Center for Childrens Healthy Lifestyles and Nutrition

Kansas City, MO, United States

Center for Childrens Healthy Lifestyles and Nutrition

Kansas City, MO, United States
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Patton S.R.,University of Kansas Medical Center | Patton S.R.,Center for Childrens Healthy Lifestyles and Nutrition | Noser A.E.,Center for Childrens Healthy Lifestyles and Nutrition | Noser A.E.,University of Kansas | And 4 more authors.
Diabetes Technology and Therapeutics | Year: 2017

Background: We update the psychometric properties of the Hypoglycemia Fear Survey-Parents of Young Children (HFS-PYC), a 26-item measure of parents' hypoglycemia fear for young children using an insulin pump. Methods: We combined three similar datasets for the analyses. The data analyzed included parents' responses to the HFS-PYC and a demographic form. For a subset of children (n = 91), we also analyzed self-monitoring of blood glucose data. We used confirmatory factor analysis (CFA) to confirm the measure's original factor structure. Additional analyses examined reliability and validity of a revised HFS-PYC for parents of young children using pumps. Results: We analyzed data from 116 parents (93% mothers). Mean child age and HbA1c were 5.2 ± 1.3 years and 8.2% ± 1.1%, respectively. CFA identified a 22-item two-factor solution (χ2 (208, n = 116) = 368.688, P < 0.001, root mean square error of approximation = 0.08, comparative fit index = 0.94, and Tucker-Lewis index = 0.93) with factors corresponding to the original subscales: worry and behavior. The revised subscales demonstrated at least adequate internal consistency (Cronbach's alpha >0.65). Correlations revealed significant negative associations between current HFS-PYC worry scores and children's mean daily blood glucose and percent of very high glucose levels per day, suggesting less fear among parents of young children with elevated glycemic levels. In addition, there was a positive association with the percent of glucose levels in target, suggesting greater hypoglycemia fear among parents of children who have better control. Conclusions: Results provide preliminary evidence for the reliability and validity of a reduced 22-item HFS-PYC for parents of children using insulin pumps. © Copyright 2017, Mary Ann Liebert, Inc. 2017.

Egan A.M.,Childrens Mercy Hospitals and Clinics | Egan A.M.,University of Missouri - Kansas City | Dreyer M.L.,Childrens Mercy Hospitals and Clinics | Dreyer M.L.,Center for Childrens Healthy Lifestyles and Nutrition | And 4 more authors.
Childhood Obesity | Year: 2013

Background: The purpose of this study was to identify rates of overweight and obesity in young children with autism spectrum disorders (ASD) and factors related to overweight. Methods: Retrospective chart reviews were conducted for 273 children with ASD [i.e., autistic disorder, Asperger's disorder, pervasive developmental disorder not otherwise specified (PDD-NOS)] after receiving outpatient services with a developmental pediatrician or the developmental team at a children's hospital. Information on child demographics, height and weight, medications prescribed, and adaptive functioning was collected from charts. Results: Rates of overweight and obesity in children with ASD were found to be above nationally representative prevalence estimates for children. Among children with autistic disorder, 17.16% had a body mass index (BMI) percentile in the overweight range and 21.89% had a BMI percentile in the obese range. For children with Asperger's disorder/PDD-NOS, 12.50% were considered overweight and 10.58% were considered obese. Neither psychotropic medications prescribed nor adaptive functioning was found to be related to whether the child was overweight or obese. Conclusions: Children with ASD are at risk for overweight and obesity, and children with autistic disorder are at greater risk for weight problems than children with Asperger's disorder/PDD-NOS. Further research is needed to identify factors related to overweight in children with ASD. Copyright © 2013, Mary Ann Liebert, Inc. 2013.

Lim S.-L.,University of Missouri - Kansas City | Cherry J.B.C.,University of Kansas Medical Center | Davis A.M.,University of Kansas Medical Center | Davis A.M.,Center for Childrens Healthy Lifestyles and Nutrition | And 7 more authors.
Nature Communications | Year: 2016

As children grow, they gradually learn how to make decisions independently. However, decisions like choosing healthy but less-tasty foods can be challenging for children whose self-regulation and executive cognitive functions are still maturing. We propose a computational decision-making process in which children estimate their motherâ €™ s choices for them as well as their individual food preferences. By employing functional magnetic resonance imaging during real food choices, we find that the ventromedial prefrontal cortex (vmPFC) encodes childrenâ €™ s own preferences and the left dorsolateral prefrontal cortex (dlPFC) encodes the projected momâ €™ s choices for them at the time of childrenâ €™ s choice. Also, the left dlPFC region shows an inhibitory functional connectivity with the vmPFC at the time of childrenâ €™ s own choice. Our study suggests that in part, children utilize their perceived caregiverâ €™ s choices when making choices for themselves, which may serve as an external regulator of decision-making, leading to optimal healthy decisions.

