Having a parent incarcerated is a serious stressor for children as well as the entire family unit. Motherly Intercession, a community-based organization in Flint serves children of incarcerated parents, mostly incarcerated mothers, and their families.
This line of community based work takes place in partnership with Motherly Intercession. We focus on implementing programming for parents and caregivers to strengthen parenting skills and enhance family communication. Programming takes place both at Motherly Intercession (Strengthening Incarcerated Families) and the Genesee County Jail (Bonding from a Distance visitation; Mom2Mom Mentoring, Parenting While Incarcerated). Efforts also focus on evaluating Motherly Intercession’s child-focused programs such as afterschool tutoring in the Reading and Counting to Success (RACS) program. In addition to the direct services provided to families and scientific publications, this work has involved training students in the complex concerns facing the very large number of children with an incarcerated family member, and in conducting community-based research. This research is a collaboration with Shirley Cochran, Executive Director of Motherly Intercession and has been funded by the National Institutes of Health (NIMH R21MH081921), Michigan Center for Clinical and Health Research (MICHR ULRR024986; U029861-186334), and the State of Michigan Children’s Trust Fund (13-25001).
Family Food Talk
Research suggests family mealtimes are important for child obesity prevention and development of healthy eating habits, but findings are not consistent. We analyzed naturalistic parent-child interactions outside of mealtimes using discourse analysis and behavioral coding approaches. The work is relevant to public health, as eating outside of mealtimes, particularly snacking after school hours, has increased in recent years, is proposed as contributing to excessive child weight gain, and is a potentially important context for child socialization around food and eating.
Understanding how children and parents talk about food and eating (“food talk”) outside of mealtimes thus holds promise for the development of future child obesity prevention efforts focused on parenting and would also fill a critical methodological gap in the science, as extant studies rely on parents’ self-reported feeding, observed structured laboratory interactions, or family mealtimes. No prior study has observed parent-child food talk between meals in relation to indicators of child obesity risk. See here for a June 2017 article on family food talk, child eating behavior, and maternal feeding practices. This research is a collaboration with Dr. Julie Lumeng, Pam Davis-Kean and Dr. Gail Viechnicki and is funded through NICHD (R03HD083656).
Mom Power Plus
EARLY LIFE STRESS AND TRAUMA
Early life stress and trauma have been associated with adult overweight and obesity and increasingly with childhood obesity risk. Positive parenting can buffer children from the effects of stress. Yet, it can be difficult for parents who are facing multiple stressors (poverty, trauma) to provide such buffering without support. Parenting that is characterized by harsh, negative, or inconsistent behaviors has also been found to be associated with increased risk for childhood obesity. Parenting is thus a possible behavioral pathway from stress exposure to childhood obesity risk. Parenting is also modifiable. Mom Power Plus was a pilot study to adapt and test an evidence-based parenting intervention to address general parenting beliefs and behaviors as well as maternal feeding beliefs and behaviors among mothers of preschool-aged children. We administered the adapted intervention to families and assess mother and child behaviors during a feeding interaction. This research is a collaboration with Dr. Megan Pesch, Dr. Katherine Rosenblum, Dr. Maria Muzik and Dr. Jamie Lawler and is funded by the Momentum Center at the University Of Michigan School Of Public Health.
ABC Preschool Study
CORTISOL AND EATING BEHAVIOR IN LOW-INCOME CHILDREN
One way that stress is hypothesized to “get under the skin” and lead to adverse health outcomes in chronically stressed, impoverished populations is via changes in stress neurobiology, specifically the hypothalamic-pituitary-adrenal (HPA), or “stress” axis and patterns of cortisol secretion. Our team was awarded a Challenge Grant in 2009 to examine stress and eating behavior in relation to obesity in low-income 3- to 5-year-olds. This study assessed diurnal cortisol patterns and eating behaviors in 380 low-income preschool-aged children. Results suggested associations between aberrant diurnal salivary cortisol patterns, food-related tantrums, and overweight, beginning at age 36 months. This study used the same cohort as the ABC Brain Games cohort and was funded by the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK 1RC1DK086376).
