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The study purpose was to examine whether adolescents who participated in organized physical activity (PA) programs differed from nonparticipants in motivation, social support, and self-efficacy related to PA; PA (min/hr); and sedentary screen time behavior. Thirty-nine 5th-7th grade adolescents participated in organized PA programs; 41 did not. Approximately 56.3% were Black, and 52.5% had annual family incomes <$20,000. Compared to nonparticipants, those who participated reported significantly higher social support (M = 2.32 vs. 3.13, p < 0.001) and fewer hours watching television or movies on a usual weekend day (M = 2.49 vs. 1.59, p = 0.016); and had higher accelerometer-measured vigorous PA (M = 0.58 vs. 1.04, p = 0.009) and moderate-to-vigorous PA (M = 2.48 vs. 3.45, p = 0.035). Involving adolescents in organized PA programs may be important for improving their moderate-to-vigorous PA, vigorous PA, and related psychosocial factors, as well as reducing sedentary screen time behavior.

Topic: Early‐life experiences, the transmission of health and disease within families, and the influence of cumulative risks as well as protective factors throughout life shape the trajectory of health, including mental health. Long‐term health trajectories established early in life are influenced by biologic, social, and environmental factors. Negative trajectories may be more salient if exposures to adversity occur during critical developmental periods. Purpose: The purpose of this brief is to (a) review pediatric health disparities related to depression and the intergenerational transmission of pediatric depression using a Life Course Health Development (LCHD) model and (b) provide recommendations for pediatric mental health research. Sources: Peer‐reviewed papers available for PubMed, CINAL, and Medline. Other sources include published books, papers, and gray materials. Conclusions: The LCHD model is a perspective to guide and foster new scientific inquiry about the development of mental health outcomes over the life course. The model enables synthesis of mental health, nursing, and public health, linking mental health prevention, risk reduction, and treatment in children. [ABSTRACT FROM AUTHOR]

The study purpose was to examine whether adolescents who participated in organized physical activity (PA) programs differed from nonparticipants in motivation, social support, and self-efficacy related to PA; PA (min/hr); and sedentary screen time behavior. Thirty-nine 5th–7th grade adolescents participated in organized PA programs; 41 did not. Approximately 56.3% were Black, and 52.5% had annual family incomes <$20,000. Compared to nonparticipants, those who participated reported significantly higher social support (M = 2.32 vs. 3.13, p <.001) and fewer hours watching television or movies on a usual weekend day (M = 2.49 vs. 1.59, p =.016); and had higher accelerometer-measured vigorous PA (M = 0.58 vs. 1.04, p =.009) and moderate-to-vigorous PA (M = 2.48 vs. 3.45, p =.035). Involving adolescents in organized PA programs may be important for improving their moderate-to-vigorous PA, vigorous PA, and related psychosocial factors, as well as reducing sedentary screen time behavior. [ABSTRACT FROM AUTHOR]

Purpose: Investigate the associations between psychosocial factors and physical activity. Design: Secondary data analysis utilizing baseline data of a large-scale community-based randomized controlled lifestyle behavior intervention. Setting: The Special Supplemental Program for Women, Infants, and Children in Michigan, USA. Subjects: Low-income overweight or obese mothers with young children (N = 740, 65% response rate). Measures: Survey data were collected via phone interview. Predictors included self-efficacy, autonomous motivation, emotional coping, and social support. Self-reported leisure physical activity was the outcome variable. Covariates were age, race, smoking, employment, education, body mass index, and postpartum status. Analysis: A multiple linear regression model was applied. Results: Self-efficacy (β =.32, 95% CI =.11,.52, P =.003) and autonomous motivation (β =.10, 95% CI =.03,.17, P =.005) were positively associated with physical activity. However, emotional coping and social support were not associated with physical activity. Conclusion: Future research should examine the longitudinal association of key psychosocial factors with physical activity. [ABSTRACT FROM AUTHOR]

Background. Episodic future thinking (EFT) has shown efficacy in laboratory settings. We conducted a pilot goal-oriented EFT (GoEFT) intervention in a real-world setting to help low-income overweight or obese mothers lose weight. This paper presents intervention acceptability and efficacy. Methods. The study used a single-group, before–after design. During the 3-week intervention, participants (N = 15) completed weekly web-based lessons and online health coaching sessions to manage stress and emotion, eat healthier, and be more physically active. Participants completed online surveys at baseline and immediately after the intervention. They also completed an interview to evaluate intervention acceptability. We applied paired t-tests to evaluate efficacy and used content analysis to discover interview themes. Results. Participants consistently identified the intervention as acceptable, noting the usefulness of pre-written goals, GoEFT strategies, and goal progress evaluations. The intervention effectively promoted weight loss (d = −0.69), fruit and vegetable intake (d = 0.45–0.49), and emotion control (d = 0.71). It also reduced fat (d = −0.51) and added sugar intake (d = −0.48) and alleviated stress (d = −0.52). Moreover, the intervention increased autonomous motivation (d = 0.75–0.88) and self-efficacy (d = 0.46–0.61). Conclusion. The GoEFT intervention was acceptable to participants, showing strong preliminary efficacy. [ABSTRACT FROM AUTHOR]

