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ObjectiveThe purpose of this study is to evaluate whether children with overweight or obesity participating in an evidence-based treatment, family-based behavioral treatment (FBT) for obesity, or a parent-only variant of FBT (PBT), experience an increase of eating disorder (ED) symptoms during and following treatment.MethodChildren (N = 150) participating in a randomized controlled trial of FBT or PBT completed measures of EDs attitudes and behaviors at baseline, following 6-months of treatment, 6 months, and 18 months after treatment.ResultsLinear-mixed effects models suggest that ED attitudes did not significantly increase. Rather, significant decreases of shape, weight, and eating concerns were shown following treatment. Loss of control over eating significantly decreased over treatment and follow-up. No participant endorsed purging at any time point.DiscussionResults confirm the hypothesis that ED symptoms do not increase after participating in FBT or a FBT-based treatment. These findings should help assuage fears of parents that enrolling their child will exacerbate ED symptoms and aid children to access evidence-based treatments that may help reduce significant physical and psychosocial complications of childhood obesity.

People with prediabetes are at risk for type 2 diabetes. They may discount the future delay discounting (DD), and not engage in preventive health behaviors. Episodic future thinking (EFT) can reduce DD when future scenarios are cued, but research is needed to assess long-term effects of EFT and when EFT is not cued. This study tested EFT training compared to control for people with prediabetes enrolled in a 6-month weight loss program on DD, weight, HbA1c, and physical activity. Results showed a reliable EFT effect on reducing DD in cued (p = 0.0035), and uncued DD tasks (p = 0.048), and significant overall changes in weight (p < 0.001), HbA1c (p, 0.001) and physical activity (p = 0.003), but no significant differences in these outcomes by group (p's > 0.05). Sixty-eight percent of the sample ended below the prediabetes HbA1c range. These results suggest that DD can be modified over extended periods, and the effects of EFT can be observed without EFT cues. However, these data do not suggest that changes in weight, HbA1c or physical activity were due to EFT training. The study was initiated before the COVID-19 pandemic which provided the opportunity to compare differences for people treated in-person or remotely. Analyses showed no differences in DD, weight, HBA1c or physical activity outcomes were observed between in-person and remote treatment, suggesting telehealth is a scalable approach to treating prediabetes., Author(s): Leonard H. Epstein [sup.1] , Rocco A. Paluch [sup.1] , Mathew J. Biondolillo [sup.1] , Jeff S. Stein [sup.2] , Teresa Quattrin [sup.1] , Lucy D. Mastrandrea [sup.1] , [...]

ImportanceFamily-based weight loss treatment (FBT) is considered the gold-standard treatment for childhood obesity and is provided to the parent and child. However, parent-based treatment (PBT), which is provided to the parent without the child, could be similarly effective and easier to disseminate.ObjectiveTo determine whether PBT is similarly effective as FBT on child weight loss over 24 months. Secondary aims evaluated the effect of these 2 treatments on parent weight loss, child and parent dietary intake, child and parent physical activity, parenting style, and parent feeding behaviors.Design, setting, and participantsRandomized 2-arm noninferiority trial conducted at an academic medical center, University of California, San Diego, between July 2011 and July 2015. Participants included 150 overweight and obese 8- to 12-year-old children and their parents.InterventionsBoth PBT and FBT were delivered in 20 one-hour group meetings with 30-minute individualized behavioral coaching sessions over 6 months. Treatments were similar in content; the only difference was the attendance of the child.Main outcomes and measuresThe primary outcome measure was child weight loss (body mass index [BMI] and BMI z score) at 6, 12, and 18 months post treatment. Secondary outcomes were parent weight loss (BMI), child and parent energy intake, child and parent physical activity (moderate to vigorous physical activity minutes), parenting style, and parent feeding behaviors.ResultsOne hundred fifty children (mean BMI, 26.4; mean BMI z score, 2.0; mean age, 10.4 years; 66.4% girls) and their parent (mean BMI, 31.9; mean age, 42.9 years; 87.3% women; and 31% Hispanic, 49% non-Hispanic white, and 20% other race/ethnicity) were randomly assigned to either FBT or PBT. Child weight loss after 6 months was -0.25 BMI z scores in both PBT and FBT. Intention-to-treat analysis using mixed linear models showed that PBT was noninferior to FBT on all outcomes at 6-, 12-, and 18-month follow-up with a mean difference in child weight loss of 0.001 (95% CI, -0.06 to 0.06).Conclusions and relevanceParent-based treatment was as effective on child weight loss and several secondary outcomes (parent weight loss, parent and child energy intake, and parent and child physical activity). Parent-based treatment is a viable model to provide weight loss treatment to children.Trial registrationClinicaltrials.gov Identifier: NCT01197443.

The present study sought to determine if episodic future thinking (EFT) can decrease delay discounting (DD) and demand for fast food under simulations of economic scarcity in adults at risk for diabetes (i.e., overweight/obese and with hemoglobin A1c values in, or approaching, the prediabetic range). Across two sessions, participants completed assessments of DD and food demand at baseline and while prompted to: (1) engage in either EFT or control episodic recent thinking, and (2) while reading a brief narrative describing either economic scarcity or neutral income conditions. Results showed that EFT significantly reduced DD, whereas the economic scarcity narrative significantly increased DD; no significant interaction between EFT and scarcity was observed. No significant effect of either EFT or scarcity was observed on food demand. We conclude that EFT decreases DD even when challenged by simulated economic scarcity in adults at risk for diabetes. The absence of a significant interaction between EFT and scarcity suggests that these variables operate independently to influence DD in opposing directions. Effects of EFT and economic scarcity on food demand require further study. The present study was registered on clinicaltrials.gov (NCT03664726)., Author(s): Jeffrey S. Stein [sup.1] , William H. Craft [sup.1] , Rocco A. Paluch [sup.2] , Kirstin M. Gatchalian [sup.1] , Mark H. Greenawald [sup.3] , Teresa Quattrin [sup.2] , [...]

