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

BMC Public Health

Sherry L Pagoto³  Andrew M Busch⁴  Matthew C Whited¹  Kristin L Schneider⁶  Molly E Waring⁵  Vernon Cail²  Hong Li²  Stephanie L Fitzpatrick²  Bradley M Appelhans² 

[1] Department of Psychology, East Carolina University, Greenville, NC, USA;Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL 60612, USA;Division of Preventive and Behavioral Medicine in the Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA;The Miriam Hospital, Providence, RI, USA;Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA;Department of Psychology, Rosalind Franklin University, North Chicago, IL, USA

关键词: Socioecologic model;    Sleep;    Home environment;    Socioeconomic status;    Childhood obesity;   

Others  :  1122988
DOI  :  10.1186/1471-2458-14-1160

 received in 2014-06-25, accepted in 2014-10-21,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Appelhans et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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