Dataset Information

Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial.

ABSTRACT: BACKGROUND:Research has demonstrated a significant positive association between frequent family meals and children's dietary intake; however, the promotion of healthful family meals has not been rigorously tested for key food environment and nutrition-related behavioral outcomes in a randomized trial. OBJECTIVE:To describe family home food environment and nutrition-related parent and child personal and behavioral outcomes of the Healthy Home Offerings via the Mealtime Environment Plus program, the first rigorously tested family meals intervention targeting childhood obesity prevention. DESIGN:Randomized controlled trial. Baseline, postintervention (12 months, 93% retention), and follow-up (21 months, 89% retention) data (surveys and dietary recalls) were collected. PARTICIPANTS/SETTING:Children aged 8 to 12 years (N=160) and their parents were randomized to intervention (n=81) or control (n=79) groups. INTERVENTION:The intervention included five parent goal-setting calls and 10 monthly sessions delivered to families in community settings that focused on experiential nutrition activities and education, meal planning, cooking skill development, and reducing screen time. MAIN OUTCOME MEASURES:Family home food environment outcomes and nutrition-related child and parent personal and behavioral outcomes. STATISTICAL ANALYSES PERFORMED:Analyses used generalized linear mixed models. Primary comparisons were contrasts between intervention and control groups at postintervention and follow-up, with adjustments for child age and parent education. RESULTS:Compared with control parents, intervention parents showed greater improvement over time in scores of self-efficacy for identifying appropriate portion sizes, with significant differences in adjusted means at both post-intervention (P=0.002) and follow-up (P=0.01). Intervention children were less likely to consume at least one sugar-sweetened beverage daily at post-intervention than control children (P=0.04). CONCLUSIONS:The Healthy Home Offerings via the Mealtime Environment Plus program involved the entire family and targeted personal, behavioral, and environment factors important for healthful changes in the home food environment and children's dietary intake. The intervention improved two nutrition-related behaviors and this may inform the design of future family meal interventions.

SUBMITTER: Fulkerson JA

PROVIDER: S-EPMC5711643 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Publications

Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial.

Fulkerson Jayne A JA Friend Sarah S Horning Melissa M Flattum Colleen C Draxten Michelle M Neumark-Sztainer Dianne D Gurvich Olga O Garwick Ann A Story Mary M Kubik Martha Y MY

Journal of the Academy of Nutrition and Dietetics 20170601 2

<h4>Background</h4>Research has demonstrated a significant positive association between frequent family meals and children's dietary intake; however, the promotion of healthful family meals has not been rigorously tested for key food environment and nutrition-related behavioral outcomes in a randomized trial.<h4>Objective</h4>To describe family home food environment and nutrition-related parent and child personal and behavioral outcomes of the Healthy Home Offerings via the Mealtime Environment ...[more]

PMID: 28578900

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Project description:Background. Quality staff-resident communication is crucial to promote outcomes in nursing home residents with dementia requiring assistance during mealtimes. Better understanding of staff-resident language characteristics in mealtime interactions help promote effective communication, yet evidence is limited. This study aimed to examine factors associated with language characteristics in staff-resident mealtime interactions. Methods. This was a secondary analysis of 160 mealtime videos involving 36 staff and 27 residents with dementia (53 unique staff-resident dyads) in 9 nursing homes. We examined the associations of speaker (resident vs. staff), utterance quality (negative vs. positive), intervention (pre- vs. post-communication intervention), and resident dementia stage and comorbidities with expression length (number of words in each utterance) and addressing partner by name (whether staff or resident named their partner in each utterance), respectively. Results. Staff (utterance n = 2990, 99.1% positive, mean = 4.3 words per utterance) predominated conversations and had more positive, longer utterances than residents (utterance n = 890, 86.7% positive, mean = 2.6 words per utterance). As residents progressed from moderately-severe to severe dementia, both residents and staff produced shorter utterances (z=-2.66, p = .009). Staff (18%) named residents more often than residents (2.0%; z = 8.14, p < .0001) and when assisting residents with more severe dementia (z = 2.65, p = .008). Conclusions. Staff-resident communication was primarily positive, staff-initiated, and resident-oriented. Utterance quality and dementia stage were associated with staff-resident language characteristics. Staff play a critical role in mealtime care communication and should continue to initiate resident-oriented interactions using simple, short expressions to accommodate resident declining language abilities, particularly those with severe dementia. Staff should practice addressing residents by their names more frequently to promote individualized, targeted, person-centered mealtime care. Future work may further examine staff-resident language characteristics at word and other levels using more diverse samples.

