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Objective: The current study examines the relationships between change in depressive symptoms and locus of control orientations among college students during the COVID-19 pandemic. Participants: A sample of 341 undergraduate students were recruited from a large Midwestern United States university. Methods: Participants completed an online cross-sectional survey with self-report measures of current depressive symptoms, retrospective pre-pandemic depressive symptoms, and locus of control. Results: Depressive symptoms changed significantly during the COVID-19 pandemic ( t (340) = 7.49, p  < 0.01). Pre-pandemic depressive symptoms predicted symptom change with the greatest changes among students who had fewer pre-pandemic symptoms (b = -0.58, p  < 0.01) and higher external locus of control orientation (b = 0.24, p  < 0.01). Conclusions: An increased presence of mental health resources is needed on college campuses and external locus of control should be targeted through clinical intervention as a risk factor for adverse depressive responses to stressors among college students.

ObjectiveWeight change is common during the first year of college and may be related to different outcomes for men and women. This study examined the moderating effects of gender on the association between weight change and college adjustment and depressive symptoms. Participants: One-hundred and eighty-one 18-19-year-old college freshmen (56.9% female; 84.5% Caucasian). Methods: Students completed a one-time survey about demographics, weight, college adjustment, and depressive symptoms during their second semester of college. Results: Increased weight change was associated with fewer depressive symptoms for both men and women ( p  < .04). For men, increased weight change was associated with better overall college adjustment, more positivity about college, less negativity about college, and less homesickness (all p  < .02). Conclusions: Universities could target men and women differently in regard to weight, college adjustment, and mental health to promote a positive college experience and optimal mental health.

