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Regular physical activity and balanced nutrition are important in maintaining a healthy weight. Nonetheless, minority populations, like Hispanics, face challenges (e.g., language barriers and transportation unavailability) that limit their participation in intervention programs to receive benefits. Furthermore, dog companionship has been shown to relate to adolescents' behavioral and socio-emotional development positively, and it has been shown to have the potential to increase physical activity in adolescence. Therefore, this study aimed to examine the feasibility, i.e., program adaptation, limited efficacy, and acceptability, of the two exercise and nutrition education interventions to improve body composition, motivation, and well-being in overweight and obese Hispanic adolescents. This pilot study was a quasi-experimental trial with eight pediatrician-referred participants (M[subscript age] =11.75±1.48) assigned to two parallel arms: (1) BRAVO! and (2) BRAVO!+. Both share identical exercise (24 hours) and nutrition (12 hours) programs centered on the self-determination theory for 12 weeks. The results suggested, first, acceptable attendance (BRAVO! = 56.25%; BRAVO!+ = 64.58%) but poor retention (BRAVO! = 33.33%; BRAVO!+ = 63.63%). Second, the findings suggested promising limited efficacy in BRAVO!+ group, with small but statistically non-significant reductions in participants' BMI (M[subscript baseline] = 33.08±6.13; M[subscript post] = 32.23±6.88; t[3] = 1.633, p = 0.201) and weight (M[subscript baseline] = 78.13±16.22; M[subscript post] = 77.62±17.64; t[3] = 0.485, p = 0.661). In addition, the results suggested high satisfaction and acceptable suitability for both programs and providing important suggestions for the future. In conclusion, our pilot study findings only partially supported the feasibility of the pet-dog-enhanced lifestyle intervention. Although this study found evidence that pet-dog companionship can improve program satisfaction and acceptability of pediatric lifestyle interventions, including a pet-dog in the intervention may contribute to high dropout evidenced in this study.

Objective: This study examined the relationships between ADHD symptomatology, the motivations for physical activity (PA) according to self-determination theory, and the acceptability of three PA promotion technologies (active video game, mobile application, and telehealth) according to the dimensions of the unified theory of acceptance and use of technology-2 (UTAUT2). Method: A total of 312 women, aged 30.7 ± 7.1 years, followed for obesity with an average body mass index of 34.5 ± 7.8 kg/m[superscript 2], were included in this sub-analysis. Results: Fifty-seven individuals (18.3%) were identified with positive screening symptoms of ADHD. No differences emerged regarding acceptability of technology-based PA. However, individuals with positive screening for ADHD tended to have higher scores for acceptability of active video game on the UTAUT2 dimensions of effort expectancy and hedonic motivation. Conclusion: This study suggests that active video game may be more appropriate than other technologies for individuals with obesity and ADHD symptoms

Objectives: Overweight and obesity among school-aged children pose a threat to both their academic performance and public health. The Healthy Primary School of the Future (HPSF) initiative was established to address this issue. Our objective was to explore the conditions that make HPSF sustainable based on the perspectives of relevant stakeholders. Design: The study utilised Group Concept Mapping, a structured methodology for conducting mixed-methods participative research, combining qualitative data collection with quantitative data analysis measures. Method: Participants included parents, teachers, school directors, politicians, labour unions, educational, nutrition and health scientists and policymakers. They were asked to respond to the prompt, 'A necessary condition to make the HPSF sustainable is . . .'. The statements generated were then assessed for their importance and feasibility. Using multidimensional scaling and hierarchical cluster analyses, we identified the shared vision among the stakeholders. Results: A total of 106 unique statements were generated and grouped statistically into 10 clusters. The most significant clusters were identified as Financing; Accessibility for everyone; and Content/Lifestyle/School Programme. The clusters that were deemed most feasible included Content/Lifestyle/School Programme; Accessibility for everyone; and Evaluation. Conclusion: Achieving sustainability for the HPSF requires a comprehensive approach that addresses the conditions outlined in all 10 clusters. Based on the ratings of feasibility and importance, our recommendation is to prioritise implementation of Content/Lifestyle/School Programme and Accessibility for everyone. Subsequently, efforts should be directed towards realising the less feasible but crucial conditions, such as Financing and Evaluation, followed by the remaining six clusters of conditions as identified.

This systematic review evaluated interventions and relevant outcomes for health promotion and obesity prevention among children and adolescents with developmental disabilities (DD). Twenty-one studies including randomized control trials (n= 9) and quasi-experimental studies (n=12) published between 2010 and 2021 met inclusion criteria related to participant characteristics, intervention type, and child obesity-related outcomes. Five types of intervention programs were identified: aerobic and strength training, sport-based physical activity, aquatic exercise, active video gaming, and diet and lifestyle. Whereas analysis of intervention outcomes, efficacy, and study rigor showed mixed results and weak evidence of effective interventions, this review identified gaps in the literature, promising strategies for addressing obesity in children with DD, and implications for practice and future research.

Views of obesity as a consequence of "lack of willpower" or other behavioral choices, rather than a complex array of biological and other factors, are quite common among undergraduate students. Many undergraduates in prenursing or biology programs have little exposure to the physiology and pathophysiology of obesity, including learning about leptin and other hormones involved in appetite control. I developed materials for teaching about the pathophysiology of obesity in two different pathophysiology courses: one designed as a survey of pathophysiology topics for prenursing majors, and the other designed as an in-depth exploration of the molecular and cellular basis of selected diseases for upper-division biology majors. In the molecular basis of disease course, obesity is covered as part of a unit organized around metabolic syndrome. The discussion includes molecular and cellular mechanisms that link obesity to several other diseases, including type 2 diabetes and atherosclerosis. This article briefly describes the approaches I have taken for teaching obesity to two different undergraduate student populations and lists several resources that may be useful tools for teaching about obesity.

