STUDY OBJECTIVES:This study aims to examine associations between changes in objectively measured sleep characteristics and growth trajectories, as well as risk of rapid weight gain (RWG) and overweight in infants. METHODS:The study analyzed data from 298 healthy term infants (48.7% boys) in the Sleep Health in Infancy & Early Childhood (Rise & SHINE) birth cohort, with sleep measured by actigraphy at 1 and 6 months. Changes in nighttime sleep duration, fragmentation (wake after sleep onset [WASO], waking bouts, sleep efficiency), and regularity (sleep regularity index [SRI]) were examined as exposures. Growth trajectory parameters-size, tempo, and velocity-were modeled from repeated anthropometric measurements using SuperImposition by Translation and Rotation (SITAR), and weight outcomes at 24 months included RWG and overweight. Associations between sleep changes and growth outcomes were examined using linear and logistic regression models. RESULTS:In adjusted models, a 1-hour increase in WASO between 1 and 6 months was associated with greater weight size (β = 0.093; 95% CI, 0.019 to 0.166), as well as higher odds of RWG (OR, 2.39; 95% CI, 1.02 to 6.07) and overweight (OR, 2.66; 95% CI, 1.16 to 6.16). A 5% decrease in sleep efficiency was associated with greater weight size (β = 0.059; 95% CI, 0.020 to 0.099) and slower weight velocity(β = -10.013; 95% CI, -18.693 to -1.332). A 5% decrease in the SRI was associated with later length tempo (β = 0.004; 95% CI, 0.001 to 0.007). No associations were observed for sleep changes with weight-for-length trajectories. CONCLUSIONS:Early sleep patterns may serve as a modifiable factor in preventing future obesity. Statement of Significance Infant sleep changes rapidly in the first two years, and early disturbances have been linked to outcomes such as obesity. Yet few studies have examined how objectively measured multidimensional sleep changes shape growth trajectories. Using actigraphy data from 1 to 6 months, this study found that greater sleep fragmentation (measured by WASO and sleep efficiency) was associated with larger weight size and higher odds of RWG and overweight at age 2. Decreases in sleep efficiency were also linked to slower weight velocity, while decreases in sleep regularity were associated with later length tempo. These findings suggest that improving infant sleep may help normalize growth and reduce later obesity risk. Future research should explore modifiable factors and guide early strategies to support healthy sleep and growth.

OBJECTIVES: Examine whether men's historical patterns of adherence to physical activity (PA) guidelines during adolescence are associated with their PA parenting practices as fathers. METHODS: Data were drawn from 565 fathers in the Fathers & Families study (F&F) followed since early adolescence. Analysis focused on men who had a child aged 2-6 years and self-reported at least two historical measures of PA (ages 10-24 years) and PA parenting practices (e.g., being active with the child and facilitating opportunities for activity). Men's patterns of adherence to PA guidelines during adolescence were identified using sequence analysis and hierarchical clustering. We examined associations between these patterns and PA parenting practices in fatherhood using ordinal logistic regression. RESULTS: We identified four patterns of adherence to PA guidelines during adolescence: Consistently Sedentary (12.2%), Early Active (18.2%), Late Active (34.2%), and Consistently Active (35.4%). Compared to men classified as Consistently Sedentary during adolescence, men classified as Late Active (OR = 1.81; 95%CI: 1.05-3.16) or Consistently Active (OR = 2.72; 95%CI: 1.57-4.76) had higher odds of engaging in supportive PA parenting practices as fathers. The PA parenting practices of fathers categorized as Early Active during adolescence did not differ from those classified as Consistently Sedentary. CONCLUSIONS: Men who consistently met PA guidelines during adolescence and those who became active later in adolescence were more likely to engage in supportive PA parenting practices as fathers. Results highlight the importance of promoting PA among adolescent boys and support calls for a preconception model of men's health.

