Faculty Bibliography

Background/Purpose: According to the California Department of Education, in Orange County (OC), California, almost 37% of 5th graders are overweight or obese, and low-income and minority youth are most impacted. Obesity causes long-term health issues and has intergenerational implications [Wang et al., 2019]. Team Kid PowerOC (KiPOWOC) is an academic-community partnership initiated in 2015 to support school health policies and coach 5th graders in Title I elementary schools through on-site mentorship for behavioral change during lunch and recess. In 2017, KiPOWOC began an annual 20-week program at Thorman Elementary (75% of students enrolled in the Free or Reduced Lunch program, and 95% Latinx).
Method(s): Quasi-experimental pretest posttest design, without a control site, implemented over two academic years. Annually, volunteer health coaches spend 700-minutes with 5th graders (Weekly: 25-min lessons, 20-min meal coaching, and 25- min active play sessions). Pre- and post-test assessments included BMI percentile (BMI%), blood pressure (BP), mile-run, and health behaviors (HABITS questionnaire). Unadjusted analyses: Two-sample paired t-test. Adjusted analyses: Bonferroni correction.
Result(s): n=142; All: Ages 9-11 years, 37.3% with overweight or obese BMI, 56% female, 73% no-sports participation; BMI%, mean(SD): pre 64.25(30.28), post 60.86(30.69), p=0.0009, sBP change -5 mm Hg, p<0.0001, change in mile run time -0.65 minutes, p<0.0001. Subgroup analyses: Obese BMI (BMI >95th percentile): BMI% change -1.88%, p=0.0011; Females: BMI% change -5.5%, p=0.0003, sBP change -5 mm Hg, p=0.0002; No sports participation: BMI% change -4.1%, p=0.0009, sBP change -5 mm Hg, p<0.0001. No significant findings were identified in health behaviors consistently across subgroups. All significant results held significance after Bonferroni correction for multiple comparisons, except sBP among children with obese BMI.
Conclusion(s): Overall, KiPOWOC demonstrated a significant impact on participants' BMI%, sBP, and mile run. In subgroup analyses, findings held significance among children with obese BMI, female sex, and no-sports participation for BMI% and mile run. A significant difference was also noted in sBP for children with female sex, and no-sports participation. Although identifying subgroup differences was not the initial goal of KiPOWOC, findings highlight that KiPOWOC may have greater impact among low-income children with these characteristics. This is of particular interest when considering that children from lowincome communities have higher risk of obesity and face barriers to sports participation [Towne et al., 2018]. Future studies of KiPOWOC will further explore the subgroup findings identified, analyze study impact with the use of a comparison site, and grow partnerships with Title I OC schools

PURPOSE/OBJECTIVE:Smoking during pregnancy may be linked to other problematic prenatal health behaviors in women. We examined interrelationships among prenatal smoking, prenatal health behaviors and mental health. The objective of this study was to examine factors that may contribute to variations in prenatal health practices among women who smoke during pregnancy. METHODS:Birth mothers from an adoption study (N = 912) were interviewed about prenatal smoking, health behaviors, and mental health symptoms at 5 months postpartum. RESULTS:One-quarter of participants (N = 222) reported smoking 6 or more cigarettes daily for at least 1 trimester. For mothers who smoked more than 6 cigarettes daily, higher levels of antisocial behaviors (β =  - .14, p = .03) and depressive symptoms (β =  - .17, p = .03) were associated with less frequent prenatal folate use; antisocial behaviors and depressive symptoms were not associated for prenatal folate use among women who did not smoke more than 6 cigarettes daily. For mothers who did not smoke more than 6 cigarettes daily, more depressive symptoms were associated with fewer prenatal care visits (β = .12, p = .01). Antisocial behaviors and anxiety symptoms were not associated with prenatal care visits in either group of mothers. CONCLUSIONS FOR PRACTICE: Maternal antisocial behaviors and depressive symptoms during pregnancy may be markers for poorer adherence to recommendations for folate supplementation among women who smoke 6 or more cigarettes daily during pregnancy, independent of adequacy of prenatal care.

OBJECTIVE:To assess relationships between material hardships, shortened sleep duration, and suboptimal sleep practices across infancy and toddlerhood in low-income Hispanic families. METHODS:We analyzed longitudinal data of 451 low-income Hispanic mother-child pairs from a child obesity prevention trial. During infancy and toddlerhood, we used adjusted linear regression to assess associations between material hardship (financial difficulty, food insecurity, housing disrepair, multiple hardships), sleep duration (24-hour, night), and the number of suboptimal sleep practices (e.g., later bedtime, co-sleeping). We used adjusted linear regression to assess the longitudinal association between the number of suboptimal sleep practices in infancy and toddlerhood, and tested whether specific or multiple hardships moderated this association. RESULTS:In infants, financial difficulty and multiple hardships were associated with decreased night sleep (B=-0.59 hours, 95% CI: -1.04, -0.14; and B=-0.54 hours, 95% CI: -1.00, -0.08). Housing disrepair was associated with decreased 24-hour sleep (B=-0.64 hours, 95% CI: -1.29, -0.01). In toddlers, each additional suboptimal sleep practice was associated with a decrease in night sleep (B=-0.19 hours, 95% CI: -0.29, -0.09). Each additional suboptimal sleep practice in infancy was associated with a 0.30 increase in the number of suboptimal sleep practices in toddlerhood (p<0.001), with greater increases for those with food insecurity or multiple hardships. CONCLUSION/CONCLUSIONS:Specific and multiple hardships shortened sleep duration during infancy, and moderated the increase of suboptimal sleep behaviors between infancy and toddlerhood. Future studies should consider these early critically sensitive periods for interventions to mitigate material hardships and establish healthy sleep practices.