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Article ; Online: Comparing Group Versus Individual Prenatal Care on Breastfeeding Practice and Motivational Factors.

Gray, Heewon L / Rancourt, Diana / Masho, Saba / Stern, Marilyn

The Journal of perinatal & neonatal nursing

2024

Abstract: Objective: Although breastfeeding in the first 6 months postpartum benefits both infants and mothers, breastfeeding rates remain low. This study examined whether group prenatal care was associated with an increased breastfeeding initiation and duration ... ...

Abstract	Objective: Although breastfeeding in the first 6 months postpartum benefits both infants and mothers, breastfeeding rates remain low. This study examined whether group prenatal care was associated with an increased breastfeeding initiation and duration compared with those receiving usual, individual prenatal care. A secondary aim was to investigate whether sociodemographic and motivational factors were associated with breastfeeding initiation and duration across prenatal care groups. Methods: Pregnant women in their third trimester (n = 211) from an innercity university medical center participated. Prenatal care type was identified from the medical chart, and data on breastfeeding duration at 1, 3, and 6 months postpartum were collected. Breastfeeding motivational factors were assessed with a survey. Logistic regressions and independent-samples t tests were used for data analyses. Results: After controlling for demographic factors, group prenatal care was associated with increased breastfeeding at 6 months postpartum (odds ratio = 2.66; P = .045) compared with individual care. Breastfeeding intention (P < .001), competence (P = .003), and autonomous motivation (P < .001) were significantly higher, while amotivation (P = .034) was significantly lower in group compared with individual prenatal care. Conclusions: Breastfeeding persistence was higher among women receiving group prenatal care, potentially due to motivational factors. Future studies should investigate how breastfeeding motivational factors could be effectively targeted in prenatal care to increase breastfeeding persistence.
Language	English
Publishing date	2024-01-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	1036365-8
ISSN	1550-5073 ; 0893-2190
ISSN (online)	1550-5073
ISSN	0893-2190
DOI	10.1097/JPN.0000000000000769
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Article ; Online: Associations Among Parents' Eating Behaviors, Feeding Practices, and Children's Eating Behaviors.

Gray, Heewon L / Buro, Acadia W / Sinha, Sweta

Maternal and child health journal

2023 Volume 27, Issue 2, Page(s) 202–209

Abstract: Parental feeding practices influence children's eating behaviors, yet it is not well-understood whether parents' own eating behaviors are associated with their feeding practices. The purpose of this study was to examine associations among parents' eating ...

Abstract	Parental feeding practices influence children's eating behaviors, yet it is not well-understood whether parents' own eating behaviors are associated with their feeding practices. The purpose of this study was to examine associations among parents' eating behaviors, parental feeding practices, and children's eating behaviors. A cross-sectional study was conducted with 76 parents of children from an elementary school in Tampa, FL. Parents completed three questionnaires with topics related to parent eating behaviors, parental feeding practices, and children's eating behaviors. Multiple regression analysis was performed, controlling for demographic covariates. Parents who reported to eat more fruits per day (β = 0.15), eat more than one kind of fruit each day (β = 0.33), eat more than one kind of vegetable each day (β = 0.29), eat 2 or more vegetables at the main meal (β = 0.36), plan meals (β = 0.19), and keep vegetables ready for the child to eat (β = 0.25) indicated that they use more positive reinforcement feeding practices (all p ≤ 0.001). There were significantly positive associations between positive reinforcement and children's eating fruits or vegetables like apples, bananas or carrots as snacks (β = 1.03) and eating more than one kind of vegetable a day (β = 1.03; all p < 0.001). No other variables had any significant associations. Findings of this study indicate that there are potential associations among parent's own eating behaviors, feeding practices, and children's eating behaviors. Further research is needed to determine the mechanism of these relationships. Targeting these parental factors may be an effective way to maximize the impact of nutrition interventions on children's dietary behavior changes.
MeSH term(s)	Child ; Humans ; Cross-Sectional Studies ; Feeding Behavior ; Parents ; Vegetables ; Fruit ; Surveys and Questionnaires ; Parenting ; Eating
Language	English
Publishing date	2023-01-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1339905-6
ISSN	1573-6628 ; 1092-7875
ISSN (online)	1573-6628
ISSN	1092-7875
DOI	10.1007/s10995-022-03572-6
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Article ; Online: Religion and Food Insecurity in the Time of COVID-19: Food Sovereignty for a Healthier Future.

