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Parental unemployment associated with the lack of the effectiveness of a children obesity prevention program: Results from the IDEFICS study

Published online by Cambridge University Press:  10 June 2020

Alelí M. Ayala-Marín
Affiliation:
Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
Pilar De Miguel-Etayo
Affiliation:
Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Ministerio de Ciencia, Innovación y Universidades, Madrid, Spain
Javier Santabárbara
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Ministerio de Ciencia, Innovación y Universidades, Madrid, Spain Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
Isabel Iguacel
Affiliation:
Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Ministerio de Ciencia, Innovación y Universidades, Madrid, Spain
Wolfgang Ahrens
Affiliation:
Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany
Stefaan De Henauw
Affiliation:
Department of Public Health, Faculty of Medicine and Health Sciences, Ghent, Belgium
Lauren Lissner
Affiliation:
Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Eszter Molnár Kurdine
Affiliation:
Department of Languages for Specific Purposes, Medical School, University of Pécs, Pécs, Hungary
Reisch Lucia
Affiliation:
Department of Intercultural Communication and Management, Centre for Corporate Social Responsibility, Copenhagen Business School, Copenhagen, Denmark
Paola Russo
Affiliation:
Institute of Food Sciences, CNR, Avellino, Italy
Michael Tornaritis
Affiliation:
Research and Education Institute of Child Health, Nicosia, Cyprus
Toomas Veidebaum
Affiliation:
Department of Chronic Diseases, National Institute for Health Development, Tallin, Estonia
Luis A. Moreno
Affiliation:
Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain Departamento de Fisiatría y Enfermería, Universidad de Zaragoza, Zaragoza, Spain
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Abstract

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The relationship between social vulnerabilities and the effectiveness of behavioral interventions to prevent obesity in children is poorly understood. Therefore, the objective of this study is to evaluate the association between parental employment and the effectiveness of IDEFICS, a multilevel behavioral intervention aiming to prevent obesity among children (2 to 9.9 years old) in eight European countries. Data from 9,901 children and their parents was included in the analysis. We determined the Body Mass Index (BMI) z-score mean difference as the measurement of the intervention effectiveness and we calculated it as the follow-up (T1) BMI z-score mean minus baseline (T0) BMI z-score mean. Parents self-reported their employment status at T0 and T1. Children were classified, at both study times (T0 and T1), as children with employed parents (both parents employed) or as children with unemployed parents (one or both parents unemployed or receiving social assistance). We calculated unadjusted and adjusted multilevel mixed model analyses to evaluate if the employment status at T0 and the evolution of the employment status within a two-year period (from T0 to T1) predicted the BMI z-score mean difference among boys and girls. In boys, parental unemployment at T0 and throughout a two-year period (T0 to T1) predicted an increase of BMI z-score mean difference when compared to boys with employed parents (unemployment at T0: adjusted β = 0.12; p = 0.028; and unemployment from T0 to T1: adjusted β = 0.20; p = 0.031). We found no difference in the effectiveness of the IDEFICS intervention among girls with unemployed parents at T0 and from T0 to T1 when compared to girls with employed parents (unemployment at T0: adjusted β = 0.04; p = 0.337; and unemployment from T0 to T1: adjusted β = 0.10; p = 0.216, respectively). Our results suggest that the influence of parental unemployment in the IDEFICS outcome is different for boys and girls. Employment of both parents, which is related to a higher income, could contribute the families to engage healthier eating and physical activity behaviors among boys. Future multilevel interventions should include a combination of community-based and school-based components, as well as family-centered components, specifically on those families with parents out of the labor force, to address specific barriers or vulnerabilities that prevent them from improving behavior and weight status.

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Copyright © The Authors 2020