Meghan M. Slining

Introduction: Student health centers serve as crucial access points for healthcare within universities, striving to create inclusive spaces where all students feel supported. However, evidence indicates that students in larger bodies frequently encounter weight bias and stigma during clinical interactions, negatively impacting both physical and psychological well-being. Methods: The purpose of the current study was to assess current practices, policies and environments related to body weight and size within campus health services at private, liberal arts colleges in the American South. Results: Among the respondent institutions, 88% have incorporated inclusive weighing protocols (such as blind weighing or weight-optional visits) and 71% have implemented broader size-inclusive initiatives. Discussion: Our findings demonstrate that private liberal arts colleges in the South are considering weight inclusivity in their practice, suggesting a promising shift toward reducing healthcare barriers and improving health outcomes for college students of all body sizes; however, there are opportunities to further reduce weight stigma.

Background: Recognizing insufficient support for healthy eating and physical activity in early childhood education centers in Greenville, South Carolina, a group of stakeholders formed a workgroup as an organizing structure. Members developed and implemented a 2-year community-based participatory research initiative aimed at nutrition and physical activity policy, systems and environment change in 10 early childhood education centers. Objectives: This article 1) describes engagement efforts and partnerships leading to formation of the workgroup and initiative, 2) presents data on Workgroup members’ knowledge and engagement, and 3) shares lessons learned. Methods: Workgroup member knowledge and engagement related to obesity prevention was measured at two time points during the ECE initiative using the “Stakeholder-driven Community Diffusion Survey.” Lessons Learned: Knowledge and engagement scores increased over the measurement period. Scores for engagement were higher than scores for knowledge at both time points. There was a substantial increase in perceived leadership and stewardship, knowledge of intervention factors and how to intervene sustainably, and understanding of local resources and roles. An important strength was stakeholder buy-in and ownership of planning and implementation processes.

With limited COVID-19-guidelines for institutions of higher education (IHEs), colleges and universities began the 2020–2021 academic year with varying approaches. We present a comprehensive COVID-19 prevention and mitigation approach at a residential university during the 2020–2021 academic year, along with campus SARS-CoV-2 transmission during this time. Risk management of COVID-19 was facilitated through (1) a layered approach of primary, secondary, and tertiary prevention measures; (2) a robust committee structure leveraging institutional public health expertise; (3) partnerships with external health entities; and (4) an operations system providing both structure and flexibility to adapt to changes in disease activity, scientific evidence, and public health guidelines. These efforts collectively allowed the university to mitigate SARS-CoV-2 transmission on campus and complete the academic year offering in-person learning on a residential campus. We identified 36 cases of COVID-19 among the 2037 in-person learners during the fall semester, 125 cases in the inter-semester break, and 169 cases among 2095 in-person learners during the spring semester. SARS-CoV-2 infection during the academic year was associated with gender (p = 0.04), race/ethnicity (p = 0.01), and sorority/fraternity membership (p < 0.01). Infection was not associated with undergraduate vs. graduate student status, Division I athlete status, or housing type (all p > 0.05). A multi-faceted public health approach was critical for reducing the impact of COVID-19 while carrying out the university’s educational mission.

Background: Early childhood education (ECE) settings are critical intervention targets for obesity prevention. This study evaluated a pilot two-year community-based participatory research (CBPR) project designed to assist ECE center directors and caregivers in policy, systems and environmental (PSE) change for improving healthy eating (HE) and physical activity (PA). Methods: A two-year CBPR study was conducted in 10 licensed ECE centers in Greenville, South Carolina. The intervention consisted of five steps: [1] baseline data collection and self-assessment using the Nutrition and Physical Activity Self-Assessment for Child Care (Go-NAP SACC), [2] tailored goal setting and action planning, [3] technical assistance and access to resources, [4] post intervention data collection and re-assessment, and [5] celebration of success. Main outcome measures (HE and PA environments, practices and policies) were assessed using the Environment and Policy Assessment and Observation (EPAO) tool at baseline and 24 months. One classroom of 3–5-year-olds was randomly selected for observation from each center (mean of 12 children per classroom). Means and standard deviations were calculated for total PA, total nutrition and each subscale of PA and nutrition. Paired sample t-tests were calculated to assess changes in EPAO scales from baseline to post intervention. Results: Ten ECE centers enrolled in the pilot study and eight completed the two-year intervention. Center-based goals were accomplished across all 8 ECE centers over the two-year intervention: 16 child nutrition goals, 6 outdoor play goals, 11 physical activity goals and 8 screen time goals across the entire sample. Nutrition policy and PA policy significantly improved (p < 0.05), with greater improvements in PA (10.0 point increase, p = .048) as compared to nutrition (3.3 point increase, p = 0.02). Conclusions: Utilizing a CBPR approach, this two-year nutrition and PA PSE intervention in ECE centers improved ECE center HE and PA policies.

