Latinos are the largest and fastest-growing ethnically diverse group in the United States. Latino children are also among the most overweight and obese ethnic groups of children in the United States. Research over the last decade has identified the home environment as a key influence on the diet and physical activity of children. To summarize cross-sectional and longitudinal research that has identified factors within the home environment of Latino families that are associated with childhood obesity and to provide recommendations for future research and intervention development with Latino families. A decade review from 2005 to 2015 was conducted. Studies identifying factors within the home environments of Latino families that were associated with childhood obesity were examined. Five main factors were identified across the literature as home environment factors that are associated with childhood obesity in Latino children. These factors included: parental influences (e.g., parent feeding practices, modeling), screen time, physical activity/sedentary behavior, socioeconomic status/food security and sleep duration. The current review identified several home environment factors that may contribute to the disparities in childhood obesity for Latino children. Results from this review such as, focusing on decreasing controlling parent feeding practices, and increasing parent modeling of healthy behaviors and child sleep duration, can be used in developing culturally-specific interventions for Latino children.

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Home Environmental Influences on Childhood Obesity in the Latino Population: A Decade Review of Literature

BACKGROUND: Severe obesity has increased 4300% in US children since 1976, and is associated with multiple cardiovascular risk factors and high adult obesity rates. OBJECTIVE: The objective of this study was to identify predictors of severe obesity in kindergarteners. METHODS: Multivariable logistic regression and recursive partitioning analysis (RPA) were used to identify prenatal/pregnancy, infant, and early childhood predictors of severe kindergarten obesity (body mass index (BMI) X99th percentile) in the Early Childhood Longitudinal Study Birth Cohort, a nationally representative longitudinal study that followed children from birth through kindergarten. RESULTS: For the 6800 children, the severe kindergarten obesity prevalence was 5.7%, with higher adjusted odds for crossing the 85th percentile of BMI at 2 years old (odds ratio (OR), 8.0; 95% confidence interval (CI), 4.1–15.7), preschool age (OR, 7.9; 95% CI, 4.9–12.8) and 9 months old (OR, 1.8; 95% CI, 1.2–2.6); maternal severe obesity (OR, 3.4; 95% CI, 1.9–5.8) and gestational diabetes (OR, 2.9; 95% CI, 1.5–5.5); drinking tea or coffee between meals/before bedtime at 2 years old (OR, 3.3; 95% CI, 1.3–8.5); Latino (OR, 2.3; 95% CI, 1.4–3.7) and multiracial (OR, 2.3; 95% CI, 1.1–4.8) race/ethnicity; and drinking sugary beverages at kindergarten age at least weekly (OR, 2.3; 95% CI, 1.4–3.7). Ever-attending center-based daycare (OR, 0.3; 95% CI, 0.1–0.9), eating fruit at least weekly at kindergarten age (OR, 0.3; 95% CI, 0.1–0.7), and maternal history of a prior newborn birth weight X4000 g (OR, 0.1; 95% CI, 0.02–0.6) were associated with reduced odds of severe obesity. RPA identified low severe obesity prevalence (1.9%) for non-85th BMI-percentile preschool crossers and high severe obesity (56–80%) for predictor clusters which included crossing the 85th BMI percentile at earlier ages, low parental education, specific maternal age cutoffs, preschooler bedtime rules, and outside walking/play frequency for 9-month-olds. CONCLUSIONS: Certain parental, prenatal/pregnancy, infant, and early childhood factors, both alone and in combination, are potent predictors of severe obesity in kindergarteners.

Factors predicting severe childhood obesity in kindergarteners.

Hispanic Mothers’ Views of the Fathers’ Role in Promoting Healthy Behaviors at Home: Focus Group Findings

OBJECTIVE This study used qualitative interviews with black and Latino participants with diabetes to further understanding about types of foods eaten, food preparation, sources of foods and meals, communication with providers, and effects of race and ethnicity on eating in this population. RESEARCH DESIGN AND METHODS Researchers recruited black and Latino adults from East Harlem, New York, to participate in four English and Spanish focus groups. Discussions were transcribed, coded, and analyzed to uncover prevalent themes, which were interpreted with the Common Sense Model of Self-Regulation. RESULTS Thirty-seven adults with diabetes participated in four focus groups. The following four major themes emerged from the analyses: 1 ) The food environment limited participants’ access to healthy foods; 2 ) understanding of diabetes and communication with clinicians about healthy eating was limited and abstract; 3 ) the short-term, negative consequences of healthy eating outweighed the benefits; and 4 ) stress, in large part from poverty and discrimination, was seen as a causal factor for both poor eating and diabetes. CONCLUSIONS Participants’ responses indicated that using healthy eating to control diabetes does not provide immediate, tangible results. Thus, these participants followed their own common sense to guide their diabetes management and improve their health. Clinicians may be better able to help patients eat healthfully if they consider these factors during medical visits.

https://care.diabetesjournals.org/content/diacare/36/10/2895.full.pdf

Challenges to healthy eating for people with diabetes in a low-income, minority neighborhood

Document beliefs about the contribution of physical activity to preschool-aged children’s health held by Latino mothers in farmworker families, and delineate their perceived barriers or constraints that impose limits on preschool-aged children’s physical activity. Qualitative data obtained through semi-structured in-depth interviews (N = 33) with mothers of preschool-aged children living in Latino farmworker families in North Carolina. Mothers universally agree that regular vigorous physical activity is good for preschool-aged children’s health, including obesity prevention. However, excessive physical activity can produce illnesses, as well as other physical and emotional problems, and should be limited. Mothers wanted their children to engage in more sedentary forms of activity because they believed it would benefit learning. Physical and chemical hazards in rural environments, distance to parks and play spaces, and lack of familiarity and concerns about neighbors constrained children’s physical activity. Although physical activity is believed to be beneficial, strong cultural beliefs and real contextual barriers undermine preschool-aged Latino farmworker children’s level of physical activity.

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Latino Mothers in Farmworker Families’ Beliefs About Preschool Children’s Physical Activity and Play

Making tortillas without lard: Latino parents' perspectives on healthy eating, physical activity, and weight-management strategies for overweight Latino children.

OBJECTIVE The aim of this study was to test the impact of an innovative nonclinical support role to improve patient experiences while supporting nurse work on inpatient units. BACKGROUND On the basis of the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) survey, patients' experience declined nationally during the COVID-19 pandemic. A nonclinical support role, titled an Experience Coordinator, was created as a test of change to collaborate with care teams and respond to patients' and families' nonclinical needs. METHODS This is a quality improvement (QI) project for a supportive role development and implementation. The health system's HCAHPS data were compared before and after the role was tested on 3 inpatient units. RESULTS The HCAHPS data indicated that 5 of the 10 domains' top box ratings increased during the QI project month compared with the previous month. CONCLUSION The study findings may support the implementation of new innovative nonclinical positions to alleviate nurses' workload and promote patients' hospital experience.

Julio Maldonado

Papers

Making tortillas without lard: Latino parents' perspectives on healthy eating, physical activity, and weight-management strategies for overweight Latino children.

Patient Experience Coordinator