Dataset Information

Parenting Intervention at Age 11 and Cotinine Levels at Age 20 Among African American Youth.

ABSTRACT: OBJECTIVES:This study was designed to test the hypothesis that African American preadolescents who participated in a family-centered parenting intervention at age 11 would show lower levels of cotinine, a biomarker for recent smoking, at age 20 than would similar participants in the control condition. The study was also designed to test the hypothesis that prevention-induced increases in supportive parenting would account for any prevention effects that emerged. METHODS:African American parents and their 11-year-old children in the rural southern United States were assigned randomly to the Strong African American Families program or to a control condition. Parents provided self-reported data on supportive parenting when the youth were 11 and 16 years of age. When the youth were 20 years of age, blood was drawn from which cotinine was assayed. RESULTS:Intervention program participants (M = 0.672, SD = 0.048) displayed significantly lower cotinine levels at age 20 years than did control participants (M = 0.824, SD = 0.059), P = .046. Mediation analyses confirmed that increases in supportive parenting accounted for intervention effects on smoking. CONCLUSIONS:We have demonstrated in this study that a randomized trial of a prevention program designed to enhance supportive parenting reduced cotinine levels among young African American adults. The developmentally appropriate family-centered intervention buffered the risk of smoking 9 years after program participation.

SUBMITTER: Chen YF

PROVIDER: S-EPMC5495525 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Parenting Intervention at Age 11 and Cotinine Levels at Age 20 Among African American Youth.

Chen Yi-Fu YF Yu Tianyi T Brody Gene H GH

Pediatrics 20170614 1

<h4>Objectives</h4>This study was designed to test the hypothesis that African American preadolescents who participated in a family-centered parenting intervention at age 11 would show lower levels of cotinine, a biomarker for recent smoking, at age 20 than would similar participants in the control condition. The study was also designed to test the hypothesis that prevention-induced increases in supportive parenting would account for any prevention effects that emerged.<h4>Methods</h4>African Am ...[more]

PMID: 28615354

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Project description:BACKGROUND/OBJECTIVE:Family relationships have been linked to obesity and related disorders in youth, but few studies have provided causal evidence of this association. This study tested the impact of a family psychosocial intervention on components of metabolic syndrome-a condition driven largely by abdominal obesity-in African American youth. In particular, the study tested whether effects were strongest among those who started at highest risk, that is, with high levels of unsupportive parenting at baseline. SUBJECTS/METHODS:Randomized clinical trial of a community sample of 391 African American youth (mean age=11.2 years) conducted in 2001-2002, with follow-up metabolic syndrome assessment in 2014-2015. Participants were assigned either to receive a weekly family intervention or to a control group. The primary study outcome was the number of components of metabolic syndrome that were clinically elevated at age 25, including central adiposity, blood pressure, triglycerides, glucose and low high-density lipoproteins. Unsupportive parenting was measured by questionnaires at baseline. RESULTS:Significant interaction effects were found between group assignment and baseline unsupportive parenting on counts of metabolic syndrome components in youth (beta=-0.17, P=0.03). Among those who started with higher levels of unsupportive parenting at age 11, participation in the family intervention reduced the number of clinically elevated components of the metabolic syndrome at age 25 relative to the control group. No such effect was seen among those who started with good parenting. Mediation analyses suggested that changes in the psychosocial targets of the parenting intervention partially accounted for the effects amongst those high in unsupportive parenting at baseline (effect size=-0.350, s.e.=0.178). CONCLUSIONS:These findings suggest that efforts to improve family relationships may be able to ameliorate the detrimental effects that harsh and unsupportive parenting have on obesity-related outcomes such as metabolic syndrome in youth.