Background: Implementing lifestyle behavior programs in real-world settings challenges researchers. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has implemented and sustained Mothers In Motion (MIM)'s client videos for clients to promote healthy lifestyle behaviors, and train-the-trainer videos, for personnel to enhance motivational interviewing techniques since 2015 and 2016, respectively. This paper describes the implementation processes and the results of client video implementation acceptability by WIC personnel. Methods: To document the implementation process, we applied the Framework for Adaptation and Modifications to Evidence-Based Implementation Strategies (FRAME-IS). To evaluate implementation acceptability, we conducted semi-structured interviews with 15 WIC personnel. A qualitative analysis was conducted to identify the common themes. Results: The facilitators for client video implementation were the inclusion of the target audience and family members addressing daily challenges, easy implementation, and compatibility with daily practice. While videos online facilitated implementation, videos in DVD format could challenge implementation. Conclusions: Future lifestyle intervention programs aimed for future implementation in community settings may consider the inclusion of the target audience and their family members and take into consideration easy implementation and compatibility. [ABSTRACT FROM AUTHOR]

Objective This study explored fast food intake as a potential mediator of the relationships among employment status; stress; depression; and fruit, vegetable, and fat intakes by race (African American vs. Non-Hispanic White) and body mass index (BMI category: overweight vs. obesity). Methods Low-income overweight and obese pregnant women (N = 332) were recruited from the Special Supplemental Nutrition Program for Women, Infants and Children in Michigan. Path analysis was performed to explore mediation effects by race and BMI category. Results Fast food intake mediated the relationship between employment status and fat intake (p = 0.02) in Non-Hispanic White women, but no mediation effect was detected in African American women. For overweight women, fast food intake mediated the relationship between employment status and fat intake (p = 0.04) and the relationship between depression and vegetable intake (p = 0.01). Also, fast food intake partially mediated the relationship between depression and fat intake (p = 0.003). For obese women, fast food intake mediated the relationship between employment status and fat intake (p = 0.04). Conclusion Fast food is an important topic for nutrition education for overweight and obese pregnant women. Future interventions may be more successful if they address issues associated with employment status (e.g., lack of time to plan and cook healthy meals) and depressive mood (e.g., inability to plan meals or shop for groceries when coping with negative emotions)., Author(s): Mei-Wei Chang[sup.1] , Roger Brown[sup.2] , Susan Nitzke[sup.3] Author Affiliations: (1) College of Nursing, Ohio State University, 342 Newton Hall, 1585 Neil Avenue, 43210, Columbus, OHUSA (2) School of [...]

Objective: To examine the influence of personal and environmental factors on healthful weight management behaviors mediated through self-efficacy among low-income obese mothers. Design: Cross-sectional design. Setting: Special Supplemental Nutrition Program for Women, Infants, and Children in Wisconsin. Participants: Two hundred eighty-four obese mothers aged 18-34 years. Main Outcome Measures: Personal factors (e.g., eating low-fat/low-calorie food for weight management), environmental factors, self-efficacy, and weight management behaviors. Data were collected via self-administered written questionnaires. Analysis: Latent class cluster analysis and structural logistic regression. Results: Women who perceived more importance of eating low-fat/low-calorie food for weight management were more likely to practice multiple behavioral strategies to manage their weight (odds ratio = 0.37) than women who perceived less importance of eating low-fat/low-calorie food for weight management. Women who reported higher positive mood self-efficacy were more likely (odds ratio = 1.63) to practice multiple strategies to manage their weight than women who reported lower positive mood self-efficacy. Environmental factors did not predict use of multiple healthful weight management behaviors. No mediation effect was found. Conclusions and Implications: Stressing the importance of food choices and reinforcing learners' self-confidence to make healthful choices at parties and celebrations may be helpful ways to address common barriers to healthful weight management.

Objective: This paper describes the design and findings of a pilot "Mothers In Motion" (P-"MIM") program. Design: A randomized controlled trial that collected data via telephone interviews and finger stick at 3 time points: baseline and 2 and 8 months post-intervention. Setting: Three Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites in southern Michigan. Participants: One hundred and twenty nine overweight and obese African-American and white mothers, 18-34 years old. Intervention: The 10-week, theory-based, culturally sensitive intervention messages were delivered via a series of 5 chapters on a DVD and complemented by 5 peer support group teleconferences. Main Outcome Measures: Dietary fat, fruit, and vegetable intake; physical activity; stress; feelings; body weight; and blood glucose. Analysis: General linear mixed model was applied to assess treatment effects across 2 and 8 months post-intervention. Results: No significant effect sizes were found in primary and secondary outcome variables at 2 and 8 months post-intervention. However, changes in body weight and blood glucose showed apparent trends consistent with the study's hypotheses. Conclusions and Implications: The P-"MIM" showed promise for preventing weight gain in low-income overweight and obese women. However, a larger experimental trial is warranted to determine the effectiveness of this intervention. (Contains 4 tables.)

