The current evidence suggests that many diet and exercise interventions to prevent obesity in children are not effective in preventing weight gain, but can be effective in promoting a healthy diet and increased physical activity levels.Being very overweight (obese) can cause health, psychological and social problems for children. Children who are obese are more likely to have weight and health problems as adults. Programmes designed to prevent obesity focus on modifying one or more of the factors considered to promote obesity.This review included 22 studies that tested a variety of intervention programmes, which involved increased physical activity and dietary changes, singly or in combination. Participants were under 18 and living in Asia, South America, Europe or North America. There is not enough evidence from trials to prove that any one particular programme can prevent obesity in children, although comprehensive strategies to address dietary and physical activity change, together with psycho-social support and environmental change may help. There was a trend for newer interventions to involve their respective communities and to include evaluations.Future research might usefully assess changes made on behalf of entire populations, such as improvements in the types of foods available at schools and in the availability of safe places to run and play, and should assess health effects and costs over several years.The programmes in this review used different strategies to prevent obesity so direct comparisons were difficult. Also, the duration of the studies ranged from 12 weeks to three years, but most lasted less than a year.

/pdf/interventions-for-preventing-obesity-in-children-4arhbcud58.pdf

Interventions for preventing obesity in children

Community-based participatory research (CBPR) is an orientation to research that places value on equitable collaborations between community members and academic partners, reflecting shared decision making throughout the research process. Although CBPR has become increasingly popular for research with adults, youth are less likely to be included as partners. In our review of the literature, we identified 399 articles described by author or MeSH keyword as CBPR related to youth. We analyzed each study to determine youth engagement. Not including misclassified articles, 27 % of percent of studies were community-placed but lacked a community partnership and/or participatory component. Only 56 (15 %) partnered with youth in some phase of the research process. Although youth were most commonly involved in identifying research questions/priorities and in designing/conducting research, most youth-partnered projects included children or adolescents in several phases of the research process. We outline content, methodology, phases of youth partnership, and age of participating youth in each CBPR with youth project, provide exemplars of CBPR with youth, and discuss the state of the youth-partnered research literature.

Youth as partners, participants or passive recipients: a review of children and adolescents in community-based participatory research (CBPR).

戦後アメリカに移住した日本人女性たちの動態 : American Community Survey 2011 PUMSデータの2次分析より

Background
Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases, including cardiovascular disease.

Objectives
To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under.

Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase Classic and Embase to identify eligible trials on 30 September 2016. We searched CINAHL and PsycINFO in July 2016, Proquest Dissertations and Theses in November 2016 and three clinical trial registers in November 2016 and June 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials.

Selection criteria
We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements.

Data collection and analysis
Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures.We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures.

Main results
We included 50 trials with 137 trial arms and 10,267 participants. Thirty trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Eleven trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Eight studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition intervention delivered to children in increasing child fruit and vegetable intake.

Thirteen of the 50 included trials were judged as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias of remaining studies.

Meta-analysis of trials examining child-feeding practices versus no intervention revealed a positive effect on child vegetable consumption (SMD 0.38, 95% CI 0.15 to 0.61; n = 1509; 11 studies; very low-quality evidence), equivalent to a mean difference of 4.03 grams of vegetables. There were no short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.11, 95% CI -0.05 to 0.28; n = 3023; 10 studies; very low-quality evidence) or multicomponent interventions versus no intervention (SMD 0.28, 95% CI -0.06 to 0.63; n = 1861; 4 studies; very low-quality evidence).

Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions.Studies reported receiving governmental or charitable funds, except for two studies reporting industry funding.

Authors' conclusions
Despite identifying 50 eligible trials of various intervention approaches, the evidence for how to increase fruit and vegetable consumption of children remains sparse. There was very low-quality evidence child-feeding practice interventions are effective in increasing vegetable consumption of children aged five years and younger, however the effect size was very small and long-term follow-up is required. There was very low-quality evidence that parent nutrition education and multicomponent interventions are not effective in increasing fruit and vegetable consumption of children aged five years and younger. All findings should be considered with caution, given most included trials could not be combined in meta-analyses. Given the very low-quality evidence, future research will very likely change estimates and conclusions. Such research should adopt more rigorous methods to advance the field.

This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.

