Promoting Social Nurturance and Positive Social Environments to Reduce Obesity in High-Risk Youth
Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth’s behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at-risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family, and social-environmental-level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and healthcare providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth.
KeywordsNurturance Positive parenting Obesity prevention Diet Physical activity Ethnic minorities Youth
- Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall Inc.Google Scholar
- Beavers, W. R., & Hampson, R. B. (2000). Succesful families: Assessment and intervention. New York, NY: W.W. Norton & Co.Google Scholar
- Broderick, C. (1993). Understanding family process: Basics of family systems theory. Thousand Oaks, CA: Sage Publications.Google Scholar
- Brownson, R. C., Fielding, J. E., & Maylahn, C. M. (2009). Evidence-based public health: A fundamental concept for public health practice. Annual Review of Public Health, 30, 175–201. doi:10.1146/annurev.publhealth.031308.10013410.1146/annurev.pu.30.031709.100001.CrossRefPubMedGoogle Scholar
- Center for Disease Control. (2016). Chronic Disease Prevention and Health Promotion. Retrieved from http://www.cdc.gov/chronicdisease/overview/.
- Colquhoun, H., Leeman, J., Michie, S., Lokker, C., Bragge, P., Hempel, S., et al. (2014). Towards a common terminology: A simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. Implementation Science, 9, 781. doi:10.1186/1748-5908-9-51.CrossRefGoogle Scholar
- Expert Panel on Integrated Guidelines for Cardiovascular, Risk Reduction in, Adolescents, National Heart, and Blood. (2011). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics, 128(Suppl 5), S213–S256. doi:10.1542/peds.2009-2107C.Google Scholar
- Flynn, M. A. T., McNeil, D. A., Maloff, B., Mutasingwa, D., Wu, M., Ford, C., et al. (2006). Reducing obesity and related chronic disease risk in children and youth: A synthesis of evidence with ‘best practice’recommendations. Obesity Reviews, 7, 7–66. doi:10.1111/j.1467-789X.2006.00242.x.CrossRefPubMedGoogle Scholar
- Gortmaker, S. L., Peterson, K., Wiecha, J., Sobol, A. M., Dixit, S., Fox, M. K., et al. (1999). Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Archives of Pediatrics & Adolescent Medicine, 153, 409–418. doi:10.1001/archpedi.153.4.409.CrossRefGoogle Scholar
- Hagger, M., Chatzisarantis, N. L., Hein, V., Soos, I., Karsai, I., Lintunen, T., et al. (2009). Teacher, peer and parent autonomy support in physical education and leisure-time physical activity: A trans-contextual model of motivation in four nations. Psychology and Health, 24, 689–711. doi:10.1080/08870440801956192.CrossRefPubMedGoogle Scholar
- Kitzman-Ulrich, H., Wilson, D. K., St. George, S. M., Lawman, H., Segal, M., & Fairchild, A. (2010). The integration of a family systems approach for understanding youth obesity, physical activity, and dietary programs. Clincal Child and Family Psychology Review, 13, 231–253. doi:10.1007/s10567-010-0073-0.CrossRefGoogle Scholar
- Koplan, J., Liverman, C. T., Kraak, V. I., & Wisham, S. L. (2006). Progress in preventing childhood obesity, how do we measure up?. Washington, DC: The National Academies Press.Google Scholar
- Lubans, D. R., Smith, J. J., Plotnikoff, R. C., Dally, K. A., Okely, A. D., Salmon, J., et al. (2016). Assessing the sustained impact of a school-based obesity prevention program for adolescent boys: The ATLAS cluster randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 13, 92. doi:10.1186/s12966-016-0420-8.CrossRefPubMedPubMedCentralGoogle Scholar
- Luepker, R. V., Perry, C. L., McKinlay, S. M., Nader, P. R., Parcel, G. S., Stone, E. J., et al. (1996). Outcomes of a field trial to improve children’s dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group. JAMA, 275, 768–776. doi:10.1001/jama.1996.03530340032026.CrossRefPubMedGoogle Scholar
- Macartney, S., Bishaw, A., & Fontenot, K. (2013). Poverty rates for selected detailed race and Hispanic groups by state and place: 2007–2011. American Community Survey Briefs. Retrieved from http://www.census.gov/prod/2013pubs/acsbr11-17.pdf.
