University of Texas Health Science Center School of Public Health, Dallas, TX, USA.
Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA.
Matern Child Health J. 2020 Sep;24(9):1130-1137. doi: 10.1007/s10995-020-02979-3.
Previous obesity prevention studies in preschool-age children have included non-Hispanic Black (NHB) children, but few have investigated between-subgroup differences even though there may be cultural risk and protective practice differences, challenging the generalizability of findings. The purpose of this study was to examine differences in early childhood obesity-related factors in NHB subgroups (Haitian, other Caribbean Islander and African-American [AA]) children.
Baseline data from two randomized controlled trials in 52 childcare centers of which 35 had data to test a preschool-based obesity prevention intervention was analyzed. The sub-sample included 370 caregiver-child dyads; 209 self-identified as AA, 120 as Haitian and 41 as Caribbean Islander/West Indian or mixed race. Multilevel regression models generated outcome estimates for group differences in body mass index (BMI) percentile, birthweight, breastfeeding initiation and duration, bottle feeding duration and age when solid foods were introduced.
Mean BMI percentile was similar for AA, Haitian and Caribbean Islander/West Indian/Multiracial (60.1th percentile, 60.8th percentile, 62.8th percentile, respectively) as was birthweight (6.3, 6.8, and 6.6 lb, respectively). Children of US-born caregivers had significantly lower BMI percentiles (9.13 percentile points) versus foreign-born caregivers. Haitian women were significantly more likely to initiate breastfeeding (64.9%) versus AA (47.6%) and Caribbean Islander/West Indian/Multiracial (62.2%) (p < .01). No significant group differences were found in breastfeeding or bottle feeding duration or age solid foods were introduced.
Findings here suggest that NHB race classification can identify important subgroup behavioral similarities which in turn may inform culturally sensitive strategies to promote early childhood healthy weight. Foreign-born caregivers may benefit from healthy weight promotion information, and as early as possible in their child's development.
此前针对学龄前儿童的肥胖预防研究纳入了非西班牙裔黑人（NHB）儿童，但很少有研究调查亚组间差异，尽管可能存在文化风险和保护实践差异，这对研究结果的普遍性提出了挑战。本研究旨在研究 NHB 亚组（海地人、其他加勒比岛民和非裔美国人[AA]）儿童中与幼儿肥胖相关的因素的差异。
对两个在 52 个儿童保育中心进行的随机对照试验的基线数据进行了分析，其中 35 个数据可用于检验基于学前的肥胖预防干预措施。该亚样本包括 370 对照顾者-儿童对；其中 209 人自我认定为 AA，120 人认定为海地人，41 人认定为加勒比岛民/西印度人或混合种族。多级回归模型生成了组间体重指数（BMI）百分位数、出生体重、母乳喂养开始和持续时间、奶瓶喂养持续时间以及固体食物引入年龄的差异的结果估计值。
AA、海地人和加勒比岛民/西印度人/多种族的平均 BMI 百分位数相似（分别为 60.1 百分位、60.8 百分位和 62.8 百分位），出生体重也相似（分别为 6.3、6.8 和 6.6 磅）。与外国出生的照顾者相比，美国出生的照顾者的儿童 BMI 百分位数显著更低（低 9.13 个百分点）。海地妇女母乳喂养的起始率明显高于 AA（64.9%）和加勒比岛民/西印度人/多种族（62.2%）（p<0.01）。在母乳喂养或奶瓶喂养持续时间或引入固体食物的年龄方面，没有发现显著的组间差异。
本研究结果表明，NHB 种族分类可以识别重要的亚组行为相似性，这反过来又可能为促进幼儿健康体重的文化敏感策略提供信息。外国出生的照顾者可能受益于健康体重促进信息，并且可以在孩子发展的早期就开始获得这些信息。