Background: Long-term trends mask critical recent dynamics in the prevalence of under- and overweight.Objective: The objective of this study was to co

Summary: Background: Most studies of childhood malnutrition in low‐ and middle‐income countries (LMICs) focus on children <5 years, with few focusing on adolescence, a critical stage in development.Objective: This study aimed to evaluate recent trends in the prevalence of under‐ and overweight among girls (15–18 years) in LMICs.Methods: Data are from Demographic and Health Surveys (53 countries) and national surveys conducted in Indonesia, China, Vietnam, Brazil and Mexico. The most recent surveys with sample sizes ≥50 when stratified by rural–urban status were included: 46.6% of countries had a survey conducted in the past 5 years, while the most recent survey for 10.3% of countries was over 10 years old. The overall rural sample size was 94 857 and urban sample size was 81 025. Under‐ and overweight were defined using the International Obesity Task Force (IOTF) sex‐ and age‐specific body mass index cut points.Results: South Asia had the highest prevalence of underweight; nearly double that of East Asia and the Pacific and sub‐Saharan Africa, and increasing annually by 0.66% in rural areas. Latin America and the Caribbean had the highest regional prevalence of overweight in both rural and urban settings, and this prevalence is increasing annually by about 0.50%. In urban areas, 38% of countries had both an under‐ and overweight prevalence ≥10%.Conclusions: There is substantial variation across and within regions in the burden of under‐ and overweight, with increasing dual burdens in urban areas. Innovative public health interventions capable of addressing both ends of the malnutrition spectrum are urgently needed.

Background: Child care facilities' policies can importantly impact health behaviors of toddlers and preschoolers. Our aim was to assess state regulations promoting physical activity (PA) in child care and compare regulations to national recommendations. Methods: We reviewed licensing and administrative regulations related to promoting PA for all states and territories for child care centers (centers) and family child care homes (homes). Three reviewers searched two sources (a publicly available website and WestlawNext™) and compared regulations with 15 Institute of Medicine recommendations. We used Pearson's and Spearman's correlations to assess associations between geographic region, year of last update, and number of regulations consistent with the recommendations. Results: The average number and range of regulations in centers and homes was 4.1 (standard deviation [SD], 1.4; range, 0–8) and 3.8 (SD, 1.5; range, 0–7), respectively. Nearly all states had regulations consistent with providing an outdoor (centers, 98%; homes, 95%) and indoor (centers, 94%, homes, 92%) environment “with a variety of portable play equipment and adequate space.” No state had regulations for staff joining children, avoiding punishment for being physically active, yearly consultation from a PA expert, or providing training/education on PA for providers. Conclusions: There is room for improvement in child care regulations around PA for young children; PA promotion should be included with future updates to regulations.

OBJECTIVES: The purpose of this study was to assess state licensing and administrative regulations promoting healthy sleep practices in child care and to compare these regulations to national recommendations. METHODS: We reviewed regulations related to healthy sleep practices for all states and territories for both child care centers (centers) and family child care homes (homes). We compared regulations with Institute of Medicine recommendations to promote sleep in child care, including (1) create environments that ensure restful sleep; (2) encourage sleep-promoting behaviors and practices; (3) encourage practices that promote child self-regulation of sleep; and (4) seek consultation yearly from a sleep expert. We used Cochran-Mantel-Haenszel trend tests to assess associations between geographic region and number of regulations consistent with the recommendations. RESULTS: The mean number of regulations for states was 0.9 for centers and 0.8 for homes out of a possible 4.0. For centers, no state had regulations for all 4 recommendations; 11 states had regulations for 2 of the 4 recommendations. For homes, 9 states had regulations for 2 of the recommendations. States in the Northeast had the greatest mean number of regulations for centers (1.2) and homes (1.1), and states in the South had the fewest (0.7 and 0.7, respectively); these geographic differences were significant for centers (P = .03) but not homes (P = .14). CONCLUSIONS: More states in the Northeast had regulations consistent with the Institute of Medicine sleep recommendations, but overall few states had regulations consistent with the recommendations.