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Objective: To explore weight talk in the homes of racially/ethnically diverse immigrant/refugee children and their families., Design: Qualitative interviews were conducted with parents of young children., Setting: Twin Cities, Minnesota., Participants: Parents from 150 families (25 families each from White, Black, Latino, Hmong, Native American, and Somali households) were recruited from primary care clinics. Eligibility criteria included: participating parent lived with a child aged 5-7 years, shared a meal with this child at least daily, and had another child living in the home., Main Outcome Measures: Weight talk (ie, weight-related conversations, teasing), intergenerational transmission of weight talk., Analysis: Qualitative content analysis using Nvivo software., Results: Themes were found for each of our 4 research questions. Themes included: (1) parents experienced weight talk in their own homes growing up; (2) parents believed their community or culture influenced weight talk in their home; (3) parents described different ways of approaching weight talk, including not discussing weight, being direct about weight, and playful teasing; and (4) parents described various strategies for addressing concerns about their children's weight., Conclusions and Implications: Results suggested weight and health were salient issues for racially/ethnically diverse parents. Further research is needed to investigate why some parents engage in weight teasing, what prompts weight teasing, and the differences between weight- and health-focused conversations to identify potential targets for intervention. Recommendations for health providers working with families with young children, such as training using nonstigmatizing language, are discussed., (Copyright © 2023 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Purpose: Weight stigma is a prevalent problem in adolescents and a risk factor for disordered eating behaviors (DEBs). This study examined whether positive family/parenting factors were protective for DEBs among an ethnically/racially and socioeconomically diverse sample of adolescents with and without weight stigmatizing experiences., Methods: In Project Eating and Activity over Time (EAT) 2010-2018, 1,568 adolescents (mean age = 14.4 ± 2.0 years) were surveyed and followed into young adulthood (mean age = 22.2 ± 2.0 years). Modified Poisson regression models examined the relationships between three weight-stigmatizing experiences and four DEBs (e.g., overeating and binge eating) in models adjusted for sociodemographic characteristics and weight status. Interaction terms and stratified models examined whether family/parenting factors were protective for DEBs based on weight stigma status., Results: Higher family functioning and support for psychological autonomy were cross sectionally protective for DEBs. However, this pattern was primarily observed in adolescents who did not experience weight stigma. For example, among adolescents who did not experience peer weight teasing, high support for psychological autonomy was associated with lower prevalence of overeating (high support: 7.0%, low support: 12.5%, p = .003). Whereas, in participants who experienced family weight teasing, the difference in prevalence of overeating based on support for psychological autonomy was not statistically significant (high support: 17.9%, low support: 22.4%, p = .260)., Discussion: General positive family and parenting factors did not entirely offset the effects of weight-stigmatizing experiences on DEBs, which may reflect the strength of weight stigma as a risk factor for DEBs. Future research is needed to identify effective strategies family members can use to support youth who experience weight stigma., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

This study characterized common patterns of weight talk and examined associations with unhealthy weight control behaviors (UWCBs) in young adults. Participants (n = 1298) were from EAT 2018 (Eating and Activity Over Time), a population-based study of emerging adults (mean age = 22.2; 53.6 % women). Latent class analyses (LCA) derived classes based on weight talk exposure for men and women. Generalized linear models examined the association between weight talk classes and extreme/less extreme UWCBs. LCA results revealed 4 patterns of weight talk exposure among young adult women: minimal weight talk (38.8 %), peer weight talk (35.2 %), multi-source weight talk (13.5 %), and parental weight talk (12.6 %). Three classes emerged among men: minimal weight talk (44.0 %), peer weight talk (29.7 %), and multi-source weight talk (26.3 %). Among young adult women, the parental weight talk class reported the highest levels of extreme and less extreme UWCBs. Among young adult men, the multi-source weight talk class reported the highest levels of less extreme UWCBs. Results provide evidence regarding the importance of parental weight talk, even among young adult children, whether or not parental weight talk is accompanied by peer weight talk. Parents have the potential to improve their young adults' weight-related behaviors through avoiding weight talk., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background and Purpose: There has been limited success addressing complex public health problems using "siloed" approaches. A next important step in addressing persistent public health problems is adopting an "integrative" approach-intentional collaboration across the domains of research, clinical practice, community, and policy. This synthesis of the literature aggregates and synthesizes the diffuse and multi-disciplinary integration literature base to describe key concepts, aspects of praxis, and challenges and successes to help guide interprofessional practice., Methods: A three-step approach was used: 1) a wide-ranging search for articles on integration theory/praxis; 2) a more focused search in the health literature bases; 3) a snowball strategy to identify additional studies., Discussion/conclusions: Identified themes included elements of successful integration; characteristics of an effective integrator; and dynamics between stakeholders in integration praxis. Results of this synthesis of the integration literature provide a deeper understanding of integration and points to clear and exciting next steps for integration praxis and inquiry.

