Brief Summary of Minutes of Annual Meeting

Meeting: Annual Meeting of W1005 - An Integrated Approach to Prevention of Obesity in High Risk Families Multistate Research Project Meeting Date: October 5-7, 2011 Meeting Location: University of Nevada Cooperative Extension Building, Conference Room E, Las Vegas, Nevada WEDNESDAY OCTOBER 5, 2011 1:00 Networking, introductions of those in attendance 1:15 Janet reviewed the agenda and the old objectives of W1005, and the timeline for completion of W1005 needs to be determined. Madeleine will lead the discussion today on the new proposal for new objectives 1 and 2. The new proposal is due January 15, 2012, and the new objectives need to be written now. The old objective 1 report was summarized by Madeleine for Jamie Dollahite. The data need to be transcribed and an analyst is needed to analyze the data that have been collected. We were requested to ask our AES Director for funding, i.e., $1000-$1500 per participant (those who collected data) for data analyses. Data will be analyzed at Cornell University but the results of the data will not be ready before the new objectives need to be submitted. Preliminary new objective 1: Synthesize current outcomes from W1005 and common threads in other NIFA and RWJF research for community-based prevention in ages 2-8 years but the age range can be expanded or changed. Determine what is missing for future research directions, conduct analysis of data from new and past research in child obesity prevention. Synthesize results from W1005 objective 1 with M. Townsends seminal paper/constructs. Laura agreed to spearhead the new objective 1; Diane has a meta-analysis program if a meta-analysis is to be conducted. Madeleine gave an overview of the preliminary results for objective 3; nine states were involved in data collection at this time. Some of the sample participants were actual measured weights and some were self-reported. In general, mothers were more accurate in reporting their weights but less accurate in reporting their childrens measurements. Kate is analyzing the data and plans to send results of these data. Parenting style and how parents feed their children was discussed as this is an important area of research and publications in this area are lacking. As a group, resilience to obesity was discussed and the difficulty of conducting research in this area as BMI for young children is not an indicator for obesity prevention. A preschooler who is overweight is not an indication that he/she will be an overweight adult. Obesity resilience was discussed and the difficulty of conducting research in this area as it is defined differently by researchers and the lack of general consensus on this topic. There was general agreement that this project had challenges as many people came on board late, many people in W1005 are not participating and this has hindered the project from quickly moving forward. Susan began a discussion of the constructs of Townsends paper which were discussed as determinants for validity. Karen and Melinda presented an overview of work completed by objective 2. An in-depth systematic review of literature was completed focusing on what would work in the field and which parameters, measures, and techniques are the most important for field practitioners. Melinda has taken the lead on the manuscript for publication. A draft of the manuscript has been sent to the objective 2 group and is being revised and will be sent to a peer-reviewed journal; probably the Journal of Nutrition Education and Behavior. Many of the findings for objective 2 will be translated into new objective 2. Janet read the objectives for 4 and 5. Madeleine thought objective 5 was not approachable but objective 4 has been approached. Pieces of objective 4 have been answered. For object 5, we need to rethink the construct of childhood obesity resilience and this may not be the correct construct for childhood obesity. This was discussed further. Steps on objective 5 for creating a childhood obesity prevention program were discussed. The framework is being discussed by the group members. Janet needs the written reports for objectives 1 -3, which are due 60 days after our meeting, so everyone should send Janet the reports by Nov. 4, 2011. Janet and Madeleine led a discussion for new objectives 1 and 2. Madeleine discussed a paper on selected contributing factors/ecological model published in Child Development Perspectives. The Six-Cs Model includes Cell (genetic/biological characteristics), child, clan (family characteristics), community, country, and cultural and societal characteristics. This gave direction for formulating new objective 1, which was