• Toddler Overweight Prevention: Developing a Model by Socioeconomic Gradients

      Schuler, Brittany R.; Lee, Bethany R. (2016)
      Background and Purpose: Childhood obesity is a major health issue associated with increased risk of long-term health consequences; early prevention is crucial for public health. Little is known about variations in predictors of overweight across gradients of social class. This study addressed this gap using the ecological framework of childhood obesity to assess how characteristics vary across socioeconomic gradients. Methods: Child, parent, and community characteristics were examined within socioeconomic status (SES) quintiles in a secondary national sample from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B). Data were collected from 9,850 families via in-home and self-administered assessments. The sample was stratified by SES quintile (1-low, medium-low, medium, medium-high, 5-high). Taylor series linearization was applied to logistic regression models within quintiles using toddler weight status as the dependent variable (overweight/normal) and parameter estimates were compared across quintiles. A qualitative pilot study was conducted with low-income parents to assess factors that protect toddlers from being overweight. Results: Regression results showed predictors of overweight varied across SES. In SES 1 (lowest), predictors included younger age, better motor development, and more children in the household. In SES 2, male gender, better motor development, poorer mental development, maternal overweight, no full-time employment, never being breastfed, solid foods before 4 months, put to bed with a bottle, and lower community engagement increased overweight. In SES 3, there were no significant predictors of overweight. In SES 4, predictors included being Caucasian and introduction of solid foods before 4 months. In SES 5, introduction of solid foods before 4 months increased risk of overweight. Qualitative findings mentioned motor development, eating habits, peer engagement, parent feeding and eating practices, family support, and WIC. Conclusion: Using an ecological and social gradient of health framework, this study indicates there are distinct predictors of toddler overweight within each SES quintile. This yields important implications for public policy, intervention developers, and researchers to address the specific needs of toddlers across the SES gradient, including attention to child development, maternal health, feeding practices and community engagement.