This study investigated the mediating roles of sleep and depression on the relationships between stress, fat intake, and fruit and vegetable intake among low-income overweight and obese pregnant women by trimesters. Participants (N = 213) completed a self-administered survey including stress (exogenous variable), depression, sleep (mediators), fat intake, and fruit and vegetable intake (endogenous variables). Path analysis was performed to compare mediation effects among pregnant women in each trimester. Consistently across three trimesters, stress was related to depression but not sleep duration, night time sleep disturbance, sleep quality, sleep latency or fat intake. Sleep duration was not associated with depression. Depending on trimester, night time sleep disturbance, sleep quality, and sleep latency were related to depression; night time sleep disturbance and depression affected fat intake; stress influenced fruit and vegetable intake. Sleep duration, sleep disturbance, sleep quality, sleep latency and depression did not mediate the relationships between stress, fat intake, and fruit and vegetable intake in the second and third trimesters. However, depression mediated the relationship between stress and fat intake in the first trimester. Stress management interventions may help low-income overweight and obese pregnant women decrease depressive symptoms and therefore contribute to overall nutritional health., Author(s): Mei-Wei Chang[sup.1] , Roger Brown[sup.2] , Susan Nitzke[sup.3] , Barbara Smith[sup.1] , Kobra Eghtedary[sup.4] Author Affiliations: (1) College of Nursing, Michigan State University, 1355 Bogue Street, RM C346, 48824, [...]

This study was conducted to identify factors that influenced stress, healthy eating and physical activity among low-income overweight or obese pregnant women. We conducted seven focus groups with 96 low-income overweight and obese pregnant women. Common themes were identified from audio tapes and transcripts. Women said that poor communication affected their relationships with spouses or significant others. They were frustrated or upset with significant others for three key reasons: failure to understand or listen to the pregnant women's pregnancy concerns, refusal to be helpful when asked and being overly concerned with the woman's safety. Most women said that they were emotional and took naps throughout the day after becoming pregnant. Many withdrew from their social interactions. They also faced numerous challenges that made healthy eating more difficult, e.g., craving for unhealthy foods and eating foods for comfort. To eat healthier, some reminded themselves to avoid overeating or stop eating in the car. Women were not physically active because of tiredness, lack of motivation, inadequate social support, or bad weather. Some stayed physically active to prevent excessive pregnancy weight gain and have an easier labor. Women equivocally said weighing themselves to manage weight would add to their stress and make them feel more depressed. When designing interventions to help low-income overweight and obese pregnant women avoid excessive pregnancy weight gain, it is important to include information and practical advice on stress management, emphasizing effective communication skills with significant others and helping them plan effective ways to manage negative feelings., Author(s): Mei-Wei Chang[sup.1] , Susan Nitzke[sup.2] , Diana Buist[sup.3] , Deborah Cain[sup.4] , Stefanie Horning[sup.5] , Kobra Eghtedary[sup.6] Author Affiliations: (1) College of Nursing, Michigan State University, 1355 Bogue Street, [...]

In the zwitterionic title compound (systematic name: 4-{[amino(inimio)methyl]amino}benzenesulfonate), C7H9N3O3S, the dihedral angle between the plane of the guanidine grouping and the benzene ring system is 44.87 (7)°. The crystal packing is stabilized by intermolecular N—H...O hydrogen bonds involving all the potential donors.

The title compound, C17H13N3OS, was obtained by the reaction of benzoyl chloride, ammonium thiocyanate and 5-aminoquinoline in the presence of polyethyleneglycol-400 (PEG-400) as a phase-transfer catalyst. The compound crystallized as discrete molecules linked by N—H...N and C—H...N hydrogen bonds involving all the potential donors, generating sheets parallel to (100). An intramolecular N—H...O bond is also present.

Objective: To establish reliability and construct and discriminant validity of selected factors adapted from the Health and Taste Attitudes Questionnaire developed in Finland and the Food Choice Questionnaire developed in England for use with low-income mothers in the United States. Design: Cross-sectional. Setting: Head Start and the Special Supplemental Nutrition Program for Women, Infants and Children sites in south-central Wisconsin. Participants: A convenience sample of 211 nonpregnant non-Hispanic black and white women. Variables Measured: Predisposing, enabling, and reinforcing constructs of the PRECEDE-PROCEED model. Analysis: Factor analyses. Results: After modification, the resulting measurement models of predisposing, enabling, and reinforcing constructs demonstrated good reliability and construct and discriminant validity. These models showed excellent model fit (g2/df range 1.5-2.0, root mean square error of approximate range .05-.07, non-normed fit index range .97-1.0, comparative fit index range .98-1.0, incremental fit index range .98-1.0), with all factor loadings significant (P < .001). Items previously developed with European adults demonstrated different pattern structures in predisposing and enabling constructs but the same structures for reinforcing construct when applied to low-income mothers in the United States. Conclusion and Implication: This modified instrument provides a tool for researchers and educators to further explore factors affecting fat intake behaviors in low-income mothers. KEY WORDS: validity, reliability, low-income women

The title compound, C10H11N4+·Cl−, has been synthesized by the reaction of 8-aminoquinoline and cyanamide. The dihedral angle between the plane of the guanidine group and the quinoline ring system is 68.64 (13)°. The crystal structure is stabilized by intermolecular N—H...Cl hydrogen bonds.