Stress Reactivity Study
STRESS REACTIVITY, CORTISOL, AND OBESITY IN LOW-INCOME CHILDREN
Under conditions of chronic stress, such as poverty, aberrations in both the normal diurnal pattern of cortisol secretion and cortisol reactivity to stress have been seen in adults, and have been related to obesity. Yet, little is known about the stress-response-obesity association in young children. This study examined how young, low-income children responded behaviorally and physiologically to challenging situations, and how their behavioral and biological responses to stress (salivary cortisol and alpha-amylase) related to their weight status and body mass index. Results, based on 250 children, demonstrated associations of blunted physiological responses to stress among children with a higher body mass index. This study used the same cohort as the ABC Brain Games cohort and was funded by the American Heart Association (10GRNT4460043).
ABC Kids Study
BIOBEHAVIORAL MECHANISMS LINKING STRESS AND OBESITY IN LOW-INCOME CHILDREN
Our early work has made clear that the pathways linking stress to obesity via eating behavior are complex and multifactorial, and involve biologic and behavioral pathways. The ABC Kids study considered mechanisms that could mediate links between stress and obesity, specifically sensitivity to food as a reward and ability to delay gratification for food. How such eating behaviors cluster and develop over time, and how different aspects of stress (i.e., chronic vs. immediate stressors) relate to these behaviors remains unknown. We examined the cross-sectional relationship of psychosocial stress (chronic and immediate stress) with obesity-promoting eating behaviors (including satiety responsiveness, reinforcing value of food, and the ability to delay gratification for food) and body mass index (BMI) z-score at age 7 years, and examined longitudinal associations of chronic stress and reactivity to stress early in life (age 3 years) with changes in obesity-promoting eating behaviors between ages 3 and 7 years. This study used the same cohort as the ABC Brain Games cohort and was funded by the National Institutes of Health (NICHD/NIDDK R01 DK098983).
ABC Toddler Study
SELF-REGULATION AS A BIOLOGICAL MECHANISM FOR EXCESS WEIGHT GAIN IN TODDLERS
Self-regulation is a broad set of skills involving control of behaviors, attention, emotions, and motivation, that begins to develop very early in the lifespan. Poor bio-behavioral self-regulation can contribute to a number of unhealthy behaviors as individuals seek and consume substances that can be calming at a neurobiological level. Toddlerhood is a time when food is an accessible substance with biological properties that may aid the individual’s ability to self-regulate. The ABC-Toddler Study examined the development of bio-behavioral self-regulation in food and non-food contexts longitudinally among low-income children ages 21 through 33 months. This study was funded by the National Institutes of Child Health and Development (NICHD 1R01HD069179).
Growing Healthy Study
ENHANCING SELF REGULATION AS A STRATEGY FOR OBESITY PREVENTION
Nearly one in five 4-year-old children in the United States is obese. Socioeconomic disparities are already apparent at this age, with low-income children having a 1.5 to 2 times higher obesity prevalence compared to middle- to upper-income children. Such disparities in obesity prevalence are poorly understood. Further, there are few obesity prevention programs targeting the preschool age range that have been rigorously tested, and their effects tend to be modest. Growing Healthy was funded by the USDA (2010-04785), Agriculture and Food Research Initiative – Childhood Obesity Challenge Area (AFRI2011-68001-30089). Growing Healthy was a randomized controlled trial that examined a novel obesity prevention program in a sample of 600 low-income preschoolers attending Head Start. This study was a collaboration between the University of Michigan (UM) and Michigan State University (MSU), our state Extension Program and 3 Head Start agencies.
Child Mealtime Behaviors
Children’s ability to accurately self-regulate their intake of food has been associated with reduced risk of obesity; thus, parents are encouraged to accurately respond to their children’s satiety cues. However, children may refuse food for reasons other than satiety (e.g., not liking the food), and parents may struggle with how to respond if cues are unclear. Further, parents’ feeding behaviors (e.g., prompting children to eat) may be based on other mealtime features, such as what the child has eaten so far during the meal. The proposed work seeks to identify patterns of dyadic mealtime behavior in relation to obesity risk in young, low-income children. Understanding how child satiety cues and parents’ responses relate to obesity risk can inform the development of interventions to prevent obesity. This research is a collaboration with Dr. Cin Cin Tan and Dr. Julie Lumeng and is funded by NICHD (R03HD084708).