OBJECTIVE:Pennington Biomedical Research Center convened a scientific symposium in March-April 2025, which brought together leaders in dissemination and implementation science to identify what is known and what is needed to foster the rapid dissemination and implementation of evidence-based, guideline-backed pediatric obesity prevention and treatment interventions. METHODS:The primary aim of the symposium was to identify effective dissemination and implementation strategies, contextual factors related to strategy selection, and mechanisms of successful intervention reach, adoption, implementation, and maintenance. Through this symposium, the overarching goal was to accelerate the rate of translation of evidence-based interventions for the prevention and treatment of pediatric obesity into practice while advancing dissemination and implementation science in settings including health care, schools, and the community. RESULTS AND CONCLUSIONS:This article summarizes the state of the scientific evidence discussed at the symposium, identifies exemplars of implementation-effectiveness trials, and provides recommendations for disseminating and implementing evidence-based pediatric obesity prevention and treatment interventions into typical clinical and community settings.

This study examined the association between transitions in BMI growth channel (BMI-GC) and the odds of underweight and overweight in young adulthood. Data were drawn from 2,759 participants in the Young Lives study (YL) and 2,782 participants in the National Longitudinal Survey of Youth 1997 (NLSY97). Normal Weight (NW) subsamples, consisting of 1,922 participants from YL and 1,477 from NLSY97, were selected for sensitivity analyses. Individual BMI-GC trajectories were estimated using linear mixed-effects models, and classified into four groups: Stable, Crossing Upwards, Crossing Downwards, and Fluctuating. Associations between BMI-GC groups and underweight and overweight at age 22 were assessed using logistic regression models. Compared to the Stable group, participants in the Crossing Downwards group had higher odds of being underweight in YL (OR: 2.62; 95%CI: 1.95-3.54), whereas those in the Crossing Upwards group had higher odds of overweight in YL (OR: 3.96 (95%CI: 2.61-5.99)) and in NLSY97 (OR: 2.55 (95%CI: 1.95-3.33)). In sensitivity analysis (NW subsamples), Crossing Downwards remained associated with underweight in YL (OR: 1.75; 95%CI: 1.23-2.48), and Crossing Upwards remained associated with overweight in both cohorts (OR: 1.95; 95%CI: 1.14-3.34 in YL and OR: 1.67; 95%CI: 1.00-2.78 in NLSY97). Crossing BMI-GC was associated with both underweight and overweight outcomes, including among participants with normal weight during childhood and adolescence. These findings highlight the importance of BMI-GC in weight assessments, offering a more nuanced understanding of growth trajectories and emphasizing the need to move beyond BMI categories alone to predict long-term nutritional risks.

This study examines bidirectional associations between fathers' food parenting practices and children's dietary intake of fruits, vegetables, fast food, and sugar-sweetened beverages (SSB) across two time points. Data were drawn from the Fathers & Families Study (n = 802 fathers of children aged 2-6 years). For each dietary outcome (fruit and vegetable ≥2 times/day; fast food and SSB <1 time/week), cross-lagged panel models were estimated to assess longitudinal associations with fathers' food parenting practices (structure and coercive control), adjusting for Time 1 sociodemographic covariates. Cross-lagged analyses revealed bidirectional associations: Higher paternal structure at Time 1 predicted children's consumption of vegetables ≥2 times/day at Time 2 (β = 0.09, 95%CI:0.01-0.17), and children consuming vegetables ≥2 times/day at Time 1 predicted higher paternal structure at Time 2 (β = 0.15, 95%CI:0.08-0.21). Similarly, higher paternal structure at Time 1 predicted a higher likelihood of children consuming fast food <1 time/week at Time 2 (β = 0.18, 95%CI:0.11-0.25), and children consuming fast food <1 time/week at Time 1 predicted higher paternal structure at Time 2 (β = 0.10, 95%CI:0.02-0.18). Additionally, higher paternal coercive control at Time 1 predicted a lower likelihood of children consuming SSB <1 time/week at Time 2 (β = -0.12, 95%CI:-0.20 to -0.04), whereas children consuming SSB <1 time/week at Time 1 predicted lower coercive control at Time 2 (β = -0.12, 95%CI:-0.21 to -0.04). Results suggest that fathers' food parenting practices and children's dietary intake may mutually shape one another over time. Further research is needed to clarify the mechanisms underlying these associations and their implications for long-term child health.