Reading nutrition facts labels is a competency for which training is given in several nutrition education programs, especially in obesity outreach workshops. The Top Trumps-style card game is commonly used in obesity prevention educational programs to engage participants in reading nutrition facts labels; however, the success of TV cooking shows among children and teenagers has not been explored for educational purposes. This paper is a descriptive study of developing a gamified activity as part of the one-time outreach workshop facilitated by the Obesity and Comorbidities Research Center (OCRC) in Brazil. By playing the MestreChef Nutritional (MCN) game, participants followed similar rules as the corresponding TV cooking show. They were challenged to decide to select food items, calculate dietary food intake, and prepare a recipe to visualize the proportion of macronutrients contained in daily diets. The analysis of the nutritional dietary table completed by participants revealed to be a rich source of information, and we identified in our cohort that selecting an adequate number of food items and making healthy food choices was not concerning. However, their lack of competency in performing mathematical reasoning, particularly in calculating serving sizes and converting grams of macronutrients into calories, was evident. Moreover, facilitators of the workshops agreed that the MCN game presents definitively more didactic effectiveness and playability than the Foods Top Trumps, a former game used in the outreach workshops. The MCN game nourishes the engagement of the participants in learning nutrition-related concepts and may be an efficient didactic resource to improve nutrition knowledge in outreach activities when an alternative method is required to stimulate reading nutrition facts labels.

Diabetes mellitus and obesity are major public health issues that significantly impact the health care system. The next generation of health care providers will need a deep understanding of the pathophysiology of these diseases if we are to prevent, treat, and eventually cure these diseases and ease the burden on patients and the health care system. Physiology core concepts are a set of core principles, or "big ideas," identified by physiology educators that are thought to promote long-term retention, create a deeper understanding, and help with formation of critical thinking skills. Here we describe our scaffolded teaching approach in an upper year undergraduate pathophysiology course to educate students about these two diseases and discuss how learning about the basis of these highly integrative diseases from the biochemical to whole body level is a meaningful tool in the physiology educator toolbox to reinforce physiology core concepts. This teaching strategy is designed to engage students in the scientific process and hone their problem-solving skills such that they are hopefully equipped to treat and eventually cure these diseases as they move forward in their careers.

Current childhood obesity treatment programs do not address medically underserved populations or settings where all members of an interdisciplinary team may not exist - either within one organization or within the community. In this paper, we describe the use of a community-academic partnership to iteratively adapt Epstein's Traffic Light Diet (TLD), into Building Healthy Families (BHF), a community-placed evidence-based pediatric weight management intervention (PWMI) and evaluate its effectiveness in reducing BMI z scores. Nine cohorts of families completed BHF. Participants included children aged 6-12 years with obesity (M = 9.46, SD = 1.74). The Framework for Reporting Adaptations and Modifications-Expanded guided our classification of modifications across BHF cohorts. Using the FRAME reporting structure, the changes that were documented were (1) planned and occurred pre-implementation, (2) based on decisions from local stakeholders (e.g., school administrator, members of the implementation team), and (3) specific to changes in content and context - with a focus on implementation and potential for local scale-up. The nature of the adaptations included adding elements (whole of family approach), removing elements (calorie counting), and substituting elements (steps for minutes of physical activity). Across 9 cohorts, 84 families initiated the BHF program, 69 families successfully completed the 12-week program, and 45 families returned for 6-month follow-up assessments. Results indicated that the BMI z score in children was reduced by 0.31 ± 0.17 at 6 months across all cohorts. Reduction in BMI z score ranged from 0.41 in cohort 4 to 0.13 in cohort 5. Iterative adaptations to BHF were completed to improve the fit of BHF to the setting and participants and have contributed to a sustained community PWMI that adheres to the underlying principles and core elements of other evidence-based PWMIs. Monitoring adaptations and related changes to outcomes can play a role in long-term sustainability and effectiveness.

Previous studies have suggested the impact of intervention fidelity on the management and prevention of chronic diseases; however, little is known about the effect of the contributing determinants (at multiple levels of influence) that can impact health-related interventions intending to improve the health status of Hispanic adolescents with overweight or obesity. The current study aimed to assess whether fidelity (i.e., dosage and quality of the program delivery), acculturation (i.e., orientation to the American culture, retention of Hispanic cultural values), and individual-level socio-demographic characteristics (i.e., income, education) predict changes in family processes (e.g., parent control), which in turn may affect adolescent health-related outcomes including body mass index (BMI), physical activity, dietary intake, and adolescents' health-related quality of life. A pathway analysis model was utilized to explore the study variables among 140 Hispanic parent-adolescent dyads randomized to Familias Unidas Health and Wellness (FUHW) intervention. Results indicated that fidelity was significantly associated with changes in parent-adolescent communication, parent monitoring, limit-setting, and control. Parents' education was associated with changes in parent limit-setting, and parent Hispanicism was associated with changes in parent limit-setting and discipline. The examination between family processes and adolescent health outcomes revealed that parents' higher discipline and improved communication with their adolescents were significantly associated with improved adolescents' quality of life, and parent control was positively associated with physical activity and negatively associated with BMI in adolescents. Our findings demonstrated the significant contribution of intervention fidelity and participants' characteristics in parenting strategies leading to adolescents' health outcomes to prevent obesity-related chronic diseases. Future research is needed to investigate the effect of environmental and organizational factors on the delivery of the intervention materials.

Overweight and obesity in childhood has reached epidemic levels, and their roles in physical and psychological health are now recognized. Recently, researchers have focused on the impact of these weight problems in health-related quality of life (HRQoL) domains, which are less investigated in children. This exploratory study examined the differences in HRQoL domains between a clinical group who were overweight/obesity treatment-seeking (n = 58) and a normal-weight group (n = 44) in a sample of 102 children, with a specific focus on school functioning and well-being. The second aim explored the link between our findings and other HRQoL dimensions. After controlling for sex and age, a multivariate analysis of variance showed lower levels in school functioning and well-being dimensions between overweight/obesity than normal-weight (F = 4.72; p < 0.05). Correlation analyses highlighted positive links between lower school functioning and well-being and lower levels of self-esteem (r = 0.308; p < 0.01) and social domains in terms of friendships (r = 0.522 ; p < 0.001) and family relationships (r = 0.561; p < 0.001) in children who were with overweight and obesity. This study discusses the implications of these findings in educational research and practices.

