Home and neighbourhood built environment features in family‐based treatment for childhood obesity

Abstract

Background: Family-based behavioral weight loss treatment for childhood obesity (FBT) helps families develop strategies to facilitate healthy choices in their home and other environments (e.g., home neighborhood).The current study examines how the home food environment, both pre- and post-FBT, and the neighborhoods in which families live are associated with child weight and weight-related outcomes in FBT. Method: Parent-child dyads (n=181) completed a 16-session FBT program and completed home environment, anthropometric, and child dietary/activity assessments at pre- and post-FBT. Parents reported on availability of food, electronics, and physical activity equipment in the home. The neighborhood food and recreation environment around each dyad’s residence was characterized using existing data within a geographic information system (GIS). Results: Families successfully made healthy home environment modifications during FBT. Regression models showed reducing RED (e.g., high energy-dense and low nutrient-dense) foods and electronics in the home during FBT had positive effects on child weight and weight-related outcomes. No neighborhood food or recreation environment variables were significantly related to outcomes, although having a larger density of public recreation spaces was associated with increases in physical activity at the trend-level. Conclusions: Modifying the home environment, specifically reducing RED foods and electronics, may be particularly important for FBT success.

Factors influencing obesity among preschoolers: multilevel approach

“…The literature regarding the relationship between physical activity environment and childhood obesity has been inconclusive (Hayes et al. ; Schalkwijk et al. ).…”

“…Among community factors, the physical activity environment was the only factor found to be positively significant with child BMI z-score. The literature regarding the relationship between physical activity environment and childhood obesity has been inconclusive (Hayes et al 2019;Schalkwijk et al 2018). A variety of definitions for the neighbourhood environment are used along with conflicting information regarding the influence of the neighbourhood environment on physical activity (Datar et al 2013).…”

Predictors of Developmental Patterns of Obesity in Young Children

“…One is coverage of possible confounds and covariates, such as pre-natal maternal hypertension, hyperlipidemia, and diet; or, postnatally, information on young children's exercise and the built environment. At least some of these factors have not been found to associate with obesity risk in early childhood (4,48,49), but it remains possible that unmeasured variables confound our results. In addition, we did not have data on biological mechanisms associated with metabolic control of obesity, such as insulin resistance, at these early ages; however, obesity status is a notable outcome in early childhood because of its established links with later cardiometabolic disease, [e.g., (6)].…”

CHECK: A randomized trial evaluating the efficacy and cost-effectiveness of home visitation in pediatric weight loss treatment

“…CHECK is grounded in a socioecological model that emphasizes the roles of both physical and social/family aspects of children's home environments in the development and maintenance of obesity [24]. For example, family routines (e.g., bedtime routines, family meals) and aspects of the physical home environment (e.g., availability of energydense foods and beverages) are considered important, modifiable, proximal influences on children's weight management behaviors [25][26][27].…”