Introduction: Maternal feeding practices may be linked to infant obesogenic outcomes, but research to date has focused primarily on infant growth as an outcome of maternal feeding practices rather than exploring additional obesogenic outcomes like infant appetite and diet. Therefore, the current study examined the association between maternal feeding practices and beliefs and infant growth, diet, and appetite simultaneously at a critical timepoint for obesity risk development (i.e., 3-months-old)., Methods: Thirty-two 3-month-old infants and their mothers participated in this cross-sectional study. Infant anthropometrics were collected by trained staff and mothers completed questionnaires regarding maternal feeding practices and beliefs and infant diet and appetite. The data were analyzed by Spearman correlations., Results: Statistically significant correlations were identified between maternal feeding practices (e.g., using food to calm, concern about infant weight) and infant satiety, appetite, food responsiveness, slow eating, and kilocalories consumed. Infant weight-for-length was related to maternal concern about infant underweight and mother-infant social interaction during feeding., Discussion: These findings highlight the importance of the mother-infant feeding relationship and how these associations may influence responsive feeding practices and infant weight-related outcomes., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: Nonalcoholic fatty liver disease (NAFLD) is the leading chronic liver disease in youth, yet little is known about the adolescent patient's experience with NAFLD, which is key for treatment engagement. We examined adolescents' experiences with NAFLD diagnosis, thoughts on how NAFLD affects their daily life, understanding and perceptions of diagnosis and treatment, and impressions of how to improve care., Methods: Utilizing a mixed-method design, adolescents with NAFLD (N = 16; Mean age = 15.8 years; Mean BMI = 37 kg/m 2 ) participated in focus groups. To supplement qualitative data, adolescents and their caregiver completed measures assessing illness perceptions, adolescent quality of life, and eating/activity behaviors., Results: Focus group themes suggested reactions to diagnosis varied from unconcerned to anxious. NAFLD diagnosis occurred within the context of other psychological/medical concerns and was not perceived to affect most adolescents' daily lives. Although adolescents understood general contributors to NAFLD, comprehension of their diagnosis varied. Adolescents were more likely to make lifestyle changes when families were supportive, and they preferred tailored recommendations for health behavior change from the healthcare team. Notably, 62.5% of adolescents were more concerned about their weight than NAFLD. Almost half (43.8%) identified as food insecure., Conclusions: Adolescents with NAFLD may benefit from personalized treatment. Care could be enhanced by ensuring comprehension of diagnosis, problem-solving personal, and family barriers and increasing family support. Harnessing adolescents' desire for weight loss may be a more salient driver for change in disease status. Interventions should also address systemic barriers such as food insecurity to ensure equitable care., Competing Interests: Sources of Funding: S.L.L. and K.M.K. were supported, in part, by an NIH post-doctoral training grant (T32 DK063929). The aforementioned funding source played no role in study design, data collection, analysis and interpretation of data, report writing, or in the decision to submit the article for publication. The remaining authors report no conflicts of interest., (Copyright © 2022 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Purpose: Current research examining mental health and history of childhood trauma as risk factors of food and alcohol disturbance (FAD) is limited. College students may be at greater risk to engage in FAD behaviors because of the common co-occurrence of alcohol misuse and disordered eating behaviors within college populations. Therefore, the current study examined anxiety, depression, and adverse childhood experiences as possible risk factors of FAD behaviors in a college student sample., Methods: Two-hundred and seven undergraduate students from a large Midwest university completed a cross-sectional survey assessing history of adverse childhood experiences, depressive symptoms, anxiety symptoms, FAD behaviors, and frequency of alcohol use., Results: Current symptoms of generalized anxiety were significantly associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.13, F(1, 204) = 4.10, p = 0.04; Bulimia subscale, β = 0.17, F(1, 204) = 6.19, p = 0.01; Diet and Exercise subscale, β = 0.19, F(1, 204) = 9.05, p < 0.01). Adverse childhood experiences were associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.14, F(1, 204) = 4.27, p = 0.04). Current depressive symptoms were not significantly associated with FAD behaviors., Conclusions: Study findings suggest that students who experience greater current symptoms of anxiety are at a greater risk to engage in FAD behaviors. Further understanding the role of anxiety in the development and maintenance of FAD behaviors may provide clinically useful information for the prevention and treatment of FAD behaviors. These findings highlight the need for further research to examine psychological distress as a risk factor for engagement in FAD behaviors longitudinally, in a larger, more diverse study sample., Level of Evidence: Level V, cross-sectional descriptive study., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction: Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behaviour change techniques (BCTs), (2) explore similarities and differences in BCTs used to target behaviours and (3) explore effectiveness of intervention components in preventing childhood obesity., Methods and Analysis: Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the Transforming Obesity in CHILDren Collaboration. Standard ontologies will be used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials provided by trialists. Narrative syntheses will be performed to summarise intervention components and compare applied BCTs by types of target behaviours. Exploratory analyses will be undertaken to assess effectiveness of intervention components., Ethics and Dissemination: The study has been approved by The University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). The study's findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with key stakeholders., Prospero Registration Number: CRD42020177408., Competing Interests: Competing interests: AB, ALS, BJJ, KEH, MA, RG, SL and LPS reports grants from NHMRC Ideas Grant TOPCHILD (Transforming Obesity Prevention for CHILDren) (GNT1186363); APE and CGA reports grants administered by the Inter-American Development Bank from The Government of Japan and The PepsiCo Foundation; AT reports grants from National Institute of Health; BJT reports grants from NZ Health Research Council; EO reports grants from the US National Institutes of Health, and the Canadian Institutes for Health Research; IMP reports grants from NIH/NIDDK; JS reports grants from PCORI, NIH NIDDK and NHLBI, and personal fees from Danone Organic, American Academy of Pediatrics and Lets Move Maine; LTK and JL reports grants from Fonds NutsOhra; MR reports grants from National Institute on Minority Health and Health Disparities-National Institutes of Health/Center for Collaborative Research in Health Disparities, and personal fees from Rhythm Pharmaceuticals; RSG reports grants from US Department of Agriculture and NIH/NICHD., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: People of all weights need to prevent changes that could lead to obesity, a leading public health issue., Objective: To assess the feasibility of Healthy Measures, a moderate carbohydrate (160-300 g/d) nutrition education and behavioral intervention., Design: An uncontrolled intervention feasibility study including in-person group meetings every 2 weeks for 3 months., Sample: Fifteen participants of normal and overweight BMI., Measurements: We assessed feasibility of recruitment, attendance, retention and satisfaction as well as anthropometric measures and social cognitive variables with Healthy Measures, a nutrition-focused intervention with moderate carbohydrate portions that also emphasizes self-monitoring of anthropometric measurements. An intent-to-treat analysis was used., Results: Healthy Measures was feasible, with 13 participants (86.7%) completing pre- and post-intervention assessments. Eight participants lost or maintained weight (53.3%); four gained weight. Healthy eating self-efficacy increased overall (t = -2.54, p = .024). Increased protein and fat intake was associated with weight loss, while reduced protein, carbohydrate, and fat intake resulted in weight gain., Conclusions: Healthy Measures shows promise for prevention of weight gain, with evidence of feasibility and positive outcomes. Further research is needed to establish efficacy relative to alternative approaches., (© 2021 Wiley Periodicals LLC.)

