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Introduction: Teaching is a stressful occupation due to high-stake job demands and limited resources, which were exacerbated during the initial phase of the COVID-19 pandemic. Our study assessed the prevalence of perceived stress and explored its predictors among elementary school teachers employed at schools serving predominantly low-income populations in five cities in the United States. Method: Our study analyzed the data among selected schools that were collected through the Brighter Bites teacher survey which comprised items measuring sociodemographic characteristics, perceived stress, perceived general health, food insecurity, and concerns regarding social determinants of health needs. The predictors of perceived stress were examined using generalized linear mixed models (GLMMs) with schools as the random variable. Findings: A total of 685 teachers were included in the analysis (84.9% female, 38.1% Hispanic, 57.6% Conclusion/Application for Practice: Our study demonstrates the heightened impact of COVID-19 on the mental well-being of teachers across a wide range of social needs. Stress management and additional social service programs are suggested to support teachers to mitigate pandemic impact.

Racial/ethnic and socioeconomic differences were shown to have an influence on child fruit and vegetable intake. This study examined the associations between parent and child fruit and vegetable intake and the home nutrition environment among Hispanic/Latino and African American families. Through a cross-sectional study design, self-reported surveys (n = 6074) were obtained from adult–child dyad participants enrolled in Brighter Bites, an evidence-based health promotion program, in the fall of 2018. For every once/day increase in frequency of parent FV intake, there was an increase in child FV intake by 0.701 times/day (CI: 0.650, 0.751, p < 0.001) and 0.916 times/day (CI: 0.762, 1.07; p < 0.001) among Hispanic/Latinos and African Americans, respectively. In Hispanic/Latino participants, significant positive associations were found between fruits as well as vegetables served at mealtimes ≥3 times/week (p < 0.001), family mealtimes 7 times/week (p = 0.018), parent–child communication about healthy eating and nutrition at least sometimes during the past 6 months (p < 0.05), and frequency of child FV intake, after adjusting for covariates. In African American participants, a significant positive association was found in fruits served at mealtimes ≥1 times/week (p < 0.05), and vegetables served at mealtimes ≥5 times/week (p < 0.05). Meals cooked from scratch a few times a day/all the time were significantly positively associated with frequency of child FV intake for both Hispanic/Latino (p = 0.017) and African American (p = 0.007) groups. The relationship between home nutrition environment and child FV intake varied by race and ethnicity. Future programs should consider designing culturally tailored interventions to address racial/ethnic-specific influences that match the child’s race, culture, and ethnicity.

US school systems underwent major upheaval, including closures, implementation of virtual and/or hybrid learning, and stringent infection mitigation protocols, during the initial phase of the COVID-19 pandemic. We aimed to examine the association between food insecurity and perceived health, perceived stress, and social determinants of health concerns among elementary schoolteachers serving predominantly low-income children during the COVID-19 pandemic.Brighter Bites, a nonprofit organization that weekly distributes fresh fruits and vegetables and nutrition education materials to more than 300 schools serving racial and ethnic minority populations with low income, conducts annual surveys of participating teachers to help determine subsequent efforts to support schools and families during the school year. We analyzed self-reported data collected electronically by the Brighter Bites teachers survey in 76 elementary schools during summer 2020. We used generalized linear mixed models to measure the association between food insecurity and health-related concerns.Of 862 teachers who responded to the survey, 685 answered the 2 questions about food insecurity status; of these, 199 (29.1%) reported experiencing food insecurity. Food insecurity was positively associated with poor perceived general health, greater perceived stress, concerns about various social determinants of health, and changes in fruit and vegetable consumption during the COVID-19 pandemic.Our study demonstrated the high prevalence of food insecurity and highlights its associated factors among elementary schoolteachers during the COVID-19 pandemic. It calls attention to the high correlation of various concerns among elementary schoolteachers during the COVID-19 pandemic. Further intervention and policy efforts are needed to relieve food insecurity-related concerns and enhance well-being among teachers.