Project description:Background/objectiveParents shape children's early experiences with food, influencing what is served, children's food choices, and how much children eat. Responsive parenting (RP) interventions such as INSIGHT have improved maternal infant feeding practices, but have only been tested among predominantly White families. This secondary analysis of data from the Sleep SAAF (Strong African American Families) RCT tests the effects of an RP intervention designed to prevent rapid infant weight gain on African American mothers' infant feeding practices.MethodsPrimiparous African American mother-infant dyads (n = 194) were randomized to an RP or safety control intervention delivered by community research associates at infant age 3 and 8 weeks. At 16 weeks, mothers completed the Babies Need Feeding questionnaire, the Infant Feeding Styles Questionnaire, and the Babies Need Soothing questionnaire. Logistic regression and general linear models examined the effect of study group on infant feeding practices. Moderation analyses explored whether effects varied by feeding mode (any breast milk versus exclusive formula), maternal age (≥ 20 years versus < 20 years), and maternal pre-pregnancy BMI (with obesity versus not).ResultsRP mothers reported more responsive feeding (p = 0.005, partial η2 = 0.02), lower likelihood of using beverages other than breast milk/formula to soothe their infant (p = 0.01, OR = 0.42, 95% CI [0.2-0.8]), and less pressure with cereal than control mothers (p = 0.09, partial η2 = 0.02). RP mothers also reported less pressure to finish/soothe than controls (p = 0.007, partial η2 = 0.04); feeding mode (B = 0.74, p = 0.003) and maternal age (B = 0.53, p = 0.04) moderated this effect. There were no significant group differences in bottle-feeding practices (e.g., adding cereal to bottle, using an appropriate nipple/bottle size), or in context-based or emotion-based food to soothe.ConclusionsResponsive parenting education influenced some feeding practices of African American mothers. Mothers reported using less pressure, a control-based feeding practice, and more responsive feeding than controls.Trial registrationSleep SAAF: A Strong African American Families Study. www.Clinicaltrialsgov NCT03505203. Registered 3 April 2018.

Project description:BackgroundIn 1999, type 2 diabetes mellitus (T2DM) was identified as an emerging epidemic in youth, and racial and ethnic minority youth were identified with high risk. Two decades later, no gold standard T2DM prevention intervention has been established for this population.ObjectiveThis study tests the efficacy of a telehealth diabetes prevention intervention for African American (AA) families with children with risk for T2DM. Concurrently, investigators aim to evaluate an implementation strategy for the uptake of the intervention by the University of Mississippi Medical Center's (UMMC) pediatric weight management clinic.MethodsThis single-arm trial will enroll 20 parents with overweight or obesity of children (8-11 years) with overweight or obesity, both of whom are at risk for T2DM. Parents will meet in small groups (5 parents per group) weekly for 11 weeks and then monthly for 4 monthly maintenance sessions via videoconference using Wi-Fi-enabled iPads with cellular connectivity. The intervention will be adapted from the National Diabetes Prevention Program and Power to Prevent, a diabetes prevention program tailored for AA families. The same lifestyle intervention facilitated by a racially concordant lifestyle coach trained in the Diabetes Prevention Program will be delivered to all groups (n=4). Participants will be recruited in-person during patient encounters at the UMMC's pediatric weight management clinic. Sessions will consist of dietary and physical activity behavior change strategies facilitated using problem-solving and goal-setting skills. The implementation strategy has 2 targets: the pediatric weight management clinic site and clinical team and parents of children at risk for T2DM engaged in intensive obesity treatment to prevent T2DM. The multifaceted implementation protocol includes 4 discrete strategies: creating a new clinical team, changing the service site, intervening with families, and promoting organizational readiness for change.ResultsRecruitment and enrollment began in December 2020, and the intervention is scheduled to be delivered to the first cohort of parents in March 2021. The results are expected to be submitted for publication beginning in November 2021 through 2022. The primary outcome measure for the pilot trial will include changes from baseline to 12 and 30 weeks in the child BMI z score and parent BMI. The implementation evaluation will include multiple measures of feasibility, acceptability, appropriateness, fidelity, and efficacy. This protocol was approved by the UMMC's Institutional Review Board (#2020V0249).ConclusionsThe proposed intervention approach is supported by the scientific literature and is scalable given the current and future health care subsidies for telehealth. Findings from this pilot trial will begin to address critical barriers to defining a gold standard lifestyle intervention for AA families with children at risk for T2DM. If effective, the intervention could be feasibly disseminated to treat obesity and prevent T2DM in high-risk AA pediatric populations.International registered report identifier (irrid)PRR1-10.2196/25699.

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Parenting Intervention at Age 11 and Cotinine Levels at Age 20 Among African American Youth.

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Parenting Intervention at Age 11 and Cotinine Levels at Age 20 Among African American Youth.

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