Objective: Children with some chronic health conditions experience family functioning difficulties. However, research examining family functioning in youth with functional gastrointestinal disorders (FGIDs) has produced mixed results. Therefore, the current review critically synthesized the literature on family functioning among youth with FGIDs., Methods: A systematic search using pediatric, family functioning, and FGID search terms was conducted in PubMed, PsycInfo, and ProQuest. Out of the 586 articles initially identified, 17 studies met inclusion criteria. Studies were included if they presented original research in English, assessed family functioning, and the study sample consisted of children (0-18 years) diagnosed with a FGID. Quality assessment ratings were conducted for each included study based on a previously developed scientific merit 3-point rating system., Results: The majority of studies (n = 13) examined family functioning between youth with FGIDs and comparison groups. The remaining studies explored associations between family functioning and study variables (e.g., child psychosocial functioning and sociodemographic factors) and examined family functioning clusters among children with FGIDs. In general, children with FGIDs demonstrated poorer family functioning compared to healthy counterparts. Findings also suggested that child psychosocial functioning, disease characteristics, and sociodemographic factors were related to family functioning among youth with FGIDs. The average quality of studies was moderate (M = 2.3)., Conclusions: Maintaining healthy family functioning appears to be challenging for some families of children with FGIDs. Future research should explore the directionality of the relationship between family functioning and child physical and psychosocial outcomes to advance the understanding and treatment of pediatric FGIDs., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Feeding problems are common in children with Autism Spectrum Disorder (ASD), and there are associations between parent reports of child ASD symptom severity and feeding problems. The current study further explores this association between ASD severity and family mealtime behaviors using directly observed naturalistic mealtime interactions., Methods and Procedures: Seventy-three children (M age  = 5.42 years) were presented an unfamiliar food during a videotaped but otherwise typical home meal. Mealtime behavior was assessed through coding of the videotaped meal using the Dyadic Interaction Nomenclature for Eating (DINE) and parent report (Brief ASD Mealtime Behavior Inventory; BAMBI). ASD severity was assessed with the clinician-completed Childhood Autism Rating Scale-Second Edition (CARS-2)., Outcomes and Results: Greater ASD severity was associated with fewer bites of the unfamiliar food, greater disruptive behavior during meals, and greater parental commands to take bites during meals. We found negative associations between limited food variety and food refusal (BAMBI subscales) and child bites of the unfamiliar food, with higher levels of limited food variety and food refusal associated with fewer bites of the unfamiliar food., Conclusions and Implications: Children with more severe ASD may eat less and be more disruptive during meals, despite parent redirection. We also found associations between the BAMBI and DINE which suggest the BAMBI may be a sensitive measure of mealtime behaviors such as food flexibility and food refusal., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: The current cross-sectional study examined whether children who are overweight experience greater levels of parent-reported bullying behaviors and victimization using a national sample. Additionally, the relations among child (mental health), family (parent-child sharing of information), and contextual factors (neighborhood safety, school engagement) and risk of victimization in children who are overweight were assessed., Methods: Caregivers provided data via the 2016 National Survey of Children's Health. A series of multinomial logistic regressions were conducted with the subsample of children aged 10 to 17 years (N = 26 094)., Results: Youth who were overweight were more likely to be victimized, but not more likely to bully. Being engaged in school and neighborhood safety were protective factors among youth who were overweight, while living in families where information is shared and difficulty making friends were risk factors., Conclusions: Children who were overweight were more likely to be victims, rather than perpetrators, of bullying. Health professionals should assess family and contextual factors in relation to victimization status when developing interventions., (© 2019 World Obesity Federation.)

