strategy, we searched the PubMed, PsycIFO, and CINAHL databases to identify eligible interventions aimed at preventing childhood obesity with an active family component published between 2008 and 2015. Characteristics of study design, behavioral domains targeted, and sample demographics were extracted from eligible articles using a comprehensive codebook. RESULTS: More than 90% of the 119 eligible interventions were based in the United States, Europe, or Australia. Most interventions targeted children 2-5 years of age (43%) or 6-10 years of age (35%), with few studies targeting the prenatal period (8%) or children 14-17 years of age (7%). The home (28%), primary health care (27%), and community (33%) were the most common intervention settings. Diet (90%) and physical activity (82%) were more frequently targeted in interventions than media use (55%) and sleep (20%). Only 16% of interventions targeted all four behavioral domains. In addition to studies in developing countries, racial minorities and non-traditional families were also underrepresented. Hispanic/Latino and families of low socioeconomic status were highly represented. CONCLUSIONS: The limited number of interventions targeting diverse populations and obesity risk behaviors beyond diet and physical activity inhibit the development of comprehensive, tailored interventions. To ensure a broad evidence base, more interventions implemented in developing countries and targeting racial minorities, children at both ends of the age spectrum, and media and sleep behaviors would be beneficial. This study can help inform future decision-making around the design and funding of family-based interventions to prevent childhood obesity.

Psychosocial and Friend Influences on Objective Sedentary Behavior and Screen Time: A Mixed Methods Analysis.

BACKGROUND: Sedentary behavior (SB) increases throughout adolescence, and is associated with adverse health outcomes. PURPOSE: Examine psychosocial and friend influences on SB and screen time in adolescents using a mixed-methods design. METHODS: 108 middle and high school students wore accelerometers to measure objective SB, completed screen time and psychosocial questionnaires, and nominated friends to complete activity questionnaires. Focus groups centered around influences on SB behavior. Regression analyses and NVivo software analyzed quantitative and qualitative data. RESULTS: Screen time was associated with greater screen time enjoyment, lower self-efficacy, and friends' screen time (r2 = .21, P < .0001). Friends influenced whether adolescents engaged in screen time behaviors, with active friends encouraging less screen time. CONCLUSION: Active friends influenced adolescents to engage in less SB. Interventions should place an emphasis on encouraging less screen time, and providing opportunities for adolescents and their friends to engage in activities that promote physical activity rather than SB.

Voices Through Cameras.

Engaging and empowering youth to promote health could be important in promoting sustainable positive behaviors. Photovoice is a community-based participatory research tool giving priority populations opportunities for active community engagement and advocacy through photography. Our project objective was to better understand youth perceptions related to food justice within their own community and identify solutions to promote positive change, using photovoice. Twelve minority youth from a low-income New York City neighborhood participated. Six photovoice sessions were conducted within a 24-week after-school food justice program, which included three photo assignments aimed at answering, "What influences me to eat healthy and unhealthy in my community and home environment?" Photos guided interviews and discussions. Inductive and deductive processes were used to identify codes; similar codes were grouped into themes. Five major themes emerged from the data: (1) attitudes toward food industry and food safety, (2) environmental influences of food choices, (3) social influences of food choices, (4) diet impact on health and well-being, and (5) solutions to improve the food environment. Participants shared their photos with community members at a celebration/photo exhibit. Photovoice could be a useful tool for youth to reflect on their food environment and engage in promoting positive change within their community.

Manga comic influences snack selection in Black and Hispanic New York City youth.

OBJECTIVE: To determine whether a single exposure to a Manga comic (Japanese comic art) with multiple messages promoting fruit intake influenced snack selection in minority urban youth. METHODS: Fifty-seven youth (mean age 10.8 y; 54% female; 74% black/African American) attending after-school programs in Brooklyn, NY participated in a pilot study in which they were randomly assigned to receive the comic or a non-health-related newsletter. After reading their media, participants were offered a snack and could choose from among healthy/unhealthy options. Secondary outcomes included knowledge, self-efficacy, and outcome expectations related to fruit intake and media transportation. Data were analyzed using regression and paired t test. RESULTS: Comic group participants were significantly more likely to choose a healthy snack, compared to the Attention-control group (odds ratio = 3.6, 95% confidence interval: 1.1-12.1, P = .04). The Comic group reported increases in self-efficacy (P = .04) and greater transportation (immersion into media) (P = .006). CONCLUSIONS AND IMPLICATIONS: Results suggest Manga comics may be a useful format to promote healthy snack selection in urban minority youth.

Intervening to Reduce Sedentary Behaviors and Childhood Obesity among School-Age Youth: A Systematic Review of Randomized Trials.

Objective. To assess the effectiveness of interventions that focus on reducing sedentary behavior (SB) among school-age youth and to identify elements associated with interventions' potential for translation into practice settings. Methods. A comprehensive literature search was conducted using 4 databases for peer-reviewed studies published between 1980 and April 2011. Randomized trials, which lasted at least 12 weeks, aimed at decreasing SB among children aged 6 to 19 years were identified. Results. Twelve studies were included; 3 focused only on SB, 1 focused on physical activity (PA), 6 were combined SB and PA interventions, and 2 studies targeted SB, PA, and diet. The majority of the studies were conducted in a school setting, while others were conducted in such settings as clinics, community centers, and libraries. Conclusions. Overall, interventions that focused on decreasing SB were associated with reduction in time spent on SB and/or improvements in anthropometric measurements related to childhood obesity. Several of the studies did consider elements related to the intervention's potential for translation into practice settings.