Using data from a community-based lifestyle behavioral intervention study, this secondary data analysis investigated whether emotional coping, coping self-efficacy, and autonomous motivation mediated the association between the intervention and perceived stress in low-income overweight or obese mothers of young children. Results showed that coping self-efficacy significantly mediated the association between the intervention and perceived stress. However, emotional coping and autonomous motivation did not significantly mediate the association between intervention and perceived stress. Interventions may be more effective in helping the target audience reduce stress if they incorporate practical skills that can increase a sense of coping self-efficacy. [ABSTRACT FROM AUTHOR]

Abstract Background Recruitment and retention are key functions for programs promoting nutrition and other lifestyle behavioral changes in low-income populations. This paper describes strategies for recruitment and retention and presents predictors of early (two-month post intervention) and late (eight-month post intervention) dropout (non retention) and overall retention among young, low-income overweight and obese mothers participating in a community-based randomized pilot trial called Mothers In Motion. Methods Low-income overweight and obese African American and white mothers ages 18 to 34 were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in southern Michigan. Participants (n = 129) were randomly assigned to an intervention (n = 64) or control (n = 65) group according to a stratification procedure to equalize representation in two racial groups (African American and white) and three body mass index categories (25.0-29.9 kg/m2, 30.0-34.9 kg/m2, and 35.0-39.9 kg/m2). The 10-week theory-based culturally sensitive intervention focused on healthy eating, physical activity, and stress management messages that were delivered via an interactive DVD and reinforced by five peer-support group teleconferences. Forward stepwise multiple logistic regression was performed to examine whether dietary fat, fruit and vegetable intake behaviors, physical activity, perceived stress, positive and negative affect, depression, and race predicted dropout as data were collected two-month and eight-month after the active intervention phase. Results Trained personnel were successful in recruiting subjects. Increased level of depression was a predictor of early dropout (odds ratio = 1.04; 95% CI = 1.00, 1.08; p = 0.03). Greater stress predicted late dropout (odds ratio = 0.20; 95% CI = 0.00, 0.37; p = 0.01). Dietary fat, fruit, and vegetable intake behaviors, physical activity, positive and negative affect, and race were not associated with either early or late dropout. Less negative affect was a marginal predictor of participant retention (odds ratio = 0.57; 95% CI = 0.31, 1.03; p = 0.06). Conclusion Dropout rates in this study were higher for participants who reported higher levels of depression and stress. Trial registration Current Controlled Trials NCT00944060

Abstract Background The objective of this study was to develop scales measuring personal and environmental factors that affect dietary fat intake behavior, physical activity, and stress management in low-income mothers. Methods FADESM (factors affecting diet, exercise, and stress management) scales were developed using the Social Cognitive Theory to measure personal (outcome expectancies, self-efficacy, emotional coping response) and environmental (physical environment, social environment, situation) factors affecting dietary fat intake behavior, physical activity, and stress management. Low-income African American and white mothers were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in three counties in Michigan. In Phase one, 45 mothers completed individual cognitive interviews. Content analyses were performed. In Phase two, items modified from the cognitive interviews were administered to 216 mothers. Factor analysis and multiple indicators/multiple causes were performed. Results Results of cognitive interviews were used to revise items for the instrument that was tested in Phase two. The factor solution revealed 19 dimensions to measure personal and environmental factors affecting dietary fat intake behavior (three dimensions), physical activity (eight dimensions), and stress management (eight dimensions). Results of multiple indicators/multiple causes model showed scale invariance. Of 19 dimensions, 15 had Cronbach alpha between 0.76 and 0.94 and four were between 0.66 and 0.69. All dimensions had composite construct reliability scores between 0.74 to 0.97 and satisfactory construct and discriminant validities. Conclusion The theory-based FADESM scales have documented good validity and reliability for measuring factors affecting dietary fat intake behavior, physical activity, and stress management in low-income women. Results of this study support the use of these scales with low-income African American and white mothers in community settings.

The article presents an interdisciplinary approach to improving Gestational diabetes mellitus (GDM) using a chronic care–based clinical framework. It discusses that women with GDM are at increased risk for preeclampsia and cesarean delivery, and likely to have recurrence of GDM in subsequent pregnancies.

Objective: Using baseline data from a community-based weight-gain prevention intervention study, the authors examined whether coping self-efficacy moderated the associations between chaotic home environment and psychosocial health (perceived psychosocial stress, depressive symptoms, and positive and negative affect) in low-income women who are overweight or obese. Method: Participants (N = 740; Mage = 28.06 ± 5.12) completed validated self-report measures of coping self-efficacy, chaotic home environment, perceived psychosocial stress, depressive symptoms, and positive and negative affect. Composite indicator structural equation modeling was used to test the moderation effects. Effect size was calculated using proportion of maximum possible (POMP) scores in the endogenous variables per unit change in the exogenous variable. Results: Coping self-efficacy significantly moderated the associations between chaotic home environment and depressive symptoms (p <.001, POMP = −0.62%) and between chaotic home environment and negative affect (p <.01, POMP = −0.36%). However, coping self-efficacy did not moderate the association between chaotic home environment and perceived psychosocial stress or positive affect. Conclusions: This study suggests that coping self-efficacy could explain some individual differences in responses to home chaos or to interventions aimed at alleviating depressive symptoms and negative affect in low-income women who are overweight or obese and who experience chaos at home. [ABSTRACT FROM AUTHOR]