Background: Research has related child participation in organized activities to health and academic benefits; however, participation may interfere with family meals., Objective: Examine whether parents perceive child participation in organized activities to interfere with family meals and how perceptions are related to the household eating environment., Design: A cross-sectional analysis was completed using survey data collected in 2015-2016 as part of the Project EAT (Eating and Activity in Teens and Young Adults) cohort study., Participants: Survey participants were originally recruited in Minneapolis-St Paul schools in 1998-1999. The analytic subsample of parents (one per household, n=389, 69% female, 31% nonwhite race, mean age=31) had one or more children involved in an organized activity. Approximately 33% of households included a child aged 2 to 5 and no older child; two thirds of households included school-aged children (6 to 18 years)., Main Outcome Measures: Parents reported family meal frequency, family meal scheduling difficulties, frequency of at-home meal preparation, and their own intake of fast food, fruit, and vegetables., Statistical Analyses Performed: Analyses compared household environment characteristics reported by parents who perceived low interference between organized activities and family meals to characteristics reported by parents who perceived moderate to high interference from at least one form of activity. Regression models included a dichotomous indicator of interference as the independent variable and were adjusted for parental and household characteristics., Results: Among parents with children at any age, moderate to high interference was associated with lower family meal frequency, greater difficulty scheduling family meals, and more fast-food intake (all P≤0.01). The perception of moderate to high interference was more common among parents who reported involvement in both sport and nonsport activities (P<0.001) and those with a school-aged child (P<0.001) vs those with only preschool-aged children., Conclusions: Follow-up research, including qualitative studies, is needed to identify the specific aspects of child participation in organized activities (eg, scheduled time of day) that may interfere with family meals., (Copyright © 2020 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Children in low-income and minority populations are at risk for poor dietary quality. At least one-third of the calories consumed by children are eaten between meals (ie, snacks). The contribution of snacking to diet quality among children is poorly understood., Objective: The current study examined associations between snacking and children's diet quality along with differences across ethnicity or race, sex, and weight status., Design: Cross-sectional data came from Phase I of the Family Matters Study, an observational study., Participants/setting: This study included 150 families with children aged 5 to 7 years old from six ethnic or racial groups (n=25 from each: African American, Hispanic, Hmong, Native American, Somali, non-Hispanic white); data were collected in Minneapolis-Saint Paul, MN in 2017-2018., Main Outcome Measures: Total daily energy (kilocalories), overall diet quality using the Healthy Eating Index (HEI-2010), and food group intakes (eg, fruit, vegetables, refined grains, sugar-sweetened beverages [SSB]) were assessed using three 24-hour dietary recalls., Statistical Analyses Performed: Conditional fixed effects estimators (within-child variation) were used in regression analyses to characterize the relationship between daily snacking and dietary intake relative to dietary intake at all other daily meal occasions. Mean (±standard deviation) overall dietary intake including all meals and snacks was compared with mean (±standard deviation) intake of meals only., Results: Among boys, snacking was found to contribute positively to HEI-2010 scores (HEI-2010=57.6, HEI-2010 without snacks=55.0; effect size [ES]=0.28, P=0.03). Snacking was an important source of fruit (ES=0.71) and dairy (ES=0.53), but also contributed to children's consumption of refined grains (ES=0.68) and SSB (ES=0.31). Very few vegetables were consumed as snacks. Furthermore, snacks contributed more to the overall diet quality (HEI-2010) of Native American (ES=0.30) and Somali (ES=0.35) youth as compared with youth from other ethnic or racial backgrounds., Conclusions: Findings suggest that snacks have the potential to improve diet quality in children. Future research should examine influences on children's food choices at snack times and barriers to serving more healthful foods as snacks that are faced by ethnically or racially diverse families., (Copyright © 2020 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Purpose: The aim of the study was to identify whether parent encouragement to diet as an adolescent predicts subsequent encouragement to diet from significant others/romantic partners as an adult and examine longitudinal associations between cumulative encouragement to diet from close relationships (i.e., parent and significant other) and later weight, weight-related, and psychosocial well-being outcomes in adulthood., Methods: Data from Project EAT I-IV, a 15-year longitudinal population-based study of socioeconomically and racially/ethnically diverse adolescents followed into adulthood (n = 1,116; mean age = 31.1 years; 61% female), were used for this study. Surveys and anthropometric measures were completed at school by adolescents in 1998-1999, and follow-up mailed and online surveys were completed at approximately 5-year intervals between 2003 and 2016., Results: Adolescents who experienced encouragement to diet from their parents were more likely to have a significant other as an adult who also encouraged them to diet. In addition, there was a significant (p < .05) cumulative effect of encouragement to diet, such that experiencing more encouragement to diet from both a parent(s) and significant other was associated with higher weight status, more unhealthy weight-control behaviors (e.g., dieting, binge eating, and unhealthy weight control behaviors), and lower psychosocial well-being (e.g., lower body satisfaction and self-esteem and higher depressive symptoms) as a young adult., Conclusions: Encouragement to diet tracked from one close relationship to another and had a cumulative effect on adult weight, weight-related, and psychosocial well-being outcomes. Future interventions, clinical work, and research should be aware of these patterns and cumulative effects of encouragement to diet to target key relationships to reduce these harmful interpersonal patterns., (Copyright © 2019 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To identify predictors associated with television (TV) watching during family meals., Methods: Parents of racially and ethnically diverse 5- to 7-year-old children (n = 150) completed 8 days of ecological momentary assessment surveys. After each meal they shared with their child, parents answered meal-related questions (eg, who was present). Adjusted generalized estimating equations were used to estimate probabilities of watching TV during family meals for individual predictors., Results: Number of adults present, location, outside influences (eg, planned meal, stress), and time to prepare the meal were independently predictive of TV watching during the meal (P < .001)., Conclusion and Implications: Results of the current study suggest that families may need assistance in addressing predictors (eg, stress) associated with watching TV during family meals, given prior research has shown watching TV during family meals is associated with negative dietary outcomes. Future research might investigate other factors that may also influence watching TV at family meals., (Copyright © 2019. Published by Elsevier Inc.)