BACKGROUND Through the Texas Childhood Obesity Research Demonstration study, we implemented and evaluated a system-oriented model of primary and secondary prevention approaches to mitigate obesity among low-income Texas children aged 2 to 12 years. Primary prevention included implementing the Coordinated Approach To Child Health Early Childhood (CATCH EC) program in Head Start preschools. In this paper, we describe the methods and results of CATCH EC program process evaluation over 2 years of implementation. METHODS We used a quasi-experimental design with serial cross-sectional data collected from Head Start centers across intervention and comparison catchment areas in Houston and Austin, Texas (intervention: N = 12 centers in 2012-2013 [Year 1], N = 12 in 2013-2014 [Year 2]; comparison: N = 13 centers in Year 1, N = 12 in Year 2). Process evaluation included center director and teacher surveys conducted in both years of implementation. We developed indices for implementation of CATCH EC and non-CATCH health events at the centers. RESULTS Implementation scores were higher among intervention centers as compared to comparison centers across both years of implementation, and these differences were statistically significant (p

The purpose of this communication is to describe the Brighter Bites produce voucher program, and its implementation and utilization across Brighter Bites families in four cities in the U.S., during the COVID-19 pandemic. The voucher program was implemented over nine weeks starting April 2020, with up to four USD 25 store-specific produce coupons sent bi-weekly to the homes of each participating Brighter Bites family (USD 100 total/family). Measures included type of produce purchased, amount of voucher that was used, number of vouchers distributed and redeemed by families, and a post-program participant satisfaction survey. Descriptive statistics, including count, frequency, and percent, were computed, both overall and stratified by city. During this time, Brighter Bites distributed a total of over 43,982 vouchers to 12,482 low-income families, with a redemption rate of 60% (at least one voucher redeemed) across all cities. During times of crisis, non-profit–for-profit partnerships, such as the one between Brighter Bites and the grocery retail industry, are feasible, and successful in providing produce to families in need.

Introduction Food insecurity affects dietary behaviors and diet quality in adults. This relationship is not widely studied among early care and education (ECE) providers, a unique population with important influences on children's dietary habits. Our study's objective was to explore how food insecurity affected diet quality and dietary behaviors among ECE providers. Methods We used baseline data from a cluster-randomized controlled trial (January 2019-December 2020) on 216 ECE providers under the Pennsylvania Head Start Association. We used radar plots to graph scores for the Healthy Eating Index 2015 and the Alternative Healthy Eating Index (AHEI) 2010 and fitted a multivariate regression model for diet quality measures, adjusting for covariates. Results Among the 216 participants, 31.5% were food insecure. ECE providers who were food insecure had a lower AHEI-2010 mean score (mean difference for food insecure vs food secure = -4.8; 95% CI, -7.8 to -1.7; P = .002). After adjusting for covariates, associations remained significant (mean difference = -3.9; 95% CI, -7.5 to -0.4; P = .03). Food insecure ECE providers were less likely to use nutrition labels (22.8% vs 39.1%; P = .046) and more likely to report cost as a perceived barrier to eating fruits and vegetables. Conclusion We found a significant inverse association between food insecurity and the AHEI-2010 diet quality score among ECE providers after adjusting for covariates. More studies are needed to examine the effects of food insecurity on dietary behaviors of ECE providers and their response to nutrition education programs targeting their health.