Research suggests participating in youth hands-on cooking programs, like those offered by Extension and 4-H, can improve nutrition behaviors and reduce the risk for obesity. We surveyed Georgia Extension professionals (n = 127) to explore factors (e.g., employee characteristics, resources, county demographics) related to offering youth hands-on cooking programs and curricula used. Over 2/3 of participants offer programs and reported creating their own curriculum. More years of experience, having received Extension Specialist training, and increased confidence were positively related to offering these programs. Results suggest training could increase confidence and program implementation and standard curricula may be needed/

A family-skills program for Latino fathers and youth was implemented to prevent youth obesity. Lessons learned focused on practices to address barriers to engagement and retention among fathers and youth within the Latino community. Program development issues included selection of organizations, facilitators, language, and delivery methods. Implementation issues included timing and location. Cultural issues regarding learner needs, and teaching and implementation methods need to be considered. Using the lessons learned, Extension professionals can create impactful programs that engage and retain Latino fathers and youth.

Healthy nutrition is essential in preventing possible diseases and treating existing diseases by controlling their course. Based on this importance, adolescence is one of the periods to be considered. Adolescence is a fundamental determinant of healthy life in adulthood and old age. Healthy nutrition awareness gained in this period will raise awareness of the adolescent individual herself/himself and the people around her/him. This research aimed to determine the nutrition awareness of middle school students in early adolescence. According to the phenomenology, the research was conducted with eight volunteer students in the 8th grade in a public middle school in the Central Anatolia region in Turkey. Data were collected through semi-structured interviews with each student individually using the "Interview Form about Nutrition Awareness in Adolescence Period" prepared by the researchers. The data were analyzed by using content analysis. As a result of the research, it was determined that the nutrition awareness of middle school students in the early adolescence period was low. In this context, increasing middle school students' nutrition awareness was recommended.

The worldwide increase in childhood overweight and obesity underscores the need to study variables like fundamental movement skill (FMS) levels from early childhood. This study investigated the bidirectional longitudinal relationship between body mass index (BMI) and process-oriented FMSs, including locomotor skills and object control skills in 675 Finnish children, aged 3-8 years at baseline (50.5% female, mean age 5.5 years) over 3 years. Standardized BMI-for-age SD scores (BMI SDS z-scores) followed Finnish national standards. The FMS assessment comprised four subtests from the Test of Gross Motor Development, third edition. Age-adjusted standardized residuals of FMS or skill domains and BMI SDS z-scores were used in a two-level, cross-classified, cross-lagged regression analysis, accounting for gender, and baseline value of the dependent variables. The results showed no statistically significant longitudinal relationship between BMI and FMS or its skill domains for either gender in either direction. This suggests that BMI and process-oriented FMS, encompassing locomotor skill and object control skill, develop independently, possibly influenced by unexplored variables. These findings contradict earlier results based on product-oriented measurements, which may include a physical capacity component. The outcomes further underscore the importance of monitoring weight status from early childhood, given its significant association with later-life weight conditions.

Research has shown that Physical Education (PE) is a white, male, and able body-dominated profession, particularly in Spain. When some female pre-service PE teachers, who had a difficult relationship with their bodies and sports abilities, enrol in such a degree, some of these problematic relations come to light. Participants for this study were four female pre-service teachers who self-identified as lesbian, anorexic, visually impaired, and big respectively. Data were collected through participant-produced texts, graphical representations, and interviews. The authors then reconstructed the participants' stories which are presented in the form of narratives. The conceptual tool of embodying norm-criticality helped us to highlight the importance of critical reflection about own beliefs, past experiences and understandings, and their influence on pedagogical practices in PE. This study contributes to the push towards a change of the stereotypical beliefs of what a PE teacher should be or look like, and in this way, emphasises the vast benefits of diversifying PE teachers' beliefs and understandings.

Background: The COVID-19 pandemic imposed social isolation measures, which impacted the child population, especially regarding physical and mental health aspects. Purpose The aim of this study was to investigate the relationship between sedentary behavior, cardiorespiratory fitness, immunoglobulin -A secretion, and anxiety symptoms in 267 children aged 6-11 years, eutrophic or overweight. Methods: Sedentary behavior was evaluated by the time of exposure to screens. Cardiorespiratory fitness was assessed using the 6-minute run/walk test and immunoglobulin-A by salivary samples. Anxiety symptoms were reported by the SCAS-version for parents. Results: It was observed that after a period of confinement, overweight in children had a negative impact on cardiorespiratory performance and sedentary behavior. Differences were also observed in the concentration and secretion rate of SIgA in the overweight group compared to the normal weight group. Discussion: The return to face-to-face classes brought a high proportion of overweight students, who showed lower aerobic performance. Considering sedentary behavior, all groups presented values greater than 2 hours of daily exposure to screens. Translation to Health Education Practice: Special attention is needed from health professionals and teachers in relation to reducing sedentary behavior and improving cardiorespiratory fitness in schoolchildren.

Objective: This cross-sectional study examined the weight bias attitudes and obesity beliefs of health science (HS), nursing, and pre-medicine undergraduate students. Methods: Using snowballing and convenience sampling strategies, students (N = 139) completed an online survey, including a 24-item Antifat Attitudes Scale (AFAS) and eight-item Belief About Obese Persons (BAOP) scale. Results: HS students have higher weight bias than nursing and pre-medicine students combined (M = 43.45, SD = 10.75), t(137) = -2.45, p = 0.016). A negative correlation exists between AFAS and BAOP suggesting high weight bias influences a belief that obesity is controllable. Gender positively predicted weight bias attitudes ([beta] = -11.43, t = -4.33, p < 0.001) and obesity beliefs ([beta] = 3.75, t = 3.01, p = 0.003). Conclusions: Findings confirm that HS students have weight bias attitudes. This supports undergraduate curricular changes on obesity etiology that may improve treatment plans of individuals who are obese.