discussed as synthesizing current outcomes from W1005 objectives 1 and 3 and common threads in other NIFA and RWJF research for community-based obesity prevention in 2-8 year-old children. It was stated that expertise in nutrition and physical activity is critical for the success of any obesity prevention program. Melinda noted that this W1005 research group has the expertise in nutrition and physical activity and discussed objective 2 in regards to facilitating integration of objective 1 into community programs. Objective 2s outcome should be educational tools for Extension faculty. Review of current best practices is needed as well as addressing what is currently being used. The outcome can be a webinar or other outcome. Janet noted that nutrition and physical activity are important but parenting styles and feeding styles need to be integrated into objective 2. Formulating a logic model and using SMART (specific, measurable, attainable, realistic, and timeline) objectives were presented as tools to help with moving forward, such as compare seminal current articles about determinants in relation to what was heard from objective 1 participants (people in the field) and disseminate information to Extension educators. The true outcome of W1005 was discussed, and it is not ongoing education for Extension faculty. Parenting practices is the umbrella. How do parenting practices influence physical activity, nutrition and eating styles. Energy balance was discussed. Practices were discussed such as diet, sleep patterns, and other factors that are influenced by parenting styles. Is the framework the parenting style? Have parenting styles changed in the past few decades? Strategies should be developed to work with parents and their parenting style. Susan Welsh provided a handout to group members in attendance of an overview of the National Institute of Food and Agriculture (NIFA), organizational structure, key personnel of NIFA, two new hires, program area priorities, and an update of NIFAs next funding announcements which should be out shortly. Discussion ended a few minutes past 5:00 p.m. with instruction for all to think about writing the new objectives. The van was to arrive at 5:15 to take group members from the University of Nevada Cooperative Extension Building to the hotel. Janet and Laura stated they would work on the project tonight and everyone was welcome to join in and work on this project in the lobby of the hotel this evening. THURSDAY OCTOBER 6, 2011 8:30 Networking, announcements, and updates on progress. 9:00 Meeting began with Janet and Laura presenting a logic model to assist with writing the objectives. The group worked on writing 2012 objective 2: Development of resources, such as journal articles used by Extension professionals; make webinars available and archive on eXtension, CYFERnet (Children, Youth and Families Education and Research Network); presentations at professional meetings, i.e., National Extension Association of FCS, Society for Nutrition Education and Behavior, Preister Conference). All of these resources would eventually facilitate the integration of objective 1 into community practice. 10:15 W1005 is scheduled to end in December 2011 and a title for the new proposed project was discussed. Direction of the new project was also discussed. After much discussion iterating energy balance, protective factors instead of resilience, parenting styles, and expected work for the new project, etc., it was decided that the best title would be, Parenting, energy dynamics, and lifestyle determinants of childhood obesity: New directions in prevention 11:30 Discussed breaking into groups or working as one group for writing. It was decided that the whole group was productive and worked well together so methodology was tackled. (Lunch was ordered in and it was a working lunch.) 2012 Objective 1: Compare and contrast outcomes from 2006 W1005 objective 1 (field practice perspective) and objective 3 (parent-child interaction) with findings from seminal obesity-prevention research to identify successful child obesity prevention strategies, as influenced by parenting. 