Objective: To identify demographic risk factors associated with high stress and examine the relationships between levels of stress, demographics and dietary fat, fruit and vegetable intakes in low-income pregnant women with overweight or obesity.Design: A cross-sectional study.Setting: Participants were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan, USA.ParticipantsParticipants (n 353) were non-Hispanic Black (black) or White (white).Results: Women aged 35 years or older (OR=4·09; 95% CI 1·45, 11·51) and who had high school or less education (OR=1·88; 95% CI 1·22, 2·89) or were unemployed (OR=1·89; 95% CI 1·15, 3·12) were significantly more likely to report high stress than women who were younger, had at least some college education or were employed/homemakers. However, race and smoking status were not associated with level of stress. Women with high stress reported significantly lower fruit and vegetable intakes but not fat intake than women with low stress. Women aged 35 years or older reported significantly higher vegetable but not fat or fruit intake than women who were 18-24 years old. Black women reported significantly higher fat but not fruit or vegetable intake than white women. Education, employment and smoking status were not significantly associated with dietary intake of fat, fruits and vegetables.Conclusions: Nutrition counselling on reducing fat and increasing fruit and vegetable intakes may consider targeting women who are black or younger or who report high stress, respectively. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of a community-based lifestyle behavioral intervention on intakes of fat, fruits, vegetables, fast foods, and beverages in low-income young mothers with overweight or obesity.Methods: Participants were randomly assigned to an intervention (watching video lessons at home plus peer support group teleconferences) or a comparison group. General linear mixed model analyses were utilized to determine mean differences between the groups (212 intervention, 126 comparison) immediately following and 3 months (196 intervention, 115 comparison) after the intervention.Results: Immediately after the intervention, the intervention group had significantly lower mean scores in intakes of fat (effect size [d] = 0.24), fast foods (d = 0.33), and non-sugar-sweetened beverages (d = 0.27) than the comparison group. No significant group differences were observed for intakes of fruits, vegetables, or sugar-sweetened beverages. Three months after the intervention, no significant group differences were observed for intakes of fat, fruits, vegetables, fast foods, and both sugar- and non-sugar-sweetened beverages.Conclusions: The intervention group improved dietary intakes of fat and fast foods but not fruits, vegetables, or beverages over the short term. Our intervention had no long-term effect on dietary intake behaviors. [ABSTRACT FROM AUTHOR]

Background: Mothers In Motion (MIM), a community-based lifestyle behavioral intervention, was designed and conducted to help low-income overweight and obese young mothers prevent further weight gain via promotion of stress management, healthy eating, and physical activity. This paper presents intervention effect on body weight (primary outcome) and summarizes lessons learned.Methods: Participants (N = 612) were recruited from 7 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) offices in Michigan and were individually randomized to an intervention n= 410) or a comparison (n =202) group (2: 1 ratio). During the 16-week intervention, intervention participants watched theory-based culturally sensitive videos (in DVD format) featuring peers from the target audience to learn skills for managing stress, eating healthier, and being more physically active. They also dialed into peer support group teleconferences to enhance skills learned in the videos and increase motivation for lifestyle behavioral changes. Body weight, the primary outcome, was measured at baseline, immediately after the 16-week intervention, and 3 months after the 16-week intervention. Intervention effect was tested via general linear mixed model for repeated measures, using baseline measures as adjusting covariates.Results: At baseline, the mean age of the participants was 28.5 ± 5.0 years (intervention: 28.4 ± 5.0, comparison: 28.9 ± 5.0); the mean body weight was 190.2 ± 1.4 lbs (intervention: 191.8 ± 30.0, comparison: 188.5 ± 29.1); and the mean body mass index (BMI) was 32.2 ± 4.4 (intervention: 32.2 ± 4.4, comparison: 31.7 ± 4.2). Of sample, 64.7% were obese. At 3 months after the 16-week intervention, no significant weight differences were found between the intervention (188.3 ± 10.6 lbs, BMI: 31.6 ± 1.8) and comparison groups (187.7 ± 10.6 lbs, BMI: 31.53 ± 1.8) when controlling for baseline body weight.Conclusions: This lifestyle behavioral intervention that focused on stress management, healthy eating and physical activity was not effective in helping low-income overweight and obese young mothers prevent further weight gain.Trial Registration: Clinical Trials NCT01839708 . This trial was registered retrospectively on February 28, 2013. [ABSTRACT FROM AUTHOR]

The Diet Habit Questionnaire (DHQ) developed by Kristal et al has been widely used to measure fat intake behaviors. Our prior work revealed the poor psychometric properties of the DHQ when used with young low-income women. The purpose of this study was to understand young low-income mothers' comprehension of the instrument. Data were collected via face-to-face cognitive interviews. Thirty black and white participants of WIC (the Special Supplemental Nutrition Program for Women, Infants, and Children) aged 18 to 45 years were recruited in 6 counties in southern Wisconsin. Three common themes emerged: lack of clarity, inappropriate assumptions, and vague response categories. WIC participants indicated that many questions were confusing because they contained complicated syntax or technical terms that were unclear. Furthermore, there were multiple interpretations to some questions. The original instrument required subjects to think about the same kind of foods between anchoring questions and embedded items. However, subjects in this study interpreted foods listed on the anchoring questions differently from the foods listed on the embedded items. There were also numerous interpretations of response categories. Our results suggest that cognitive interview is a useful technique for instrument development and there is a need to revise the DHQ to better assess the fat intake behaviors of the WIC participants. This study was supported by UW-Madison School of Nursing and Department of Nutritional Sciences.