BACKGROUND We present results of the development and feasibility testing of CATCH Healthy Smiles, a school-based oral health program, among children in grades K-2 in Houston, Texas. METHODS Study design was cross-sectional (N = 2 schools; N = 125 parent-child dyads; 31 kindergarteners, 42 first graders, and 52 second graders). CATCH Healthy Smiles program was implemented by trained school teachers in the 2016-2017 school year. Trained dentists conducted dental assessments to measure dental caries increment score (d3mfs). Parent-reported 24-hour dietary recalls and surveys assessed child and parent behavioral, environmental, and psychosocial factors. Logistic regression analysis assessed factors associated with caries experience adjusting for covariates. RESULTS Of the 113 children with complete dental assessments, 54% children in grade K, 62% in first grade, and 73% in second grade had caries experience. Children with caries experience had a higher body weight (AdjOR = 1.13, 95% confidence interval [CI]: 1.02-1.29), were less likely to be girls (AdjOR = 0.22, 95% CI: 0.05-0.82), had greater odds of difficulty drinking hot or cold beverages because of dental problems (AdjOR = 13.13, 95% CI: 1.09-275.14), greater frequency of consuming sugar-sweetened beverages (AdjOR = 11.53, 95% CI: 2.10-87.19), greater odds of receiving government assistance (AdjOR = 14.62, 95% CI: 2.74-119.81), and lower odds of seeing a dental provider (AdjOR = 0.11, 95% CI: 0.02-0.45). Process evaluation showed that 100% of the CATCH Healthy Smiles lessons and activities were taught in the two schools with a high degree of program fidelity and acceptability across the schools, children, and parents. CONCLUSIONS These data will be used to conduct a subsequent fully powered cluster randomized controlled trial.

Introduction Little is known about the social needs of low-income households with children during the coronavirus-2019 (COVID-19) pandemic. Our objective was to conduct a cross-sectional quantitative and qualitative descriptive analysis of a rapid-response survey among low-income households with children on social needs, COVID-19-related concerns, and diet-related behaviors. Methods We distributed an electronic survey in April 2020 to 16,435 families in 4 geographic areas, and 1,048 responded. The survey asked families enrolled in a coordinated school-based nutrition program about their social needs, COVID-19-related concerns, food insecurity, and diet-related behaviors during the pandemic. An open-ended question asked about their greatest concern. We calculated descriptive statistics stratified by location and race/ethnicity. We used thematic analysis and an inductive approach to examine the open-ended comments. Results More than 80% of survey respondents were familiar with COVID-19 and were concerned about infection. Overall, 76.3% reported concerns about financial stability, 42.5% about employment, 69.4% about food availability, 31.0% about housing stability, and 35.9% about health care access. Overall, 93.5% of respondents reported being food insecure, a 22-percentage-point increase since fall 2019. Also, 41.4% reported a decrease in fruit and vegetable intake because of COVID-19. Frequency of grocery shopping decreased and food pantry usage increased. Qualitative assessment identified 4 main themes: 1) fear of contracting COVID-19, 2) disruption of employment status, 3) financial hardship, and 4) exacerbated food insecurity. Conclusion Our study highlights the compounding effect of the COVID-19 pandemic on households with children across the spectrum of social needs.

ObjectiveBrighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and families. Due to COVID-19-related school closures, states were under "shelter in place" orders, and Brighter Bites administered a rapid assessment survey to identify social needs among their families. The purpose of this study is to demonstrate the methodology used to identify those with greatest social needs during this time ("high risk"), and to describe the response of Brighter Bites to these "high risk" families.MethodsThe rapid assessment survey was collected in April 2020 across Houston, Dallas, Washington DC, and Southwest Florida. The survey consisted of items on disruption of employment status, financial hardship, food insecurity, perceived health status and sociodemographics. The open-ended question "Please share your greatest concern at this time, or any other thoughts you would like to share with us." was asked at the end of each survey to triage "high risk" families. Responses were then used to articulate a response to meet the needs of these high risk families.ResultsA total of 1048 families completed the COVID-19 rapid response survey, of which 71 families were triaged and classified as "high risk" (6.8% of survey respondents). During this time, 100% of the "high risk" participants reported being food insecure, 85% were concerned about their financial stability, 82% concerned about the availability of food, and 65% concerned about the affordability of food. A qualitative analysis of the high-risk group revealed four major themes: fear of contracting COVID19, disruption of employment status, financial hardship, and exacerbated food insecurity. In response, Brighter Bites pivoted, created, and deployed a framework to immediately address a variety of social needs among those in the "high risk" category. Administering a rapid response survey to identify the immediate needs of their families can help social service providers tailor their services to meet the needs of the most vulnerable.