Purpose: This paper aims to investigate how narrative is constructed to create connections with fat readers, how books function to envision spaces of fat liberation for young readers and to highlight the incredible importance of providing bigger mirrors (Bishop, 1990) for fat representation in children's literature. Design/methodology/approach: This paper analyzes and reflects on two texts that contain counternarratives of fatness: The (Other) F Word: A celebration of the fat and fierce edited by Angie Manfredi (2019) and Big by Vashti Harrison (2023) to interrogate how these two narratives intentionally disrupt anti-fat bias. Findings: Body size and fatness are identities that need to be included in diversity efforts within education. Books like The (Other) F Word: A celebration of the fat and fierce (Manfredi, 2019) and Big (Harrison, 2023) offer positive representations of fatness, disrupt biases around body size and provide spaces that allow fat students to find joy, hope, connection and, more than anything, imagine a way toward liberation. Research limitations/implications: This paper highlights the need to include more narratives of positive fat representation within children's literature and calls for educators to interrogate their own anti-fat biases and practices. Originality/value: There is a lack of research on fat representation specifically within children and young adult literature. This paper provides an analysis of two pieces of literature with fat representation that brings attention to the need for this type of future research.

Purpose: This study aims to use an autoethnography and ethnopoetic approach, interweaving personal narratives with scholarly research, to illuminate the profound and far-reaching consequences of fat phobia. Through a multifaceted lens, the lived experiences of a fat, black woman subjected to fat shaming, discrimination and societal prejudice are explored. Design/methodology/approach: Ethnopoetic methodologies were used to showcase how creating critically compassionate dialogues on fat phobia can be used to create discursive spaces where fat folx are able to share their lived experiences, discuss how they are socialized into current beliefs and analyze the confluence of face, gender, fat and body positivity. Findings: By artfully blending autoethnographic memories with poetical insight, the manuscript offers a poignant exploration of the emotional and psychological toll exacted upon those marginalized by fat bias. Originality/value: The works aims to cultivate understanding and empathy, fostering a deeper awareness of the urgent need to challenge and dismantle fat phobia within educational institutions and society at large for the betterment of all individuals.

Purpose: In recent years, issues related to body image, fat shaming, and societal perceptions of weight have gained more attention in educational discourse (Carmona-Márquez, "et al.," 2023; Dark and Aphramor, 2023; Nutter, Ireland, Alberga, "et al.," 2019; Schorb, 2022). The purpose of this paper is to explore the importance of engaging students and educators to critically examine fat ideology in teacher education and P-12 classrooms through the lens of multicultural education. Design/methodology/approach: Using a multicultural lens to examine fat phobia in education. Findings: This paper explores the importance of engaging students and educators to critically examine fat ideology in teacher education and P-12 classrooms through the lens of multicultural education. Practical implications: By acknowledging the intersection of body image bias with cultural diversity, educators can foster inclusive environments that challenge harmful stereotypes and promote body positivity. This paper also provides strategies for integrating discussions on fat ideology within the multicultural education framework, aiming to empower both teachers and students from a multicultural education perspective to think critically and advocate for social justice. Social implications: This paper also provides strategies for integrating discussions on fat ideology within the multicultural education framework, aiming to empower both teachers and students from a multicultural education perspective to think critically and advocate for social justice. Originality/value: The issue of fat phobia is rarely discussed in education.

Purpose: Early childhood and early elementary are key times when children develop internal and external antifat attitudes; thus, it is necessary to better understand the available children's literature around fatness. This paper aims to examine children's picture books with fat protagonists to better understand the current landscape of children's literature. Drawing on relevant literature around fat characters and the fat studies movement, this critical content analysis considers five children's books featuring fat protagonists. Design/methodology/approach: This study uses critical content analysis to analyze texts featuring fat protagonists, including two rounds of initial reading and analysis. Using lenses of critical literacy and critical multicultural analysis, the author looks for common themes, silences and absences in the texts, images and peritext. Findings: This paper identifies themes of characters initially internalizing antifatness, then pushing back against antifat bias toward existing with joy and without stigma. Several of these texts even draw on the history of fat activism, highlighting societal critique and a potential activist component of children's literature with fat protagonists. Research limitations/implications: The study has a small number of books, due to the limited number of texts that fit the study parameters. Practical implications: The paper concludes with examples of scaffolding for teachers and parents to have conversations with young children about antifat bias while also acknowledging notable absences, particularly boy protagonists. Social implications: These themes illustrate the power of young children to push back against antifat bias and critique oppressive social structures. Originality/value: There have been very few studies looking at antifatness in children's picture books. With more books with fat protagonists coming out in the 2020s, this study offers an understanding of the themes present, while also emphasizing the need for an intersectional approach to literature with fat protagonists.

Purpose: This paper aims to address weight-based bullying as a persistent issue among adolescents. Fat phobia, rooted in societal biases against overweight individuals, leads to social exclusion and discrimination, negatively impacting mental health and equality. Educational settings suffer from the profound effects of fat phobia, creating a toxic atmosphere that distracts from learning and marginalizes students who don't conform to traditional physical norms. Design/methodology/approach: This paper combines historical analysis, literature review and critical discourse analysis. It examines the historical roots of fat phobia, explores the impact of societal influences, analyzes contemporary educational practices and the use of popular culture as a innovative tool. Findings: Leveraging popular culture in anti-fat phobia education effectively challenges stereotypes. Educators empower students to critically analyze media depictions, encouraging empathy and inclusivity. Current events serve as critical teaching tools, sparking discussions on intersecting discrimination forms and equity. Practical implications: This paper emphasizes the urgent need to comprehensively address fat phobia in education, advocating for a shift in societal attitudes toward body diversity. Popular culture can serve as an educational tool to create inclusive classrooms where all students are valued and free from weight-based discrimination. Social implications: This paper emphasizes the urgent need to comprehensively address fat phobia in education, advocating for a shift in societal attitudes toward body diversity. Popular culture can serve as an educational tool to create inclusive classrooms where all students are valued and free from weight-based discrimination. Originality/value: The originality and value of this paper lie in its multi-faceted approach to examining weight-based discrimination, its historical context, practical educational strategies, and the innovative use of popular culture as a tool for promoting inclusivity and empathy.