- Miller, W. R., Brown, J. M., Simpson, T. L., et al. (1995). What works? A methodological analysis of the alcohol treatment outcome literature. In R. K. Hester & W. R. Miller (Eds.), Handbook of Alcoholism treatment approaches: Effective alternatives (2nd ed., pp. 12–44). Needham Heights, MA: Allyn & Bacon.Google Scholar
- Miller, G. E., Chen, E., & Parker, K. J. (2011a). Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a model of behavioral and biological mechanisms. Psychological Bulletin, 137, 959–997. doi:10.1037/a0024768.CrossRefPubMedPubMedCentralGoogle Scholar
- Miller, G. E., Lachman, M. E., Chen, E., Gruenewald, T. L., Karlamangla, A. S., & Seeman, T. E. (2011b). Pathways to resilience maternal nurturance as a buffer against the effects of childhood poverty on metabolic syndrome at midlife. Psychological Science, 22, 1591–1599. doi:10.1177/0956797611419170.CrossRefPubMedPubMedCentralGoogle Scholar
- Sallis, J., & Glanz, K. (2006). The role of built environments in physical activity, eating, adn obesity in childhood. Child Obesity, 16, 89–108. Retrieved from http://www.jstor.org/stable/3556552.
- St. George, S. M., Wilson, D. K., Schneider, E. M., & Alia, K. A. (2013). Project SHINE: Effects of parent-adolescent communication on sedentary behavior in African American adolescents. Journal of Pediatric Psychology, 38, 997–1009. doi:10.1093/jpepsy/jst027.CrossRefPubMedPubMedCentralGoogle Scholar
- Standage, M., Gillison, F. B., Ntoumanis, N., & Treasure, D. C. (2012). Predicting students’ physical activity and health-related well-being: A prospective cross-domain investigation of motivation across school physical education and exercise settings. Journal of Sport and Exercise Psychology, 34, 37–60. doi:10.1123/jsep.34.1.37.CrossRefPubMedGoogle Scholar
- Taveras, E. M., Gortmaker, S. L., Hohman, K. H., Horan, C. M., Kleinman, K. P., Mitchell, K., et al. (2011). Randomized controlled trial to improve primary care to prevent and manage childhood obesity: The High Five for Kids study. Archives of Pediatric and Adolescescent Medicine, 165, 714–722. doi:10.1001/archpediatrics.2011.44.CrossRefGoogle Scholar
- Wandersman, A., Chien, V. H., & Katz, J. (2012). Toward an evidence-based system for innovation support for implementing innovations with quality: Tools, training, technical assistance, and quality assurance/quality improvement. American Journal of Community Psychology, 50, 445–459. doi:10.1007/s10464-012-9509-7.CrossRefPubMedGoogle Scholar
- West, F., Sanders, M. R., Cleghorn, G. J., & Davies, P. S. (2010). Randomised clinical trial of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change. Behaviour Research and Therapy, 48, 1170–1179. doi:10.1016/j.brat.2010.08.008.CrossRefPubMedGoogle Scholar
- Wilson, D. K., Evans, A. E., Williams, J., Mixon, G., Sirard, J. R., & Pate, R. (2005). A preliminary test of a student-centered intervention on increasing physical activity in underserved adolescents. Annals of Behavioral Medicine, 30, 119–124. doi:10.1207/s15324796abm3002_4.CrossRefPubMedPubMedCentralGoogle Scholar
- Wilson, D. K., Griffin, S., Saunders, R. P., Kitzman-Ulrich, H., Meyers, D. C., & Mansard, L. (2009). Using process evaluation for program improvement in dose, fidelity and reach: The ACT trial experience. International Journal of Behavioral Nutrition and Physical Activity, 6, 79. doi:10.1186/1479-5868-6-79.CrossRefPubMedPubMedCentralGoogle Scholar
- Wilson, D. K., Kitzman-Ulrich, H., Resnicow, K., Van Horn, M. L., George, S. M., Siceloff, E. R., et al. (2015). An overview of the Families Improving Together (FIT) for weight loss randomized controlled trial in African American families. Contemporary Clinical Trials, 42, 145–157. doi:10.1016/j.cct.2015.03.009.CrossRefPubMedPubMedCentralGoogle Scholar
- Wilson, D. K., Van Horn, M. L., Kitzman-Ulrich, H., Saunders, R., Pate, R., Lawman, H. G., et al. (2011). Results of the “Active by Choice Today” (ACT) randomized trial for increasing physical activity in low-income and minority adolescents. Health Psychology, 30, 463–471. doi:10.1037/a0023390.CrossRefPubMedPubMedCentralGoogle Scholar