Instituting interventions during the prenatal period is optimal for early obesity prevention in the child. Healthy Eating Active Living (HEAL) is a six-week, multi-component program to promote breastfeeding, healthy dietary habits, cooking skills and physical activity among Medicaid-eligible pregnant-women in Texas. HEAL is integrated into the healthcare system and offered as a standard-of-care for eligible patients. Methods: Preliminary evaluation of this natural experiment conducted from March 2015 through October 2016 informs the initial feasibility, acceptability and effects of the program on participant diet, home nutrition environment, physical activity, and breastfeeding self-efficacy and intentions measured using self-report surveys. Analysis of covariance (ANCOVA) was conducted to evaluate pre- and post-intervention changes, controlling for participants' ethnicity, age, and income level. Interaction effects of session attendance on the outcomes were further assessed. Results: Of the 329 women who enrolled in HEAL, 210 women completed the pre-post assessment (64% retention rate). Pre-to-post intervention, there were significant increases in availability and intake of fruits and vegetables, self-efficacy towards consuming more fruits and vegetables, and cooking frequency and skills (p

Background The aim of this study is to evaluate the feasibility and preliminary impact of the Create Healthy Futures program, a self-paced, 6-lesson, web-based intervention on promoting healthy eating for Early Care and Education (ECE) providers, using a group-randomized controlled trial design with 3 repeated measurements. Methods Nine ECE facilities in Ohio were recruited and randomly assigned to intervention (N = 4) and comparison (N = 5). The 111 participants are mostly female (97.3%), college graduated (59.5%), and overweight or obese (75.2%). Nutrition-related psychosocial and environmental factors and individual behaviors were assessed at baseline, post-test, and 3-month follow-up. We used mixed model analyses to compare changes between time points, controlling for ethnicity, age, and center effect, and calculated effect size to assess the magnitude of change. Results We observed significant between-group changes in improving nutrition knowledge (p = .003), increasing perceived support for staff wellness (p = .038), and reducing perceived barriers to eating fruits and vegetables (p = .004) and promoting nutrition in classrooms (p = .038), with small to medium effect sizes. The study demonstrated high feasibility with 94.1% enrollment rate, 87.5% intervention completion rate, and 83.8% retention rate. Conclusions This pilot study demonstrated high feasibility and acceptability of nutrition intervention programs using an online platform among ECE providers.

This study presents the impact of a 2-year implementation of Coordinated Approach to Child Health Early Childhood (CATCH EC), a preschool-based healthy nutrition and physical activity program, on child BMI z-scores, BMI percentiles, diet, physical activity, and sedentary behaviors among 3- to 5-year old children across Head Start centers in Houston and Austin, Texas.We used a quasi-experimental study design with serial cross-sectional data collection (Intervention catchment area: n = 12 centers, 353 parent-child dyads in Year 1; n = 12 centers, 365 parent-child dyads; Comparison catchment area: n = 13 centers in year 1, 319 parent child dyads; and n = 12 centers, 483 parent-child dyads in year 2). Child height and weight were measured and parent self-report surveys were conducted at year 1 (fall 2012) and year 2 (spring 2014).In year 1, 34.8% of the children were overweight or obese, 74% were Hispanic, and80% reported an annual household income of$25,000. In year 2, 32.2% were overweight or obese, 72% were Hispanic, and 82.3% reported an annual income of$25,000. Results demonstrated significantly lower child BMI z-scores [β = -0.26 (95% confidence interval, CI: -0.50 to -0.01), p = 0.041] and BMI percentiles [β = -6.5 (95% CI: -12.4 to -0.69), p = 0.028] from year 1 to 2 follow-up among those in intervention Head Start centers, compared to those in the comparison centers. There were no significant between-group changes in child dietary, physical activity, or screen time behaviors.Implementation of a preschool-based obesity prevention program can be modestly effective in lowering the prevalence of child overweight in low-income populations.

