Objective: In this study, we evaluated the afterschool PAWS (Peer-education About Weight Steadiness) Club program delivered by peer or adult educators to improve food choices, physical activity, and psychosocial variables related to healthy eating. Methods: We had 109 adolescents (53 in adult-led group; 56 in peer-led group) participate in a cluster randomized controlled intervention. The 12-session curriculum framed within Social Cognitive Theory (SCT) and Stages of Change addressed mediators of behavior change related to cooking skills, food intake, and physical activity. Anthropometric, dietary intake, physical activity, and SCT mediators were assessed at baseline, post-intervention, and 6-months post-intervention. Results: Adolescents in the peer-led group significantly improved whole grain intake at post-intervention (p = .017) and 6-months post-intervention (p = .014). Both peer-led and adult-led groups had significant reductions in caloric intake at 6-months post-intervention (p = .047). Only the adult-led group improved self-efficacy (SE) and social/family support (SS) for healthy eating at post-intervention [p = .019 (SE); p = .048 (SS)] and 6-months post-intervention [p = .036 (SE); p = .022 (SS)]. Conclusions: The PAWS Club program promoted lower caloric intake by adolescents. Peer educators were effective at increasing whole grains in adolescents, and adult educators contributed to positive changes in SE and SS related to healthy eating.

Globalization prompts remote acculturation toward U.S. culture in Jamaica; this study used a bioecological systems approach to examine its proximal impact on nutrition through U.S. cable TV consumption, and maternal influences in the home. Overall, 330 randomly selected adolescent-mother dyads from schools in Kingston, Jamaica (M = 13.8 years, SD = 1.8) completed questionnaires reporting American identity and behavioral preferences, daily time spent watching U.S.-produced TV programs, and frequency of eating unhealthy foods. Actor-partner interdependence models revealed that girls' American identity/behavior directly predicted their unhealthy eating, whereas girls' mothers and boys' American identity/behavior indirectly predicted unhealthy eating as mediated by their U.S. TV hours. Additionally, mothers' American identity/behavior predicted daughters' unhealthy eating as mediated by mothers' U.S. TV hours. Remote acculturation theory may facilitate more targeted research and prevention/intervention.

Policymakers, scientists, and food and nutrition practitioners suggest that there is a societal decline in culinary skills, which is predictive of poor dietary habits contributing to childhood obesity. A narrative review was conducted to critically evaluate culinary skill interventions for children ages 5–12 y in schools to identify specific programs and programmatic factors associated with improvement in the quality of diet, body mass index (BMI), and positive changes in psychosocial variables. The culinary interventions were implemented in urban and rural areas in the United States, Australia, and England. PubMed and Medline, the Cochrane database, and a hand-search of publications identified 131 articles; 6 articles were selected for further examination on the basis of the inclusion criteria. Study designs included 1 randomized controlled trial and 5 quasi-experimental studies. Three interventions were grounded in behavioral theory, of which 2 incorporated the Social Cognitive Theory framework. The target population and setting included children and early adolescents in schools. The study methodology primarily included cooking classes combined with nutrition education lessons, parent and community components, gardening classes, tasting sessions, school lunchroom components, trips to a farmers market, or visits to a restaurant. Qualitative evaluations of the programs indicated positive findings in terms of program appeal and improvement in cooking skills and healthy eating. Quantitative analysis indicated improvement in food preferences, cooking skills, cooking self-efficacy, cooking behavioral intentions, food-preparation frequency, knowledge, healthy dietary intake, BMI, and blood pressure. The findings from this review support a positive relation between culinary interventions with children in schools and improvement in cooking skills, consumption of a healthy diet, and positive changes in anthropometric assessments. This review also suggests that integration with the academic curriculum and school lunch program may be potential avenues to explore for improving the longevity and success of the cooking programs. Further research should emphasize rigorous methodologic standards, develop theory-based standardized frameworks, and evaluate long-term effects of culinary interventions.

Parents substantially influence children’s diet and physical activity behaviors, which consequently impact childhood obesity risk. Given this influence of parents, the objective of this umbrella review was to synthesize evidence on effects of parent involvement in diet and physical activity treatment and prevention interventions on obesity risk among children aged 3–12 years old. Ovid/MEDLINE, Elsevier/Embase, Wiley/Cochrane Library, Clarivate/Web of Science, EBSCO/CINAHL, EBSCO/PsycInfo, and Epistemonikos.org were searched from their inception through January 2020. Abstract screening, full-text review, quality assessment, and data extraction were conducted independently by at least two authors. Systematic reviews and meta-analyses of diet and physical activity interventions that described parent involvement, included a comparator/control, and measured child weight/weight status as a primary outcome among children aged 3–12 years old were included. Data were extracted at the level of the systematic review/meta-analysis, and findings were narratively synthesized. Of 4158 references identified, 14 systematic reviews and/or meta-analyses (eight treatment focused and six prevention focused) were included and ranged in quality from very low to very high. Our findings support the inclusion of a parent component in both treatment and prevention interventions to improve child weight/weight status outcomes. Of note, all prevention-focused reviews included a school-based component. Evidence to define optimal parent involvement type and duration and to define the best methods of involving parents across multiple environments (e.g., home, preschool, school) was inadequate and warrants further research. PROSPERO registration: CRD42018095360.

Grocery store tours are increasingly used as an avenue for nutrition education to improve knowledge and/or alter food selection behaviors and may result in positive outcomes, but it is unknown whether these outcomes persist for longer than 3 months after the tour and whether there are common attributes of effective grocery store tours. More rigorous studies with uniform methodology in study design and outcome measures are needed to confirm the effectiveness of supermarket tours.