{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T10:49:05Z","timestamp":1785494945343,"version":"3.56.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Childhood Obesity"],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess changes in weight-related health behaviors and social determinants of health (SDoH) among youth with overweight\/obesity during the coronavirus disease 2019 (COVID-19) pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We assessed weight-related health behaviors (physical activity, screen time, sleep, and diet) and SDoH (food insecurity, income\/childcare, and caregivers' perceived stress) before vs. during the pandemic with a survey administered August\u2013October 2020 to caregivers of 2\u201317-year olds and adolescents 13\u201317 years old with BMI \u226585th percentile seen in clinic within 6 months prepandemic. We analyzed changes in continuous variables using paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests and categorical variables with McNemar's or Fisher's exact tests, and the influence of social determinants on behavior change using multivariable regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 129 caregivers and 34 adolescents completed surveys. Compared with prepandemic, caregivers reported youth decreased moderate\/vigorous physical activity (\u221287.4 [205.7] minutes\/week,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and increased recreational screen time (2.5 [2.1] hours\/day,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Fewer had regular bedtimes (before: 89% and during: 44%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and more ate most meals with television (before: 16% and during: 36%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Food insecurity increased from 27% to 43% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), 45% reported reduced household income, and caregivers with moderate\/high perceived stress scale scores increased from 43% to 64% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Moderate\/high caregiver stress and food insecurity were associated with greater magnitudes of adverse behavior change.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Alarming changes in health behaviors among youth with overweight\/obesity, particularly among those with stressed caregivers and food insecurity, may increase prevalence of obesity-related comorbidities and exacerbate health disparities. There is an urgent need to expand access to effective interventions for overweight\/obesity that address psychosocial stressors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/chi.2021.0196","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T16:39:22Z","timestamp":1639759162000},"page":"369-382","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Changes in Weight-Related Health Behaviors and Social Determinants of Health among Youth with Overweight\/Obesity during the COVID-19 Pandemic"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0475-4312","authenticated-orcid":false,"given":"Pamela","family":"Hu","sequence":"first","affiliation":[{"name":"Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Samuels","sequence":"additional","affiliation":[{"name":"Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin R.","family":"Maciejewski","sequence":"additional","affiliation":[{"name":"Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangyong","family":"Li","sequence":"additional","affiliation":[{"name":"Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlin","family":"Aloe","sequence":"additional","affiliation":[{"name":"Yale University School of Public Health, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Van Name","sequence":"additional","affiliation":[{"name":"Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Savoye","sequence":"additional","affiliation":[{"name":"Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1632-7038","authenticated-orcid":false,"given":"Mona","family":"Sharifi","sequence":"additional","affiliation":[{"name":"Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,29]]},"reference":[{"key":"e_1_3_7_2_2","first-page":"146","article-title":"Well-being of parents and children during the COVID-19 pandemic: A national survey","author":"Patrick SW","year":"2020","unstructured":"Patrick SW, , Henkhaus LE, , Zickafoose JS, et al. Well-being of parents and children during the COVID-19 pandemic: A national survey. Pediatrics, 2020; 146.","journal-title":"Pediatrics"},{"key":"e_1_3_7_3_2","unstructured":"Fryar CD . Prevalence of overweight obesity and severe obesity among children and adolescents aged 2\u201319 years: United States 1963\u20131965 through 2017\u20132018. NCHS Health E-Stats 2020. 