2012 Objective 2: The aim of objective 2 is to translate the outcomes of objective 1 for use by community and public health professionals. Using the results of objective 1 (above), develop resources such as translational research articles that community and public health professionals could use in implementing community programs. One avenue of dissemination will be webinars through eXtension, CYFERnet (Children, Youth and Families Education and Research Network), and professional organizations (e.g., National Extension Association of Family and Consumer Sciences, Society for Nutrition Education and Behavior, Preister Conference). All of these webinars will be archived for future use. A second avenue of dissemination will be translational presentations at professional meetings (e.g., National Extension Association of Family and Consumer Sciences, Society for Nutrition Education and Behavior, Preister Conference). (e.g., National Extension Association of Family and Consumer Sciences, Society for Nutrition Education and Behavior, Preister Conference). (e.g., National Extension Association of Family and Consumer Sciences, Society for Nutrition Education and Behavior, Preister Conference). Outputs: Were determined Outcomes or projected Impacts: 1. Advance the science of child obesity prevention, particularly an understanding of parenting, energy dynamics, and lifestyle determinants. 2. More effective programs resulting from the educators being more focused on those determinants of child obesity prevention, which are most effective in family- and community- based settings. (Writing of objectives, outputs, milestones, impacts ensued until 5:10 p.m.) FRIDAY OCTOBER 7, 2011 8:30 Networking 8:40 Janet presented the work that needed to be completed this morning. Group 2 is meeting for 1 hour. We will work under the assumption that the project will be continued. Need to elect officers. Susan Welsh advised about guidelines for multistate research projects. W1005, as is, will not meet again. A new project proposal will be submitted. Need volunteers for writing. Previous work needs to be summarized. Related, current, and previous work and also work not the same as another CRIS project needed. Melinda will do summary for Group 2, Madeleine will do summary for Group 3 and Jill will do summary report for Group 1. The new proposal will need a justification about the importance of the proposed project. Melinda will investigate energy balance and parenting. Janet stated that this needs to be completed before the end of December. Beth Olson stated she could probably work on obesity write-up and Diane Tidwell also could help. Laura will work on parenting and feeding write-up. Janet asked how to address educators role in obesity prevention. There was discussion about writing the new proposal and sharing the workload. There was also discussion of logistics of new proposal with new people joining a multistate project. There are many people who joined W1005 but never participated. It was noted that Amy Mobley and Nahid Sistani want to volunteer and participate but were not able to travel to this years meeting. Susan discussed the guidelines for joining multistate research projects and the experiment directors role in approving individuals. Specifics of the new proposal were discussed. Janet will work on an outreach plan. Projected participation in Appendix E was discussed. When the proposal is entered into the system (NIMSS), the core group of W1005 can request to sign up for participation on the project. Ron will upload it to NIMSS. Assuming the new proposal is approved, where should the next meeting be and volunteers are needed for chair, vice-chair, and secretary. Kay and Linda said they could host next years meeting in Tucson, Arizona, which is where it was last year. Slate of Officers was presented: Janet Kurzynske, Chair; Laura Hubbs-Tait, Vice-Chair; Diane Tidwell, Secretary Melinda Manore made a motion for the above named individuals to be the officers, seconded by Karen Spears, no discussion, all voted in favor, no one objected. 9:30 Group 2 convened to a separate conference room to work on old objective 2. Remainder of W1005 members worked on sections for the new proposal. 11:30 Meeting ended but work continued until 12:00 by those still in attendance. Minutes for the annual meeting of W1005 An Integrated Approach to Prevention of Obesity in High Risk Families Multistate Research Project respectively submitted by Diane Tidwell, Secretary.

OBJECTIVE ONE: *Approach: Collaborative effort of nine states to interview low-income parents (specifically mothers) of children ages 3-10 years old to assess parent-child interactions as they relate to key behaviors identified as being associated with resilience to overweight. The principal investigators agreed upon a single questionnaire and interview protocol. One principal investigator volunteered to conduct the primary analyses, with input from others. Two semi-structured qualitative interview guides were developed by the multistate team. One was for Cooperative Extension nutrition educators supervising EFNEP and/or SNAP-Ed programs that serve low-income audiences, and one was for paraprofessional frontline educators who