Project description:BackgroundQuality staff-resident communication is crucial to promote outcomes in nursing home residents with dementia requiring assistance during mealtimes. Better understanding of staff-resident language characteristics in mealtime interactions help promote effective communication, yet evidence is limited. This study aimed to examine factors associated with language characteristics in staff-resident mealtime interactions.MethodsThis was a secondary analysis of 160 mealtime videos involving 36 nursing staff and 27 residents with moderately severe to severe dementia in 9 nursing homes. Mixed-effects models was used to examine the relationships between factors and language characteristics in staff-resident mealtime interactions. The independent variables were speaker (resident vs. staff), utterance quality (negative vs. positive), intervention (pre- vs. post-communication intervention), and resident dementia stage and comorbidities. The dependent variables were expression length (number of words in each utterance) and addressing partner by name (whether staff or resident named their partner in each utterance). All models included staff, resident, and staff-resident dyad as random effects.ResultsStaff (utterance n = 2990, 99.1% positive, mean = 4.3 words per utterance) predominated conversations and had more positive, longer utterances than residents (utterance n = 890, 86.7% positive, mean = 2.6 words per utterance). As residents progressed from moderately severe to severe dementia, both residents and staff produced shorter utterances (z=-2.66, p = .009). Staff (18%) named residents more often than residents (2.0%; z = 8.14, p < .0001) and when assisting residents with more severe dementia (z = 2.65, p = .008).ConclusionsStaff-resident communication was primarily positive, staff-initiated, and resident-oriented. Utterance quality and dementia stage were associated with staff-resident language characteristics. Staff play a critical role in mealtime care communication and should continue to initiate resident-oriented interactions using simple, short expressions to accommodate resident declining language abilities, particularly those with severe dementia. Staff should practice addressing residents by their names more frequently to promote individualized, targeted, person-centered mealtime care. Future work may further examine staff-resident language characteristics at other levels of language using more diverse samples.

Project description:Parental cognitive functioning is thought to play a key role in parenting behavior and may inform response to behavioral intervention. This open-label pilot study examined the extent to which parent and child cognition impacted response to behavioral parent training for children with ADHD. Fifty-four participants (27 parent-child dyads; Mages?=?10.6 and 45.2 for children and parents, respectively) completed tasks assessing visuospatial and phonological working memory, inhibitory control, and choice-reaction speed at pre-treatment. Drift diffusion modeling decomposed choice-reaction time data into indicators of processing speed (drift rate) and response caution (boundary separation). Parents completed a 10-week manualized behavioral parent training program. Primary outcomes were pre- and post-treatment child ADHD and conduct problem severity, and parent-reported relational frustration and parenting confidence. Bayesian multiple regressions assessed parent and child cognitive processes as predictors of post-treatment outcomes, controlling for pre-treatment behavior. Better child visuospatial and phonological WM and higher parental response caution were associated with greater reductions in inattention. For conduct problems, better parental self-regulation (stronger inhibitory control and greater response caution) predicted fewer post-treatment conduct problems. Higher parental response caution also predicted lower post-treatment relational frustration and higher parental confidence. Bayesian evidence supported no relation between parent and child cognitive functions and treatment-related changes in hyperactivity. This pilot study demonstrates that cognitive processes central to etiologic theories of ADHD and models of parenting behavior can be successfully integrated into treatment outcome research to inform which families are most likely to benefit from behavioral interventions. This study demonstrates the feasibility of bridging the translational research gap between basic and applied clinical science and facilitates research on the role of cognition in psychosocial interventions.

Dataset Information

Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial.

Publications

Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial.

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