Interventions for increasing fruit and vegetable consumption in children aged five years and under

Lu Ann Aday, PhD, is a highly respected medical sociologist who is the principal author of eight previous books. She is currently professor of behavioral sciences and management and policy sciences at the University of Texas School of Public Health. She was formerly on the staff of Odin Anderson's Department of Sociology at the University of Chicago, and Professor Anderson contributes a brief foreword to this book. The author's major theme is the concept of vulnerability, with special emphasis on the health care needs of specific populations. The audience will be the vast array of public health, health care, social science, social work, and policy analysis professionals, academicians, and researchers. It is easy to predict that this book will be a required text for students of these disciplines in virtually every academic setting in the United States. The author divides the vulnerable into nine population groups, based on the primacy

At Risk in America: The Health and Health Care Needs of Vulnerable Populations in the United States

The purpose of this study was to determine whether religiosity, spirituality, and sexual attitudes accounted for differences in sexual behaviors among college students. The sample included 960 college students enrolled at four northeastern colleges. Results indicated differences in sexual attitudes, religiosity, and spirituality by gender. Moreover, sexual attitudes, religiosity, and spirituality were associated with sexual behaviors among college students. Sexual behaviors among males were influenced by their sexual attitudes, religiosity, and spirituality, while for females, their sexual behaviors were mostly influenced by their sexual attitudes. College health professionals can use these findings when discussing sexual practices with students.

Religiosity, spirituality, sexual attitudes, and sexual behaviors among college students.

The purpose of this study was to determine the health information sources used by Latinos in southwest Ohio, identify individual Latino residents’ functional health literacy levels, and identify any access barriers to those sources of health information. Results show almost two-thirds had low acculturation levels to US culture. Overall, the major source of health information is a medical setting, followed by media technology (which included the Internet). However, when it comes to being ill, the primary source becomes a media choice, then medical. The barriers to accessing health information included language and lack of confidence/knowledge. Participants reported moderate satisfaction with the sources of health information available, and had an ‘adequate’ health literacy level in Spanish. This study was important because it filled an existing information gap for the Latino community, a racial ethnic minority population in the southwest Ohio area. With the results of this study, health educators and other health care practitioners might be better able to understand the health care needs of the Latino community and could essentially create improved and culturally competent health communications.

A qualitative study examining Latino functional health literacy levels and sources of health information

The purpose of this study was to conduct a pilot participatory needs assessment, using Photovoice to engage in a critical dialogue with preadolescent Latina girls about their perceptions of health and immediate health concerns. Seven Latina girls participated in the Photovoice study and held a photography exhibition for the community to display their photographs and quotes from their discussions. Eight themes about being healthy emerged. Conducting a needs assessment, which concentrates on the voices and needs of these girls, can be the first step to creating successful and cost-efficient programs and interventions specifically suited to this group.

"Picturing" health: a photovoice pilot of Latina girls' perceptions of health.

The relationships among acculturation, health protective sexual communication, and HIV/AIDS risk behaviors of Hispanic women are examined. Respondents represented 14 Latin American countries, a mean age of 29.5 years, and relatively low education and income levels. A significant correlation was found between higher non-Hispanic acculturation level and higher sexual communication with new partners. Higher non-Hispanic acculturation levels were also correlated with higher number of sexual partners in the prior 12 months. The higher the score for health protective sexual communication, the higher the reported frequency of condom use with new sexual partners in the past 12 months. Given the low number of sexual partners, HIV/AIDS risk for this group of women appears to be related to not knowing whether their partners had other sexual partners and to low frequency of condom use. Implications for health education are discussed.

Acculturation, Health Protective Sexual Communication, and HIV/AIDS Risk Behavior Among Hispanic Women in a Large Midwestern City

Throughout the Midwest and the southern United States, new groups of Hispanic/Latino and other immigrants are settling in large numbers. In many regions, very little infrastructure exists in social service, health care, and educational entities that would allow professionals to deliver much-needed services. Little data exist on the sociodemographics of new immigrant communities in the South and the Midwest. Sociodemographic information provides social work professionals and community planners with valuable clues about the health and social services that may be necessary to promote a viable, livable community. In this article, the authors report on a survey of 535 Hispanic adults conducted in a midwestern city, surrounded by urban, suburban, and rural areas in three adjacent states. This information can be used to design programs and services to benefit new immigrants and to assist communities in predicting future needs.

Liliana Rojas-Guyler

Papers

Religiosity, spirituality, sexual attitudes, and sexual behaviors among college students.

A qualitative study examining Latino functional health literacy levels and sources of health information

"Picturing" health: a photovoice pilot of Latina girls' perceptions of health.

Acculturation, Health Protective Sexual Communication, and HIV/AIDS Risk Behavior Among Hispanic Women in a Large Midwestern City

The Diverse Faces of Latinos in the Midwest: Planning for Service Delivery and Building Community