Purpose: To explore predictors of breastfeeding behavior and seek to replicate prior findings using a recent nationally representative United States (US) sample, which has not been done previously., Design: Secondary data analysis using the National Survey of Children's Health 2011 to 2012., Setting: Households in the 50 US states, the District of Columbia, and the US Virgin Islands., Participants: Caregivers with a child between 6 months and 6 years of age (n = 26 552)., Measures: Caregiver-reported child breastfeeding behavior, child birth weight, child/maternal/family demographics, maternal physical and mental health, and household tobacco exposure., Analysis: A multinomial logistic regression explored whether child, maternal, and family characteristics predicted exclusive breastfeeding for 6 months or breastfeeding for a suboptimal duration., Results: Approximately 79% and 17% of the sample-initiated breastfeeding and exclusively breastfed for 6 months, respectively. Child ethnicity/race, maternal education, household tobacco exposure, family composition, and family income predicted odds of both exclusive breastfeeding for 6 months and breastfeeding for a suboptimal duration or not exclusively. Normal or high child birth weight and better maternal physical health predicted greater odds of exclusive breastfeeding for 6 months., Conclusion: Rates of exclusive breastfeeding for 6 months remain low in the United States. Single-parent and step-families, lower income families, non-Hispanic black children, children with exposure to tobacco, and children of mothers with lower education are at greatest risk.

Objectives High birth weight (HBW ≥ 4000 g) infants are at increased risk for obesity, but research has yet to identify the mechanism for this increased risk and whether certain subsets of HBW infants are at greater risk. Methods This exploratory study examined child eating behaviors and maternal feeding practices and beliefs across 21 HBW and 20 normal birth weight (NBW, 2500-3999 g) infants at 7-8 months of age using maternal-report measures (n = 41) and a bottle feeding task (n = 16). Results HBW infants were at increased risk for high weight-for-length at 7-8 months (F (2, 38) = 6.03, p = .02) compared to NBW infants, but no statistically significance differences on weight gained per day since birth, child eating behaviors, or most maternal feeding practices and beliefs were found between HBW and NBW infants. However, HBW infants who maintained a high weight-for-length (≥ 85th percentile) at 7-8 months had a higher birth weight, gained more weight per day, and had lower maternal-reported satiety responsiveness and maternal social interactions during feedings than their HBW counterparts who were currently below the 85th percentile. Conclusions for Practice HBW infants did not differ from NBW infants on eating behaviors and feeding practices, but children born at HBW who maintain excess weight during infancy do differ from those infants who fall below the 85th percentile for weight-for-length. Future research should identify risk factors that longitudinally differentiate HBW infants at greatest risk for maintaining excess weight and develop early screening and intervention efforts for this subset of at-risk infants.

Objective: National health organizations and expert committees have issued recommendations for health behaviors related to obesity risk. Behavioral and family-based weight management interventions for preschoolers often target improving adherence to these recommendations, but it is unknown how the health behaviors of preschoolers with obesity enrolled in weight control treatments (WCTs) compare with these guidelines. In this study, the dietary intake, activity, and sleep behaviors of preschoolers with obesity enrolled in a family-based behavioral WCT are described and compared with national health behavior recommendations., Methods: Health behaviors of 151 preschoolers with obesity (M age = 4.60, SD = 0.93) enrolled in a clinical trial of a weight management program were measured at baseline through caregiver-report questionnaires, three 24-hr dietary recalls, and accelerometers., Results: In total, 70% of the sample exceeded daily caloric recommendations, only 10 and 5% met recommendations for fruit and vegetable intake, respectively, and only 30% met the recommendation of consuming no sugar-sweetened beverages. The majority of the sample met the daily recommendations for 60 min of moderate-to-vigorous activity (80%), < 2 hr of screen time (68%), and sleep duration (70%)., Conclusions: Behavioral weight management interventions for preschoolers with obesity should target the health behaviors where children are not meeting recommendations.

Objective: This study investigated parent report of adolescent behaviors and flourishing of adolescents with asthma from a nationwide sample., Methods: A secondary analysis of the 2011-2012 National Survey of Children's Health was conducted. There were 2,880 youth with asthma in our sample and 25,841 without asthma between 13 and 17 years of age. Analyses examined flourishing among adolescents with and without asthma and the impact of adolescent arguing, bullying, and mood difficulties on adolescent flourishing for adolescents with asthma, while controlling for sex, age, and race., Results: Findings indicated lower flourishing for youth with asthma compared to youth without asthma. Moreover, adolescents with asthma who experienced negative behaviors, such as arguing and bullying, and adolescents who were experiencing sad feelings had lower flourishing., Conclusions: The results were consistent with literature, indicating that relatively poorer behavioral and emotional functioning is related to lower flourishing in adolescents with asthma. The results highlight the importance of screening for emotional functioning in adolescents and the need for further research to understand characteristics of adolescents related to their positive functioning.

