Childhood Obesity最新文献

{"title":"Prioritizing Early Childhood Educators Health: Insights for Worksite Health Promotion Efforts.","authors":"Beatriz A Carmona, Lily Deng, Caleb Gilbert, Ella Freimuth, Rujia Xie, Laura L Bellows","doi":"10.1089/chi.2024.0366","DOIUrl":"10.1089/chi.2024.0366","url":null,"abstract":"<p><p><b><i>Background:</i></b> Early childhood education (ECE) educators play an instrumental role in children's health and development but unfortunately have poor health themselves. This project examined the physical and psychological health of New York licensed ECE educators. <b><i>Methods:</i></b> A sequential, explanatory mixed methods design (quan→QUAL) consisted of a 110-item survey and semi-structured interviews to examine physical (diet, physical activity [PA], sleep, and body mass index [BMI]) and psychological health (stress and burnout). Quantitatively, multiple linear regressions tested associations between physical and psychological health, controlling for age and income, using R (v4.3.2, 2023); α < 0.05. Qualitatively, content analysis with pattern recognition for pragmatic synthesis was performed. <b><i>Results:</i></b> Survey respondents (<i>n</i> = 1423) and interview participants (<i>n</i> = 36) worked in a variety of ECE settings; 74% had overweight/obesity and 24% deemed themselves \"unhealthy.\" Many had poor health behaviors-low diet quality (74%), limited regular PA (28%), poor sleep quality (34%), and moderate/high stress levels (74%). Most desired changes to health behaviors but were challenged due to work environments and job demands. Work-based factors impacted both their physical and mental health and influenced their personal life. Burnout and stress were high, and feelings of underappreciation were prevalent. Higher burnout (emotional exhaustion) was significantly associated with higher BMI (β = 0.18, <i>p</i> < 0.01) and stress (β = 1.09, <i>p</i> < 0.01) and lower PA (β = 2.62, <i>p</i> < 0.01) and sleep (β = 0.94, <i>p</i> < 0.01). <b><i>Conclusion:</i></b> ECE educators are experiencing high stress/burnout, have poor health behaviors, and have high prevalence of obesity. Workplace health promotion efforts are needed to improve educators' health and potentially that of the children in their care.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Testing of the Observational System for Recording Physical Activity in Children-Toddlers.","authors":"Cailyn A Van Camp, Anela Panlasigue, Kimberly A Clevenger, Janet L Hauck, Kerry L McIver, Karin A Pfeiffer","doi":"10.1089/chi.2024.0376","DOIUrl":"https://doi.org/10.1089/chi.2024.0376","url":null,"abstract":"<p><p><b><i>Background:</i></b> Direct observation (DO) tools developed for preschoolers have been used to describe toddler physical activity (PA). No DO system created to assess PA levels and the childcare environment of toddlers exists. The purpose of this study was to develop the Observational System for Recording Physical Activity in Children-Toddlers (OSRAC-T) and assess the inter- and intra-rater reliability. <b><i>Methods:</i></b> This tool is an extension of the Observational System for Recording Physical Activity in Children-Preschool and uses the same focal child, time sampling system (5-second observation and 25-second recording). Tool content was established through identifying similar research, consulting with experts, and conducting informal observations. A sample of toddlers (12-36 months) was observed and video recorded during childcare. In-person observations were compared to video observations from one coder (intrarater reliability). Video observations (39% of intervals) were coded by two raters to determine interrater reliability. <b><i>Results:</i></b> The final instrument included nine categories that described PA level and type, social and environmental contexts, and transition support relevant to toddlers. Observers completed 124 observation sessions (<i>n</i> = 31; 25.5 ± 6.0 months) resulting in 7,757 30-second observation intervals. Interval-by-interval agreement was moderate to high (58.90%-95.30%) for all categories, and interrater reliability was low to moderate (<i>k</i> = 0.28-0.69). <b><i>Conclusion:</i></b> The OSRAC-T is a reliable observation system to assess several PA-related behaviors of toddlers. It may be used to better inform early childcare center design, future intervention studies, or to assess correlates or relationships between PA behavior and health outcomes in toddlers.