Schanbacher, William / Gray, Heewon L

Ecology of food and nutrition

2021 Volume 60, Issue 5, Page(s) 612–631

Abstract: The COVID-19 pandemic has exposed and amplified food insecurity in marginalized communities of color, revealing systemic health and socioeconomic inequalities. Given the role that religious organizations play in building social capital, disseminating ... ...

Abstract	The COVID-19 pandemic has exposed and amplified food insecurity in marginalized communities of color, revealing systemic health and socioeconomic inequalities. Given the role that religious organizations play in building social capital, disseminating information to local communities, and facilitating the distribution of basic necessities such as food, they are integrally involved in short- and long-term solutions to food insecurity. Yet, literature on the role of religious institutions for mitigating food insecurity is limited. The literature related to methods and means by which religious organizations engage community efforts to mitigate food security as well as studies in food sovereignty will be reviewed.
MeSH term(s)	COVID-19 ; Food Insecurity ; Humans ; Pandemics ; Religion ; SARS-CoV-2
Language	English
Publishing date	2021-10-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	120096-3
ISSN	1543-5237 ; 0367-0244
ISSN (online)	1543-5237
ISSN	0367-0244
DOI	10.1080/03670244.2021.1946689
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Article: Religion and Food Insecurity in the Time of COVID-19: Food Sovereignty for a Healthier Future

Schanbacher, William / Gray, Heewon L.

Ecology of food and nutrition. 2021 Sept. 03, v. 60, no. 5

2021

Abstract	The COVID-19 pandemic has exposed and amplified food insecurity in marginalized communities of color, revealing systemic health and socioeconomic inequalities. Given the role that religious organizations play in building social capital, disseminating information to local communities, and facilitating the distribution of basic necessities such as food, they are integrally involved in short- and long-term solutions to food insecurity. Yet, literature on the role of religious institutions for mitigating food insecurity is limited. The literature related to methods and means by which religious organizations engage community efforts to mitigate food security as well as studies in food sovereignty will be reviewed.
Keywords	COVID-19 infection ; color ; food security ; food sovereignty ; nutrition ; religion ; social capital
Language	English
Dates of publication	2021-0903
Size	p. 612-631.
Publishing place	Routledge
Document type	Article
ZDB-ID	120096-3
ISSN	1543-5237 ; 0367-0244
ISSN (online)	1543-5237
ISSN	0367-0244
DOI	10.1080/03670244.2021.1946689
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Article ; Online: Factors impacting physical activity among post-treatment pediatric cancer survivors with overweight and obesity.

Brown, Nashira I / Sauls, Rachel / Almendares, Maria / Gray, Heewon L / Stern, Marilyn

European journal of pediatrics

2024

Abstract: Background: Pediatric cancer survivors (PCS) with overweight and obesity are at risk for various secondary chronic diseases. Although previous research has found physical activity (PA) as beneficial after treatment, the PA levels are low among PCS, ... ...