work directly with participants; all informants had been employed in their current position for at least a year. The guides were similar but the wording was adjusted to reflect the informants responsibilities in working with program participants. Questions were designed to understand what staff believed were the most important behaviors to target with participants to prevent obesity among children 4 to 10 years old and their families, and the characteristics of the EFNEP or SNAP-Ed programming that facilitate this goal. In addition, educators were asked about their perceptions of participants beliefs about behaviors that lead to obesity, as well as barriers participants face to changing these behaviors. Item design was guided by the Socio-Ecological Model to account for potential individual, family, community, and cultural influences related to childrens healthy eating. Seven states, representing the northwestern, midwestern, southern, and northeastern United States have participated. Study design and data collection protocol were developed by the multi-state team. A purposive and convenience sample of educators was chosen. Racial/ethnic diversity among informants was sought to the extent possible. Interviews were conducted by phone, audio-recorded, and transcribed verbatim. Content analysis of the transcripts has been conducted by some individual states. In the summer of 2011, two members designed and led a workshop for conducting a consistent and systematic content analysis if members wished to analyze their own state data. However, to facilitate analysis of the multistate dataset, the group will take a different approach. In FFY 2012, all transcripts will be provided to Cornell where a single analyst will use Atlas- ti to manage the data, and code and analyze the interviews using the constant comparative method. Comparison to analyses done by individual states will provide checks on interpretation and validity. Peer debriefing will occur with the multistate team via conference call. *Progress: Input: Participants are: Cornell University, New York (Jamie Dollahite) ; University of Nebraska (Kaye Stanek Krogstrand); University of Nevada (Madeleine Sigman-Grant); South Carolina State University (Rafida Idris); University of Kentucky (Janet Kurzynske); University of Tennessee (Betty Greer, Naima Moustaid-Moussa); Washington State University (Jill Armstrong Shultz). A total of 91 Cooperative informants were interviewed  33 supervisors and 43 frontline personnel. Funding sources were: Federal Formula Funds (Hatch), State funds and Discretionary funds (personal and university) Outputs: Data analysis to date All participating states have collected data, and all but one transcribed the interviews. Four states have analyzed their data and two have partially analyzed it. Transcripts are now being submitted to Cornell for a unified analysis. Student involvement Both undergraduate (n=1) and graduate students (n=4) have been involved in collecting and analyzing data. One masters thesis with a subsequent paper will be forthcoming. OBJECTIVE TWO *Approach: Identified evidence-based field methods for anthropometric, fitness, physical activity and metabolic parameters that could be used to measure changes in risk factors for obesity and chronic disease in children and families in school and community settings. *Progress: Input: The following individuals participated in Objective 2: K. Hongu, R. Idris, A. Lindsay, M. Manore, K. Spears. No outside funding, besides that provided by the university and AES, supported our contributions to this project. Students did participate in helping to gather data and organize data and research articles. Group 2 identified evidence-based field methods for anthropometric, fitness, physical activity and metabolic parameters that could be used to measure changes in risk factors for obesity and chronic disease in children and families in school and community settings. We conducted an extensive literature review on the above parameters to determine those that could be used in the field for project and/or research evaluations and assessments. Our target populations were children, especially young children between the ages of 4-11y olds, and their parents (adults). This work is supportive of the other objectives in W1005. Outputs: Publications in Progress: We have now complied a rough draft of our paper, Field assessment for obesity prevention in children and parents: Anthropometrics, physical activity, fitness and metabolic parameters, which will be submitted the Journal of Nutrition Education and Behavior. The authors on the manuscript are Manore, Hongu, Idris, Lindsay and Spears. Our goal is to