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The home environment and childhood obesity in low-income households: indirect effects via sleep duration and screen time.

Appelhans BM, Fitzpatrick SL, Li H, Cail V, Waring ME, Schneider KL, Whited MC, Busch AM, Pagoto SL - BMC Public Health (2014)

Bottom Line: The best-fitting path model explained 26% of variance in child weight status, and included paths linking chaos in the home environment, lower caregiver screen time monitoring, inconsistent implementation of bedtime routines, and the presence of a television in children's bedrooms to childhood overweight/obesity through effects on screen time and sleep duration.This study adds to the existing literature by identifying aspects of the home environment that influence childhood weight status via indirect effects on screen time and sleep duration in children from low-income households.Pediatric weight management interventions for low-income households may be improved by targeting aspects of the physical and social home environment associated with sleep.

View Article: PubMed Central - PubMed

Affiliation: Department of Preventive Medicine, Rush University Medical Center, 1700 W, Van Buren St,, Suite 470, Chicago, IL 60612, USA. brad_appelhans@rush.edu.

ABSTRACT

Background: Childhood obesity disproportionally affects children from low-income households. With the aim of informing interventions, this study examined pathways through which the physical and social home environment may promote childhood overweight/obesity in low-income households.

Methods: Data on health behaviors and the home environment were collected at home visits in low-income, urban households with either only normal weight (n = 48) or predominantly overweight/obese (n = 55) children aged 6-13 years. Research staff conducted comprehensive, in-person audits of the foods, media, and sports equipment in each household. Anthropometric measurements were collected, and children's physical activity was assessed through accelerometry. Caregivers and children jointly reported on child sleep duration, screen time, and dietary intake of foods previously implicated in childhood obesity risk. Path analysis was used to test direct and indirect associations between the home environment and child weight status via the health behaviors assessed.

Results: Sleep duration was the only health behavior associated with child weight status (OR = 0.45, 95% CI: 0.27, 0.77), with normal weight children sleeping 33.3 minutes/day longer on average than overweight/obese children. The best-fitting path model explained 26% of variance in child weight status, and included paths linking chaos in the home environment, lower caregiver screen time monitoring, inconsistent implementation of bedtime routines, and the presence of a television in children's bedrooms to childhood overweight/obesity through effects on screen time and sleep duration.

Conclusions: This study adds to the existing literature by identifying aspects of the home environment that influence childhood weight status via indirect effects on screen time and sleep duration in children from low-income households. Pediatric weight management interventions for low-income households may be improved by targeting aspects of the physical and social home environment associated with sleep.

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Related in: MedlinePlus

Final path model linking features of the home environment to childhood overweight/obese status through sleep duration (N = 103). Values are standardized path coefficients.
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Fig1: Final path model linking features of the home environment to childhood overweight/obese status through sleep duration (N = 103). Values are standardized path coefficients.

Mentions: The second stage of analysis focused on modeling associations between the social and physical home environment and child weight status through mediating paths involving sleep duration. Variables included in the initial model were total media items in the home, the presence of a television in the index child’s bedroom, screen time (as an influence on sleep duration), caregiver screen time monitoring, consistent implementation of a bedtime routine, perceived chaos and disorganization in the home environment, and several covariates (index caregiver BMI, child age, household income, index caregiver education). Total media items in the home was not associated with sleep duration or screen time and was removed from the model. The final path model (Table 4; Figure 1; model χ2 = 5.11, p = .95; CFI = 1.00; RMSEA = 0.00) explained 26% of variance in weight status, and 23% of the variance in both sleep duration and screen time.Table 4


The home environment and childhood obesity in low-income households: indirect effects via sleep duration and screen time.

Appelhans BM, Fitzpatrick SL, Li H, Cail V, Waring ME, Schneider KL, Whited MC, Busch AM, Pagoto SL - BMC Public Health (2014)

Final path model linking features of the home environment to childhood overweight/obese status through sleep duration (N = 103). Values are standardized path coefficients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4233039&req=5

Fig1: Final path model linking features of the home environment to childhood overweight/obese status through sleep duration (N = 103). Values are standardized path coefficients.
Mentions: The second stage of analysis focused on modeling associations between the social and physical home environment and child weight status through mediating paths involving sleep duration. Variables included in the initial model were total media items in the home, the presence of a television in the index child’s bedroom, screen time (as an influence on sleep duration), caregiver screen time monitoring, consistent implementation of a bedtime routine, perceived chaos and disorganization in the home environment, and several covariates (index caregiver BMI, child age, household income, index caregiver education). Total media items in the home was not associated with sleep duration or screen time and was removed from the model. The final path model (Table 4; Figure 1; model χ2 = 5.11, p = .95; CFI = 1.00; RMSEA = 0.00) explained 26% of variance in weight status, and 23% of the variance in both sleep duration and screen time.Table 4

Bottom Line: The best-fitting path model explained 26% of variance in child weight status, and included paths linking chaos in the home environment, lower caregiver screen time monitoring, inconsistent implementation of bedtime routines, and the presence of a television in children's bedrooms to childhood overweight/obesity through effects on screen time and sleep duration.This study adds to the existing literature by identifying aspects of the home environment that influence childhood weight status via indirect effects on screen time and sleep duration in children from low-income households.Pediatric weight management interventions for low-income households may be improved by targeting aspects of the physical and social home environment associated with sleep.

View Article: PubMed Central - PubMed

Affiliation: Department of Preventive Medicine, Rush University Medical Center, 1700 W, Van Buren St,, Suite 470, Chicago, IL 60612, USA. brad_appelhans@rush.edu.

ABSTRACT

Background: Childhood obesity disproportionally affects children from low-income households. With the aim of informing interventions, this study examined pathways through which the physical and social home environment may promote childhood overweight/obesity in low-income households.

Methods: Data on health behaviors and the home environment were collected at home visits in low-income, urban households with either only normal weight (n = 48) or predominantly overweight/obese (n = 55) children aged 6-13 years. Research staff conducted comprehensive, in-person audits of the foods, media, and sports equipment in each household. Anthropometric measurements were collected, and children's physical activity was assessed through accelerometry. Caregivers and children jointly reported on child sleep duration, screen time, and dietary intake of foods previously implicated in childhood obesity risk. Path analysis was used to test direct and indirect associations between the home environment and child weight status via the health behaviors assessed.

Results: Sleep duration was the only health behavior associated with child weight status (OR = 0.45, 95% CI: 0.27, 0.77), with normal weight children sleeping 33.3 minutes/day longer on average than overweight/obese children. The best-fitting path model explained 26% of variance in child weight status, and included paths linking chaos in the home environment, lower caregiver screen time monitoring, inconsistent implementation of bedtime routines, and the presence of a television in children's bedrooms to childhood overweight/obesity through effects on screen time and sleep duration.

Conclusions: This study adds to the existing literature by identifying aspects of the home environment that influence childhood weight status via indirect effects on screen time and sleep duration in children from low-income households. Pediatric weight management interventions for low-income households may be improved by targeting aspects of the physical and social home environment associated with sleep.

Show MeSH
Related in: MedlinePlus