Background: Television (TV) watching at family meals has been associated with poorer dietary quality and weight outcomes in children. Most research has been limited to family meals, overlooking the influence of TV at any meal., Objective: This study assesses how often children are eating meals at home while watching TV, the association between child dietary intake while watching TV during meals eaten at home and whether the association depends on meal type (eg, breakfast) or child race/ethnicity, and whether the number of meals consumed while watching TV at home is associated with overall child dietary quality or weight status., Design: The Family Matters study utilized a cross-sectional design and was conducted between 2015 and 2016., Participants/setting: Three 24-hour dietary recalls were conducted on children aged 5 to 7 years (n=150; 25 each from non-Hispanic white, African American, Latino, Native American, Somali, and Hmong households)., Main Outcome Measures: Main outcomes of this study were dietary intake at meals, overall dietary quality, and child weight status., Statistical Analysis Performed: Conditional fixed effects estimators were used to address correlated error terms to model within-person variation between TV and dietary intake and race/ethnicity differences in child dietary outcomes., Results: TV was watched during 30% of meals eaten at home, which differed significantly by race/ethnicity (P<0.001). Although effect sizes were small, TV watching at meals was associated with unhealthier intake of some foods groups (eg, increased sugar-sweetened beverages and chips/crackers and decreased fruits), dependent on the meal occasion (eg, snacks). However, TV watching during meals at home was not significantly associated with dietary intake for other food groups. These associations did not depend on race/ethnicity. An association between number of meals consumed while watching TV with overall dietary quality or weight status was not found., Conclusions: Although more research is needed, results suggest TV watching while eating meals at home is relatively common, depends on race/ethnicity, and that TV watching at some meal occasions is associated with child intake of certain food groups, with a majority being unhealthy., (Copyright © 2019 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: To describe meal characteristics across breakfast, lunch, and dinner family meals in racially/ethnically diverse and immigrant/refugee households via ecological momentary assessment; identify real-time meal characteristics associated with family meal frequency; and identify qualitative themes regarding parents' perspectives about meal characteristics and meal types that influence family meal frequency., Design: Cross-sectional study., Setting: In-home visits., Participants: Children aged 5-7 years (n = 150) and their families from diverse and low-income households., Main Outcome Measure(s): Mixed methods., Analysis: Multiple linear regression and hybrid deductive and inductive content analysis., Results: Quantitative results indicated several similar meal characteristics occurring across weekdays and weekend days and by meal type (eg, parent prepared the meal, food mostly homemade, meal eaten at table) and some significant negative associations (P < .05) between meal characteristics and family meal frequency (eg, fast food for family meals). Eight main qualitative themes with several subthemes supported and expanded the quantitative findings and added depth to interpretation of the findings., Conclusions and Implications: Results identified specific meal characteristics both quantitatively and qualitatively that may inform the development of interventions to increase the frequency of family meals so that more families can benefit from the protective nature of family meals., (Copyright © 2019 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: Interest in initiatives that promote home cooking has been increasing, but no studies have examined whether home cooking is associated with dietary quality using longitudinal data on meals served in a diverse sample of families., Objective: The present study examined data on multiple meals per family in diverse households to determine whether home-cooked meals are more likely to contain nutritious ingredients than pre-prepared meals., Design: Data for the study came from the National Institutes of Health-funded Family Matters Study. As part of this study, between 2015 and 2016, 150 families provided ecological momentary assessment data on 3,935 meals over an 8-day observation window., Participants/setting: In this study, investigators followed 150 families with children aged 5 to 7 years old from six racial/ethnic groups (n=25 each non-Hispanic white, non-Hispanic black, Hispanic, Native American, Hmong, and Somali families). Recruitment occurred through primary care clinics serving low-income populations in Minnesota., Main Outcome Measures: The main outcomes were participants' self-reports of whether they served fruits, vegetables, and whole grains at a meal, and reports were made within hours of the meal., Statistical Analyses Performed: Within-group estimator methods were used to estimate the associations between meal preparation and types of food served. These models held constant time-invariant characteristics of families and adjusted for whether the meal was breakfast, lunch, dinner, or a snack and whether it was a weekend meal., Results: For all racial/ethnic and poverty status groups, meals that were fully or partly home-cooked were more likely to contain fruits and vegetables than pre-prepared meals (P<0.001). Meals that were partly home-cooked were the most likely to contain whole grains (P<0.001). Restaurant meals were more likely to contain vegetables than pre-prepared meals (P<0.001) but were equally likely to contain fruits and/or whole grains as pre-prepared meals., Conclusions: Interventions or initiatives that encourage fully or partly home-cooked meals may help families incorporate nutritious foods into their diets. In addition, evaluations of potential strategies to increase the likelihood of supplementing pre-prepared and restaurant meals with nutritious meal ingredients warrants further investigation., (Copyright © 2019 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: To describe a direct observational approach (ie, interactive family board game) to measure familyfunctioning and parenting behaviors of relevance to child weight and weight-related behaviors and to examine family functioning and parenting factors from multiple family dyads (eg, siblings, parent-child) and their associations with child weight and weight-related behaviors., Design: Cross-sectional, mixed-methods study., Setting: Two home visits were conducted with families 10days apart with a 7-day observational period between home visits., Participants: Children (n = 150) aged 5-7years and their families from 1 of 6 racial and ethnic or immigrant and