Abstract	Background: Pediatric cancer survivors (PCS) with overweight and obesity are at risk for various secondary chronic diseases. Although previous research has found physical activity (PA) as beneficial after treatment, the PA levels are low among PCS, highlighting the need for lifestyle interventions targeting PA. Methods: A secondary analysis of preliminary baseline data from a multi-site trial, NOURISH-T + , a healthy lifestyle intervention for PCS with overweight and obesity, and their caregivers, was conducted to assess factors related to PCS PA (i.e., moderate to vigorous intensity PA, MVPA). Kendall's Tau-b was used to assess correlations between PCS MVPA, health and treatment-related factors, and caregivers' sedentary behavior and MVPA. Wilcoxon Signed Ranks Test was used to assess the differences between PCS and caregiver sedentary behavior and MVPA. A multiple linear regression analysis was performed to determine predictors of PCS MVPA. Results: Seventy-three PCS-caregiver dyads were included in this analysis (N = 146). Many of the PCS were female, diagnosed with Acute Lymphoblastic Leukemia, stage 1, with a mean body mass index (BMI) percentile of 94.4 ± 4.7. Caregivers were female and parents to the PCS. Significant correlations were found between PCS MVPA, time since treatment, PCS weight change since COVID, caregiver sedentary behavior and MVPA. Significant differences were observed between PCS and caregiver sedentary behavior and MVPA. Household income, radiation treatment, and caregiver MVPA were significant predictors of PCS MVPA. Conclusions: Demographics, cancer treatment type, and caregiver role modeling are important factors to consider when developing future lifestyle interventions for PCS. (NCT04656496, registered 12-07-2020). What is known: • Parents/caregivers are presumed to be a potential influence on their children's physical activity What is new: • Parents/caregivers' moderate-to-vigorous physical activity is the strongest predictor of their children's (pediatric cancer survivors') physical activity.
Language	English
Publishing date	2024-04-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-024-05584-6
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Article: Recommended practices for virtual nutrition education interventions for adolescents with autism spectrum disorder: A reflection from two pilot interventions during the COVID-19 pandemic.

Buro, Acadia W / Shurack, Riley H / Garcia, Jeanette M / Gray, Heewon L

Nutrition and health

2023 Volume 30, Issue 1, Page(s) 15–19

Abstract: Youth with autism spectrum disorder (ASD) demonstrate unhealthy eating behaviors and dietary patterns compared to their neurotypical counterparts. Given the increased risk of unhealthy weight gain and the onset of the COVID-19 pandemic, modified ... ...

Abstract	Youth with autism spectrum disorder (ASD) demonstrate unhealthy eating behaviors and dietary patterns compared to their neurotypical counterparts. Given the increased risk of unhealthy weight gain and the onset of the COVID-19 pandemic, modified nutrition programs in this population are warranted. The authors independently conducted two virtual pilot interventions during COVID-19 that offered feasible and acceptable alternatives to in-person delivery, providing unique opportunities for participant engagement and family involvement. Future virtual nutrition education programs for adolescents with ASD may include visual and verbal aids through Zoom, more parent/family integration, and accommodations for those with varying ASD severity levels.
MeSH term(s)	Humans ; Adolescent ; Autism Spectrum Disorder/therapy ; Pilot Projects ; Pandemics/prevention & control ; COVID-19 ; Parents
Language	English
Publishing date	2023-01-24
Publishing country	England
Document type	Journal Article
ZDB-ID	603215-1
ISSN	2047-945X ; 0260-1060
ISSN (online)	2047-945X
ISSN	0260-1060
DOI	10.1177/02601060231151985
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Article ; Online: Optimizing Outcomes: A Systematic Review of Psychosocial Risk Factors Affecting Perinatal Black/African-American Women with Substance Use Disorder in the United States.

Rodriguez de Lisenko, Norma C / Gray, Heewon L / Bohn, Joseph

Maternal and child health journal

2022 Volume 26, Issue 10, Page(s) 2090–2108

Abstract: Introduction: Despite studies having examined and discussed the various multifaceted risk factors affecting perinatal women with substance use disorder (SUD), the limited amount of research on Black/African-American (B/AA) women allows health ... ...