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The National Physical Activity Plan Early Childhood Education Strategy: State Policy Surveillance.","authors":"Falon T Smith, Ben D Kern, Carolyn Gura, Sia Singhi, Rebecca A Batista","doi":"10.1089/chi.2024.0383","DOIUrl":"https://doi.org/10.1089/chi.2024.0383","url":null,"abstract":"<p><p>The importance of establishing national surveillance systems to monitor physical activity promotion is well recognized. This article outlines the methodological process undertaken to develop an evaluation rubric for assessing state licensing regulations alignment with the National Physical Activity Plan Education Sector Early Childhood Education (ECE) strategy. This tool offers a cost-effective mechanism for ongoing surveillance of ECE physical activity policies, with the potential to inform modifications that promote uniform standards and establish consistent, high-quality opportunities for the nation's youngest children.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Composition, Body Mass, and Cardiovascular Health in Mid-Childhood and Midlife: A Compositional Data Analysis.","authors":"Mengjiao Liu, Dorothea Dumuid, Tim Olds, David Burgner, Susan Ellul, Markus Juonala, Yichao Wang, Sarath Ranganathan, Michael Cheung, Louise Baur, Terry Dwyer, Jessica A Kerr, Kate Lycett, Melissa Wake","doi":"10.1089/chi.2024.0316","DOIUrl":"https://doi.org/10.1089/chi.2024.0316","url":null,"abstract":"<p><p><b><i>Background:</i></b> We aimed to quantify associations of cardiovascular (CV) large and small artery measures with body composition and body mass (1) separately and (2) in combination in 11- to 12-year-old children and their parents. <b><i>Methods:</i></b> In the population-based cross-sectional Child Health CheckPoint study (1495 children, mean 12 ± 0.4 years, 49.3% girls; 1496 parents, mean 44.3 ± 5.0 years, 86.7% mothers), we measured weight, height, body composition [truncal fat, non-truncal fat, fat-free mass (FFM)], and CV functional (blood pressure, pulse wave velocity, arterial elasticity) and structural (carotid intima-media thickness, retinal arteriolar/venular caliber) outcomes. Using compositional data analyses, we examined associations of body composition (expressed as log ratios) and body mass (multiplicative total) with CV measures in separate and combined models. <b><i>Results:</i></b> Mean BMI z-score was 0.3 in children [standard deviation (SD) 1.0, 4.5% obese], and mean BMI was 27.9 in parents (SD 6.1, 28.8% obese). In both children and adults, more adverse CV measurements were associated with higher %truncal fat, %non-truncal fat, and body mass and lower %FFM. Compared with normal-weight children, children with obesity had poorer CV measures (e.g., 1 SD faster pulse wave velocity, 0.5 SD lower arterial elasticity), with higher body mass and lower %FFM mainly accounting for these relationships. All relationships were similar, albeit larger, for parents. <b><i>Conclusion:</i></b> Poorer CV health in both generations was associated with higher body mass, lower %FFM, and, to a lesser extent, higher %truncal and non-truncal fat. Trials could test whether weight reduction interventions with vs. without FFM preservation differentially improve CV functional and structural precursors.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Associations Between Physical Activity and Skin Carotenoid Levels in a Small Sample of Preschoolers: A Pilot Study.","authors":"Faten Hasan, Damon Swift, Christopher Kuenze, Wen You, Jamie Zoellner, Amanda J Nguyen, Carolyn Dunn, Sibylle Kranz","doi":"10.1089/chi.2024.0345","DOIUrl":"https://doi.org/10.1089/chi.2024.0345","url":null,"abstract":"<p><p>Recent literature proposed an association between physical activity (PA) and carotenoid status due to their overlapping role in mediating oxidative stress. However, this relationship has yet to be explored in young children. This study examined the relationship between objectively measured PA (ActiGraph triaxial accelerometry) and skin carotenoid levels (pressure-mediated reflection spectroscopy) in a sample of 3- to 5-years-old. Fourteen children (44 ± 7 months old, 71% male) from a single child care center were included in this cross-sectional analysis. Linear regression modeling indicated more time spent in PA was associated with higher skin carotenoid scores (β = 3.448, <i>p</i> = 0.032). These findings from our pilot study indicate a potential cross-sectional link between physical activity and carotenoid status in young children.