refugee groups, including African American, Hispanic, Hmong, Native American, Somali, and white, participated in the Family Matters study between 2014 and 2016., Main Outcome Measure: Child weight status and weight-related behaviors (ie, diet quality, physical activity)., Analysis: Adjusted logistic and linear regression models with robust SEs were used in analysis., Results: Higher family functioning scores across the majority of family dyads were significantly associated with lower child weight status (P < .05). In addition, some family functioning scores were associated with child diet and physical activity, but not consistently. Parenting behavior scores were inconsistently associated with child weight and weight-related outcomes., Conclusions and Implications: Results suggest that the interactive family board game task is a direct observational approach that researchers can use with family members to measure family functioning and parenting behaviors related to childhood obesity. Future interventions may want to consider including multiple family members in both measurement and intervention development to target childhood obesity., (Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To explore the extent to which parents divide responsibilities of feeding (what, when, where, how much, and whether) with their children and the factors that influence parents' approach to feeding., Design: Individual interviews., Participants: Parents (n = 40) of preschoolers., Phenomenon of Interest: Division of feeding responsibilities; motivation for feeding approach; challenges to feeding., Analysis: Audio-recorded interviews were transcribed verbatim and coded using deductive and inductive content analysis., Results: Parent's approaches to feeding varied widely. A few parents followed the Division of Responsibility approach closely. Instead, many parents gave their child more than the recommended amount of influence over what foods were served and offered children less than the recommended amount of autonomy over the whether and how much of eating. Meals and snacks were approached differently; parents exhibited less control over the timing of snacks as well as the types and amounts of foods eaten during snacks, compared with the control exhibited during meals., Conclusions and Implications: These data support future research to understand the impact of this framework on child health outcomes when it is adhered to on all eating occasions, including snacks. Collaboration by researchers and clinicians to explore alternative frameworks that encourage parents to provide the structure and autonomy support may enhance positive outcomes in children., (Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To determine whether family food and mealtime practices experienced in adolescence are carried forward into parenthood., Design: Baseline (Project Eating and Activity in Teens and Young Adults [EAT]-I) and 15-year follow-up (EAT-IV) survey data from a population-based cohort study (Project EAT)., Participants: Cohort members identified as parents at follow-up (n = 727). To gain additional data about the practices of both parents in the household, significant others completed surveys at EAT-IV (n = 380)., Main Outcome Measure: Frequency of family meals, healthfulness of foods at home, frequency of meals in front of the television, and expectations of being home for dinner., Analysis: Linear regression models tested associations between parent food and mealtime practices reported at baseline and follow-up controlling for demographics., Results: Healthy and unhealthy home food availability, expectations to be home for dinner, and eating in front of the television in adolescence predicted similar outcomes 15 years later among female parents (effect sizes range: β = .2-.3; P < .001), and to a lesser extent among males. Families ate more frequent family meals when either 1 or both parents reported frequent family meals as an adolescent compared with when neither parent reported frequent family meals as an adolescent., Conclusions and Implications: It is important to invest in parenting interventions that target healthful family food and mealtime practices because of the potential long-term impact on their own children's parenting practices., (Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

There are disparities in the prevalence of childhood obesity for children from low-income and minority households. Mixed-methods studies that examine home environments in an in-depth manner are needed to identify potential mechanisms driving childhood obesity disparities that have not been examined in prior research. The Family Matters study aims to identify risk and protective factors for childhood obesity in low-income and minority households through a two-phased incremental, mixed-methods, and longitudinal approach. Individual, dyadic (i.e., parent/child; siblings), and familial factors that are associated with, or moderate associations with childhood obesity will be examined. Phase I includes in-home observations of diverse families (n=150; 25 each of African American, American Indian, Hispanic/Latino, Hmong, Somali, and White families). In-home observations include: (1) an interactive observational family task; (2) ecological momentary assessment of parent stress, mood, and parenting practices; (3) child and parent accelerometry; (4) three 24-hour child dietary recalls; (5) home food inventory; (6) built environment audit; (7) anthropometry on all family members; (8) an online survey; and (9) a parent interview. Phase I data will be used for analyses and to inform development of a culturally appropriate survey for Phase II. The survey will be administered at two time points to diverse parents (n=1200) of children ages 5-9. The main aim of the current paper is to describe the Family Matters complex study design and protocol and to report Phase I feasibility data for participant recruitment and study completion. Results from this comprehensive study will inform the development of culturally-tailored interventions to reduce childhood obesity disparities., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Despite research linking family meals to healthier diets, some families are unable to have regular meals together. These families need guidance about other ways to promote healthy eating among adolescents., Objective: Our aim was to examine the association between various parenting practices and adolescent fruit and vegetable (F/V) intake at different levels of family meal frequency., Design: We conducted a cross-sectional, population-based survey of influences on adolescent weight-related behaviors using Project EAT (Eating and Activity in Teens) 2010., Participants/setting: Participants were 2,491 adolescents recruited from middle/high schools in Minneapolis/St Paul, MN., Measures: Adolescent F/V intake was ascertained with a food frequency questionnaire. Survey items assessed frequency of family meals and F/V