Abstract	Introduction: Despite studies having examined and discussed the various multifaceted risk factors affecting perinatal women with substance use disorder (SUD), the limited amount of research on Black/African-American (B/AA) women allows health disparities in this population to widen. Segmenting the needs of the low-income B/AA female population with SUD is crucial when creating multi-layered and multi-faceted innovative upstream evidence-based interventions. This review assesses and examines studies that investigate psychosocial, environmental, and systemic level risk factors related to implicit bias, trauma, toxic stress, food issues, and SUD. Methods: The principal investigator (PI) utilized PubMed, Google Scholar, ProQuest Dissertations and Theses Global to perform a systematic scoping review of the published literature. Research focused on risks factors affecting low-income perinatal B/AA women. The literature review examined articles published January 2010 through December 2020. Inclusion criteria incorporated risk factors, health disparities, and SUD. Studies selected for this review have been published in English and conducted in the USA. Results: Our research identified 509 articles, of which we chose to include 75. The literature highlights health disparities influenced by risks factors of implicit biases, trauma, and toxic stress, which construct physical and emotional barriers to healthy food and food resources in B/AA women with SUD. Conclusion: The PI found limited or non-existent research on innovative interventions targeting perinatal B/AA women with SUD. This review recommends deconstructing hidden psychosocial, environmental, and systematic risk factors to assist in developing novel comprehensive strategies and wraparound support services.
MeSH term(s)	African Americans/psychology ; Female ; Humans ; Parturition ; Pregnancy ; Risk Factors ; Substance-Related Disorders/complications ; Substance-Related Disorders/epidemiology ; United States/epidemiology
Language	English
Publishing date	2022-08-10
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	1339905-6
ISSN	1573-6628 ; 1092-7875
ISSN (online)	1573-6628
ISSN	1092-7875
DOI	10.1007/s10995-022-03503-5
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Article ; Online: Experiences of New Visitors With Low Food Security Seeking Food Assistance During the COVID-19 Pandemic.

Uy, Whitney Fung / Lillpopp, Rose / Tyson, Dinorah Martinez / Himmelgreen, David / Wright, Lauri / Gray, Heewon L

Journal of nutrition education and behavior

2023 Volume 55, Issue 12, Page(s) 884–893

Abstract: Objective: To describe the experiences of first-time visitors with low food security seeking food assistance during the coronavirus disease 2019 pandemic.: Design: A qualitative study.: Setting: Emergency food distribution sites in West Central ... ...

Abstract	Objective: To describe the experiences of first-time visitors with low food security seeking food assistance during the coronavirus disease 2019 pandemic. Design: A qualitative study. Setting: Emergency food distribution sites in West Central Florida. Participants: Adults (aged 18-64 years) seeking food assistance between November, 2020 and July, 2021. Phenomenon of interest: Using food security as a multidimensional concept, in-depth interviews explored the impact of emergency food assistance on food availability, access, utilization, and stability. Analysis: Applied thematic analysis was conducted to identify emergent themes. Results: Participants (n = 18) were White (55.6%), female (72.2%), and aged 40-59 years (55.6%). Seven salient themes described participants' experience seeking food assistance (eg, the crisis resulting in seeking food assistance, mixed quality of pantry foods, and gaining firsthand insight on hunger). Although food assistance increased food availability and access, there were barriers to using the pantry foods (eg, foods not preferred, health/allergies). Conclusions and implications: Study findings suggest that first-time visitors seeking emergency food assistance during the coronavirus disease 2019 pandemic may be experiencing temporary cycles of financial instability, which could impact dietary quality. Because pantry foods are often the primary source of household food supply, client-focused emergency food distribution tailored to client needs can increase food availability, access, and utilization.
MeSH term(s)	Adult ; Humans ; Female ; Pandemics ; Food Assistance ; COVID-19 ; Diet ; Food Supply ; Food Security
Language	English
Publishing date	2023-11-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1878-2620
ISSN (online)	1878-2620
DOI	10.1016/j.jneb.2023.10.009
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Article: Autism Spectrum Disorder Diagnosis and Other Child, Family, and Community Risk Factors for Obesity among Children and Adolescents Aged Ten to Seventeen Years in the United States: A Mediation Analysis

Buro, Acadia W. / Salinas-Miranda, Abraham / Marshall, Jennifer / Gray, Heewon L. / Kirby, Russell S.

