Alexandra K Adams1, Emily J Tomayko2, Kate A Cronin3, Ronald J Prince4, Kyungmann Kim5, Lakeesha Carmichael6, Tassy Parker7. 1. Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT. Electronic address: alexandra.adams2@montana.edu. 2. School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR. 3. Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI. 4. Department of Population Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI. 5. Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI. 6. Frontier Science and Technology Research Foundation, Madison, WI. 7. Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM.
Abstract
OBJECTIVE: To describe sociodemographic factors and health behaviors among American Indian (AI) families with young children and determine predictors of adult and child weight status among these factors. DESIGN: Descriptive, cross-sectional baseline data. SETTING: One urban area and 4 rural AI reservations nationwide. PARTICIPANTS: A total of 450 AI families with children aged 2-5 years participating in the Healthy Children, Strong Families 2 intervention. INTERVENTION: Baseline data from a healthy lifestyles intervention. MAIN OUTCOME MEASURES: Child body mass index (BMI) z-score and adult BMI, and multiple healthy lifestyle outcomes. ANALYSIS: Descriptive statistics and stepwise regression. RESULTS: Adult and child combined overweight and obesity rates were high: 82% and 40%, respectively. Food insecurity was high (61%). Multiple lifestyle behaviors, including fruit and vegetable and sugar-sweetened beverage consumption, adult physical activity, and child screen time, did not meet national recommendations. Adult sleep was adequate but children had low overnight sleep duration of 10 h/d. Significant predictors of child obesity included more adults in the household (P = .003; β = 0.153), an adult AI caregiver (P = .02; β = 0.116), high adult BMI (P = .001; β = 0.176), gestational diabetes, high child birth weight (P < .001; β = 0.247), and the family activity and nutrition score (P = .04; β = 0.130). CONCLUSIONS AND IMPLICATIONS: We found multiple child-, adult-, and household-level factors influence early childhood obesity in AI children, highlighting the need for interventions to mitigate the modifiable factors identified in this study, including early life influences, home environments, and health behaviors.
OBJECTIVE: To describe sociodemographic factors and health behaviors among American Indian (AI) families with young children and determine predictors of adult and child weight status among these factors. DESIGN: Descriptive, cross-sectional baseline data. SETTING: One urban area and 4 rural AI reservations nationwide. PARTICIPANTS: A total of 450 AI families with children aged 2-5 years participating in the Healthy Children, Strong Families 2 intervention. INTERVENTION: Baseline data from a healthy lifestyles intervention. MAIN OUTCOME MEASURES: Child body mass index (BMI) z-score and adult BMI, and multiple healthy lifestyle outcomes. ANALYSIS: Descriptive statistics and stepwise regression. RESULTS: Adult and child combined overweight and obesity rates were high: 82% and 40%, respectively. Food insecurity was high (61%). Multiple lifestyle behaviors, including fruit and vegetable and sugar-sweetened beverage consumption, adult physical activity, and child screen time, did not meet national recommendations. Adult sleep was adequate but children had low overnight sleep duration of 10 h/d. Significant predictors of childobesity included more adults in the household (P = .003; β = 0.153), an adult AI caregiver (P = .02; β = 0.116), high adult BMI (P = .001; β = 0.176), gestational diabetes, high child birth weight (P < .001; β = 0.247), and the family activity and nutrition score (P = .04; β = 0.130). CONCLUSIONS AND IMPLICATIONS: We found multiple child-, adult-, and household-level factors influence early childhood obesity in AI children, highlighting the need for interventions to mitigate the modifiable factors identified in this study, including early life influences, home environments, and health behaviors.
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