Purpose: The Fathers & Families (F&F) Study was established to address critical gaps in understanding fathers’ roles in shaping young children’s health-related behaviors and family health. F&F integrates a family systems perspective with a life course framework to examine determinants and consequences of fathers’ weight-related parenting practices. Participants: F&F is a longitudinal cohort of 1,272 fathers of children aged 1–6 years and 582 co-parents recruited between 2021 and 2023 through two phases: re-contact of male participants from the Growing Up Today Study (GUTS) and targeted recruitment through Michigan Medicine to enhance racial and ethnic diversity. Fathers complete surveys annually for up to three years (T1–T3), with parallel data collected from co-parents across many domains. A unique feature of the cohort is linkage to prospectively collected preconception data from GUTS spanning adolescence through adulthood (1996–2021). Findings to date: Results demonstrate links between boys’ diet and physical activity trajectories during adolescence and their food and physical activity parenting practices as fathers. In particular, more positive health behavior trajectories across the adolescent period (i.e., consistently healthy behaviors or improving health behaviors) were associated with more supportive food and physical activity parenting practices as fathers. Other findings include bidirectional associations between fathers’ food parenting and children’s dietary behaviors and that children’s diets were healthiest when both parents (fathers and their co-parents) use structure-based food practices. Conclusion: The F&F study addresses critical gaps in understanding fathers’ roles in shaping child health and family well-being. With multi-informant assessments of parenting, co-parenting, and child behaviors, and prospective linkage to preconception data, F&F provides a unique life-course resource to inform father-inclusive research and family-centered interventions.

Food parenting practices play a vital role in shaping children’s food intake, yet evidence linking fathers’ earlier diet patterns to later parenting is limited. This study examined the association between fathers’ diet quality patterns during their adolescence and food parenting practices during fatherhood. Data were drawn from Fathers Families (F F), a father-based cohort that recruited participants from an ongoing cohort in the United States that has followed participants since adolescence. Participants (n = 584) reported their dietary intake during adolescence (ages 10–18) using a Youth/Adolescent Food Frequency Questionnaire across multiple survey waves (1996–2011), and reported their food parenting practices using an online survey completed in 2021–2022. Fathers’ diet quality patterns during their adolescence were derived from Healthy Eating Index-2020 (HEI-2020) scores using sequence analysis and hierarchical clustering. Associations between these adolescent diet quality patterns and food parenting practices (coercive control, structure, autonomy support) were estimated with ordinal logistic regression, adjusting for sociodemographic covariates and family meal frequency measured during adolescence. Three diet quality patterns were identified in adolescence: Low HEI-2020 (50.0

Background While vaccines are safe and effective, vaccine hesitancy negatively impacts Latinx adults and adults with mental illness, resulting in low vaccination rates. Evidence suggests that Motivational interviewing (MI) may reduce vaccine hesitancy among underserved populations. This trial evaluates the effectiveness of MI integrated into behavioral health on vaccine hesitancy and COVID-19 and influenza vaccination among Latinx adults with mental illness. Methods Implemented in partnership with NeighborHealth, a Federally Qualified Health Center (FQHC) in a predominantly-Latinx community, Motivational Interviewing for Vaccine Uptake in Latinx Adults (MI Vacuna) is a novel intervention, comprised of Motivational Interviewing (MI) and a warm handoff, implemented by behavioral health (BH) clinicians to address vaccine hesitancy in their patients. Utilizing a pragmatic multiple-period, cluster-randomized crossover trial design this study: 1) tests the effectiveness of MI Vacuna on COVID-19 and influenza vaccine uptake among Latinx adults with mental illness; 2) investigates moderators of intervention effects including patient-provider ethno-language concordance and country of origin; and 3) examines theory-based elements on the causal pathway between the intervention and vaccine uptake. Primary outcomes include patient COVID-19 and influenza vaccine uptake extracted from electronic health records. Secondary outcomes include vaccine hesitancy and provider trust, evaluated using patient surveys and interviews. Implementation outcomes are measured using multiple data sources. Discussion This novel study tests the effect of MI within the context of BH on COVID-19 and influenza vaccine hesitancy and uptake among Latinx adults. Results inform the sustainability and scale-up of MI Vacuna and BH-centered efforts to target patient vaccine hesitancy.Trial Registration: clinicaltrials.gov, NCT06062056