parenting practices (availability, accessibility, parent modeling, parent encouragement, and family communication)., Statistical Analyses: Linear regression models were used to examine associations with and interactions among family meals and parenting practices. Models were adjusted for age, sex, socioeconomic status, race/ethnicity, and energy intake (kilocalories per day)., Results: Family meals, F/V availability, F/V accessibility, F/V modeling, and encouragement to eat healthy foods were independently associated with higher F/V intake. Of the 949 (34%) adolescents who reported infrequent family meals (≤2 days/wk), mean F/V intake was 3.6 servings/day for those with high home F/V availability vs 3.0 servings/day for those with low home F/V availability. Similar differences in mean F/V intake (0.3 to 0.6 servings/day) were found for high vs low F/V accessibility, parental modeling, and parent encouragement for healthy eating. Frequent family meals in addition to more favorable parenting practices were associated with the highest F/V intakes., Conclusions: Food parenting practices and family meals are associated with greater adolescent F/V intake. Longitudinal and intervention studies are needed to determine which combination of parenting practices will lead to improvements in adolescent diets., (Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Little is known about the healthfulness of foods offered at family meals or the relationship between the food's healthfulness and child overall dietary intake., Objective: This exploratory study uses a newly developed Healthfulness of Meal Index to examine the association between the healthfulness of foods served at family dinners and child dietary intake., Design: Direct observational, cross-sectional study., Participants/setting: Primarily low-income, minority families (n=120) video recorded 8 days of family dinners and completed a corresponding meal screener. Dietary recalls were completed on the target child (6 to 12 years old). The Healthfulness of Meal Index was used to measure meal healthfulness and included component scores for whole fruit, 100% juice, vegetables, dark green vegetables, dairy, protein, added sugars, and high-sodium foods., Main Outcome Measures: Child dietary intake measured by three 24-hour dietary recalls., Statistical Analyses Performed: Linear regression models estimated the association between the healthfulness of foods served at dinner meals and overall child HEI., Results: The majority of coded meals included foods from protein and high-sodium components; more than half included foods from dairy and vegetable components. Nearly half of the meals had an added-sugar component food (eg, soda or dessert). Few meals served foods from fruit, 100% juice, or dark green vegetable components. Many components served at family dinner meals were significantly associated with child daily intake of those same foods (ie, dark green vegetable, non-dark green vegetables, dairy, and added sugars). The Healthfulness of Meal Index total score was significantly associated with child HEI score., Conclusions: This study represents the first report of a new methodology to collect data of foods served at family dinners. Results indicated a significant association between the majority of components served at family dinner meals and child overall dietary intake. Validation of the Healthfulness of Meal Index and video-recorded family meal methodology is needed to strengthen these research methods for use in future studies., (Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of the study was to describe parent and adolescent involvement in food preparation for the family and to examine whether adolescents' food preparation involvement was related to their dietary quality (e.g., fruit and vegetable intake, sugar-sweetened beverage consumption, and various common nutrients) and eating patterns (e.g., frequency of breakfast, family meals, fast food intake)., Methods: Data from two linked population-based studies, Eating and Activity in Teens 2010 and Families and Eating and Activity among Teens were used in cross-sectional analyses. Mothers (n = 1,875), stepmothers (n = 18), fathers (n = 977), stepfathers (n = 105), and adolescents (n = 2,108) from socioeconomically and racially/ethnically diverse households participated in the study. Adolescents completed food frequency questionnaires and surveys in school. Parents individually completed surveys by mail or phone. Linear regression was used to estimate differences in adolescent dietary quality and eating patterns between those who do and do not engage in meal preparation., Results: Parent and adolescent report of "usually preparing food for the family" was related to several sociodemographic characteristics, including race/ethnicity (minority populations), parent education (college or higher), parent employment status (part time or stay-at-home caregiver), household size (≤3 children), and adolescent gender (female). Adolescent involvement in food preparation for the family was significantly associated with several markers of better dietary quality and better eating patterns. In contrast, parent involvement in food preparation for the family was unrelated to adolescent dietary intake., Conclusions: Results suggest that involving adolescents in food preparation for the family is related to better adolescent dietary quality and eating patterns. Public health interventions and health care providers may want to encourage adolescents to help with food preparation for the family. Additionally, adolescents may benefit from interventions/programs that teach cooking skills in order to increase the likelihood of participating in food preparation for the family., (Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

The current mixed-methods study examined the prevalence of negative weight-based talk across multiple family members (i.e., mother, father, older/younger brother, older/younger sister) and analyzed qualitative data to identify what negative weight-based talk sounds like in the home environment. Children (n=60; ages 9-12) and their families from low income and minority households participated in the study. Children reported the highest prevalence of negative weight-based talk from siblings. Among specific family members, children reported a higher prevalence of negative weight-based talk from mothers and older brothers. In households with younger brothers, children reported less negative weight-based talk compared to other household compositions. Both quantitative and qualitative results indicated that mothers' negative weight-based talk focused on concerns about child health, whereas fathers' and siblings' negative weight-based talk focused on child appearance and included teasing. Results suggest that interventions targeting familial negative weight-based talk may need to be tailored to specific family members., Competing Interests: Authors have no conflicts of interest to report., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: Little is known about parent feeding practices with siblings. Because this is a new area of research, qualitative research is needed to understand parents' perspectives about how they make decisions about feeding siblings and whether they adapt their feeding practices dependent on sibling characteristics such as weight status. The main objective of the current study was to describe parent feeding practices with siblings., Design: Qualitative cross-sectional study with 88 parents with at least 2 siblings., Setting: Parents were interviewed in their homes in Minneapolis/St Paul Minnesota., Participants: Parents were from racially/ethnically diverse (64% African American) and low-income households (77% earned < $35,000/y)., Main Outcome Measure: Parents' perceptions of feeding practices with siblings., Analysis: Qualitative interviews were coded using a hybrid deductive and inductive content analysis approach., Results: Parents indicated that they used child food preferences, in-the-moment decisions, and planned meals when deciding how to feed siblings. Additionally, the majority of parents indicated that they managed picky eating by making 1 meal or giving some flexibility/leeway to siblings about having other food options. Furthermore, parents endorsed using different feeding practices (eg, food restriction, portion control, pressure-to-eat, opportunities for healthful eating) with siblings dependent on child weight status or age/developmental stage., Conclusions and Implications: Findings from the current study may inform future research regarding how to measure parent feeding practices with siblings in the home environment and the development of interventions tailored for families with multiple children in the home. Future quantitative research is needed to confirm these qualitative findings., (Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: Few studies have examined concordance/discordance between caregivers to identify whether caregivers see familial and parental factors in the home environment similarly or differently and whether the agreement or disagreement is related to adolescent obesity risk. Answers to these questions are important and may inform whether family-based childhood obesity interventions need to target both parents., Objective: The main objective of the study was to examine whether and how parental concordance/discordance on factors in the home environment (eg, importance of family meals, parent feeding practices, encouraging child physical activity, and limit setting on child screen time) are associated with adolescent health behaviors and weight status., Design: Data from two linked population-based studies were used in cross-sectional analyses. Linear regression models examined associations between parental concordance/discordance on home environment factors and adolescents' health behaviors and weight status., Participant/settings: Racially/ethnically and socioeconomically diverse adolescents (n=1,052; 54% girls; mean age=14.3 years) and their parents (n=2,104; 52% women; mean age=41.0 years) from Minneapolis and St Paul, MN, participated in the study. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents., Results: Parental concordance on home environment factors was high for some factors (eg, 68% concordance on not pressuring adolescent to eat) and low for other factors (eg, 2% concordance on parent engaging in physically activity with child 4+ hours per week). Parental concordance on positive home environment factors (eg, frequency of family meals) was associated with more adolescent healthful eating patterns and hours of physical activity (P<0.05), but not consistently. When parents were discordant, adolescents had higher consumption of fast food and more unhealthy weight control behaviors (P<0.05), but not consistently., Conclusions: Results suggest there is some degree of parental concordance on home environment factors; however, the results were inconsistent and approximately one-third of parents were discordant on these factors. Future research is needed to further examine the role of parental concordance/discordance on adolescent health behaviors and weight status., (Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Research has shown that family weight talk and teasing are associated with child overweight status and unhealthy weight control behaviors. However, little is known about how weight talk and teasing are experienced in the home, how parents respond, and what factors influence whether weight talk and teasing occur. The main objective of this study is to qualitatively examine weight talk and teasing in the home environments of diverse low-income children. Parents (N=118) from a mixed-methods cross-sectional study were interviewed in their home. The majority of parents (90% female; mean age=35 years.) were from minority (65% African American) and low income (<$25,000/year) households. A grounded theory analysis found the following themes: weight talk contradictions, overt and covert weight talk/teasing, reciprocal teasing, and cultural factors related to weight talk/teasing. These themes should be addressed when developing family-based interventions to reduce weight talk and teasing in the home environment., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The aim of this study is to investigate individual and joint associations of the home environment and the neighborhood built environment with adolescent dietary patterns and body mass index (BMI) z-score. Racially/ethnically and socioeconomically diverse adolescents (n=2682; 53.2% girls; mean age14.4 years) participating in the EAT 2010 (Eating and Activity in Teens) study completed height and weight measurements and surveys in Minnesota middle and high schools. Neighborhood variables were measured using Geographic Information Systems data. Multiple regressions of BMI z-score, fruit and vegetable intake, and fast food consumption were fit including home and neighborhood environmental variables as predictors and also including their interactions to test for effect modification. Supportive family environments (i.e., higher family functioning, frequent family meals, and parent modeling of healthful eating) were associated with higher adolescent fruit and vegetable intake, lower fast food consumption, and lower BMI z-score. Associations between the built environment and adolescent outcomes were fewer. Interaction results, although not all consistent, indicated that the relationship between a supportive family environment and adolescent fruit and vegetable intake and BMI was enhanced when the neighborhood was supportive of healthful behavior. Public health interventions that simultaneously improve both the home environment and the neighborhood environment of adolescents may have a greater impact on adolescent obesity prevention than interventions that address one of these environments alone., (© 2013 Published by Elsevier Ltd.)