Davis A.M.,Center for Childrens Healthy Lifestyles and Nutrition | Davis A.M.,University of Kansas Medical Center | Canter K.S.,Center for Childrens Healthy Lifestyles and Nutrition | Canter K.S.,University of Kansas | And 6 more authors.
Journal of Pediatric Psychology | Year: 2014

Objective The current study presents results of an exploratory factor analysis (EFA) of the Behavioral Pediatric Feeding Assessment Scale (BPFAS) in a sample of rural children with overweight and obesity. Relationships between mealtime behavior and health outcomes are also explored. Methods EFA was used to assess the fit of the BPFAS in a group of 160 treatment-seeking children (Mage = 9.11, SD = 1.77) living in rural Midwest communities. Correlations were also computed between factor scores and select health variables (child body mass index z-score and diet variables). Results The EFA identified a 5-factor solution as the best fitting model (Tucker-Lewis Index =. 96, root mean square error of approximation =. 05), although several items (i.e., 7 of 25) did not load on any factor. 2 factors were correlated with health variables of interest. Conclusion Study results suggest that certain items on the BPFAS may not be appropriate for use with rural children with pediatric overweight or obesity. Implications for future research and practice are discussed. © 2013 The Author 2013.

Davis A.M.,University of Kansas Medical Center | Davis A.M.,Center for Childrens Healthy Lifestyles and Nutrition | Gallagher K.,Harvard University | Taylor M.,Kansas State University | And 6 more authors.
Journal of Developmental and Behavioral Pediatrics | Year: 2013

Objective: Teenage pregnancy is a major public health concern in the United States. In addition to other life stressors, adolescent mothers and their children are at risk for obesity and other negative health outcomes. The current study examines the impact of a brief in-home educational intervention designed to improve health knowledge and behavior in a sample of low-income adolescent mothers. Method: Forty-six teen mothers received 6 in-home educational sessions focused on nutrition and physical activity, with baseline and follow-up knowledge and behavior assessments. Results: Results indicate significant improvements in mothers' health knowledge and physical activity pertaining to themselves and to their children, and also an unexpected increase in sedentary behaviors. Conclusion: Results from this study indicate that knowledge-focused interventions may be an effective method to facilitate positive health behavioral change for teenage mothers. Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

Bruce A.S.,University of Kansas Medical Center | Bruce A.S.,Center for Childrens Healthy Lifestyles and Nutrition | Bruce A.S.,Childrens Mercy Hospital | Lim S.-L.,University of Missouri - Kansas City | And 7 more authors.
Appetite | Year: 2015

The goal of this concise narrative review is to examine the current literature regarding endogenous and exogenous influences on youth food choices. Specifically, we discuss internal factors such as interoception (self-awareness) of pain and hunger, and neural mechanisms (neurofunctional aspects) of food motivation. We also explore external factors such as early life feeding experiences (including parenting), social influences (peers), and food marketing (advertising). We conclude with a discussion of the overlap of these realms and future directions for the field of pediatric food decision science. © 2015 Elsevier Ltd.

PubMed | Center for Childrens Healthy Lifestyles and Nutrition, Center for Health Outcomes and Health Services Research and Childrens Mercy Kansas City
Type: | Journal: Pediatric diabetes | Year: 2016

Adherence to the type 1 diabetes (T1D) regimen, while predictive of glycemic control, decreases during adolescence. For adolescents, attaining adequate sleep is an additional challenge. This study evaluates the impact of sleep on adherence in teens with T1D.Forty-five adolescents aged 12-18 yr, with T1D for at least 6 months while on insulin pump therapy.Adolescents logged their sleep on a written diary for 2 wk. Corresponding insulin pump/glucometer downloads as well as sleep habit questionnaires were also obtained.Data from 20 girls and 25 boys, with a mean age of 151.6yr and mean glycated hemoglobin of 8.71.1% (72mmol/mol), were analyzed. Overall, average sleep was 8.60.9h per night. Sleep durations were compared to the next days frequency of self-monitored blood glucose (SMBG) and total daily insulin bolus frequency. Associations were found between sleep duration and youths SMBG and insulin bolus frequencies (p<0.03 and p<0.001, respectively). Specifically, a 15- and 20-min increase in sleep was associated with one additional SMBG check and one additional insulin bolus, respectively.Analyses suggest an associated increase in T1D self-management behaviors in youths with increased sleep duration. These findings highlight the importance of assessing sleep in clinical practice, and encourage further research to examine effective strategies to address sleep hygiene as part of routine diabetes management.