Purpose: The purpose of this study was to assess patterns of health-care utilization among children who potentially had tobacco smoke exposure (TSE) compared to those who were not exposed., Design: A secondary data analysis of the 2011 to 2012 National Survey on Children's Health was performed., Setting: Households nationwide were selected., Participants: A total of 95 677 children aged 0 to 17 years., Measures: Sociodemographic characteristics, TSE status, and health-care visits were measured., Analysis: Multivariable logistic regression models were performed., Results: A total of 24.1% of children lived with smokers. Approximately 5% had home TSE. Participants who lived with a smoker were significantly more likely to have had a medical care visit (odds ratio [OR] = 1.22, confidence interval [CI] = 1.21-1.22) and were more likely to seek sick care or health advice at an emergency department (OR = 1.23, CI = 1.23-1.24) but were less likely to have had a dental care visit (OR = 0.82, CI = 0.82-0.83) than those who did not live with a smoker. Similar findings were found among participants who had home TSE., Conclusion: TSE is a risk factor for increased use of pediatric medical care. Based on the high number of children who potentially had TSE and received sick care or health advice at an emergency emergency department, this setting may be a venue to deliver health messages to caregivers.

Objective: To test the hypotheses that an innovative skills-based behavioral family clinic and home-based intervention (LAUNCH) would reduce body mass index z score (BMIz) compared with motivational interviewing and to standard care in preschool-aged children with obesity., Study Design: Randomized controlled trial with children between the ages of 2 and 5 years above the 95 th percentile for body mass index for age and sex recruited from 27 pediatrician offices across 10 recruitment cycles between March 12, 2012 and June 8, 2015. Children were randomized to LAUNCH (an 18-session clinic and home-based behavioral intervention), motivational interviewing (delivered at the same frequency as LAUNCH), or standard care (no formal intervention). Weight and height were measured by assessors blinded to participant assignment. The primary outcome, BMIz at month 6 after adjusting for baseline BMIz, was tested separately comparing LAUNCH with motivational interviewing and LAUNCH with standard care using regression-based analysis of covariance models., Results: A total of 151 of the 167 children randomized met intent-to-treat criteria and 92% completed the study. Children were 76% White and 57% female, with an average age of 55 months and BMI percentile of 98.57, with no demographic differences between the groups. LAUNCH participants demonstrated a significantly greater decrease in BMIz (mean = -0.32, SD = ±0.33) compared with motivational interviewing (mean = -0.05, SD = ±0.27), P < .001, ω 2  = 0.74 and compared with standard care (mean = -0.13, SD = ±0.31), P < .004, ω 2  = 0.75., Conclusions: In preschool-age children, an intensive 6-month behavioral skills-based intervention is necessary to reduce obesity., Trial Registration: Clinicaltrials.gov NCT01546727., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Youth with disabilities are at increased risk for obesity compared with their typically developing peers and face unique barriers to healthy lifestyles. A limited number of weight management programs have been specifically tailored to accommodate youth with disabilities, and outcomes research in this population is scarce. We investigated the effectiveness of a specialized multidisciplinary weight management program for children with disabilities., Methods: Youth (N = 115) ages 2-18 years (mean age = 10.46) and their families receiving care in the Special Needs Weight Management Clinic (SNWMC) were followed over a period of 12 months. Child height and weight were measured by trained clinicians and used to calculate Body Mass Index z-scores (BMIz). A two-level multilevel model was estimated with repeated measurements of BMIz nested within patients., Results: Significant BMIz reductions of 0.02 per month were observed over the course of treatment when controlling for child age and baseline BMIz. A significant interaction between child age and time revealed that younger (vs. older) children exhibited greater decreases in BMIz over the course of treatment. Sex, ethnicity, disability diagnosis, and insurance moderated change in BMIz over the course of treatment., Conclusions: Outcomes of the SNWMC revealed significant decreases in BMIz with <5 sessions on average over 12 months and indicated the increased efficacy of early intervention in youth with disabilities. Future research should continue to modify interventions for families with adolescent children with disabilities as well as investigate additional variables that may impact success in treatment.