The Diet Habit Questionnaire (DHQ) was developed to measure 5 dimensions of fat intake behaviors: substitution of specially manufactured low-fat foods, modification of meat, avoiding fried foods, replacing high-fat foods with fruits and vegetables, and avoiding fat as spread or flavoring. The purpose of this study was to test the psychometric properties of the DHQ in young low-income mothers. Data were collected via self-administered Block Food Frequency Questionnaire and the DHQ. Nonpregnant African American and white women (N = 113) aged 18 to 45 years were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in 6 counties in southern Wisconsin. Data analyses were based on 85 subjects because we excluded women who reported daily caloric intake of less than 600 or greater than 3500. Results revealed that the DHQ has poor psychometric properties when used in WIC mothers: substitution of specially manufactured low-fat foods (r = .21, A = .76), modification of meat (r = .24, A = .57), avoiding fried foods (r = .43, A = .75), replacing high-fat foods with fruits and vegetables (r = .27, A = .61), avoiding fat as spread or flavoring (r = -.04, A = .43), and summary scores (r = .38, A = .84). The DHQ should be modified to provide more reliable data in planning and evaluating health promotion and disease prevention programs for this population. This study was supported by UW-Madison School of Nursing and Department of Nutritional Sciences.

Limited research has examined factors associated with home food availability. This study investigated the associations among demographics, body mass index category, stress, and home food availability among low-income overweight or obese pregnant women. This cross-sectional study enrolled 332 participants who were non-Hispanic black or white. We performed logistic regression modeling for unprocessed food, processed food, overall ultra-processed food, and three subcategories of ultra-processed food (salty snacks, sweet snacks and candies, and soda). Black women were less likely than white women to have large amounts of processed foods (OR = 0.56), salty snacks (OR = 0.61), and soda (OR = 0.49) available at home. Women with at least some college education or at least a college education were more likely to have large amounts of unprocessed food (OR = 2.58, OR = 4.38 respectively) but less likely to have large amounts of soda (OR = 0.44; OR = 0.22 respectively) available at home than their counterparts. Women with higher stress were less likely to have large amounts of unprocessed food available at home (OR = 0.58) than those with lower stress. Home food availability varied by race, education, and levels of stress in low-income overweight or obese pregnant women. [ABSTRACT FROM AUTHOR]

This study examined consumption proportions and factors associated with sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and 100% fruit juice (FJ) consumption. We recruited Non-Hispanic Black (n = 136) and White (n = 192) low-income overweight or obese pregnant women aged 18 to 46 years (mean = 25.7 years) from the Special Supplemental Nutrition Program for Women, Infants, and Children clinics in Michigan, USA. Independent variables included weight status, trimester, smoking, stress, education, employment, race, and age. Dependent variables were high (consuming ≥ 1 serving/day) versus low consumptions of SSB, ASB, and 100% FJ. Multivariate logistic regression modeling was performed to examine factors associated with beverage consumption. Out of the sample, 48.2%, 6.7%, and 31.3% reported high SSB, ASB, and 100% FJ consumption, respectively. SSB consumption was associated with smoking (OR: 3.77, p < 0.001), education (OR: 0.57, p = 0.03), and race (OR: 1.69, p = 0.03). Artificially sweetened beverage consumption was not associated with any factors examined. One hundred percent FJ consumption was associated with stress (OR: 0.90, p = 0.03) and race (OR: 4.48, p < 0.001). Clinicians may advocate for reductions in SSB and 100% FJ consumption tailored to client consumption characteristics. [ABSTRACT FROM AUTHOR]

This secondary analysis study addressed a gap of knowledge: whether perceived stress reduction created by a lifestyle intervention might serve as a mediator for reducing fat and fast food intakes in low-income overweight or obese mothers of young children. This analysis included 338 low-income overweight or obese mothers of young children who completed a phone interview immediately after the 16-week lifestyle intervention. Valid surveys were used to assess perceived stress and fat and fast food intakes. Composite indicator structural equation modeling was performed to test the mediation effects. The overall effect of the intervention was not significant for fat intake but was significant for fast food intake (B = −0.53, p < 0.05). When assessing the potential role of perceived stress as a mediator, the indirect effects of the intervention on fat (B = −0.39, p < 0.01) and fast food (B = −0.27, p < 0.01) intakes were both significant. Future dietary intervention studies aimed to reduce fat and fast food intakes in low-income overweight or obese mothers of young children might consider including practical strategies aimed at reducing perceived stress. [ABSTRACT FROM AUTHOR]

