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      Nutrition-Related Knowledge, Attitudes, and Practices (KAP) among Kindergarten Teachers in Chongqing, China: A Cross-Sectional Survey

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          Abstract

          Kindergarten teachers play an important role in providing kindergarten children with education on nutrition. However, few studies have been published on nutrition-related knowledge, attitudes, and practices (KAP) of Chinese kindergarten teachers. This study aimed to assess the nutrition-related knowledge, attitudes, and practices (KAP) of kindergarten teachers in Chongqing, China. Thus, a cross-sectional survey was conducted using a structured KAP model questionnaire administered to 222 kindergarten teachers, who were senior teachers from 80 kindergartens in 19 districts and 20 counties in Chongqing. Multiple regression analysis was used to analyze the influential factors. Among the participants, 54.2% were familiar with simple nutrition-related knowledge; only 9.9% of them were satisfied with their knowledge of childhood nutrition; and 97.7% of them had a positive attitude to learn nutrition-related knowledge. Only 38.7% of the participants had attended pediatric nutrition knowledge courses or training. Multiple regression analysis confirmed significant independent effects on the nutrition knowledge score ( p < 0.0001) of respondents on age, type of residence, type of kindergarten, body mass index(BMI), professional training of kindergarten teachers, behavior of having ever participated in childhood nutrition education knowledge courses or training, and behavior of having ever paid attention to children’s nutrition knowledge. The model indicated that independent variables explained 45.4% (adjusted R 2) of the variance found in the knowledge scores of respondents. While there were low levels of nutrition knowledge and training, it was still encouraging to note that there were positive attitudes towards acquiring nutrition-related knowledge among kindergarten teachers in Chongqing, China. These findings provide some implications that necessary training measures need to be carried out to improve the nutrition-related knowledge level among kindergarten teachers in China.

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          Eating patterns and obesity in children. The Bogalusa Heart Study.

          Gerald S. Berenson, Theresa Nicklas, Issa Zakeri … (2003)
          Childhood obesity is a growing public health problem. This study examined the association between eating patterns and overweight status in children who participated in the Bogalusa Heart Study. A single 24-hour dietary recall was collected on a cross-sectional sample of 1562 children aged 10 years (65% Euro-American [EA], 35% African American [AA]) over a 21-year period. Overweight was defined as body mass index greater than the 85th percentile using Centers for Disease Control and Prevention reference standards. Multivariate logistic regression was used to investigate the association between eating patterns and overweight. Consumption of sweetened beverages (58% soft drinks, 20% fruit flavor drinks, 19% tea, and 3% coffee) (p<0.001); sweets (desserts, candy, and sweetened beverages) (p<0.001); meats (mixed meats, poultry, seafood, eggs, pork, and beef) (p<0.051); and total consumption of low-quality foods (p<0.01) were positively associated with overweight status. Total amount of food consumed, specifically from snacks, was positively associated with overweight status (p<0.05). There was a lack of congruency in the types of eating patterns associated with overweight status across four ethnic-gender groups. The percent variance explained from the eating pattern-overweight models was very small. The interaction of ethnicity and gender was significantly associated with overweight status (p<0.001). The odds of being overweight for EA males were 1.2 times higher than for AA females. These results demonstrate that numerous eating patterns were associated with overweight status, yet the odds of being overweight were very small. Additional studies are needed to confirm these findings in a longitudinal sample having multiple days of assessment.
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            Increasing healthy eating vs. reducing high energy-dense foods to treat pediatric obesity.

            James N Roemmich, Jonathan H. Epstein, Rocco Paluch … (2008)
            The objective was to compare targeting increased eating of healthy foods vs. reducing intake of high energy-dense foods within the context of a family-based behavioral weight control program. Forty-one 8-12 year-old children >85th BMI percentile were randomly assigned to a 24-month family-based behavioral treatment that targeted increasing fruits and vegetables and low-fat dairy vs. reducing intake of high energy-dense foods. Children in the increase healthy food group showed greater reduction in zBMI compared to children in the reduce high energy-dense food group at 12- (-0.30 zBMI units vs. -0.15 zBMI units, P = 0.01) and 24- (-0.36 zBMI units vs -0.13 zBMI units, P = 0.04) month follow-up. Parents in the increase healthy food group showed greater reductions in concern about child weight (P = 0.007), and these changes were associated with child zBMI change (P = 0.008). Children in the reduce high energy-dense group showed larger sustained reductions in high energy-dense foods (P < 0.05). Baseline levels of high energy-dense foods (P < 0.05), parent food restraint (P = 0.01), parent concern over parent weight (P = 0.01) and parent acceptance of the child (P < 0.05) moderated child zBMI change, with greater sustained reductions in zBMI for children in the increase healthy food group for each measure. Parent zBMI change followed the same pattern as child changes, and parent and child zBMI changes were correlated (P < 0.001). Focusing on healthy food choices within an energy restricted diet may be useful in family-based weight control programs.
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              Social Media–Promoted Weight Loss Among an Occupational Population: Cohort Study Using a WeChat Mobile Phone App-Based Campaign