Objectives: This study aims to validate an obesity-specific health-related quality of life (HRQOL) measure, Sizing Me Up (SMU), in treatment-seeking Latino youth. Pediatric obesity has been associated with reduced HRQOL; therefore, valid measures are important for use in diverse populations that may be at increased risk for obesity and related comorbidities., Methods: Structural equation modeling tested the fit of the 5-subscale, 22-item SMU measure in Latino youth, 5-13 years of age, with obesity ( N = 204). Invariance testing was conducted to examine equivalence between Latino and non-Latino groups ( N = 250)., Results: SMU achieved acceptable fit in a Latino population [χ 2 = 428.33, df = 199, p < .001, Root Mean Squared Error of Approximation = 0.072 (0.062-0.082), Comparative Fit Index = 0.915, Tucker-Lewis Index = 0.901, Weighted Root Mean Square Residual = 1.2230]. Additionally, factor structure and factor loadings were invariant across Latino and non-Latino groups, but thresholds were not invariant., Conclusions: SMU is a valid measure of obesity-specific HRQOL in treatment-seeking Latino youth with obesity., (© The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com)

Objective: To compare the efficacy of opt-in versus opt-out recruitment methods in pediatric weight management clinical trials., Methods: Recruitment of preschoolers and school-age children across two obesity randomized controlled trials (RCTs) were compared using the same opt-in recruitment approach (parents contact researchers in response to mailings). Opt-in and opt-out strategies (parents send decline postcard in response to mailings if they do not want to participate) were then compared across two preschool obesity RCTs., Results: Opt-in strategies yielded a significantly lower overall recruitment rate among preschoolers compared with school-age children. Among preschoolers, an opt-out strategy demonstrated a significantly higher overall recruitment rate compared with an opt-in strategy with the main advantage in the number of families initially contacted., Conclusions: Opt-out recruitment strategies may be more effective in overcoming the barriers of recruitment in the preschool age-group because it does not rely on parent recognition of obesity., (© The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com)

Objectives: To examine parent report of flourishing in children with hearing impairments compared to children without hearing impairments, and to explore whether school engagement and bullying related to child flourishing., Methods: Participants were 655 children with hearing impairments and 44, 618 children without hearing impairments who were 10-17 years of age. Caregivers completed telephone interviews about their child's functioning for the National Survey of Children's Health., Results: Children without hearing loss had higher parent-reported flourishing compared to children with hearing loss when controlling for child demographics (i.e., race, age, sex). School engagement was positively related to flourishing of children with hearing loss. Bullying behaviors were not related to flourishing of children with hearing loss., Conclusion: Improving school engagement may increase flourishing of children with hearing loss, which is critical given that children with hearing loss experience lower flourishing than children without hearing loss. Examining the relationships among other risk and resilience factors and flourishing for children with hearing loss will provide information for interventions to enhance the adaptation of these children., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: Child and adolescent overweight and obesity are independent risk factors for poor social outcomes. Whether children who are overweight display greater bullying behaviors than normal weight peers, controlling for demographic and other social-ecological factors, was examined. The influence of child (e.g., mental health), family (e.g., income, parent mental health, and exposure to domestic violence), and community (e.g., exposure to neighborhood violence, unfair treatment based on race or ethnic group) factors on bullying risk in the subset of children who are overweight and obese was explored., Methods: We conducted a secondary data analysis of the 2011-2012 National Survey of Children's Health, a cross-sectional study providing a nationally representative sample of participants, using a series of multinomial logistic regressions in Mplus software (Muthén & Muthén, Los Angeles, CA). Participants were 41,361 youth ages 10-17 years., Results: Despite statistically significant differences in unadjusted analyses, no differences were found in bullying behavior by weight status once controlling for other factors. Child, family, and neighborhood factors predicted bullying behavior in both the overall sample and the subset of overweight and obese youth. However, some risk factors were unique to children who were overweight or obese., Conclusions: Children who are overweight or obese are not at greater risk for engaging in bullying behavior than normal weight peers. Health professionals targeting bullying behavior should be aware of the impact child, family, and neighborhood factors have on bullying by overweight and obese children and adolescents.