Background: Over 45% of American women 20-39 years old are at risk for type 2 diabetes, cardiovascular disease, and other health conditions because they are overweight or obese. The prevalence of overweight and obesity is disproportionately high among low-income women. This paper describes the study design and rationale of a community based intervention (Mothers In Motion, MIM) aimed to prevent weight gain among low-income overweight and obese mothers 18-39 years old by promoting stress management, healthy eating, and physical activity.Methods/design: Peer recruiters approach participants from 5 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Michigan. The MIM delivers theory-based, culturally-sensitive intervention messages via a combination of DVDs and peer support group teleconferences (PSGTs). The DVD features African American and white overweight and obese WIC mothers who participated in a healthy lifestyle intervention patterned after MIM. The PSGTs are led by paraprofessionals from Michigan State University Extension and WIC providers in Michigan who are trained in motivational interviewing and group facilitation skills. Participants are randomly assigned to an intervention (n=350) or comparison group (n=175). The intervention group receives a 16-week intervention on a weekly or bi-weekly basis. Participants are asked to watch 10 MIM DVD chapters at home and join 10 PSGT sessions by phone. The comparison group receives printed educational materials. The primary outcome is body weight. Secondary outcomes include dietary fat, fruit, and vegetable intake; physical activity; stress, and affect. Mediators are self-efficacy, emotional coping response, social support, and autonomous motivation. Telephone interviews and in-person data collection at WIC offices occur at 3 time points: baseline, immediately, and 3 months after the 16-week intervention.Discussion: If MIM shows effectiveness, it could have a favorable impact on public health and community programs. The DVDs and PSGTs will be disseminated in WIC, Extension, clinical practice that promote healthy lifestyles for similar target audiences to make a broad contribution to the prevention of weight gain in low-income mothers. Also, our methodology can be adapted by researchers and community stakeholders to help other low-income populations prevent weight gain.Trial Registration: Clinical Trials Number: NCT01839708. [ABSTRACT FROM AUTHOR]

Sugar-sweetened beverage (SSB) consumption is strongly associated with obesity. Autonomous motivation and self-efficacy, key concepts of self-determination theory, may influence SSB consumption. Low-income mothers of young children experience disproportionate rates of obesity. Whether autonomous motivation and self-efficacy are associated with SSB consumption in low-income mothers of young children is unknown. This exploratory secondary data analysis explored whether autonomous motivation or self-efficacy were associated with SBB consumption using data from a lifestyle intervention for low-income, overweight or obese mothers with young children. Participants (N = 311) completed surveys assessing autonomous motivation, self-efficacy, and SSB consumption at baseline, after the 16-week intervention, and at 3-month follow-up. Using baseline data, we performed linear regression models to explore associations of self-efficacy and autonomous motivation with SSB consumption. We also performed mixed effects models to explore whether autonomous motivation or self-efficacy were associated with SSB consumption over time. At baseline, a one-point increase in autonomous motivation and self-efficacy were associated with 4.36 (p < 0.001) and 6.43 (p = 0.025) fewer ounces of SSB consumption per day, respectively. In longitudinal models, SSB consumption decreased over time. Change in SSB consumption was associated with self-efficacy (B = -4.88; p = 0.015) and autonomous motivation (B = -2.29; p = 0.008). Our findings suggest self-efficacy and autonomous motivation may influence SSB consumption among mothers of young children with overweight and obesity. Further investigation should explore if self-efficacy and autonomous motivation have long-term effects on SSB consumption., (© 2024 The Author(s). Research in Nursing & Health published by Wiley Periodicals LLC.)

Background: Dietary intake of micronutrients and essential fatty acids in overweight or obese pregnant women during early pregnancy is unknown. We investigated the proportion of pregnant women meeting recommendations for dietary intake of micronutrients and essential fatty acids and compared stress and depressive symptoms between those meeting and below recommendations., Methods: Participants (N = 70) were overweight or obese pregnant women ≤16 weeks gestation. They completed two 24-hour dietary recalls and online surveys measuring stress and depressive symptoms. Micronutrients of interest included B vitamins, choline, and trace minerals (calcium, magnesium, selenium, and zinc). Essential fatty acids were docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)., Results: Low proportions of participants met recommendations for choline (21.4%) and folate (24.3%). Yet, the proportion of women meeting recommendations for other B vitamins and trace minerals were much better. Less than 9.0% of participants met recommendations for essential fatty acids. Compared with those below recommendations for B3 and selenium, participants meeting recommendations had significantly fewer depressive symptoms., Conclusions: Low proportions of overweight or obese pregnant participants met dietary intake recommendations for micronutrients and essential fatty acids., Competing Interests: Conflicts of Interest The authors declare no conflict of interest. The sponsor has no role in the design, execution, interpretation, or writing of the study.

Introduction: This paper presents a pilot lifestyle behavior intervention effect on gestational weight gain and maternal and neonatal outcomes and intervention acceptability., Materials and Methods: Overweight or obese pregnant participants (N = 70) were randomized to the intervention or usual care group. The 20-week intervention integrated Hope theory and goal-oriented episodic future thinking (GoEFT) to prevent excessive gestational weight gain through stress and emotion management, healthy eating, and physical activity. Intervention participants completed a weekly web intervention module with 2 parts (I and II) and joined individual health coaching sessions (10 sessions). The primary outcome was gestational weight gain (GWG). Secondary outcomes included maternal and neonatal outcomes. Data were collected at 3 time points: baseline (< 17 weeks gestation, T1), 24-27 weeks gestation (T2), and 35-37 weeks gestation (T3). Intervention participants completed a semi-structured interview to evaluate the intervention. We compared GWG at T2 and T3 with T1 for intervention and usual care groups using t-tests and conducted content analysis to identify common themes for intervention acceptability., Results: There were no significant group differences in GWG at T2 and T3. Maternal and neonatal outcomes were similar between groups. Common themes for intervention acceptability were disked web Part I intervention presented in text, the need for choosing a weekly intervention topic, raising awareness through GoEFT and self-evaluation, increased motivation through GoEFT, and usefulness of pre-written goals and goal progress evaluation., Conclusions: Results of process evaluation are helpful for researchers to design a lifestyle intervention to prevent excessive gestational weight gain., Competing Interests: Conflicts of Interest The authors declare no conflict of interest. The sponsor has no role in the design, execution, interpretation, or writing of the study.

