Psychology Journal Club: Pediatric Obesity 2017
With Dr. She'thel Reddy · StayCurrentMD
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Pediatric Obesity 9 items
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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Exercise Journal Club: Pediatric Obesity 2017
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Nutrition Journal Club: Pediatric Obesity 2017
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Welcome & Introduction: Pediatric Obesity 2017
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Public Policies to Address Obesity: Pediatric Obesity 2017
46 min · Published Feb 2018
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Social Determinants of Health: Pediatric Obesity 2017
42 min · Published Feb 2018
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Rapid Fire and Conclusion: Pediatric Obesity 2017
23 min · Published Feb 2018
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What the experts said
The intervention can improve maternal-child relationships, suggesting the need to focus on more than just nutrition and activity, but the bigger family system including relationships and messages about eating and healthy habits.
Maternal depression can impact bonding with the child and the quality of interaction with the child.
In the Strong for Life Clinic, they screen for depression in children and also do a depression screener for the primary caregiver (usually the mother).
A typical well-child checkup is 15 to 20 minutes, which is really pushing it, especially with an adolescent.
A pilot project is adapting the 5210 message to the adult population and prenatal population, piloting in about 5 OB practices to look at how messages resonate and the role of OB providers in starting healthy eating and active living for the mother.
A quick assessment of parenting styles can be done by asking what a typical day is like, which reveals information about boundaries for bedtimes, rules for homework, and level of parental involvement.
Practices that incorporate mental health within the practice find it valuable to have a psychologist with an open schedule who can see families during the same visit for issues like ADHD, school problems, or weight and feeding concerns.
Group care models have shown increased satisfaction and improved rates of coming on time to clinic.
In group care, there is a central piece but then patients go to their own room for individual exams and time for sensitive or personal questions.
Group care requires patients to sign a HIPAA waiver, and parents have been amazingly open to share their stories with each other, perhaps even more open than they would have been with providers alone.
Risk factors for obesity are similar to characteristics that go into social and emotional development of children, including emotion regulation, temperament, inhibitory control, and reward sensitivity.
General parenting interventions that improve parent-child communication in adolescence and social development in younger children have found a decrease in BMI, greater initiation of breastfeeding, and reduction in obesity.
The study hypothesized that families at risk who declined intervention would demonstrate obesity-promoting feeding styles and their child would have an obese BMI by age 5.
The study controlled for confounds including child gender, siblings, insurance status, birth weight, and maternal factors (age, race, country of origin, educational attainment, marital status, employment status, depressive symptoms, and BMI).
The Ages and Stages Questionnaire social-emotional subscale assessed self-regulation, compliance, communication, adaptive behaviors, autonomy, affect, and interpersonal interactions to define risk groups.
The behavioral intervention had three levels: collaborative monitoring for least risk, on-site intervention (home or office visit) for greater risk, and outside referrals for long-term care for families with severe risks.
Child feeding practices assessed included food consumption frequencies, eating out at restaurants, family meals, restriction, pressuring children to eat, setting limits, monitoring, reinforcing, using food as reward, using food for emotion regulation, parental role modeling, and maintaining healthy home food environment.
The study used retrospective data from a community health center providing pediatric primary care, including mothers of 5-year-old children who had at least one social-emotional screening during the child's first 3 years of life.
In the at-risk group that declined to participate, there was decreased limit setting, less restriction, more pressure to eat, lack of sensitivity or non-responsiveness to feeding cues, more permissive parenting, and mothers were more likely to report depressive symptoms.
The study found a link between social-emotional problems during the first 3 years of life and a connection with obesity at age 5.
Families that participated in the generalized intervention saw benefit in their child's weight status.
The intervention led to 15% incidence of obesity at 5 years old, a decrease but still an unacceptable number.
Families at risk who participated had the lowest consumption of juice of any group, including those not at risk, suggesting messaging about sugary drinks stuck.
A study on well-baby group care in the first 2 years as an alternative model showed decreased prevalence in obesity at age 2 years in the group care.