Cross-sectional and longitudinal research has shown that family meals are protective for adolescent healthful eating behaviors. However, little is known about what parents think of these findings and whether parents from single- vs dual-headed households have differing perspectives about the findings. In addition, parents' perspectives regarding barriers to applying the findings on family meals in their own homes and suggestions for more widespread adoption of the findings are unknown. The current study aimed to identify single- and dual-headed household parents' perspectives regarding the research findings on family meals, barriers to applying the findings in their own homes, and suggestions for helping families have more family meals. The current qualitative study included 59 parents who participated in substudy of two linked multilevel studies-EAT 2010 (Eating and Activity in Teens) and Families and Eating and Activity in Teens (F-EAT). Parents (91.5% female) were racially/ethnically and socioeconomically diverse. Data were analyzed using a grounded theory approach. Results from the current study suggest that parents from both single- and dual-headed households have similar perspectives regarding why family meals are protective for healthful eating habits for adolescents (eg, provides structure/routine, opportunities for communication, connection), but provide similar and different reasons for barriers to family meals (eg, single-headed=cost vs dual-headed=lack of creativity) and ideas and suggestions for how to increase the frequency of family meals (eg, single-headed=give fewer options vs dual-headed=include children in the meal preparation). Findings can help inform public health intervention researchers and providers who work with adolescents and their families to understand how to approach discussions regarding reasons for having family meals, barriers to carrying out family meals, and ways to increase family meals depending on family structure., (Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Research has shown that adolescents who frequently share evening meals with their families experience more positive health outcomes, including diets of higher nutritional quality. However, little is known about families eating together at breakfast., Objective: This study examined sociodemographic differences in family meal frequencies in a population-based adolescent sample. In addition, this study examined associations of family breakfast meal frequency with dietary quality and weight status., Design: Cross-sectional data from EAT 2010 (Eating and Activity in Teens) included anthropometric assessments and classroom-administered surveys completed in 2009-2010., Participants/setting: Participants included 2,793 middle and high school students (53.2% girls, mean age=14.4 years) from Minneapolis/St Paul, MN, public schools., Main Outcome Measures: Usual dietary intake was self-reported on a food frequency questionnaire. Height and weight were measured., Statistical Analyses Performed: Regression models adjusted for sociodemographic characteristics, family dinner frequency, family functioning, and family cohesion were used to examine associations of family breakfast frequency with dietary quality and weight status., Results: On average, adolescents reported having family breakfast meals 1.5 times (standard deviation=2.1) and family dinner meals 4.1 times (standard deviation=2.6) in the past week. There were racial/ethnic differences in family breakfast frequency, with the highest frequencies reported by adolescents of black, Hispanic, Native American, and mixed race/ethnicity. Family breakfast frequency was also positively associated with male sex, younger age, and living in a two-parent household. Family breakfast frequency was associated with several markers of better diet quality (such as higher intake of fruit, whole grains, and fiber) and lower risk for overweight/obesity. For example, adolescents who reported seven family breakfasts in the past week consumed an average of 0.37 additional daily fruit servings compared with adolescents who never had a family breakfast meal., Conclusions: Results suggest that eating breakfast together as a family can have benefits for adolescents' dietary intake and weight status., (Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

The last decade of research has suggested that family meals play an important role in promoting healthful dietary intake in youth. However, little is known about the structural characteristics and interpersonal dynamics of family meals that might help to inform why family meals are protective for youth. The current mixed methods, cross-sectional study conducted in 2010-2011 includes adolescents and parents who participated in two linked population-based studies. Participants included 40 parents (91.5% female) and adolescents (57.5% female) from the Minneapolis/St Paul, MN, area participating in EAT (Eating and Activity Among Teens) 2010 and F-EAT (Families and Eating and Activity Among Teens). The structural (eg, length of the meal, types of foods served) and interpersonal characteristics (eg, communication, emotion/affect management) of family meals were described, and associations between interpersonal dynamics at family meals and adolescent body mass index and dietary intake were examined via direct observational methods. Families were videorecorded during two mealtimes in their homes. Results indicated that family meals were approximately 20 minutes in length, included multiple family members, were typically served family style (70%), and occurred in the kitchen 62% of the time and 38% of the time in another room (eg, family room, office). In addition, significant associations were found between positive interpersonal dynamics (ie, communication, affect management, interpersonal involvement, overall family functioning) at family meals and lower adolescent body mass index and higher vegetable intake. These findings add to the growing body of literature on family meals by providing a better understanding of what is happening at family meals in order to inform obesity-prevention studies and recommendations for providers working with families of youth., (Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Purpose: This article examines the relationship between family functioning (e.g., communication, closeness, problem solving, behavioral control) and adolescent weight status and relevant eating and physical activity behaviors., Methods: Data are from EAT 2010 (Eating and Activity in Teens), a population-based study that assessed eating and activity among socioeconomically and racially/ethnically diverse youths (n = 2,793). Adolescents (46.8% boys, 53.2% girls) completed anthropometric assessments and surveys at school between 2009 and 2010. Multiple linear regression was used to test the relationship between family functioning and adolescent weight, dietary intake, family meal patterns, and physical activity. Additional regression models were fit to test for interactions by race/ethnicity., Results: For adolescent girls, higher family functioning was associated with lower body mass index z score and percent overweight, less sedentary behavior, higher intake of fruits and vegetables, and more frequent family meals and breakfast consumption. For adolescent boys, higher family functioning was associated with more physical activity, less sedentary behavior, less fast-food consumption, and more frequent family meals and breakfast consumption. There was one significant interaction by race/ethnicity for family meals; the association between higher family functioning and more frequent family meals was stronger for nonwhite boys compared with white boys. Overall, strengths of associations tended to be small, with effect sizes ranging from -.07 to .31 for statistically significant associations., Conclusions: Findings suggest that family functioning may be protective for adolescent weight and weight-related health behaviors across all race/ethnicities, although assumptions regarding family functioning in the homes of overweight children should be avoided, given small effect