Background: This paper presents results of a pilot intervention effect on lifestyle behaviors, psychosocial factors, and affect among overweight or obese pregnant women., Methods: 70 participants were randomized to the intervention or usual care group. During the 20-week intervention, participants completed a weekly online intervention module and joined individual online health coaching. Data were collected at baseline (<17 weeks gestation), 24-27 weeks gestation (T2), and 35-37 weeks gestation (T3). Lifestyle behaviors included dietary intake (caloric, fat, added sugar, fruit, and vegetable) and physical activity (PA). Psychosocial factors were autonomous motivation, self-efficacy, executive functions, and consideration of future consequences (CFC). Affect comprised stress and emotional control. Two-sample t -tests and Cohen's d effect sizes were used to compare between group mean differences in the change from baseline to T2 and T3., Results: At T2, intervention positively influenced fruit intake ( d = 0.47), autonomous motivation for healthy eating ( d = 0.36), self-efficacy for healthy eating ( d = 0.25) and PA ( d = 0.24), executive functions (behavior regulation, d = -0.21; metacognition, d = -0.69), and emotional control ( d = 0.79). At T3, the intervention improved PA ( d = 0.19), autonomous motivation for healthy eating ( d = 0.33), self-efficacy for healthy eating ( d = 0.50) and stress management ( d = 0.62), executive functions (metacognition, d = -0.46), CFC ( d = 0.25), stress ( d = -0.45), and emotional control ( d = 0.72)., Conclusion: The pilot intervention has positive effects on most psychosocial variables and affect in both the short and long terms., Competing Interests: Conflicts of Interest The authors declare no conflict of interest. The sponsor has no role in the design, execution, interpretation, or writing of the study.

Background: The study explored potential mediation by executive functions (behavioral regulation index [BRI] and metacognition index [MI]) in association between perceived stress, prenatal distress, emotional control, and dietary intake (total calorie, total fat, added sugar, fruits, and vegetables)., Methods: 70 overweight or obese pregnant women completed validated online surveys and two 24-hour dietary recalls. Path analyses were performed., Results: Increased perceived stress was associated with increased BRI both directly (p < 0.001) and indirectly through increased MI (perceived stress to MI: p < 0.001, MI to BRI: p < 0.001). Subsequently, increased BRI was associated with increased total fat intake (p = 0.01). Two-stage mediation was found in the association of prenatal distress with total fat intake. Increased prenatal distress was associated with increased MI (p < 0.001). Higher MI was associated with higher BRI (p < 0.001), and higher BRI was associated with increased total fat intake (p = 0.01)., Conclusions: Future intervention studies for overweight or obese pregnant women might focus on stress management to alleviate perceived stress and prenatal distress or on strategies to boost executive functions, each of which might ultimately help to reduce total fat intake., Competing Interests: 9.Conflicts of Interest The authors declare no conflict of interest. The sponsor has no role in the design, execution, interpretation, or writing of the study.

Background: Depressive symptoms are particularly prevalent among low-income overweight or obese mothers with young children, indicating the importance of understanding and addressing this serious health condition. Although lifestyle behavior interventions are promising for alleviating depressive symptoms in low-income overweight or obese mothers with young children, mechanisms underlying the association between these interventions and depressive symptoms in this priority population remain unknown., Objective: A secondary analysis of data from a randomized controlled trial that tested a 16-week community-based lifestyle behavior intervention for low-income overweight or obese mothers with young children was conducted to examine whether autonomous motivation, coping self-efficacy, and emotional coping mediated the association between the intervention and depressive symptoms., Methods: The analysis included 338 participants who completed data collection at baseline and immediately after the intervention. Participants responded to validated surveys measuring autonomous motivation, coping self-efficacy, emotional coping, and depressive symptoms. To test mediation effects, composite indicator structural equation modeling was performed adjusting for baseline measures. The proportion of maximum possible (POMP) scores in the outcome variable per unit change in the predictor variables was used to calculate effect size., Results: The intervention alleviated depressive symptoms ( B = -2.42, p = 0.015, POMP = -4.31%), and coping self-efficacy negatively and fully mediated the association between the intervention and depressive symptoms ( B = -1.42, p = 0.002, POMP = -2.53%). Autonomous motivation and emotional coping were not significant mediators., Conclusions: Interventions aimed to alleviate depressive symptoms in low-income overweight or obese mothers with young children should include strategies to improve coping self-efficacy. However, continued research is needed to identify other mechanisms that may be contributing to the effect of lifestyle behavior interventions on depressive symptoms in this at-risk group. This information can then be used to simplify and strengthen the interventions and potentially lead to effective dissemination and implementation., Competing Interests: Author Disclosure Statement The authors declare no conflicts of interest.