Objective: This cross-sectional study examined students' perspectives on the ramifications of obesity being recognized as a chronic disease in Canada. Participants: Undergraduate and graduate students (n = 150) in health-related programs at a major Canadian university. Methods: An online survey featured open-ended questions to capture student perspectives on recognizing obesity as a disease. Data were evaluated using content analysis methods. Results: Positive themes identified included: (a) treatment accessibility; (b) improved healthcare provider attitudes; (c) de-stigmatization of obesity; (d) promotion of health behaviors; and (e) greater research/funding. Negative themes included potential: (a) healthcare system burdens; (b) perpetuation of obesity stigma; (c) medicalization of obesity; and (d) de-emphasis on modifiable risk factors as contributing to obesity. Conclusions: There is a need to increase students' understanding of the multifaceted nature of obesity and the prevention of obesity-related stigma within healthcare. Findings may inform post-secondary health curricula and obesity initiatives.

The increased focus on preventing obesity in physical education spaces often leads to weight-centric ideology and anti-fat attitudes that subject fat students to weight stigma and can reduce their enjoyment of and engagement in physical activity. To promote lifelong physical activity and health among students, physical educators must reexamine their beliefs regarding weight as an indicator of both health and capacity for physical activity. This article discusses common misconceptions about the relationship between weight, health, and physical activity and provides examples and resources for educators to create a more weight-inclusive physical education program.

The present study investigates the effect of obesity and overweight on children's cognitive abilities and well-being using survey data from West Bank schools. The results show the significant adverse impact of obesity on a child's well-being by raising externalizing (behavioral) problems and increasing the probability of classifying a child with abnormal mental health difficulties, according to the Strength and Difficulties Questionnaire (SDQ), while no such impact was founded on the cognitive test results. The analysis further exposes that teachers' negative attitude toward obese students is an important factor that contributes to the association between obesity/overweight and higher SDQ scores.

This paper describes how eight London nurseries examined whether better use of bicycles would strengthen children's physical activity as a step to reducing child obesity. The nurseries are part of a social enterprise which offers one-third of the 4200 nursery places to children from poor and disadvantaged families/communities where rates of child obesity are high and increasing. The research was instigated because the nurseries built a partnership with Bikeworks which provided free bikes and staff wanted to ensure they were using them effectively to benefit children. Parents were involved but also asked a specific question about interest in a bike lending scheme. The paper concluded that staff became more observant of how they could enhance their practice using bikes to support children's physical and sociolinguistic development. It heightened the importance of observation of the children but also in identifying barriers such as poor cycling surface and state of bike repairs. Parents considered bikes to be a key part of their children's nursery life especially extending physical skills but were divided evenly about the value of introducing a bike lending scheme.

Objective: To examine the association of CRF and adiposity with cardiometabolic risk factors and metabolic syndrome among emerging adults. Participants: 5681 (60.1% Men; 21 ± 1years) college students from a large university located in the northeast of the United States. Methods: Participants completed an objective health assessment that involved the assessment cardiometabolic risk factors, CRF, and adiposity. Data of 5681 students' (60.1% Men; 21 ± 1years) who had CRF, adiposity, all risk factors necessary to determine metabolic syndrome evaluated were analyzed using logistic regression analyses. Results: Poor CRF and elevated adiposity were associated with cardiometabolic risk factors and metabolic syndrome regardless of sex, with the association between adiposity and risk factors found to be stronger compared to CRF. Conclusions: Targeted and tailored screening and interventions are urgently needed to reduce adiposity and increase CRF to avoid serious short and long-term negative health outcomes in this population.

Background: Internationally 18% of youth are obese. Fitness testing can be used to establish fitness surveillance, which can inform policy and targeted interventions aimed at addressing obesity. The purpose of this study was to estimate the prevalence of overweight, obesity, and low fitness in Idaho school-aged youth through a pilot study. Methods: A convenience sample of 13 teachers from 11 north Idaho rural schools collected FitnessGram fitness data: body composition (body mass index [BMI]), aerobic capacity (Progressive Aerobic Cardiovascular Endurance Run [PACER] test), muscular endurance (curl up), strength (pushup), and flexibility (sit and reach). Results: A total of 761 students (aged 9-18 years) from grades 3&5, 7, and 9 to 12 participated in the study. Approximately 24% of 3&5 and 22% of 7th, and 12% of 9 to 12th-grade students were categorized as Needs Improvement/Health Risk by FitnessGram standards for BMI. Similarly, approximately 25% of 3&5, and 22% of 7 and 9 to 12th-grade students were considered Needs Improvement/Health Risk for PACER. Implications for School Health Policy, Practice, and Equity: Results from fitness testing can provide school and public health representatives with a "needs assessment" of student health that can be used to help develop policies and practices to improve student health and wellbeing. Conclusions: This study provides a model for statewide annual fitness testing surveillance and reporting within K-12 public school physical education classrooms.

The family has a key role in the obesity management of children with autism. This study examines the relationship between the nutrition-physical activity behaviors of autistic children with their families and children's obesity levels during COVID-19 pandemic. The descriptive and cross-sectional study involved 80 parents of autistic children. A positive correlation was found between children's mean BMI values before and during the pandemic (p = 0.000). Family Nutrition and Physical Activity Scale (FNPAS) and Brief Autism Mealtime Behavior Inventory (BAMBI) score were 55.18 ± 7.86 and 31.76 ± 8.79, respectively. In addition, it was found that 32.5% of the children ate more than before the pandemic, 50.0% engaged in less physical activity, and 16.3% didn't do any physical activity. The study results suggesting the risk of obesity.

