Physical activity has been highlighted internationally as a beneficial intervention for weight co... more Physical activity has been highlighted internationally as a beneficial intervention for weight control and the improvement of physical and mental health. This review highlights findings from recent literature to guide office-based promotion of physical activity for obesity treatment and prevention. Children worldwide participate in far less than the current physical activity recommendations. Family-based activity provides children with positive role modeling as well as motivational support for maintaining an active lifestyle. The integration of physical activity into daily life can be an effective alternative to sports and structured exercise programs. Decreasing sedentary behaviors is also a positive contribution, although its link to physical activity levels is still unclear. Some families may see neighborhood safety and access to recreational facilities as barriers to keeping their children physically active. Research in the field of pediatric obesity and overweight treatment and prevention continues to find challenges and solutions. Promotion of physical activity by the pediatric provider is demonstrated by current evidence to be a positive intervention against this global problem.
Associations between household social needs, acculturation, and emotional health remain understud... more Associations between household social needs, acculturation, and emotional health remain understudied, particularly among Latinx mothers. We analyzed baseline survey data from 455 Latinx mothers in a previous study. Using multinomial regression, we examined whether emotional problems and perceived stress were associated with household social needs and acculturation. Almost half the sample reported four or more household social needs. Social needs cumulatively and independently predicted increased odds of frequent emotional problems or perceived stress. Lower acculturation predicted lower odds of frequent emotional problems. There is increased risk for emotional problems and stress in low-income Latinx mothers who experience high social need. Integrated social service and mental health care models may be one way to improve health outcomes. More research is needed to understand how clinical settings can leverage unique cultural protective factors to address the social and emotional hea...
Supplemental material, sj-pdf-2-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-2-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-1-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-1-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-7-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-7-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-4-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-4-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-5-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-5-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-3-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-3-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-6-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-6-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Informal caregivers are increasingly performing medical/nursing tasks in the home for adult care ... more Informal caregivers are increasingly performing medical/nursing tasks in the home for adult care recipients, often without adequate support. In the current study, using data from the Caregiving in the U.S. 2015 survey (N = 1,248), we examined associations between performing medical/nursing tasks and caregiver well-being (e.g., physical strain, emotional stress, burden of care). Overall, 58% of caregivers performed medical/nursing tasks. Compared to those who did not, those performing tasks had higher risk of emotional stress, physical strain, and high burden of care. Among task performers, difficulty performing tasks was associated with higher risk of all outcomes; having no choice in caregiving was independently associated with higher risk of emotional stress and physical strain. Caregivers performing medical/nursing tasks, particularly those who find tasks difficult, are at risk for adverse outcomes. New clinical approaches are needed to ensure meaningful conversations about caregivers' willingness, availability, and ability to perform medical/nursing tasks and to provide support for this part of the caregiving role. [Journal of Gerontological Nursing, 46(9), 25-35.].
The study evaluated an educational intervention with family child care home (FCCH) providers to i... more The study evaluated an educational intervention with family child care home (FCCH) providers to implement nutrition standards. A convenience sample of licensed California FCCH providers (n = 30) attended a 2-hour, in-person group training in English or Spanish on nutrition standards for infants and children aged 1 to 5 years. Provider surveys and researcher observations during meals/snacks were conducted pre- and 3 months post-intervention. Providers rated the training as excellent (average score of 4.9 on a scale of 1-5). Adherence, assessed by survey and observation and compared over time using paired t-tests, increased from an average of 36% pre-intervention to 44% post-intervention ( P = .06) of providers (n = 12) for infant standards and from 59% to 68% ( P
Physical activity has been highlighted internationally as a beneficial intervention for weight co... more Physical activity has been highlighted internationally as a beneficial intervention for weight control and the improvement of physical and mental health. This review highlights findings from recent literature to guide office-based promotion of physical activity for obesity treatment and prevention. Children worldwide participate in far less than the current physical activity recommendations. Family-based activity provides children with positive role modeling as well as motivational support for maintaining an active lifestyle. The integration of physical activity into daily life can be an effective alternative to sports and structured exercise programs. Decreasing sedentary behaviors is also a positive contribution, although its link to physical activity levels is still unclear. Some families may see neighborhood safety and access to recreational facilities as barriers to keeping their children physically active. Research in the field of pediatric obesity and overweight treatment and prevention continues to find challenges and solutions. Promotion of physical activity by the pediatric provider is demonstrated by current evidence to be a positive intervention against this global problem.
Associations between household social needs, acculturation, and emotional health remain understud... more Associations between household social needs, acculturation, and emotional health remain understudied, particularly among Latinx mothers. We analyzed baseline survey data from 455 Latinx mothers in a previous study. Using multinomial regression, we examined whether emotional problems and perceived stress were associated with household social needs and acculturation. Almost half the sample reported four or more household social needs. Social needs cumulatively and independently predicted increased odds of frequent emotional problems or perceived stress. Lower acculturation predicted lower odds of frequent emotional problems. There is increased risk for emotional problems and stress in low-income Latinx mothers who experience high social need. Integrated social service and mental health care models may be one way to improve health outcomes. More research is needed to understand how clinical settings can leverage unique cultural protective factors to address the social and emotional hea...
Supplemental material, sj-pdf-2-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-2-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-1-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-1-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-7-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-7-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-4-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-4-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-5-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-5-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-3-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-3-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Supplemental material, sj-pdf-6-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants ... more Supplemental material, sj-pdf-6-gph-10.1177_2333794X21989555 for Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers by Lorrene D. Ritchie, Victoria Keeton, Danielle L. Lee, Klara Gurzo, Elyse Homel Vitale, Lauren E. Au and Abbey Alkon in Global Pediatric Health
Informal caregivers are increasingly performing medical/nursing tasks in the home for adult care ... more Informal caregivers are increasingly performing medical/nursing tasks in the home for adult care recipients, often without adequate support. In the current study, using data from the Caregiving in the U.S. 2015 survey (N = 1,248), we examined associations between performing medical/nursing tasks and caregiver well-being (e.g., physical strain, emotional stress, burden of care). Overall, 58% of caregivers performed medical/nursing tasks. Compared to those who did not, those performing tasks had higher risk of emotional stress, physical strain, and high burden of care. Among task performers, difficulty performing tasks was associated with higher risk of all outcomes; having no choice in caregiving was independently associated with higher risk of emotional stress and physical strain. Caregivers performing medical/nursing tasks, particularly those who find tasks difficult, are at risk for adverse outcomes. New clinical approaches are needed to ensure meaningful conversations about caregivers' willingness, availability, and ability to perform medical/nursing tasks and to provide support for this part of the caregiving role. [Journal of Gerontological Nursing, 46(9), 25-35.].
The study evaluated an educational intervention with family child care home (FCCH) providers to i... more The study evaluated an educational intervention with family child care home (FCCH) providers to implement nutrition standards. A convenience sample of licensed California FCCH providers (n = 30) attended a 2-hour, in-person group training in English or Spanish on nutrition standards for infants and children aged 1 to 5 years. Provider surveys and researcher observations during meals/snacks were conducted pre- and 3 months post-intervention. Providers rated the training as excellent (average score of 4.9 on a scale of 1-5). Adherence, assessed by survey and observation and compared over time using paired t-tests, increased from an average of 36% pre-intervention to 44% post-intervention ( P = .06) of providers (n = 12) for infant standards and from 59% to 68% ( P
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