OBJECTIVE:Using a nationally representative sample, this study examined associations between fathers' adverse childhood experiences (ACEs) and fathering and whether fathers' behavioral health mediated this association. METHODS:Data from 4814 fathers who were followed from adolescence through early adulthood in the National Longitudinal Study of Adolescent to Adult Health. On average, fathers were 33 years old and self-identified as non-Hispanic White (64%), followed by non-Hispanic Black (17%) or Hispanic (12%). Fathers self-reported on 13 ACEs during waves 1 to 4 and 2 measures of behavioral health (depressive symptoms and alcohol consumption) and fathering (stress and satisfaction), assessed at wave 4 or 5. A multiple mediation model was estimated using a structural equation model to examine direct and indirect pathways between fathers' ACEs and fathering, through behavioral health. RESULTS:There was a significant direct effect of ACEs on fathering satisfaction (B = -0.04, standard error (SE) = 0.02, P < .01), as well as a significant indirect effect through fathers' depressive symptoms (B = -0.04, SE = 0.01, P < .001), resulting in a total effect of -0.08 (SE = 0.02, P < .001). Fathers' ACEs were also linked to heavy drinking (B = 0.01, SE = 0.00, P < .05). ACEs were not associated with fathering stress. CONCLUSIONS:Findings indicate the importance of reaching and engaging ACE-exposed fathers in behavioral health and parenting interventions. Given that health promotion in fathers has benefits for their children, leveraging pediatric encounters to identify at-risk fathers has the potential to improve both fathers' and children's health.

Background: Head Start, a federally funded preschool for low-income families, offers a unique space for interventionists to equitably reach parents and children, and promote healthful behavior for chronic disease prevention. However, determinants of implementation in this context remain understudied, hindering opportunities for improvement. We aim to identify organization-level factors affecting implementation of an obesity prevention program, as relayed by implementation partners at Head Start. Methods: Communities for Healthy Living (CHL), designed and implemented with Greater Boston Head Start (n = 16 programs across n = 2 agencies), is a cluster-randomized obesity prevention trial offering enhanced nutrition support, media campaign, and a parenting program. The current study draws on two years (2017-19) of data collected from Head Start implementation partners. Pre-implementation, staff completed anonymous surveys: implementation readiness (n = 119), staff training evaluation (n = 166), and facilitator training evaluation (n = 22); response frequencies were tabulated. Mid-implementation, staff and leadership participated in focus groups (n = 3 groups with n = 16 participants) and interviews (n = 9); transcripts were analyzed using a deductive-inductive hybrid approach, grounded in the Consolidated Framework for Implementation Research. Results: Most staff strongly agreed or agreed they understood their role (98.8%), planned on recruiting parents (98.2%), and reported commitment to implementation (92.5%); however, fewer identified CHL as a priority (69.7%) and were confident in their ability to coordinate efforts (84.9%), handle challenges (77.3%), and receive support (83.2%). Thematic analysis yielded implementation facilitators, including mission alignment, partner engagement in design, allocation of intervention-specific resources, and expressed leadership support. Barriers included strains imposed on staff workflow, a lack of shared responsibility, and challenges in coordinating CHL activities amidst competing Head Start programs. Conclusions: Responsive efforts to address deliverer-identified barriers to implementation may include reducing intervention impact on preexisting workflow, as well as clearly distinguishing intervention activities from preexisting Head Start programs.

Racial and ethnic disparities in children's diets are prevalent. Little is known about how fathers' food parenting practices may contribute to these disparities. We examined racial and ethnic variations in food parenting practices and their associations with 2-6-year-old children's diets in a cross-sectional sample of U.S. fathers surveyed in 2021-2023 (N = 1015; 16% Asian, 9% Black, 6% Hispanic, 70% White; Mage = 37 years) using path analysis. Fathers' food parenting practices were significantly associated with children's diets, yet little evidence emerged that fathers' food parenting practices explained racial and ethnic disparities in children's diets. These findings suggest the potential importance of structural constraints on healthy eating (e.g., access to healthy food) among minoritized children beyond fathers' food parenting practices.