Mothers of children with Autism Spectrum Disorder (ASD) often experience chronic stress and are at risk for adverse health. However, little is known about fathers, especially when their child is in early childhood. Parenting stress, eating behavior and physical health was evaluated in mothers (n = 48) and fathers (n = 43) of young children (3-7 years) with ASD by questionnaires and physical measurements. Mother's prevalence rates of obesity (39.1%), abdominal obesity (59.6%) and metabolic syndrome (21.6%) were higher than the norm. In fathers, the prevalence rate of clinical parenting stress (33%) was higher than the norm. Parenting stress was positively related to disinhibited eating in mothers, not in fathers. It is crucial to monitor stress and health of parents of children with ASD.

The purpose of this study was to explore the validity of evidence for self-efficacy to regulate physical activity scale (SERPA) measurement using an exploratory latent variable approach. The objectives were to explore the dimensionality, temporal invariance, and external validity of scores produced by the SERPA, a modified version of the barriers self-efficacy scale. Data (N[subscript baseline]= 461 and N[subscript 30 days post-baseline] = 427) from the Well-Being and Physical Activity Study (ClinicalTrials.gov, identifier: NCT03194854), which deployed the Fun For Wellness intervention, were analyzed. A two-dimensional factor structure explained responses to the SERPA at baseline. There was evidence for at least partial strict temporal measurement invariance for this two-dimensional structure. There was evidence for external validity of the SERPA measurement as evidenced by group assignment (i.e. the intervention) exerting a direct effect on the proposed two-dimensional structure of latent self-efficacy to regulate physical activity in adults with obesity at 30 days post-baseline.

Objective: The use of social networks has grown substantially over the past few years and especially during COVID-19. This study aims to investigate the possible relationship between social media addiction and obesity which may lead to disturbed body perception in university students. Participants: A total of 250 undergraduates participated. Results: Social media addiction depends on the number of years of social media use, meal skipping, and increased frequency of fast food consumption. There was a significant relationship between fast-food consumption frequency and body perception. No significant relationship was found between BMI and SMAS while there was a significant relationship between SMAS and body perception. Conclusion: The findings support, social media addiction may lead to increased risk factors for obesity and as a consequence impair body perception in young adults.

Background: Feeding behaviors adopted by parents influence children's eating, and parent mental health may affect feeding interactions. Anxiety disorders are the most prevalent mental disorders among adults; thus, there is a need to comprehensively understand the relationship between parent anxiety symptomatology and feeding behaviors. Objective: This systematic review provides the first comprehensive overview that focuses solely on parent anxiety and nonresponsive feeding. Based on PRISMA guidelines, the goal of this review is to elucidate current literature gaps and to inform future interventions that aim to reduce the risk of childhood obesity. Methods: PubMed and APA PsycInfo were searched with an extensive keyword combination to identify empirical studies from peer-reviewed journals that focus on parent anxiety and feeding behaviors that are utilized with typically developing children of ages 6 months or older. After independent and masked screening rounds of 925 articles, 10 studies were included for data extraction. In accordance with the PRISMA guidelines, the independently extracted data included the following: authors, year of publication, sample characteristics, study design, anxiety and feeding measures, study goal, main findings, and methodological limitations. Results: Of the 10 studies included in this systematic review, 70% indicated an association between parent anxiety symptomatology and nonresponsive feeding behaviors of restriction, control, and emotional feeding. Ninety percent of the included studies had a mother-only sample. Conclusions: Parents with anxiety symptomatology tend to use nonresponsive and obesogenic feeding practices. Given this relationship, parent anxiety is a potential area for inclusion in interventions that aim to reduce children's risk for obesity.

This study aimed to examine the moderating effect of student engagement between weight bias internalization and depressive symptoms in Korean adolescent girls with higher weight. Ninety-nine girls with higher weight ([greater than or equal to]85th body mass index percentile) in early adolescence (aged 12-14 years) participated in this cross-sectional study. Weight bias internalization, student engagement, and the interaction between these variables were significantly associated with depressive symptoms. Furthermore, a simple slope analysis indicates that higher student engagement was associated with more significant relief in depressive symptoms. Thus, promoting higher student engagement with family and school support may help reduce depressive symptoms related to weight bias internalization in adolescent girls with higher weight. Therefore, family- and school-based programs are required to enhance student engagement in adolescent girls with higher weight.

I provide novel evidence on the role of imperfect information in shaping childhood obesity. Between 2003 and 2017, 24 states began requiring schools to perform Body Mass Index assessments on students. Using the 1991 to 2017 National and State Youth Risk Behavior Surveys and a stacked difference-in-differences identification strategy, I show that these state-mandated school-based BMI assessments were associated with an increase in the likelihood that teens described themselves as overweight and reported that they were trying to lose weight. The relationship was most pronounced for overweight teens, suggesting that the assessments improved awareness about BMI status among this group, though I also find that non-overweight teen girls were subsequently more likely to incorrectly describe themselves as overweight. While I do not detect meaningful changes in exercise or calorie-limiting behaviors, I do find that these state-mandated school-based BMI assessments were associated with a modest reduction in BMI.

The workplace has been highlighted as a potential setting to deliver health promotion programs to target modifiable health behaviors that contribute to chronic disease. This review evaluated the effectiveness of interventions implemented within the workplace that targeted either smoking, nutrition, alcohol, physical activity, and/or overweight and obesity in men. A review protocol was prospectively registered through PROSPERO (CRD42021293398). Five electronic bibliographic databases were searched for randomized controlled trials conducted in the workplace assessing chronic disease risk factors in men from January 2010 to August 2021. Eleven studies were included, reporting on overweight and obesity n = 8, physical activity n = 7, nutrition n = 4, alcohol n = 3, smoking n = 3, with eight studies assessing multiple outcomes. Results were mixed. Narrative synthesis highlighted studies reporting improvements to snacking frequency, sugar sweetened beverage consumption, and physical activity (METs and Vo2 max). Meta-analysis highlighted pooled mean decrease in body weight of -0.28 kg up to 3 months; -1.38 kg for >3 months, and pooled mean decrease in body mass index 0.06 kg/m2 up to 3 months; -0.27 kg/m2 for >3 months. Despite the encouraging direction of the relationship, results were not statistically significant (p > 0.05). Findings underscore the potential of workplace health promotion programs targeting certain chronic disease risk factors in men; however, future research should consider long-term study designs to assess the efficacy of workplace health programs as a solution to the growing burden of global disease.