submit the manuscript by Dec 2011. Student Involvement: Teran B. (AZ/NASA Space Grant Undergraduate Research Intern, 2010-2011, Hongu, K, Mentor) Innovative Use of Smart Phones in Encouraging Healthy Lifestyles among Youth in an Environmental Education Program. Knutson N. (AZ/NASA Space Grant Undergraduate Research Intern, 2010-2011, Hongu, K, Mentor) Development of an 8-Week Program Utilizing Mobile Technologies to Promote and Maintain Physical Activity in Youth. Sweat W. (current MS student, Dept of Nutrition and Exercise Science, Manore MM, Chair). Reducing Metabolic Syndrome Risk Factors in Overweight, Premenopausal Women: Dietary and Physical Activity Behavior Modification. Pilolla K. (current PhD student, Dept of Nutrition and Exercise Science, Manore MM, Chair). Prevention of Metabolic Syndrome in Midlife Adults: Role of Nutrition and Exercise. (Recipient: USDA National Need Fellow, 2007-2010) Guebels C. (MS 2011, Dept of Nutrition and Exercise Science, Manore MM, Chair). Active Women with and without Menstrual Disorders: Comparison of Resting Metabolic Rate and Energy Availability. (Recipient: ACSM 2011 Nutrition Student Interest Group Research Award.) Ciadella L. (PhD 2011, Dept of Nutrition and Exercise Science, Manore MM, Chair). Nutrition, Exercise and Menstrual Dysfunction. (Recipient: Travel award for NIH Dietary Supplement Research Practicum, 2008; Recipient: USDA National Need Fellow, 2007-2010) Rezaei Arya S, Spears K (chair) Masters thesis: "Relationship between proximity, density, and diversity of food outlets and obesity". May 2011 Lee J. (current MS student,), Spears K (chair): Examining an association between self-esteem and energy balance and risk for disordered eating and energy balance among college freshmen. OBJECTIVE THREE *Approach: Participants developed and administered a uniform research survey protocol to assess feeding styles, parenting styles, and dietary intake in relationship to perceived and actual weights of young children and their mothers. *Progress: Input: The following participants conducted a total of 213 survey interviews: Nahid Sistani, Beth Olson, Lisa Jahns, Madeleine Sigman-Grant ,Laura Hubbs-Tait ,Kaye Stanek-Kongstrand, Kate Dickin, Amy Mobley, and Rafida Idris. Additional members of the objective are: Nurgul Fitzgerald, :Janet Kurzynske, Vivian Haley-Zitlin and Diane Tidwell. Outputs: Data Analysis to date: Coordination and management of the receipt and cleaning of data from 10 states on child and parent weight and height, food and activity habits; parenting and child feeding practices; and parental perceptions of child weight. Creation of a multistate dataset on 279 mother-child dyads representing a diverse group of low-income families with children aged 3-10 years. Preliminary analysis of data and conference calls with multi-state collaborators to plan analyses and develop a manuscript. Collection of additional extensive data on participating parents in New York, in an expanded study that includes more surveys plus 3 qualitative interviews on parents reactions to and experiences with feeding and parenting practices recommended to help avoid unhealthy weight gain in children. Continued conducting training and evaluation of Healthy Children, Healthy Families: Parents making a difference!, a parent workshop series on food, active play and parenting skills to prevent childhood obesity, delivered through multiple Cooperative Extension sites in NY. Collaboration with Aidan Tait and Blanca Bojorquez on initial translation of W1005 questionnaire for Spanish-mostly speaking mothers Student Involvement: Several undergraduate and 3 graduate nutrition students have been involved in data entry, data cleaning and preliminary analysis including calculation of parent and child BMI and creation of other variables. In addition, one graduate student completed her Masters degree based on this work. Ajok Beatrice Okwonga. Mediators and moderators of the links of parenting styles and feeding practices to child weight status. Dissertation completed at Oklahoma State University, July 2011. Advisor: Laura Hubbs-Tait. Implementation and evaluation of the Snack Pack Project in Two Mississippi Head Start Centers (doctoral dissertation, August 2011). Committee: Diane K. Tidwell (chair), Chiquita A. Briley, Barry P, Hunt, A. Kathleen Ragsdale, Michelle L. Lee. Retrieved from http://sun.library.msstate.edu/ETD-db/theses/available/etd-06272011-182340/ Hung, Ling-Shen. A meta-analysis of school-based childhood obesity prevention programs (doctoral dissertation, December 2010). Committee: Diane K. Tidwell (chair), Chiquita A. Briley, Barry P, Hunt, Michelle L. Lee, Michael Hall. Retrieved from