Fathers are underrepresented in food parenting research partly due to the lack of succinct, theory-informed, and father-mother equivalent food parenting measurement tools. To address this, we 1) tested the factorial validity of a brief food parenting measure utilizing a subset of items from the Comprehensive Feeding Practices Questionnaire (CFPQ) to represent coercive control, structure, and autonomy support, 2) assessed the extent to which the brief tool works similarly in fathers and mothers (i.e., measurement invariance), and 3) evaluated its internal reliability and concurrent validity. Participants included 1,071 fathers of children aged 2-6 years and 487 of their co-parents (mothers) from the Fathers & Families study. Fathers and mothers responded to 16 CFPQ items, and fathers reported on children’s diets. Confirmatory factor analysis (CFA) was used to test factorial validity. Multi-group CFA was used to examine measurement invariance across fathers and mothers. Internal reliability was examined using Cronbach’s alpha and the Spearman-Brown coefficient. Concurrent validity was assessed utilizing multiple logistic regressions to examine associations between the three food parenting factors and children’s intakes of fruit, vegetables, sugar-sweetened beverages (SSBs), and fast food. CFA confirmed a three-factor model with 11 items, including coercive control (four items), structure (five items), and autonomy support (two items). Multi-group CFA indicated measurement invariance across fathers and mothers. Internal reliability was established. Concurrent validity was strong for structure, but weaker for coercive control and autonomy support. Further refinements are encouraged to enhance items’ utility in characterizing fathers’ food parenting practices, including in different social and cultural contexts.

U.S. immigrant parents encounter various challenges during the migration and resettlement process, such as acculturative stress and dissonance in parenting practices between the cultures in the U.S. and those in their country of origin. Although studies have established a link between increased perceived stress and reduced parenting self-efficacy in U.S.-born parents, which could be alleviated by levels of parental empowerment, little is known about this pathway in the context of migration. Guided by the Family Adjustment and Adaptation Response Model and with a focus on low-income immigrant parents of young children, we examined (1) the association between perceived stress and parenting self-efficacy, and (2) whether parental empowerment constitutes a buffer between perceived stress and parenting self-efficacy. Participants included foreign-born, low-income parents (n = 680) with preschool-aged children enrolled in Head Start of Greater Boston. Linear regression models were conducted to examine the relationship between perceived stress and parenting self-efficacy. An interaction term between perceived stress and empowerment was included to test the moderating effect of each dimension of parental empowerment (i.e., resource empowerment, critical awareness, and relational empowerment). Results showed higher perceived stress was associated with lower parenting self-efficacy and this relationship was moderated by relational empowerment. Findings suggest that relational empowerment can be an important resource for immigrant parents with high stress and a protective factor to improve self-efficacy in their parenting. These results pose important implications regarding how healthcare professionals and clinicians may support parents, for example, through the development of culturally sensitive parenting interventions and the creation of safe environments for parent-to-parent relationships.

Parents have primary influence over the development of their children’s eating behaviours, however less attention has been given to whether or how their coparenting plays a role in this association. The aim of this study was to investigate the cross-sectional associations between mothers’ and fathers’ food parenting practices and children’s eating behaviour and examine whether coparenting quality moderates or confounds these associations. Parents (222 mothers and 167 fathers) with children 18 months to 5 years completed an online survey that assessed their food parenting practices and coparenting quality. One parent per family (91% mothers) also reported their children’s food approach behaviours. We used linear regressions with generalized estimating equations to examine the associations between food parenting practices and children’s eating behaviours. To explore moderation by coparenting quality, we included an interaction term in each model (coparenting quality x food parenting practice). To explore confounding, models were adjusted for coparenting quality. All models were stratified by parent gender and included parent educational attainment, child age, and child BMI z-scores as covariates. Among both mothers and fathers, we found that structure and autonomy support food parenting practices were inversely associated with children’s food responsiveness, and desire to drink, while coercive control practices were positively associated with these food approach behaviours. We found the opposite direction of association between these food parenting practices and children’s enjoyment of food. Among mothers, autonomy support was inversely associated with children’s emotional overeating, while coercive control was positively associated with this eating behaviour. Coparenting quality did not moderate or confound the associations. Future studies should continue to explore these associations among families with young children and consider feeding coparenting in the association.