School-age children with overweight or obesity continue to be problematic in the United States, and are associated with many health, social, and financial problems. Schools provide an excellent venue in which to promote healthy weight in students, and school nurses are well-positioned to play an essential role in controlling obesity. The number of studies reporting relationships among school health infrastructure and prevalence of elevated Body Mass Index (BMI) is limited. The present study explored associations between three components of school health infrastructure (staff, services, budget) and the proportion overweight or obese 1st, 3rd, and 6th grade students, after controlling for selected factors (race, county education level, county poverty level, rurality). Study results supported an independent association between elevated BMI and school health staff. Additionally, independent associations between elevated BMI and the following covariates were supported: household income, race, and parents' educational level. There is an ultimate need for well-designed studies addressing these associations.

Background: Adolescents with overweight or obesity are at greater risk of having physical and psychosocial consequences. With increased disparities and inadequate literature on prevalence of adolescent weight status in rural Appalachia, there is potential for further complications. Unfortunately, adolescent obesity treatment options are often limited, especially in medically underserved regions. Methods: This cross-sectional study of adolescents at eight rural Appalachian schools examined weight status among and associations between body mass index percentile (BMIp) categories and health-related perceptions and weight-control intentions. Previously validated instruments were utilized. Analyses included independent samples t-tests, ANOVA tests, and chi-squared tests. Results: Of 814 adolescents (ages 11-13; 55.0% girls), BMIp revealed 20.8% overweight, 22.7% obese, and 10.6% severely obese. Adolescents with higher BMIp categories reported poorer self-rated health, inaccurate weight perceptions, and greater weight loss intentions (all p < 0.05). Conclusions: Findings, including high prevalence of adolescents with overweight and obesity, emphasize the need for more obesity prevention and treatment options. Schools may be an ideal setting to reach at-risk adolescents and provide obesity prevention and treatment options, especially in medically underserved regions such as rural Appalachia. Opportunities and challenges to apply findings, including school-based obesity programs, are discussed.

This study was conducted to evaluate the BMI of the children with intellectual disability and the factors affecting their BMI. This descriptive and cross-sectional study was carried out between March 2016 and April 2016 in Turkey and consisted of 135 children. Children's anthropometric measurements were and their BMI values were calculated. Categorization of children by BMI percentile according to AAP reference values was performed. There was a significant difference between the BMI categories of the children (p < 0.05) and the education level of children's father (x2 = 8.960; p = 0.028), the degree of intellectual disability (x2 = 16.113; p = 0.008), the presence of other disabilities (x2 = 22.013; p = 0.000), type of disability (x2 = 21.359; p = 0.001), the nutrient intake (x2 = 38.935; p = 0.000) and the presence of nutritional problems (x2 = 7.687; p = 0.042). Father's education level, children's degree of disability, child's having presence of other disabilities, child's being dependent in the view of nutrient intake, and child's having nutritional problems were determined as factors affecting BMI.

Rates of obesity continue to rise in the United States and across the globe. Obesity is a risk factor for developing insulin resistance, type 2 diabetes, and cardiovascular disease. For clinicians, other health care providers, and educators, providing patients with accurate and meaningful information about obesity, including lifestyle (diet and exercise) interventions and symptom monitoring, is challenging because of infrequent contact, methods of communication, a lack of effective patient education resources, and inefficient patient feedback methods. Evidence suggests that significantly more patients are now getting their health care information online from general medical websites, disease-specific network communities, and social media. Thus, harnessing the power of technologies, including personal computers and smartphones, with attention to social media may equip health care providers with methods to serve their patients better by addressing challenges, improving indirect patient contact, and enhancing health outcomes. This article aims to provide an overview of technology with a focus on social media use in obesity education and outreach. Practical information is provided related to creating content, delivering content, and managing the social media space for the novice creator.

Researchers are increasingly using web-based technologies to deliver family-based, prevention programming. Few studies have examined the success of such approaches for families with low incomes. The purpose of this study was to describe the level of in-class and online engagement in a childhood obesity prevention program for parents with low incomes, to examine the demographic correlates of parent engagement, and to examine dosage effects on parental feeding outcomes as a function of online exposure. All participants attended in-class nutrition education classes (Eating Smart ? Being Active) as part of the Expanded Food and Nutrition Education Program (EFNEP) in Colorado and Washington State (classes were offered in English and Spanish). Participants in this analysis were 168 parents from a larger cluster randomized controlled trial who had been randomly assigned to also receive a newly developed, mobile-based version of an efficacious, feeding-focused, childhood obesity prevention program. Results showed that despite high levels of in-person attendance (70%), participants only accessed 47% of the videos (online content). Older parents and parents of girls showed higher levels of in-person attendance; currently employed parents showed lower levels. Online engagement varied as a function of ethnicity and acculturation: non-Hispanic parents accessed the most videos, low-acculturated Hispanic parents accessed the second most, and highly acculturated Hispanic parents accessed the least. In contrast, low-acculturated Hispanic parents showed the highest in-person attendance. For all but one outcome, significant online program effects were found only for parents who accessed at least half of the videos. Implications for mobile-based, family-based prevention programs for parents with low incomes are considered.