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Coparenting Quality, the Home Food Environment, and Child's Body Mass Index.","authors":"Carmen Ramos, Ana Baylin, Jess Haines, Alison L Miller, Katherine W Bauer","doi":"10.1089/chi.2024.0375","DOIUrl":"https://doi.org/10.1089/chi.2024.0375","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although positive coparenting, or how parents relate during childrearing, is known to support children's socioemotional development, the role of coparenting in supporting children's healthy eating and growth is poorly understood. This study examined associations between coparenting quality, the home food environment, and young children's body mass index (BMI). <b><i>Methods:</i></b> Cross-sectional data were obtained from 290 mothers and their 3-year-old children who participated in the Sprout study. Mothers who indicated they had a coparent in their household completed surveys to assess coparenting quality, food parenting practices, family mealtime routines and structure, and home food availability. Mothers also reported the foods served at two typical meals, and a healthy meal index (HMI) score was calculated to assess the nutritional quality of meals. Children's height and weight were measured and used to calculate BMI z-scores (BMIz). <b><i>Results:</i></b> Mothers who reported more positive coparenting also reported providing children more guidance for healthy eating (β = 0.15, <i>p</i> < 0.001), less use of food to control children's emotions (β = -0.15, <i>p</i> < 0.01), less use of food as a reward (β = -0.27, <i>p</i> < 0.01), more structured mealtimes (β = 0.22, <i>p</i> < 0.001), and more household availability of fruits and vegetables (β = 0.11, <i>p</i> < 0.01). Mothers who reported greater coparent agreement on childrearing also had children with lower BMIz (β = -0.11, <i>p</i> = 0.03). Mothers who reported greater endorsement of their partner's childrearing competency had a higher mean HMI score (β = 1.82, <i>p</i> < 0.01). <b><i>Conclusion:</i></b> Among dual-parent, highly resourced families with young children, stronger coparenting practices were associated with several food-related parenting practices that support healthy eating and weight among young children.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking Physical Activity and Nutrition Policies and Practices in Early Childhood Education and Care: Five Years Post-Implementation of a Provincial-Level Active Play Standard.","authors":"E Jean Buckler, Olivia De-Jongh González, Patti-Jean Naylor, Sophie Marshall-Beaucoup, Chris Wright, Luke Wolfenden, Guy Faulkner, Valerie Carson, Mariana Brussoni, Louise C Mâsse","doi":"10.1089/chi.2024.0365","DOIUrl":"https://doi.org/10.1089/chi.2024.0365","url":null,"abstract":"<p><p><b><i>Background:</i></b> Early childhood education and care (ECEC) settings are key for improving health behaviors, including physical activity (PA) and nutrition. In 2017, the province of British Columbia (BC) implemented a provincial-level Active Play policy supported by a capacity-building intervention. Significant improvements in all PA policies and practices and the majority of nutrition policies were observed post-implementation. The purpose of this study was to understand if PA and nutrition policies and practices were maintained at 5+ years post-provincial policy implementation. <b><i>Methods:</i></b> This study employed a repeated cross-sectional design to distribute surveys querying about PA and nutrition policies and practices to ECEC centers across BC at three time