Dreyer Gillette M.L.,Center for Childrens Healthy Lifestyles and Nutrition | Dreyer Gillette M.L.,University of Missouri - Kansas City | Borner K.B.,Center for Childrens Healthy Lifestyles and Nutrition | Borner K.B.,University of Kansas | And 9 more authors.
Journal of Developmental and Behavioral Pediatrics | Year: 2015

Children with autism spectrum disorder (ASD) may be at increased risk for overweight and obesity, but little information is known about correlates of overweight and obesity in this population. This study compared prevalence rates of parent-reported overweight and obesity and specific health behaviors (i.e., parent report of child sleep, family meal patterns, child screen time, and child physical activity) among children with ASD (N more than 900 [weighted to represent 690,000; age 10-17]) compared with children without ASD using data from a nationally representative sample. Additionally, the relationship between specific health behaviors (i.e., child sleep, family meals, screen time, and physical activity) and weight status was examined in the ASD population. Data were from the National Survey of Children's Health 2011-2012. Results indicate that children with ASD were more likely to be obese but not more likely to be overweight than non-ASD youth. Children with ASD engaged in physical activity less than children without ASD, but no differences were found on sleep, most measures of screen time, and mealtimes. However, parent perceived poorer sleep was associated with increased weight status, and fewer family meals were associated with normal weight status among children with ASD. © 2015 Wolters Kluwer Health, Inc.

Davis A.M.,Center for Childrens Healthy Lifestyles and Nutrition | Davis A.M.,University of Kansas Medical Center | Wambach K.A.,University of Kansas Medical Center | Nelson E.L.,University of Kansas Medical Center | And 4 more authors.
Telemedicine and e-Health | Year: 2014

Background: Maternal health behaviors during pregnancy/infancy can have a significant impact on maternal and child health. Many women engage in health risk behaviors during pregnancy. Multiple health behavior change (MHBC) interventions provide support to change health behaviors, but further information is needed on potential targets for such an intervention, as well as on the feasibility of technology use and e-health with this population.Materials and Methods: Two studies were completed as part of this project. First, a survey to examine views regarding health behaviors, desires to change health behaviors, and use of technology was completed by 68 pregnant women presenting for routine care. Based on survey findings, a brief MHBC e-health educational intervention related to breastfeeding, healthy nutrition/lifestyle, and stress management, using iPad® (Apple, Cupertino, CA) and text-messaging media, was then developed and piloted in the home with five pregnant women.Results: In the survey, the majority of participants reported interest in receiving help to improve health behaviors, including losing weight or eating a healthier diet, breastfeeding, smoking cessation, and help with depression. The majority of women reported access to a computer with Internet, a phone, and frequent use of text messaging. In the second phase, results suggest that the home-based intervention was feasible and that the technology was convenient and user-friendly.Conclusions: Pregnant women are interested in improving health behaviors and found a brief technology-based e-health intervention feasible, convenient, and user-friendly. In-home technology appears to be a feasible and convenient approach to addressing the multiple health behavior change needs of pregnant women. Copyright © 2014, Mary Ann Liebert, Inc.

Hampl S.E.,University of Kansas | Hampl S.E.,Center for Childrens Healthy Lifestyles and Nutrition | Davis A.M.,Center for Childrens Healthy Lifestyles and Nutrition | Davis A.M.,University of Kansas Medical Center | And 3 more authors.
Obesity | Year: 2013

Objective: The effectiveness of group-based comprehensive, multidisciplinary (stage 3) pediatric weight management programs is backed by a growing body of literature, yet insurance coverage of these programs is scarce to nonexistent, limiting their reach and long-term survival. The objective of this study was to better understand the perspectives of insurers and large employers on the issue of group-based treatment coverage. Design and Methods: The authors performed a qualitative study utilizing structured interviews with these stakeholders, following accepted techniques. Results: Six major themes emerged: cost, program effectiveness, corporate social responsibility, secondary parental (employee) benefits, coverage options and new benefit determination. Conclusion: Future efforts to secure payment for group-based pediatric weight management programs should address these key themes. Copyright © 2012 The Obesity Society.

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