sizes., (Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To explore multiple family members' perceptions of risk and protective factors for healthful eating and physical activity in the home., Design: Ten multifamily focus groups were conducted with 26 families., Setting and Participants: Community setting with primarily black and white families. Family members (n = 103) were aged 8 to 61 years., Main Outcome Measures: Risk and protective factors for healthful eating and physical activity in the home environment., Analysis: A grounded hermeneutic approach., Results: Ten major themes were identified by family members related to health behaviors in the home environment, including accessibility to healthful foods and activity, time constraints, stage of youth development, individual investment in health behaviors, family investment in health behaviors, family meals and shared activities, parent modeling, making health behaviors fun, making health behaviors part of the family lifestyle, and community investment in family health behaviors., Conclusions and Implications: This study identified the importance of the family system and the reciprocal influences within the home environment on health behaviors. In addition, individual and community-level suggestions were identified. Insights from the families provide leads for future research and ideas for the prevention of youth obesity., (Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Weight teasing is common among adolescents, but less is known about the continuation of this experience during young adulthood. The present study uses survey data from a diverse sample of 2287 young adults, who participated in a 10-year longitudinal study of weight-related issues to examine hurtful weight comments by family members or a significant other. Among young adults, 35.9% of females and 22.8% of males reported receiving hurtful weight-related comments by family members, and 21.2% of females and 23.8% of males with a significant other had received hurtful weight-related comments from this source. Hispanic and Asian young adults and overweight/obese young adults were more likely to report receiving comments than those in other groups. Weight teasing during adolescence predicted hurtful weight-related comments in young adulthood, with some differences by gender. Findings suggest that hurtful weight talk continues into young adulthood and is predicted by earlier weight teasing experiences., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Purpose: To learn about parent weight talk, parent dieting, and family weight-teasing in the homes of adolescent girls at risk for obesity and weight-related problems. To examine associations between these family variables and girls' weight status, body satisfaction, and disordered eating behaviors., Methods: Data were collected at baseline from girls participating in a school-based intervention to prevent weight-related problems. Participants included 356 adolescent girls from 12 high schools. The girls' mean age was 15.8 years; 46% were overweight or obese; and more than 75% were racial/ethnic minorities., Results: A high percentage of girls reported parent weight talk (i.e., comments about one's own weight and encouragement of daughter to diet), parent dieting, and family weight-teasing. For example, 45% of the girls reported that their mothers encouraged them to diet and 58% reported weight-teasing by family members. Weight-teasing was strongly associated with higher body mass index, body dissatisfaction, unhealthy and extreme weight control behaviors, and binge eating with loss of control in the girls. Parent weight talk, particularly by mothers, was associated with many disordered eating behaviors. Mother dieting was associated with girls' unhealthy and extreme weight control behaviors. In no instances were family weight talk and dieting variables associated with better outcomes in the girls., Conclusions: Parent weight-related comments and dieting behaviors, and family weight-teasing, may contribute to disordered eating behaviors in adolescent girls. Health care providers can help parents provide a supportive home environment by discouraging weight-based comments, which may be intended to be helpful, but can have unintentional harmful consequences.

Background: Research on family meals in the past decade has shown a positive association between family meal frequency and adolescent healthy dietary intake. However, less is known about factors within the home environment, such as parenting style, that may be associated with family meal patterns., Objective: The purpose of this study is to test cross-sectional and 5-year longitudinal associations between parenting styles (authoritative, authoritarian, permissive, and neglectful) and the frequency of family meals among adolescents., Study Design: Data were from Project Eating Among Teens, a population-based study comprised of youth from diverse ethnic/racial and socioeconomic backgrounds. Two cohorts of adolescents (middle school and high school) completed in-class surveys in 1999 (Time 1) and mailed surveys in 2004 (Time 2). Multiple linear regression models were used to predict mean frequency of family meals at Time 1 and Time 2 from adolescent report of parenting style (both mother and father) at Time 1. Cross-sectional analyses included both adolescent cohorts (n=4,746) and longitudinal analyses included only the younger cohort (n=806) because family meal frequency was not assessed in the older cohort at Time 2., Results: Cross-sectional results for adolescent girls indicated a positive association between maternal and paternal authoritative parenting style and frequency of family meals. For adolescent boys, maternal authoritative parenting style was associated with more frequent family meals. Longitudinal results indicated that authoritative parenting style predicted higher frequency of family meals 5 years later, but only between opposite sex parent/adolescent dyads., Conclusions: Future research should identify additional factors within the home environment that are associated with family meal frequency to develop effective interventions that result in increased family meals for youth. Also, future research should investigate the mealtime behaviors of authoritative parents and identify specific behaviors that dietetics practitioners and other health care providers could share with parents of adolescents to help them increase family meal frequency., (Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)

Purpose: Current research indicates that specific parenting styles are associated with adolescent overweight, dietary intake, and physical activity; but most of the research has been cross-sectional, making it difficult to determine the temporal order of these associations. The current study adds to the previous research by examining 5-year longitudinal associations between parenting style and adolescent weight and weight-related behaviors., Methods: Data from Project EAT, a population-based study with adolescents from diverse ethnic and socioeconomic backgrounds, were used. Adolescents (N = 2,516) from 31 Minnesota schools completed in-class assessments in 1999 (Time 1) and mailed surveys in 2004 (Time 2). Multiple linear regression models were used to predict mean levels of adolescent outcomes at Time 2 from parenting style at Time 1., Results: Time 1 maternal authoritative parenting style predicted lower body mass index in adolescent sons and daughters at Time 2. Time 1 paternal permissive parenting style predicted more fruits and vegetables intake in daughters at Time 2. Significant associations were not found between parenting style and adolescent physical activity., Conclusions: Findings suggest that authoritative parenting style may play a protective role related to adolescent overweight and that the dimension of warmth and/or caring in the parent-adolescent relationship may be important in relation to female adolescent healthy dietary intake. Further exploration of opposite sex parent-adolescent dyad patterns related to parenting style and adolescent weight and weight-related behaviors is warranted., (Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.)