http://sun.library.msstate.edu/ETD-db/theses/available/etd-11112010-120704/ OBJECTIVE 4: *Approach: Determine appropriate tools to effectively measure salient behavioral differences between low-income families in the parent-relationships identified in Objective 3 for the community setting. *Progress: Input: Data analysis of Objective 2 & 3. As analysis is completed, it is anticipated that some tools will be identified that are appropriate for the community setting. OBJECTIVE 5 *Approach: Design a framework for childhood obesity prevention strategies targeting the development of resilience behaviors. *Progress: Input: Input on identifying protective factors that could promote resilience to overweight obesity in 3- to 10-year-old children was provided by participants who contributed to W1005 objective 3 and also are focused on analyzing objective 3 data from a resilience perspective. In alphabetical order, participants included Katherine L. Dickin (New York), Laura Hubbs-Tait (Oklahoma), Lisa Jahns (North Dakota), Amy Mobley (formerly Indiana, now Connecticut), Madeleine Sigman-Grant (Nevada), and Nahid Sistani (Alabama). The objective 3/objective 5 group collaborated with objective 3-only members on data collection with low-income mothers and their 3- to 10-year-old children to identify patterns of maternal parenting styles, feeding styles, feeding practices, and modeling of healthy eating and activity linked to child obesity and overweight. Behaviors that were positively linked to overweight and obesity were viewed as risk factors that would not promote resilience of children in low-income families to overweight and obesity. In contrast, behaviors that were negatively linked to overweight and obesity were viewed as protective factors that would promote such resilience. Preliminary analyses reveal the possibility that, as is the case in several other studies (e.g., Rhee et al., 2006), authoritative general parenting style may be one of the protective factors against childhood overweight and obesity in the multistate data set. The decision was made to focus on parent-child interactions rather than the full range of risk and protective factors implied in the original objective 5 for several reasons. First, research-identified risk factors for and protective factors against the development of overweight and obesity in 3- to 10-year old children has greatly increased since 2006 (e.g., Harrison et al., 2011; Larson, Ward, Neelon, & Story, 2011; Townsend, Ontai, Young, Ritchie, & Williams, 2009), making an inclusive and exhaustive framework of prevention strategies unattainable. Second, for children in the 3- to 10-year-old age range, research has increasingly identified the importance of parenting as critical for childhood obesity prevention (e.g., Harrison et al., 2011; Rhee et al., 2006; Stice, Shaw, & Marti, 2006; Tabacchi, Giammanco, LaGuardia, & Giammanco, 2007; Topham et al., 2010). The focus on parenting has resulted in the merging of objective 5 into objective 3 for the final extension year of the current W1005 multistate project as well as an emphasis on parenting in the W1005 proposal for 2012-2013 to 2016-2017. References for Objective 5: Harrison K, Bost K, Jacobsohn G, et al. Toward a developmental conceptualization of contributors to overweight and obesity in childhood: The SixCs model. Child Development Perspectives. 2011;5:50-58. Larson N, Ward DS, Neelon SB, Story M. What role can child-care settings play in obesity prevention? A review of the evidence and call for research efforts. J Am Diet Assoc. 2011;111:1343-1362. Rhee KE, Lumeng JC, Appugliese DP, Kaciroti N, Bradley RH. Parenting styles and overweight status in first grade. Pediatrics. 2006;117:2047-54. Stice E, Shaw H, Marti N. A meta-analytic review of obesity prevention programs for children and adolescents: The skinny on interventions that work. Psychological Bulletin. 2006;132:667-691. Tabacchi G, Giammanco S, La Guardia M, Giammanco M. A review of the literature and a new classification of the early determinants of childhood obesity: From pregnancy to the first years of life. Nutrition Research. 2007;27:587604. Topham GL, Harrist AW, Page MC, Rutledge JM, Kennedy TS, Shriver LH, Hubbs-Tait L. Maternal depression and socioeconomic status moderate the parenting style/child obesity association. Public Health Nutrition. 2010;13:1237-1244. Townsend M, Ontai L, Young T, Ritchie L, Williams S. Guiding family-based obesity prevention efforts in low-income children in the United States. Part 2: What behaviors do we measure?. International Journal of Child and Adolescent Health. 2009;2:31-47.

See attached W1005 minutes for list of publications.