points: time 1, prior to implementation of the Active Play standard (2016-2017) and capacity-building intervention, time 2, 1-2 years post-implementation (2018-2019), and time 3, 5+ years post-implementation (2022-2023). <b><i>Results:</i></b> The majority of PA and all nutrition policies were maintained from time 2 (<i>n</i> = 378) to time 3 (<i>n</i> = 639). Prevalence of policies related to the provision of activities that address fundamental movement skills (odds ratio [OR] = 0.30) and total amount of active play (OR = 0.56) significantly decreased from time 2 to time 3. All reported PA practice prevalence levels decreased to time 1 levels. <b><i>Conclusions:</i></b> Center-level health behavior policies were largely maintained 5 years post-implementation, except some PA policies and practices returned to pre-implementation levels. Staff capacity and turnover as well as change in implementation support may explain these changes. Ongoing implementation support is needed to ensure maintenance of health promoting policies and practices in ECEC.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonpharmacological Childhood Obesity Management in Denmark Reduces Steatotic Liver Disease and Obesity.","authors":"Rebecca Berg Pedersen, Maria Martens Fraulund, Elizaveta Chabanova, Louise Aas Holm, Torben Hansen, Henrik S Thomsen, Jens-Christian Holm, Cilius Esmann Fonvig","doi":"10.1089/chi.2024.0287","DOIUrl":"https://doi.org/10.1089/chi.2024.0287","url":null,"abstract":"<p><p><b><i>Background:</i></b> Steatotic liver disease (SLD) represents a multisystem disease and is a common complication of childhood obesity. We studied fat content at the abdominal level (liver, subcutaneous, and visceral) and the response to childhood obesity management. <b><i>Methods:</i></b> In this retrospective longitudinal study, 8-18-year-olds with a body mass index (BMI) z-score above 1.28 (corresponding to a BMI above the 90th percentile), as a proxy for obesity, were offered person-centered, family-oriented obesity management in a hospital setting and in a magnetic resonance (MR) scan. Liver fat content (LFC) was assessed by MR spectroscopy, whereas subcutaneous adipose tissue and visceral adipose tissue (VAT) were assessed by MR imaging. We conducted nonparametric tests to evaluate baseline-to-follow-up changes and comparisons between participants with and without an MR assessment. Additionally, a logistic regression model examined the association between changes in LFC and BMI z-score. <b><i>Results:</i></b> The study group comprised 1002 children and adolescents (52% females) with an MR assessment at baseline. The median age was 13.0 years, the median BMI was 28.4, and the BMI z-score was 2.90. At baseline, 378 (38%) exhibited SLD defined by an LFC above 1.5%. Among the 322 with a follow-up MR scan, 76% of the patients with SLD reduced their LFC. BMI z-score and VAT (both <i>p</i> < 0.001) were reduced during intervention. <b><i>Conclusions:</i></b> SLD is highly prevalent (38%) in children and adolescents with obesity. A chronic care obesity management model reduced the fat content in the liver, the visceral fat, and the degree of obesity.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Well-Being and Child Appetitive Traits at 5 Years Old: Findings from the ROLO Longitudinal Birth Cohort Study.","authors":"Anna Delahunt, Sarah Louise Killeen, Aisling A Geraghty, Eileen C O'Brien, Marie C Conway, Sharleen L O'Reilly, Ciara M McDonnell, Fionnuala M McAuliffe","doi":"10.1089/chi.2024.0336","DOIUrl":"https://doi.org/10.1089/chi.2024.0336","url":null,"abstract":"<p><p><b><i>Background:</i></b> Maternal depression has been linked with increased risk of childhood obesity. Furthermore, maternal negative affectivity in early childhood has been associated with food fussiness. We explored the relationship between longitudinal maternal well-being mid-pregnancy, at 2 years and 5 years postpartum and children's appetitive traits at 5 years of age. <b><i>Methods:</i></b> This is a secondary analysis of the ROLO (randomized control trial of low glycemic diet in pregnancy) longitudinal birth cohort study including pregnancy (<i>n</i> = 279), 2 years (<i>n</i> = 