MS, University of Cincinnati, 2019, Allied Health Sciences: Nutrition

Adolescent obesity has continued to rise in the United States. With this rise, more adverse outcomes and diseases that were once restricted to the adult population are occurring in children and adolescents. Similar to adult treatment strategies, lifestyle changes, involving diet and exercise, are recommended as the first line of treatment for pediatric obesity. However, optimal delivery approaches for these interventions to achieve and sustain weight loss in children and adolescents are not known. Purpose: The purpose of the present study was to examine the acceptability and efficacy of a calorie-controlled DASH dietary intervention combined with high intensity interval training (HIIT) delivered in one-face-to-face counseling visit compared to the same approach enhanced with a telephone-delivered behavior modification program over 12 weeks to overweight and obese adolescents. Methods: Overweight and obese adolescents were recruited from Cincinnati Children's Hospital Medical Center main and branch Healthworks! Clinics. The present study was a randomized controlled trial with two arms: DASH-IT reduced (one-face-to-face lifestyle intervention visit) and DASH-IT intervention (enhanced with telehealth behavior modification delivered in 10-phone calls). Acceptability of the intervention was determined by process evaluation questionnaire addressing different aspects of the intervention and delivery approach. Outcome measures were collected before the intervention and after 3 months and included a 3-day dietary recall (analyzed for change in DASH score and DASH food groups and related nutrients), body mass index, body composition (lean and fat mass) and blood pressure measurements. Results: Based on the process evaluation questionnaire for the reduced and enhanced versions of the intervention, 62% stated they would recommend the DASH diet to a friend and 64% answered that they would recommend the HIT exercise program to a friend. More than half of participants in t (open full item for complete abstract)

Committee: Sarah Couch Ph.D. (Committee Chair); Abigail Peairs Ph.D. (Committee Member) Subjects: Nutrition

MA, University of Cincinnati, 2016, Arts and Sciences: Psychology

According to the National Health and Nutrition Survey (NHANES; 2009-2010), approximately one in three children are overweight or obese, including 23% of preschool age children (i.e., 2-5 year olds; Ogden, Carroll, Kit, & Flegal, 2014). Emerging literature highlights that the preschool age period is a critical time for establishing healthy behaviors and preventing obesity (Baidal, & Taveras, 2012). There are several child-related contributors to obesity, such as, child consumption and physical activity behaviors (Polacsek et al., 2009). Researchers have also identified parent-related contributors to obesity, parental modeling, reinforcing feeding practices, and foods provided in the home (Haire-Joshu et al., 2008). In addition to these risks, preschool age children from urban environments are often at increased risk for obesity due to environmental barriers, including limited access to healthy food options and low neighborhood safety (Biro & Wien, 2010). The overall aim of this study was to use focus groups and questionnaire data to examine parental perception of (1a) the current state of obesity and health behaviors in urban preschoolers (1b) critical child, parent, and environmental barriers related to obesity and healthy lifestyles; and (1c) what is needed to design and optimize effective healthy lifestyle and obesity interventions and programs.

Committee: Monica Mitchell Ph.D. (Committee Chair); Farrah Jacquez Ph.D. (Committee Member); Bridgette Peteet Ph.D. (Committee Member) Subjects: Public Health

BS, Kent State University, 2014, College of Nursing

There has been a dramatic increase in obesity in children globally. The World Health Organization (WHO) has estimates (as cited in Gaffney, Kitsantas, Brito, & Kastello, 2014) that over forty-million children under the age of five years old are overweight or obese. Not only is it affecting adults, it is also a growing concern for children as well. Trends have shown that obesity is increasing with no hint of slowing down. Nutrition and lifestyle are the key factors affecting obesity. What if a parent is unaware of how much a child should be eating or what they should be eating? Without this knowledge, children could be overfed or fed an unhealthy diet. Family education regarding proper pediatric nutrition is lacking in inner-city communities and communities with high poverty rates, which can be evidenced by the climbing rate of obesity in children within these areas. A child can be taught the difference between healthy and unhealthy foods, but needs the support of their caretakers to prepare and organize meals to help avoid becoming over weight. The objective of this project is to develop an easy-to-use guide about healthy pediatric nutrition from infancy through adolescence for family education purposes. This guide has been designed in simplistic terms in order to be used by families with limited knowledge of key guidelines to healthy pediatric nutrition through examples and factual information and focuses on the major points of infant, toddler, preschool, school-age, and adolescent nutrition through examples and facts.