In their recent Viewpoint article, Beidas et al. (2023) argue that researchers should test psychosocial interventions in the contexts in which they are meant to be delivered and that they can accelerate the deployment of these interventions by advancing directly from pilot trials to effectiveness and implementation studies without conducting efficacy trials. In this commentary, we argue that this is a well-intended but problematic approach and that there is a more productive strategy for translational behavioral intervention research. The commentary discusses issues concerning intervention development, refinement, and optimization; pilot and efficacy testing of interventions; the contexts in which interventions are delivered; clinical practice guidelines; and quick versus programmatic answers to significant clinical research questions. Testing psychosocial interventions in the contexts in which they are meant to be delivered is a complex task for interventions that are designed to be used in a wide variety of contexts. Nevertheless, interventions can be tested in the contexts in which they are meant to be delivered without sacrificing programmatic intervention development or safety and efficacy testing. What is the public health significance of this article?: Safe and effective psychosocial interventions are needed for a wide variety of clinical or public health problems. The best way for researchers to meet these needs is to conduct studies to ensure that their interventions are safe and effective before deploying them in public health or clinical service settings. [ABSTRACT FROM AUTHOR]

Background: To examine whether different dimensions of parenting at different ages help small-for-gestational-age (SGA) children "catch-up" the normal children in cognition and psychomotor. Methods: We analyzed data of 800 children born SGA and 3,000 children born appropriate-for-gestational-age (AGA) from the Early Childhood Longitudinal Study-Birth cohort. The Two Bag Task was used to measure 2-year or 4-year parenting dimensions. Children's reading, math, gross motor, and fine motor scores were assessed at 5 years. Multivariable linear regression models were fitted to test the interactions between SGA and 2-year or 4-year parenting dimensions on 5-year cognitive and psychomotor outcomes (dependent variables). Results: There were significant interactions between SGA and early parenting on 5-year reading, math, and fine motor scores. The gap between SGA and AGA children in 5-year fine motor score was attenuated to null [-0.25 (95% confidence interval, -0.41, -0.09) vs. 0.03 (-0.13, 0.20)] when 2-year parental sensitivity score increased from 1 standard deviation (SD) below mean (Mean - SD) to 1 SD above mean (Mean + SD). The gap between SGA and AGA children in 5-year fine motor [-0.28 (-0.44, -0.13) vs. 0.06 (-0.09, 0.22)] and math [-1.32 (-2.27, -0.37) vs. 0.20 (-0.77, 1.17)] scores was also attenuated to null when 4-year parental emotional support score increased from Mean - SD to Mean + SD. In contrast, the gap between SGA and AGA children in 5-year reading score increased from 0.49 (-0.90, 1.88) to -1.31 (-2.55, -0.07) when 4-year parental intrusiveness score increased from Mean - SD to Mean + SD. Similarly, the gap between SGA and AGA children in fine motor score increased with 4-year parental negative regard from 0.02 (-0.14, 0.18) to -0.23 (-0.38, -0.08). Conclusions: Early high-quality parenting may buffer some adversity in long-term reading, math, and fine motor skills related to SGA birth, whereas low-quality parenting can amplify the adversity.

The majority of people with prediabetes transition to type 2 diabetes. Weight gain is a known predictor of increasing the risk of diabetes, but another reason may be a focus on immediate rewards and discounting of the future. Delay discounting (DD: devaluation of future consequences) is related to obesity and poor glycemic control in persons with type 2 diabetes. This study was designed to assess whether changes in DD are associated with HbA1c change beyond BMI change in individuals with prediabetes. Hierarchical regression showed changes in BMI (p = 0.008) and the $1000 DD task (p = 0.04) were associated with HbA1c change beyond demographic characteristics, with the full model accounting for 25.8% of the variance. Those with greater BMI increases and greater increases in discounting of the future showed the greatest increases in HbA1c. DD represents a novel target to prevent progression from prediabetes to type 2 diabetes., Author(s): Leonard H. Epstein [sup.1] , Rocco A. Paluch [sup.1] , Jeff S. Stein [sup.2] , Alexandra M. Mellis [sup.2] , Teresa Quattrin [sup.1] , Lucy D. Mastrandrea [sup.1] , [...]

Effortful control (EC), a self‐regulation skill, is associated with long‐term developmental outcomes. Music has been associated with infant self‐regulation and may be an intervention strategy for enhancing EC during toddlerhood. This investigation included 32 parent‐child dyads from a previously conducted randomized controlled trial (RCT). Participants (9‐15‐months old at baseline) attended either a music enrichment program or a playdate control once a week for 1 year and monthly for an additional year. At age 3, participants completed snack and gift delay effortful control tasks. Groups were compared using one‐way ANOVA. We found that participants in the music group had a significantly higher score during snack delay (music mean = 3.47 ± 0.94; control mean = 2.45 ± 1.51; p = 0.03; Cohen's d = 0.84). We did not find a significant group difference for latency to peek (music mean = 39.10 ± 20.10; control mean = 30.90 ± 19.88; p = 0.25; d = 0.57) or latency to touch (music mean = 105.73 ± 417.69; control mean = 98.35 ± 28.84; p = 0.38; d = 0.29) for the gift task. This study provides initial evidence that early participation in a music enrichment program may benefit later development of EC. This study is registered at ClinicalTrials.gov (NCT02936284). [ABSTRACT FROM AUTHOR]