Objective: For children with obesity, long-term sustainability of weight loss after treatment is difficult to achieve. This study examined 2-year anthropometric outcomes of a moderately intensive group behaviorally based weight management program., Methods: One hundred seventy-three children with obesity ages 8-18 years participated with their parent or adult caregiver in a 24-week multicomponent intervention, which was followed by monthly sessions for a total of 2 years. Children were considered treatment completers if they attended ≥50% of the 24 weekly sessions. A multilevel model (multiple assessment time points nested within participants) was used to test person-level change in BMI z-score (BMIz) for program completers between (1) pre- and post-treatment, (2) pretreatment and 24-month follow-up, (3) post-treatment and 12-month follow-up, and (4) post-treatment and 24-month follow-up., Results: One hundred twenty-four (72%) of the participants completed the 24-week intervention. Significant reductions in BMIz were observed over the course of treatment (β = -0.03; standard error [SE] = 0.004; t = -6.85; p < 0.001). Completers showed a significant reduction in BMIz between initiation of treatment and 2-year follow-up (n = 110 at 24 weeks; n = 38 at 24 months; β = -0.02; SE = 0.005; t = -4.12; p < 0.001). Children did not show any significant changes in BMIz between post-treatment and 24-month follow-up (β = -0.006; SE = 0.011; t = -0.61; p = 0.54), suggesting that treatment effects were maintained., Conclusions: Children maintained treatment gains achieved during a 24-week family-based behavioral weight management program at 2-year follow-up. Although these findings suggest that gains are sustainable, further research is needed to understand how these long-term changes impact child health.

Parent and child mealtime behaviors associated with consumption of unfamiliar foods by children with ASD were examined. Families of 38 children aged 2 through 8 years old and diagnosed with ASD videotaped a typical home mealtime during which parents presented the child with an unfamiliar food and mealtime behaviors were subsequently coded through an observational coding system. The child taking sips of their drink was the only behavior related to whether the child took a bite of the unfamiliar food throughout the course of the meal. Parent direct commands and parents feeding the child were related to greater frequency of subsequent bites in a close temporal window, while child play, the child being away from the table, and child talk about things other than food related to lower frequencies of subsequent bites. Clinical interventions for food selectivity in children with ASD might provide parents education on effective mealtime parenting strategies and decreasing inappropriate child mealtime behaviors., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This study was conducted to examine if adolescents with a seizure disorder/epilepsy display less flourishing (thriving) than peers without seizures using data from the National Survey of Children's Health 2011-2012. Adolescent demographics, symptom severity, and parents' anger toward their child were explored as possible predictors of flourishing. Adolescents with seizures exhibited lower flourishing than peers, and flourishing among adolescents with seizures was predicted by symptom severity, age, race/ethnicity, sex, and parental anger. Study results suggest adolescents with a seizure disorder/epilepsy should be targeted for interventions that promote flourishing., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Children with autism spectrum disorder (ASD) may be at increased risk for overweight and obesity, but little information is known about correlates of overweight and obesity in this population. This study compared prevalence rates of parent-reported overweight and obesity and specific health behaviors (i.e., parent report of child sleep, family meal patterns, child screen time, and child physical activity) among children with ASD (N = more than 900 [weighted to represent 690,000; age 10-17]) compared with children without ASD using data from a nationally representative sample. Additionally, the relationship between specific health behaviors (i.e., child sleep, family meals, screen time, and physical activity) and weight status was examined in the ASD population. Data were from the National Survey of Children's Health 2011-2012. Results indicate that children with ASD were more likely to be obese but not more likely to be overweight than non-ASD youth. Children with ASD engaged in physical activity less than children without ASD, but no differences were found on sleep, most measures of screen time, and mealtimes. However, parent perceived poorer sleep was associated with increased weight status, and fewer family meals were associated with normal weight status among children with ASD.

Background: The current study compares the effectiveness of a condensed 12-week version and a 24-week version of the same pediatric behavioral weight management program., Methods: Children (n=162) between the ages of 8 and 18 years (baseline BMIz=2.39; standard deviation=0.29) were randomized to either a 12- or 24-week version of the same behavioral weight management program. Child anthropometric data were recorded at baseline, 6 weeks, 12 weeks, 24 weeks, and 12 months. A two-level longitudinal model was used to examine within- and between-group differences in BMIz change over time., Results: A significant group-by-time interaction was found (β=-0.01; standard error, <0.01; p<0.01) with the 24-week group showing greater reductions in BMIz. Children in the 24-week group showed significant BMIz reductions over time (z=-5.18; p<0.01), but children in the 12-week group did not (z=-0.85; p=0.39)., Conclusions: Children in the 24-week program demonstrated greater reductions in BMIz than children in the 12-week group. Therefore, there may be additional benefit to sessions above and beyond the 8- to 12-week minimum suggested for pediatric weight management programs.