Committee: Jean Zaluski (Advisor); Leslie Heaphy (Committee Member); John Lovell (Committee Member); Debra Shelestak (Committee Member) Subjects: Nursing; Nutrition

DNP, Otterbein University, 2014, Nursing

The World Health Organization (WHO) in 1995 described obesity as a chronic disease and one of the most important public health threats and in 2000 reported obesity as a global epidemic. The numbers of obese children are increasing in society; moreover, the onset of obesity is occurring at even a younger age than in the past. The prevalence of pediatric obesity is staggering and interventions need to be developed to decrease the risk for chronic and related psychological diseases. The objective of this project was to provide education on utilization of a tool kit to increase the nurse practitioner (NP) participants' knowledge base in regards to pediatric obesity prevention, recognition, and treatment. As the pre-intervention, a questionnaire was distributed to the participants to measure their knowledge of childhood obesity. The participants utilized a tool kit in their clinical practice for a two-month period. At the end of the intervention the Project Director met with the participants and distributed the same questionnaire to determine if participant knowledge, skills and perceptions changed after adopting the tool kit principles into their practice. Data analysis was completed utilizing an analysis of both the mode and median for each question to determine whether or not there was a change in the pre and post-intervention responses. An analysis of pre and post-frequency distributions was completed to determine the direction and extent of that change. Statistical significance of each change was tested utilizing the Mann-Whitney U-Test. Mode, median, and statistical significance were calculated utilizing Excel. Post-intervention participants reported that children would not outgrow overweight, and identified that a significant barrier to pediatric obesity treatment was not the patient, but lack of preparation on the part of NPs. The results supported that increased knowledge did translate into improved treatment practices in the ambulatory care setting. As mor (open full item for complete abstract)

Committee: Patricia Keane PhD (Advisor); Alicia Ribar PhD (Committee Member); Cynthia Yensel MSN (Committee Member) Subjects: Medicine; Nursing; Nutrition

Master of Science (MS), Wright State University, 2008, Nursing

The rising rate of obesity in the pediatric population has demanded further investigation from members of the health care community. Numerous exercise and nutrition programs have been developed to help combat the growing rate of obesity within the pediatric population but many lack the family-centered approach needed to achieve increased compliance with the prescribed plan of care. Both parenting styles and parental feeding behaviors have been shown to play a contributing role in the weight of children. According to previous research, the authoritarian parenting style often leads to an increased BMI in children. Research examining parental feeding behaviors indicates that high rates of disinhibition, especially within mothers, contribute to an increased BMI in children. Very few research studies have examined both factors and the relationship they have with BMI in school-age children and adolescents. This research study used a descriptive design to explore parenting styles, parental feeding behaviors and BMI in school-age children and adolescents. The sample consisted of 33 families attending a Midwest hospital-based lipid clinic for the first time from January 4, 2007 through March 15, 2007. The response rate for this study was 92%. Parenting styles were measured using the Parental Authority Questionnaire and parental feeding behaviors were measured using the Three Factor Eating Questionnaire. The child or adolescent's BMI percentile was calculated and then recorded on the demographic questionnaire. The demographic questionnaire was then handed to the parent(s) to be completed. Of the 33 questionnaires, two were excluded because of incompleteness and one was excluded as the parent was unable to understand the questionnaires due to a low literacy rate for a final sample size of 30. The typical participants were white, middleclass, married females who worked and had at least a high school education. The majority of parents (open full item for complete abstract)

Committee: Bobbe Gray PhD (Committee Chair); Donna Curry PhD (Committee Member); James Ebert MD (Committee Member); Joseph Thomas Jr., PhD (Other) Subjects: Nursing