Early intervention can reduce disability in children diagnosed with autism spectrum disorder. Screening for autism spectrum disorder in young children identifies those at increased likelihood of diagnosis who may need further support. This study assessed in "utero" exposure to maternal obesity and diabetes and offspring performance on the Quantitative Checklist for Autism in Toddlers, an autism spectrum disorder screening questionnaire administered between 18 and 24 months at well-child visits. This retrospective cohort study included 65,433 singletons born in a single healthcare system. Demographic data, maternal obesity, Type 1/Type 2 and gestational diabetes mellitus information, and Quantitative Checklist for Autism in Toddlers score in children 12-30 months old were extracted from electronic medical records. Negative binomial models were used to estimate incidence rate ratios of associations between maternal obesity and diabetes exposure and continuous offspring Quantitative Checklist for Autism in Toddlers scores. Maternal obesity, Type 1/Type 2 diabetes (incidence rate ratio: 1.13, 1.06-1.21) and gestational diabetes mellitus [less than or equal to] 26 weeks (incidence rate ratio: 1.10, 1.05-1.17) were associated with one-unit increases in Quantitative Checklist for Autism in Toddlers scores. Relationships with obesity and gestational diabetes mellitus [less than or equal to] 26 weeks remained after mutual adjustment and excluding children with autism spectrum disorder diagnoses. No associations were reported for gestational diabetes mellitus > 26 weeks. Maternal obesity and diabetes were associated with higher Quantitative Checklist for Autism in Toddlers scores in children 12-30 months old, suggesting these exposures in pregnancy may be associated with a range of early childhood behavior.

Using the 2017-2018 National Health and Nutrition Examination Survey (weighted population size = 35,460,209; 8-18 years old; 52.1% males), we compared the obesity prevalence in children and adolescents between body mass index-based (BMI-based) and total percent body fat-based (BF%-based, measured by the dual-energy x-ray absorptiometry) cutoffs. The BMI-based cutoffs exhibited closer alignments (k, 0.88-0.97) in the childhood obesity prevalence, while the absolute (sex-specific) BF% cutoffs had higher prevalence rates than the relative (age- and sex-specific) BF% cutoffs (k = 0.43 [95% CI, 0.38-0.49]), overly labeling Non-Hispanic white and Other race/ethnicity females with obesity. The BF%-based cutoffs had higher prevalence rates in most sex, age, and race/ethnicity groups than the BMI-based cutoffs. Furthermore, the absolute BF% cutoffs overly labeled Hispanic and Other race/ethnicity females with obesity. In summary, childhood obesity prevalence varied by sex, age, race/ethnicity across different cutoffs, with the BMI-based cutoffs showing closer alignments than the BF%-based cutoffs.

New approaches are needed when working in rural communities to identify and communicate holistic evaluation impacts related to community-based health promotion efforts of Cooperative Extension. Specifically, there is a lack of recorded long-term programmatic impacts of these programs, including behavior changes related to consuming nutritious and healthy food. The current study explored rural community members' experiences with cognitive dissonance in relation to decreased adult obesity and the adoption of healthier food consumption practices related to an extension health promotion program, as cognitive dissonance can help explain several motivational components of potential behavior change. Through a qualitative research design using a thematic analysis of focus group data, the authors observed an overall positive association between community members' experiences with cognitive dissonance, resulting in the acceptance of healthier food choices over inherited unhealthy practices, increased knowledge and awareness about nutrient-dense food, and increased physical activity. The cognitive dissonance framework revealed positive indicators of long-term programmatic impact related to food choice and consumption patterns. However, the analysis also indicated that while interventions improved access to resources, socio-economic barriers still existed that would ensure sustainability and depth of positive changes leading to long-term behavioral change in rural communities.

The current study examines the efficacy of an 8-week pretend play intervention targeting social-cognitive abilities in children with Prader-Willi syndrome (PWS), ages 6-9. PWS is a rare disorder associated with various social, emotional, and cognitive challenges linked to pretend play impairments, and for which interventions are sparse. Nineteen children were quasi-randomized to receive the intervention or be part of a waitlist control group. Participants who received the intervention (n = 10) demonstrated significant improvements in various components of pretend play, most notably in organization of play, which may generalize to broader social-cognitive gains. These findings provide evidence of the intervention's efficacy in enhancing pretend play skills and related social-cognitive abilities during this critical period of development for children with PWS.

Parental behaviors and attitudes are effective in health outcomes of children. Obesity among children has been found to be related with limited nutrition knowledge and unhealthy eating and habits. Therefore, this study identified the causes and factors associated with obesity among children and revealed their own routines from the perspective of mothers. Content analysis was used in the current qualitative research. Potential and eligible participants were selected by visiting four preschool centers in Sarab, Iran. The height and weight of 113 children aged 5-6 years were measured by standard scales, along with calculating their body mass index. The mothers of children at or above the 50th percentile were invited to appointments for interviews in the preschool centers. Then, 37 semi-structured face-to-face interviews were carried out with mothers and analyzed by two independent researchers manually. The factors associated with obesity in preschool children were categorized into four main themes, including insufficient physical activity, poor perception of body weight, unhealthy behavioral habits, and genetic factors. The mothers did not consider their children at risk of becoming overweight, as their perceived sensitivity was low. The results of this study can be supportive in designing family and parent-centered interventions to control obesity among children.

Risky behaviors (substance abuse, obesity, suicide, bullying, and others), many of which are indeed preventable, are common among high school students. The most important task in detecting, preventing, and intervening in risky behaviors in schools falls to the school guidance service and school psychological counselor. The main objective of this study is to determine the types and prevalence of risky behaviors observed among high school students and to analyze the practices performed by the school guidance service for such behaviors. This study was organized in accordance with the mixed research design for which qualitative and quantitative approaches were used together. In this context, quantitative (N1=566) and qualitative (N2=21) data collection processes were carried out with psychological counselors working in different types of high schools in 12 provinces. While statistical procedures were included for the quantitative data of the research, content analysis techniques were used for the qualitative data. The results showed smoking, peer bullying, cyberbullying, school dropout, obesity, delinquency, abuse, suicidal tendency and attempt, alcohol use, bonsai use, and other substance use as risky behaviors in high schools. The levels and frequency of these behaviors vary across school types. The preventive activities in the schools were generally based on informative seminars, and practical studies were limited. The research results also indicated that studies of risky behaviors were not sufficiently included in Ministry or school guidance framework programs. Furthermore, it was found that parents, teachers, and administrators gave limited support to the studies carried out within the scope of education and intervention for risky behaviors in schools. These results demonstrate that school psychological counselors encountered several personal, institutional, or legal obstacles in their studies on risky behaviors.