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Parent healthful eating attitudes and motivation are prospectively associated with dietary quality among youth with type 1 diabetes.

ABSTRACT: A family-based behavioral nutrition intervention grounded in Social Cognitive and Self-Determination Theories showed an increased intake of whole plant foods. This study examined 1) whether the intervention changed parent diet-related attitudes/beliefs, 2) whether these attitudes/beliefs were associated with youth diet quality, and 3) the moderating roles of youth age and parent nutritional knowledge. Youth with type 1 diabetes and their parents (n = 136, mean ± SD youth age = 12.6 ± 2.8 years) participated in an 18-month trial targeting intake of whole plant foods. Parents reported attitudes/beliefs (self-efficacy, outcome expectations, perceived barriers, autonomous and controlled motivation) for providing healthy food to their families, and type 1 diabetes-specific nutrition knowledge at 6, 12, and 18 months. Whole Plant Food Density (WPFD; cup or ounce equivalents per 1000 kcal of whole grains, fruit, vegetables, legumes, nuts and seeds) was calculated from 3-day youth food records. Linear mixed models estimated the intervention effect on parent attitudes/beliefs, associations of parent attitudes/beliefs with youth WPFD and the moderating roles of parent nutrition knowledge and youth age. There was no effect of the intervention on parent attitudes/beliefs. Across groups, higher parent self-efficacy and autonomous motivation were positively associated with youth WPF. Parent perceived barriers and negative outcome expectations were inversely associated with youth WPFD, especially when parents had higher nutrition knowledge. Youth age did not modify any associations. Parent diet-related attitudes/beliefs were associated with youth diet quality, highlighting the importance of parent psychosocial factors across this age range. Despite a positive effect on youth diet, the intervention did not affect parent attitudes/beliefs, suggesting it worked through a different mechanism.

SUBMITTER: Eisenberg MH

PROVIDER: S-EPMC5978430 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Parent healthful eating attitudes and motivation are prospectively associated with dietary quality among youth with type 1 diabetes.

Eisenberg Miriam H MH Lipsky Leah M LM Gee Benjamin B Liu Aiyi A Nansel Tonja R TR

Vulnerable children and youth studies 20170412 3

A family-based behavioral nutrition intervention grounded in Social Cognitive and Self-Determination Theories showed an increased intake of whole plant foods. This study examined 1) whether the intervention changed parent diet-related attitudes/beliefs, 2) whether these attitudes/beliefs were associated with youth diet quality, and 3) the moderating roles of youth age and parent nutritional knowledge. Youth with type 1 diabetes and their parents (n = 136, mean ± SD youth age = 12.6 ± 2.8 years) ...[more]

PMID: 29861779

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Project description:Constructs based on Social Cognitive Theory have shown utility in understanding dietary behavior; however, little research has examined these relations in youth and parents concurrently. Unique demands of dietary management among families of youth with type 1 diabetes (T1D) suggest the importance of investigation in this population. The purpose of this study was to develop and evaluate youth and parent measures of self-efficacy, outcome expectations, and barriers for healthful eating, and parent modeling of healthful eating, in a sample of youth with type 1 diabetes and their parents.Youth (n=252) ages 8-18 years with diabetes duration ?1 year and parents completed self-report measures of healthful eating attitudes including self-efficacy, perceived barriers, positive and negative outcome expectations; youth reported parent modeling of healthful eating. Youth dietary intake from 3-day diet records was used to calculate the Healthy Eating Index 2005 and the Nutrient Rich Foods 9.3 index, measures of overall diet quality. The relations among parent and youth healthful eating attitudes, parent modeling, and youth diet quality were examined using structural equation modeling.Internal consistency and test-retest reliability of the measures were acceptable. The structural equation model demonstrated acceptable fit (CFI/TLI=0.94/0.94; RMSEA=0.03), and items loaded the hypothesized factors. Parent modeling ?^=.27,p=.02 and attitudes toward healthful eating (latent variable comprised of self-efficacy, barriers, outcome expectations) ?^=.16,p=.04 had direct effects on youth diet quality. Parent modeling had a direct effect on youth attitudes ?^=.49,p<.001; parent attitudes had an indirect effect on youth attitudes through parent modeling ?^=.12,p,<.001. Youth attitudes were not associated with youth diet quality. Overall, the model accounted for 20% of the variance in child diet quality.Parent diet-related behaviors demonstrated an impact on youth attitudes and diet quality, suggesting the importance of family-based clinical and public health efforts to improve diet.

Project description:BackgroundAlthough early intervention is crucial in interrupting the development of eating disorders, little is currently known about help-seeking behaviours among individuals experiencing eating disorder symptoms. Given that eating disorders typically begin early in life, it is necessary to investigate the processes employed by children, adolescents, and emerging adults when seeking services for troubling symptoms. This is a growing concern as the COVID-19 pandemic has resulted in an increase in the number of individuals engaging in disordered eating behaviours. This scoping review explores the current state of the literature for evidence on how youth with eating disorder symptoms seek help, with the aim of better understanding how to identify and treat more individuals earlier.MethodsUsing scoping review methodology, we searched seven databases for studies published from January 2000 to April 2021 that reported on help-seeking attitudes, behaviours, and healthcare utilization patterns for children and adolescents (< 18 years), emerging adults (18-25 years), and a mixture of these groups (< 25 years). Seven thousand, two hundred, and eighteen articles were identified for review. After duplicates were removed, three reviewers independently screened titles and abstracts and reviewed full-text articles. Findings related to help-seeking activity were extracted from the 62 articles that were ultimately included in this scoping review.ResultsStudy findings were summarized into help-seeking patterns (i.e., rates, types) as well as factors ranging from the individual level to society that influenced help-seeking behaviour. Many youth meeting eating disorder criteria were not seeking help. Notable barriers to help-seeking included poor mental health literacy, experiences with healthcare providers who failed to detect and lacked knowledge about eating disorders, minimal support from family and friends, and stigma surrounding eating disorders and help-seeking for mental health concerns.ConclusionsThe results of this scoping review can be used to inform early intervention and health promotion program development. Future research should focus on the help-seeking attitudes and activities among underrepresented groups with eating disorders (e.g., men, ethnic and gender minorities), the perspectives of family and other supporters in the help-seeking process for youth, and retrospective accounts from adults with lived experience of an eating disorder. Plain English summary Addressing and interrupting eating disorder-related thoughts and behaviours as soon as possible, with the help of a mental health professional, leads to better outcomes for youth struggling with an eating disorder. However, little is known about what prompts youth to talk about their weight, body, or eating concerns with someone-like their parent, friend, teacher, guidance counsellor, or primary care practitioner. This review explores the available published research on help-seeking patterns and preferences among youth with eating disorder concerns. Our team followed a standardized process to find 62 relevant articles for this paper. Of note, many young people who reported eating disorder concerns were not seeking help for themselves. Feeling supported by family and their primary care provider, understanding the signs of an eating disorder, and not feeling shame for reaching out for help reportedly led youth to speak up about their concerns. The findings have clinical implications for learning effective ways to help youth feel safe to speak freely about their eating disorder-related concerns, which enhances the chances of intervening early and catching symptoms before they worsen.

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Parent healthful eating attitudes and motivation are prospectively associated with dietary quality among youth with type 1 diabetes.

Publications

Parent healthful eating attitudes and motivation are prospectively associated with dietary quality among youth with type 1 diabetes.

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