Childhood obesity. 2022 Apr. 07,

2022

Abstract: Background: This study explored whether there are mediated effects of child and family risk in the association between community and organizational risk and obesity among children and adolescents aged 10–17 years using 2017–2018 National Survey of ... ...

Abstract	Background: This study explored whether there are mediated effects of child and family risk in the association between community and organizational risk and obesity among children and adolescents aged 10–17 years using 2017–2018 National Survey of Children's Health (NSCH) data, addressing autism spectrum disorder (ASD) and co-occurring conditions. Methods: This cross-sectional study (N = 27,157) used 2017–2018 NSCH data. Frequency distributions and chi-square tests were used to describe participants with and without ASD. Cumulative risk indices were created for child, family, community, and organizational level risk, and mediation analyses were conducted in a two-mediator model (X₁: community risk, X₂: organizational risk, M₁: child risk, M₂: family risk) for the dichotomous outcome (Y: obesity). Path analyses were performed using generalized structural equation modeling in Stata 16.0. Results: Direct effects for all four risk indices were associated with obesity in single index models (all p < 0.001); only child and family risk indices were associated with obesity in a full model with all four risk indices (both p < 0.001). When child and family risk indices were assessed as mediators, the indirect effects of community and organizational risk were significant (all p < 0.0001). The total effect of community risk on obesity was significant with family risk as a mediator (p = 0.002). The total effect of organizational risk was not significant with either mediator. Conclusion: Findings suggest that child and family factors play a strong role in obesity risk and that ASD contributes to this risk. Community risk may be another strong predictor of obesity, mediated by family risk. Additional research on social-ecological risk factors for obesity is needed to identify leverage points to improve obesity risk in children and adolescents with and without ASD.
Keywords	autism ; childhood obesity ; children ; cross-sectional studies ; cumulative risk ; equations ; models ; national surveys
Language	English
Dates of publication	2022-0407
Publishing place	Mary Ann Liebert, Inc.
Document type	Article
ZDB-ID	2639910-6
ISSN	2153-2176 ; 2153-2168
ISSN (online)	2153-2176
ISSN	2153-2168
DOI	10.1089/chi.2021.0260
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Article: Change in Food Consumption and Food Choice Determinants among East Asian International Students in New York

Lee, Jong Min / Contento, Isobel / Gray, Heewon L

Journal of hunger & environmental nutrition. 2020 May 3, v. 15, no. 3

2020

Abstract: This study describes East Asian international students’ changes in food consumption since coming to the US, and reasons for the changes. The results of this cross-sectional study from four campuses in the New York area show that after coming to the US, ... ...

Abstract	This study describes East Asian international students’ changes in food consumption since coming to the US, and reasons for the changes. The results of this cross-sectional study from four campuses in the New York area show that after coming to the US, they ate/drank more processed food, water, raw vegetables, meat, dairy, and other Asian foods, and ate fewer cooked vegetables and foods from their home countries. The main reasons were their concerns about health, weight, availability, convenience, taste, and price. The least chosen reasons were related to concerns about food sustainability issues. Future research should focus on conducting qualitative studies to better understand nuances in international students’ food choice concerns and motivations.
Keywords	area ; cross-sectional studies ; food choices ; food consumption ; hunger ; meat ; motivation ; prices ; processed foods ; raw vegetables ; research ; students ; sustainable agriculture ; taste ; vegetables ; water ; weight ; New York
Language	English
Dates of publication	2020-0503
Size	p. 418-441.
Publishing place	Taylor & Francis
Document type	Article
Note	NAL-light
ZDB-ID	2251933-6
ISSN	1932-0256 ; 1932-0248
ISSN (online)	1932-0256
ISSN	1932-0248
DOI	10.1080/19320248.2018.1555071
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