Investigating the complexity of childhood obesity within multilevel environments in a Hispanic sample using structural equation modeling
The trend of obesity among Hispanic children is impacted by multiple factors working jointly. The current study aimed to explore the associations among factors at different ecological levels with child’s anthropometric outcomes in a Hispanic sample. The sample consisted of 309 children (5-9 years) who were enrolled in the project Transformacion Para Salud (Transformation for Health), an 18-month community-based intervention project in West Texas. Baseline data were used for this study. Measured factors included: child daily sugar-sweetened beverage intake and fruit/vegetable intake, TV viewing time, parent’s nutrition knowledge, support for physical activity, family meal and fast food frequency, acculturation, and participation in food assistance program(s). The outcomes were child’s body mass index percentile, waist circumference, and body fat percentage. Effects of all these factors on anthropometric outcomes were tested by structural equation modeling. For all three anthropometric outcomes, the models fit the data adequately: CFI is 0.921-0.940 and RMSEA is 0.040-0.042. Child daily sugar-sweetened beverage was positively impacted by daily TV viewing and fast food frequency. Child fruit and vegetable intake was negatively related to fast food frequency and positively related to parent’s support physical activity and participation in food assistance programs. Parent’s nutrition knowledge had a negative effects on child weight status. Acculturation was positively associated with fast food frequency, parent’s nutrition knowledge, and physical activity support. The significant factors associated with overweight and obesity may provide a basis for future prevention and intervention strategies targeting Hispanic children.