168), and 5 years (<i>n</i> = 295) postpartum. Maternal well-being was measured using the World Health Organization-Five Well-Being Index. Children's appetitive traits were measured at 5 years of age using the Children's Eating Behavior Questionnaire. Bivariate correlation and then linear regression, adjusted for potential confounders, were used to determine relationships between maternal well-being at each timepoint and offspring's appetitive traits at 5 years old. <b><i>Results:</i></b> Mean maternal well-being was higher at 5 years postpartum (63.3%) than mid-pregnancy (58.2%) or at 2 years postpartum (61.0%) (<i>p</i> = 0.001). No relationships were observed between maternal well-being mid-pregnancy and child's appetitive traits at 5 years. In adjusted regression, at 2 years postpartum, maternal well-being was negatively associated with \"Emotional Overeating\" (<i>B</i> = -0.029, <i>p</i> = 0.024), \"Satiety Responsiveness\" (<i>B</i> = -0.040, <i>p</i> = 0.014), \"Slowness Eating\" (<i>B</i> = -0.072, <i>p</i> = <0.001), and \"Emotional Undereating\" (<i>B</i> = -0.054, <i>p</i> = 0.010) and positively associated with \"Enjoyment of Food\" (<i>B</i> = 0.050, <i>p</i> = 0.007). Maternal well-being at 5 years postpartum was negatively associated with \"Satiety Responsiveness\" (<i>B</i> = -0.025, <i>p</i> = 0.033) and \"Slowness Eating\" (<i>B</i> = -0.031, <i>p</i> = 0.024). <b><i>Conclusion:</i></b> Maternal well-being in early childhood may influence children's appetitive traits; however, further research is required to fully explore this relationship.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family and Home Environment Predictors of Children's 24-Hour Movement Guideline Adherence: A Mixed-Methods Study.","authors":"Roddrick Dugger, Taylor Williams, Sarah Burkart, Xuan Xuan Zhu, Layton Reesor-Oyer, Christopher D Pfledderer, Lauren von Klinggraeff, Hannah Parker, James White, Alexander C McLain, Robert Glenn Weaver, Bridget Armstrong, Michael W Beets","doi":"10.1089/chi.2024.0381","DOIUrl":"https://doi.org/10.1089/chi.2024.0381","url":null,"abstract":"<p><p><b><i>Background:</i></b> During summer, children may meet fewer 24 hours Movement Guidelines (24 hr-MGs) [moderate-vigorous physical activity (PA): ≥60 minutes/day, screen time: ≤2 hours/day, sleep: 9-11 hours/day) compared with the school year. Structured environments within community settings (<i>e.g.</i>, summer programs) support guideline adherence. Information about the relationship between structured home environments and 24 hr-MGs is needed. This mixed-methods study examined which features of the family, home, and community environment supported children in meeting 24 hr-MGs during the school year and summer. <b><i>Methods:</i></b> Children's PA and sleep data were estimated from wrist-worn accelerometry, and screen time was assessed via parent-reported nightly surveys (14 days) at two time points [school year: (March-April) and summer (July-August) of 2021]. Parents completed a survey at each time point with 13 measures of the family (<i>e.g.</i>, screen time rules), home (<i>e.g.</i>, bed sharing), and community (<i>e.g.</i>, summer program enrollment) environment. Multilevel mixed effect logistic regression estimated the odds of meeting 24 hr-MGs at each time point. Parents (<i>n</i> = 20) completed a qualitative interview and thematic analysis revealed parents perceived facilitators and barriers to guideline adherence. <b><i>Results:</i></b> Summer program enrollment and bedtime rules were associated with greater odds of meeting the PA [odds ratios (ORs): 4.9, 95% confidence intervals (CIs): (1.4, 17.1)] and ≥two 24 hr-MGs [OR: 2.2, 95 CI: (1.2, 4.0)] during summer, respectively. Parents perceived family rules/routines supported guideline adherence and lack of access to summer programs was a barrier. <b><i>Conclusions:</i></b> Structured environments at home and in the community can support children in meeting 24 hr-MGs guidelines. Interventions that expand access to summer programming and encourage implementation of structured home routines may support meeting multiple 24 hr-MGs during summer.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}