Objective To evaluate the effectiveness of the parent- and early care education (ECE) center-based Lunch is in the Bag program on communication between parent, child, and their ECE center providers around fruits, vegetables and whole grain foods (FVWG). Method A total of n = 30 ECE center; 577 parent–child dyads participated in this group-randomized controlled trial conducted from 2011 to 2013 in Texas (n = 15 ECE center, 327 dyads intervention group; n = 15 ECE center, 250 dyads comparison group). Parent–child and parent-ECE center provider communication was measured using a parent-reported survey administered at baseline and end of the five-week intervention period. Multilevel linear regression analysis was used to compare the pre-to-post intervention changes in the parent–child and parent-ECE center provider communication scales. Significance was set at p Results At baseline, parent–child and parent-ECE center provider communication scores were low. There was a significant increase post-intervention in the parent-ECE center provider communication around vegetables (Adjusted β = 0.78, 95%CI: 0.13, 1.43, p = 0.002), and around fruit (Adjusted β = 0.62, 95%CI: 0.04, 0.20, p = 0.04) among the parents in the intervention group as compared to those in the comparison group. There were no significant intervention effects on parent–child communication. Conclusion Lunch is in the Bag had significant positive effects on improving communication between the parents and ECE center providers around FVWG.

Intake of fruits and vegetables (FV) continues to be low in children in the United States. The purpose of this study was to conduct a pilot feasibility evaluation of Brighter Bites, a school-based food co-op to provide access to fresh FV and nutrition education to low-income children and their families. Brighter Bites is a 16-week school-based food co-op consisting of: (1) Weekly distribution of 50-60 servings of fresh FV; (2) Weekly bilingual parent handouts and recipe demonstrations; and (3) implementing CATCH, a coordinated school health program in schools. Brighter Bites was pilot tested using a pre-post evaluation design in one charter school in Houston, TX, USA (n = 57 3rd grade parent-child dyads; 94.1 % Hispanic, 91 % low-income). Evaluation, at baseline, midpoint, and post-intervention, included self-reported child and parent surveys on psychosocial factors, dietary habits and mealtime practices. Pearson's Chi square test, Fisher's exact-test or paired t test were used to determine changes pre- to post-intervention (at p0.05). Process data using parent surveys, teacher surveys, attendance logs, and produce cost data were used to determine feasibility and acceptability of program. Participants received on average 61 servings of FV weekly for 16 weeks at the cost of $4.31/family/week. Results showed significant increases in child reported self-efficacy, outcome expectations and attitudes towards consuming FV (p0.05). We found significant increases in child exposure to FV and child preference of various FV from baseline to post-intervention (p0.05). Parent surveys showed significant improvements in mealtime practices at home: decrease in children eating while watching TV, increase in eating dinner with the family, less fast food, less sugary drinks with meals, more children asking for FV as snacks. Process data showed 98 % retention rate and high parent acceptability of program components. Brighter Bites is a promising strategy to increase FV access and education in low-income populations using existing infrastructure of schools and food banks.

Introduction Practices and barriers to promoting healthy eating and physical activity at Head Start centers may influence children’s energy balance behaviors. We examined differences between directors’ and teachers’ perspectives on best practices and barriers to promoting healthy eating and physical activity in Head Start centers. Methods We conducted a cross-sectional study of directors (n = 23) and teachers (n = 113) at 23 Head Start centers participating in the baseline assessment of the Texas Childhood Obesity Research Demonstration study. Participants completed surveys about practices and barriers to promoting healthy eating and physical activity. Multilevel regression models examined differences between director and teacher responses. Results More than half of directors and teachers reported meeting most best practices related to nutrition and physical activity; few directors or teachers (