Parents play an important role in childhood obesity prevention, yet interventions to curb child obesity tend to only focus on one parent, typically the mother. Family-based interventions that involve multiple family members can be more effective in reducing child obesity risk. It has also been shown that family members can either facilitate or mitigate the effectiveness of such programs; for example, mothers and fathers could disagree on child feeding behaviors. Despite this, surprisingly limited research has examined how fathers and mothers jointly navigate their parenting around child feeding (i.e., feeding-related coparenting). The proposed work will use qualitative methods to identify coparenting in the feeding domain. Better understanding feeding-related coparenting (e.g., how parents negotiate child feeding and meal preparation) between father-mother dyads can directly inform the development of effective family-based interventions to prevent childhood obesity. This research is a collaboration with Dr. Cin Cin Tan and Dr. Julie Lumeng and is funded through NICHD (R03HD086430).
Promoting Activities and Trajectories of Health for Children (PATH)
During early childhood, there are dramatic changes in self-regulation, or the ability to control behavioral impulses, manage emotions, and maintain focus and attention. Early self-regulatory capacities set the stage for an individual’s ability to control behaviors associated with later health outcomes, such as engaging in healthy eating practices and physical activity. Yet, associations of self-regulation and health-related behaviors (e.g., diet, exercise) have almost never been examined in young children.
Identifying early-life self-regulation skills may relate to emergent health behaviors is a critical step toward informing prevention efforts and developing interventions that directly address child self-regulation capacity as a mechanism of health behavior change. The PATH project seeks to engage self-regulation as an intervention target in a randomized cluster controlled trial (RCT) designed to enhance motor competence, perceived motor competence, and physical activity in preschoolers. Specifically, we will be assessing children’s self-regulation before and after participating in the physical activity promotion and motor competence intervention, the Children’s Health Activity Motor Program (CHAMP; L. Robinson, PI; R01HL132979). We will be testing the extent to which changes in child self-regulation as a result of CHAMP participation relate to changes in motor competence, perceived motor competence, and physical activity, behaviors that have been associated with reduced obesity risk, in a sample of preschool-aged children attending Head Start. We are using the Head Toes Knees and Shoulders [HTKS] assessment for self-regulation. This project is being conducted in collaboration with Leah Robinson, PhD, in the School of Kinesiology and the Child Movement, Activity, and Developmental Health Lab.
Sleep and Emotion Regulation
Sleep is a fundamental, and modifiable, regulatory developmental process that has the potential to affect many areas of child functioning including self-control, emotion regulation, school readiness, and health, including obesity (Miller, 2015). We conduct research on the biological, behavioral, and social-environmental aspects of sleep with the goal to improve child health broadly. Investigating mechanisms and correlates of sleep is an important first step in developing interventions. We have found associations between poor sleep and obesity risk (Miller et al 2014; Miller et al 2015), behavior problems in toddlers (Conway in press), and child temperament (Wilson, Miller et al 2014). Low-income preschoolers with sub-optimal sleep environments obtained less sleep overall and went to bed later than children whose parents reported better sleeping environments (Wilson, Miller, et al., 2014a; Chung et al, 2014); in collaboration with a community partner (Sweet Dreamzzz) we found that a brief classroom based sleep intervention improved sleep among children attending Head Start (Wilson et al 2014).
Based in Colorado, the new Sleep and the Neural Basis of Emotion Processing in Childhood study involves a sleep-training intervention with preschoolers. When individuals are “underslept”, their emotion regulation capacity suffers. We are examining whether increasing sleep can change the neurobiological processes associated with emotional and behavioral regulation in young children. This research is a collaboration with Dr. Monique LeBourgeois and is funded by NIMH (R01 MH086566; NIMH R21 MH100765).
Children’s Environmental Health: Community Outreach
Dr. Miller is the Director of the Community Outreach and Translation Core (COTC) of the Children’s Environmental Health Center at the University of Michigan. The goal of the COTC is to connect with community organizations that focus on children and environmental health and to promote projects that translate environmental health science findings from research to application. Much of this work is based in Grand Rapids. Projects have included an asthma mapping project that used data from Head Start to indicate regions of the city of Grand Rapids and Kent County, Michigan with high numbers of preschool-aged children with asthma.
This project was in collaboration with the Asthma Network of West Michigan, the Kent County Head Start Program, Healthy Homes Coalition of West Michigan, the Kent County Health Department, and the West Michigan Environmental Action Council. The COTC has also helped to develop an environmental health asset map for Kent County for community organizations focused on children and environmental health, and the Lead 101 program in collaboration with Health Homes.