2020."},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7037a3"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.156"},{"key":"e_1_3_7_6_2","doi-asserted-by":"crossref","first-page":"12779","DOI":"10.1111\/ijpo.12779","author":"Ten Velde G","year":"2021","unstructured":"Ten Velde G, , Lubrecht J, , Arayess L, et al. Physical activity behaviour and screen time in Dutch children during the COVID-19 pandemic: Pre-, during- and post-school closures. Pediatr Obes, 2021:e12779.","journal-title":"Pediatr Obes"},{"key":"e_1_3_7_7_2","author":"Beck AL","unstructured":"Beck AL, , Huang JC, , Lendzion L, et al. Impact of the COVID-19 pandemic on parents' perception of health behaviors in children with overweight and obesity. Acad Pediatr 2021.","journal-title":"Acad Pediatr"},{"key":"e_1_3_7_8_2","volume-title":"National Bureau of Economic Research Working Paper Series","author":"Agostinelli F","year":"2020","unstructured":"Agostinelli F, . When the Great Equalizer Shuts Down: Schools Peers, , and Parents in Pandemic Times. National Bureau of Economic Research Working Paper Series. 2020; No. 28264."},{"key":"e_1_3_7_9_2","doi-asserted-by":"crossref","first-page":"2020006924","DOI":"10.1542\/peds.2020-006924","article-title":"Addressing pandemic-intensified food insecurity","volume":"146","author":"Hetrick RL","year":"2020","unstructured":"Hetrick RL, , Rodrigo OD, , Bocchini CE. Addressing pandemic-intensified food insecurity. Pediatrics, 2020; 146:e2020006924.","journal-title":"Pediatrics"},{"key":"e_1_3_7_10_2","author":"Jenssen BP","unstructured":"Jenssen BP, , Kelly MK, , Powell M, et al. COVID-19 and changes in child obesity. Pediatrics 2021.","journal-title":"Pediatrics"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/chi.2021.0038"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09429-3"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2020.04.013"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.00573"},{"key":"e_1_3_7_15_2","doi-asserted-by":"crossref","first-page":"12416","DOI":"10.1111\/cob.12416","article-title":"Obesity and activity patterns before and during COVID-19 lockdown among youths in China","volume":"10","author":"Yang S","year":"2020","unstructured":"Yang S, , Guo B, , Ao L, et al. Obesity and activity patterns before and during COVID-19 lockdown among youths in China. Clin Obes, 2020; 10:e12416.","journal-title":"Clin Obes"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-14-199"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2018.02.010"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_7_19_2","unstructured":"Blanco A . Most Connecticut school districts sticking with hybrid of online and in-person learning; 133 coronavirus cases among students and staff last week. The Hartford Courant. 2020."},{"key":"e_1_3_7_20_2","unstructured":"A SAS Program for the 2000 CDC Growth Charts (ages 0 to <20 years). National Center for Chronic Disease Prevention and Health Promotion. Available at https:\/\/www.cdc.gov\/nccdphp\/dnpao\/growthcharts\/resources\/sas.htm Published 2019. Updated February 26 2019."},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2009.28335"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/oby.21782"},{"issue":"3","key":"e_1_3_7_23_2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/obr.12184","article-title":"Reliability of primary caregivers reports on lifestyle behaviours of European pre-school children: The ToyBox-study","volume":"15","author":"Gonz\u00e1lez-Gil EM","year":"2014","unstructured":"Gonz\u00e1lez-Gil EM, , Mouratidou T, , Cardon G, et al. Reliability of primary caregivers reports on lifestyle behaviours of European pre-school children: The ToyBox-study. Obes Rev, 2014; 15 Suppl 3:61\u201366.","journal-title":"Obes Rev"},{"key":"e_1_3_7_24_2","unstructured":"National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Questionnaire 2019-2020 Physical Activity and Physical Fitness (PAQ). Department of Health and Human Services Centers for Disease Control and Prevention. Available at https:\/\/wwwn.cdc.gov\/nchs\/data\/nhanes\/2019-2020\/questionnaires\/PAQ_K.pdf Published 2019."},{"key":"e_1_3_7_25_2","first-page":"41","article-title":"Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks","author":"Forrest CB","year":"2018","unstructured":"Forrest CB, , Meltzer LJ, , Marcus CL, et al. Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks. Sleep, 2018; 41.","journal-title":"Sleep"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-020-02700-5"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2019.11.002"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.24.2697"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-3146"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.2307\/2136404"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-020-00329-3"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.15036"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijpo.12438"},{"key":"e_1_3_7_34_2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.5888\/pcd16.180368","article-title":"Parent-perceived stress and its association with children's weight and obesity-related behaviors","volume":"16","author":"Baskind MJ","year":"2019","unstructured":"Baskind MJ, , Taveras EM, , Gerber MW, et al. Parent-perceived stress and its association with children's weight and obesity-related behaviors. Prev Chronic Dis, 2019; 16:E39.","journal-title":"Prev Chronic Dis"},{"key":"e_1_3_7_35_2","doi-asserted-by":"crossref","first-page":"215262","DOI":"10.1001\/jamanetworkopen.2021.5262","article-title":"Trends in food sources and diet quality among US children and adults, 2003\u20132018","volume":"4","author":"Liu J","year":"2021","unstructured":"Liu J, , Micha R, , Li Y, , Mozaffarian D. Trends in food sources and diet quality among US children and adults, 2003\u20132018. JAMA Netw Open, 2021; 4:e215262.","journal-title":"JAMA Netw Open"},{"key":"e_1_3_7_36_2","first-page":"379","article-title":"Association of children's mode of school instruction with child and parent experiences and well-being during the COVID-19 pandemic\u2014COVID Experiences Survey, United States, October 8\u2013November 13, 2020","volume":"70","author":"Verlenden JV","year":"2021","unstructured":"Verlenden JV, , Pampati S, , Rasberry CN, et al. Association of children's mode of school instruction with child and parent experiences and well-being during the COVID-19 pandemic\u2014COVID Experiences Survey, United States, October 8\u2013November 13, 2020. MMWR Morb Mortal Wkly Rep 2021, 2021; 70:379\u2013376.","journal-title":"MMWR Morb Mortal Wkly Rep 2021"},{"key":"e_1_3_7_37_2","unstructured":"AAP. Obesity Management and Treatment During COVID-19 [Interim Guidance]. 2020. Available at https:\/\/services.aap.org\/en\/pages\/2019-novel-coronavirus-covid-19-infections\/clinical-guidance\/obesity-management-and-treatment-during-covid-19 Last accessed December9 2020."},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-1880"},{"key":"e_1_3_7_39_2","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.jpeds.2018.07.011","article-title":"Preventing childhood obesity through a mindfulness-based parent stress intervention: A Randomized Pilot Study","volume":"202","author":"Jastreboff AM","year":"2018","unstructured":"Jastreboff AM, , Chaplin TM, , Finnie S, et al. Preventing childhood obesity through a mindfulness-based parent stress intervention: A Randomized Pilot Study. J Pediatr, 2018; 202:136\u2013142.e1.","journal-title":"J Pediatr"},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.0332"},{"key":"e_1_3_7_41_2","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1002\/oby.22860","article-title":"Zooming toward a telehealth solution for vulnerable children with obesity during coronavirus disease 2019","volume":"28","author":"Woo Baidal JA","year":"2020","unstructured":"Woo Baidal JA, , Chang J, , Hulse E, et al. Zooming toward a telehealth solution for vulnerable children with obesity during coronavirus disease 2019. Obesity (Silver Spring), 2020; 28:1184\u20131186.","journal-title":"Obesity (Silver Spring)"}],"container-title":["Childhood Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/chi.2021.0196","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/chi.2021.0196","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/chi.2021.0196","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:24:12Z","timestamp":1777386252000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/chi.2021.0196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,29]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,9,1]]}},"alternative-id":["10.1089\/chi.2021.0196"],"URL":"https:\/\/doi.org\/10.1089\/chi.2021.0196","relation":{},"ISSN":["2153-2168","2153-2176"],"issn-type":[{"value":"2153-2168","type":"print"},{"value":"2153-2176","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,29]]}}}