Purpose: To explore whether the physical activity (PA) component of the Coordinated Approach to Child Health Early Childhood (CATCH EC) program helps increasing preschoolers’ PA during active times at preschool. Design: Nonrandomized controlled experimental study. Setting: Head Start centers in Houston, Texas, 2009 to 2010 school year. Participants: A total of 439 preschoolers aged 3 to 5 years (3 intervention centers, n = 220; 3 comparison centers, n = 219). Intervention: The CATCH EC preschool-based teacher-led nutrition and PA program. Measures: Preschoolers’ PA was measured at baseline and postintervention using the System for Observing Fitness Instruction Time–Preschool version, a direct observation method measuring PA at the classroom level. Parent surveys provided demographic data. Analysis: Pre-to-post changes in preschoolers’ PA were examined using the Mann-Whitney U test. Results: Results show a significant decrease in the percentage time preschoolers spent in level 2 PA (low activity) at intervention ( P = .005) and comparison ( P = .041) centers. Indoor vigorous activity increased significantly on an average by +6.04% pre-to-post intervention among preschoolers in the intervention group ( P = .049); no significant change was found in the comparison group. Conclusion: The CATCH EC favorably increased indoor vigorous PA level among low-income children attending Head Start.

Garden-based lessons are gaining popularity as a means of increasing fruit and vegetable intake among children. The study objective was to pilot test a garden-based preschool curriculum for feasibility and acceptability in Harris County Department of Education Head Start using qualitative and quantitative methods. A total of 103, 3- to 5-year-old children at two Head Start centers in Harris County, Texas participated. PLANT Gardens (Preschoolers Learn About Nutrition Through Gardens), a theoretically grounded, teacher-led, garden-based nutrition education program for preschoolers was implemented over 8 weeks in spring 2008. Heights and weights were measured on participating children. Data regarding program feasibility and acceptability were obtained through post-intervention focus groups with teachers and parents, weekly lesson plan evaluation forms completed by project staff, and post intervention teacher surveys. Pre−post self-reported parent surveys were used to evaluate the effects of the program on their preschooler’s fruit and vegetable preferences and willingness. The results showed that, overall, 28.4 percent of the Head Start preschooler’s population were overweight or obese, yet only 3 percent of parents perceived their preschooler as overweight. This pilot test revealed strong acceptability and feasibility of the PLANT Gardens program in this Head Start population. Results of the parent surveys (n= 25) indicated a significant increase in their preschooler’s willingness to try new fruits and vegetables (67% at baseline vs 84% post-intervention; p = 0.026). Data were used to further refine the program components. In conclusion, the PLANT Gardens program showed good initial feasibility and acceptability and is a promising program to increase preference and intake of fruits and vegetables in a preschool population. Further evaluation of behavioral outcomes using a larger sample size and a prospective design is needed.

Purpose.To evaluate the ethnic differences in the home physical activity and screen time environment of preschoolers enrolled in Head Start.Design.Cross-sectional.Setting.Sixteen Harris County Department of Education (HCDE) Head Start centers, Texas.Subjects.Seven hundred and six preschoolers enrolled in HCDE Head Start centers and their parents.Measures.Items from the parent-reported Healthy Home Survey evaluating the home physical activity environment and the Nutrition Screening form evaluating screen time.Analysis.Mixed model linear and logistic regression analysis.Results.Of the parents, 75.06% were overweight or obese. Hispanic parents were more likely to have a yard or open space (p = .014) and usable play equipment in the yard (p = .019) for their children to play in compared to African-Americans. Conversely, more African-American parents reported having a television (TV) in their preschooler's bedroom (p = .032) and were less likely to cut down their child's TV viewing time (p = .036). African-American preschoolers were reportedly more likely to eat while watching TV (p = .009), play video games for ≥ 2 hours on weekdays (p = .018) and have computer time for ≥ 2 hours on weekends (p = .007), compared to Hispanics.Conclusion.The Hispanic participants of this study had a healthier home environment for physical activity and screen time as compared with their African-American counterparts. Future interventions targeting lifestyle change need to address these factors in an ethnic-specific manner.