              Chao He, Shiyan Wu, Yingying Zhao … (2017)
              Background Being overweight and obese are major risk factors for noncommunicable diseases such as cardiovascular diseases. The prevalence of overweight and obesity is high throughout the world and these issues are very serious in the Shunyi District in China. As mobile technologies have rapidly developed, mobile apps such as WeChat are well accepted and have the potential to improve health behaviors. Objective This study aims to evaluate the effectiveness of a mobile app (WeChat) as an intervention on weight loss behavior. Methods This study was conducted among an occupational population from August 2015 to February 2016 in the Shunyi District of Beijing. Before the intervention, the Shunyi District Government released an official document for weight loss to all 134 government agencies and enterprises in Shunyi District. Participants willing to use our official WeChat account were enrolled in a WeChat group and received 6 months of interventions for weight loss; those who were not willing to use the account were in a control group given routine publicity on weight loss. Results In total, 15,310 occupational participants including 3467 participants (22.65%) in the control group and 11,843 participants (77.35%) in the WeChat group were enrolled. Participants in the WeChat group lost more weight (mean 2.09, SD 3.43 kg) than people in the control group (mean 1.78, SD 2.96 kg), and the difference in mean weight loss between the two groups for males was significant based on the stratification of age and educational level. To control for confounding factors and to explore the effects of WeChat on weight loss, the propensity score method with a multinominal logistic regression was utilized. For males, this showed that the WeChat group (with both active and inactive subgroups) had a higher probability of maintaining weight, weight loss from 1 to 2 kg, or weight loss more than 2 kg than the control group. However, the control group had higher probability of weight loss from 0 to 1 kg. Being active in WeChat was likely to be associated with weight loss. The more active participants were in the weight loss program via WeChat, the more weight they lost. Conclusions The weight loss intervention campaign based on an official WeChat account focused on an occupation-based population in Shunyi District was effective for males. The more active male participants were in using WeChat, the more weight they lost. There might be no effect or there may even be a negative effect on weight loss for females. Future research should focus on how to improve adherence to the WeChat weight loss interventions, to improve and refine the WeChat content such as developing a variety of materials to attract interest, and to protect personal privacy, especially for females.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Environ Res Public Health
                Journal ID (iso-abbrev): Int J Environ Res Public Health
                Journal ID (publisher-id): ijerph
                Title: International Journal of Environmental Research and Public Health
                Publisher: MDPI
                ISSN (Print): 1661-7827
                ISSN (Electronic): 1660-4601
                Publication date (Electronic): 28 March 2018
                Publication date (Print): April 2018
                Volume: 15
                Issue: 4
                Electronic Location Identifier: 615
                Affiliations
                [1 ]School of Public Health and Management, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China; 15178844252@ 123456163.com (H.L.); xianglong1989@ 123456126.com (X.X.); dengyuanliu@ 123456foxmail.com (D.L.); rys0606@ 123456163.com (Y.R.); yuanjun@ 123456cqmu.edu.cn (J.Y.)
                [2 ]Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
                [3 ]Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China
                [4 ]Preventive Medicine Department, Loma Linda University Medical Center, Loma Linda, CA 92354, USA; cesarreis@ 123456hotmail.com
                [5 ]Behavioral & Environmental Health, School of Public Health, Jackson State University, 350 West Woodrow Wilson Avenue, Jackson, MS 39213, USA; manoj.sharma@ 123456jsums.edu
                [6 ]Health Sciences, Walden University, 100 Washington Avenue South, Suite 900, Minneapolis, MN 55401, USA
                [7 ]Medical Examination Center, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; chenyao11526@ 123456aliyun.com
                Author notes
                [* ]Correspondence: zhaoyong@ 123456cqmu.edu.cn ; Tel.: +86-138-8346-0842; Fax: +86-023-6848-5031
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-6291-9069
                https://orcid.org/0000-0003-1873-4734
                https://orcid.org/0000-0002-7839-5730
                https://orcid.org/0000-0002-4624-2414
                Article
                Publisher ID: ijerph-15-00615
                DOI: 10.3390/ijerph15040615
                PMC ID: 5923657
                PubMed ID: 29597273
                SO-VID: 9e213fe2-0cf8-4fb7-996a-128a6e5f96b9
                Copyright © © 2018 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 08 February 2018
                Date accepted : 23 March 2018
                Categories
                Subject: Article

                ScienceOpen disciplines: Public health
                Keywords: kindergarten teachers,nutrition,knowledge,attitude,behavior,china
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: kindergarten teachers, nutrition, knowledge, attitude, behavior, china

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