Understanding childhood obesity in a diverse population of low income children li

描述(由申请人提供)：生活在贫困农村社区的美国儿童身体活动的机会有限，获得健康食品的机会也很有限。这一领域的研究有限，因为许多工作都是在城市和郊区完成的。鉴于肥胖率不断上升，有必要确定在农村地区推动这一流行病的因素。 具体目标和假设：1.描述居住在美国四个不同地区(阿巴拉契亚、中央山谷、密西西比河三角洲和东南部)的低收入农村父母的喂养和养育方式，并检验喂养方式工具(CFSQ/CFQ)和喂养方式和养育方式工具(CFSQ/PDI-S)之间的一致性。假设1a：需求和反应性的喂养方式维度(CFSQ)与进食压力、限制和监控水平的喂养方式维度(CFQ)之间存在关联。假设1b：需求性和反应性的喂养方式维度与养成、不一致、跟随、组织、放手、惩罚、推理、提醒和控制的父母教养方式维度存在相关。 2.在低收入农村人群中，确定父母喂养方式与儿童膳食质量、能量摄入和体重状况的关系。假设2a：儿童饮食质量与父母对喂养的需求度(+)和反应性(+)以及进食压力(+)、限制(-)和监测(+)之间存在关联，由CFQ衡量。假设2b：儿童能量摄入与父母对喂养的需求度(-)和反应性(-)之间存在关联，CFSQ测量的进食压力(-)、限制(+)和监控水平(-)。假设2c：父母报告的进食压力得分，由CFQ测量，在BMI z得分较高和平均得分较高的儿童中会有所不同。 3.探讨低收入农村父母体力活动相关教养方式和教养方式与子女体力活动水平的关系。假设3a：孩子的PA水平与其父母的活动相关练习分数之间存在正相关关系。假设3b：根据PDI-S的测量，父母权威的孩子的体力活动水平与父母非权威的孩子相比是不同的。 方法：a.研究/评估设计：对99名亲子二人组的父母教养方式、喂养方式、身体成分、身体活动和饮食习惯进行定量、横断面评估。地点和人口：目标人群是居住在中央山谷(CA)、密西西比河三角洲(MS，AR)、阿巴拉契亚(KY)和美国东南部(GA，SC)地区贫困地区的6-11岁的美国农村小学儿童。我们将从每个地区随机选择1所学校(N=4所学校)。措施：父母将完成《照顾者喂养方式问卷》、《儿童喂养问卷》、《父母养育维度问卷》，作为喂养方式和全球养育方式的测量工具。父母还将报告他们的家庭人口统计数据、季节性活动，以及关于他们自己的习惯、态度和对体育活动的看法的问题。孩子们将自我报告他们的食物和活动偏好，并参与家长协助的24小时回忆，并佩戴体力活动监测器。父母和孩子都将测量他们的身高和体重，以确定BMI。D.分析：将使用SPSS对定量数据进行描述性、探索性和相关性分析。24小时召回将使用NDS-R进行分析。将使用SAS下载和计算活动监视数据。多元回归模型将检验喂养方式和父母养育方式对儿童健康结果的影响。

DESCRIPTION (provided by applicant): US Children living in impoverished rural communities have limited opportunities for physical activity and accessibility to healthy foods. Research in this area is limited as much of the work has been done in urban and suburban areas. Given the increasing obesity rates it is necessary to identify the factors that are driving this epidemic in rural areas. Specific Aims and Hypotheses: 1. To describe the feeding and parenting styles of low income, rural parents living in four distinct areas of the US (Appalachia, Central Valley, Mississippi River Delta, and the Southeast) and to examine the agreement among feeding style instruments (CFSQ/CFQ) and between feeding style and parenting style instruments (CFSQ/PDI-S). Hypothesis 1a: There are associations between the feeding style dimensions of demandingness and responsiveness (CFSQ) and the feeding style dimensions (CFQ) of pressure to eat, restriction, and level of monitoring. Hypothesis 1b: There are associations between the feeding style dimensions of demandingness and responsiveness (CFSQ) and the parenting style subscales (PDI-S) of nurturance, inconsistency, follow thru, organization, letting go, punishment, reasoning, reminding, and control. 2. To determine the relationship between parent feeding styles and child's dietary quality, energy intake, and weight status in a low income, rural population. Hypothesis 2a: There are associations between child diet quality and parent level of demandingness (+) and responsiveness (+) toward feeding, as measured by the CFSQ, and pressure to eat (+), restriction (-), and level of monitoring (+), as measured by the CFQ. Hypothesis 2b: There are associations between child energy intake and parent level of demandingness (-) and responsiveness (-) toward feeding as measured by the CFSQ and pressure to eat (-), restriction (+), and level of monitoring (-) as measured by the CFQ. Hypothesis 2c: The pressure to eat score reported by parents, as measured by the CFQ, will be different between children who have a high vs. average BMI z-score. 3. To determine the relationship between physical activity-related parenting practices and parenting styles of low income rural parents and their child's physical activity level. Hypothesis 3a: There is a positive association between a child's PA level and their parents activity-related practices score. Hypothesis 3b: Levels of physical activity will be different in children with an authoritative parent, as measured by the PDI-S, compared to children with a nonauthoritative parent. Methods: a. Study/evaluation design: Quantitative, cross-sectional assessment of parenting style, feeding styles, body composition, and physical activity and dietary habits among 99 parent-child dyads. b. Setting and population: The target population is rural American elementary school children between the ages of 6-11 years living in poor areas within the Central Valley (CA), Mississippi Delta (MS, AR), Appalachia (KY), and Southeast (GA, SC) regions of the US. We will randomly select 1 school from each region (N=4 schools). c. Measures: Parents will complete the Caregiver's Feeding Styles Questionnaire, Child Feeding Questionnaire, Parenting Dimensions Inventory as measures of feeding style and global parenting style. Parents will also report their family demographics, seasonal activities, and questions about their own habits, attitudes, and perceptions toward physical activity. Children will self-report their food and activity preferences as well as participate in a parent-assisted 24-hour recall and wear a physical activity monitor. Both parents and children will have their height and weight measured to determine BMI. d. Analysis: Descriptive, exploratory, and correlation analyses will be performed using SPSS for the quantitative data. The 24-hour recalls will be analyzed using NDS-R. Activity monitor data will be downloaded and computed using SAS. Multivariate regression models will test for the effect of feeding style and parenting style on child health outcomes.