The family and home environment are important in shaping the dietary patterns of children, yet research among low-income, minority groups is limited. We examined ethnic differences in the home food environment and parental practices among 706 low-income, African-American and Hispanic families of preschoolers. Questionnaires measured the access and availability of various foods in the home, parental practices, and meal consumption behaviors. Mixed model logistic regression and ANCOVA were used to assess ethnic differences. Unhealthy foods were available for both groups. Hispanic families were more likely to have fresh vegetables (AOR = 2.9, P = 0.001), fruit (AOR = 2.0, P = 0.004), and soda available (AOR = 1.40, P = 0.001) compared to African-Americans. African-Americans families were more likely to restrict (AOR = 0.63, P = 0.001) and reward with dessert (AOR = 0.69, P = 0.001). Hispanic families consumed more family meals together (P = 0.003) and less meals in front of the television (P = 0.006). Health promotion interventions should consider the behavioral differences between ethnicities.

Background: The literature on theoretically-based programs targeting healthy nutrition and physical activity in preschools is scarce. Purpose: To pilot test CATCH Early Childhood (CEC), a preschool-based nutrition and physical activity program among children ages three to five in Head Start. Methods: The study was conducted in two Head Start centers (N=75 children, their parents; 9 teachers). CEC was implemented by trained teachers over six weeks in fall 2008. Qualitative data on feasibility and acceptability was collected using post-intervention parent and teacher focus groups and lesson plan evaluation forms. Pre-to-post intervention changes in children's fruit and vegetable intake and physical activity at school were evaluated. Results: Results showed good feasibility and acceptability for the classroom curriculum, activity box and parent tip-sheets. There was a trend towards an increase in children's fruit, 100% fruit juice and vegetable intake and mean minutes of physical activity at school ...

Screen media (television, computers, and videogames) use has been linked to multiple child outcomes, including obesity. Parents can be an important influence on children's screen use. There has been an increase in the number of instruments available to assess parenting in feeding and physical activity contexts, however few measures are available to assess parenting practices regarding children's screen media use. A working group of screen media and parenting researchers convened at the preconference workshop to the 2012 International Society for Behavioral Nutrition and Physical Activity (ISBNPA) annual meeting, “Parenting Measurement: Current Status and Consensus Reports,” to identify and prioritize issues in assessing screen media parenting practices. The group identified that screen media use can pose different risks for children, depending on their age and developmental stage, across physiologic, psychosocial, and development outcomes. With that in mind, a conceptual framework of how parents may influence their child's screen-viewing behaviors was proposed to include the screen media content, context of viewing, and amount viewed. A research agenda was proposed to prioritize a validation of the framework and enhance the ability of researchers to best assess parenting influences across the three domains of content, context and amount of children's screen media use.

The purpose of this study is describe the initial feasibility, reliability, and validity of an instrument to measure physical activity in preschoolers using direct observation. The System for Observing Fitness Instruction Time for Preschoolers was developed and tested among 3- to 6-year-old children over fall 2008 for feasibility and reliability (Phase I, n=67) and in fall 2009 for concurrent validity (Phase II, n=27). Phase I showed that preschoolers spent >75% of their active time at preschool in light physical activity. The mean inter-observer agreements scores were ≥.75 for physical activity level and type. Correlation coefficients, measuring construct validity between the lesson context and physical activity types with and with the activity levels, were moderately strong. Phase II showed moderately strong correlations ranging from .50 to .54 between the System for Observing Fitness Instruction Time for Preschoolers and Actigraph accelerometers for physical activity levels. The System for Observing Fitness Instruction Time for Preschoolers shows promising initial results as a new method for measuring physical activity among preschoolers.