| Family Eating Environment and Family Physical Activity Environment (Exposure Variables): |
| Family Eating Environment (parent report) |
| Importance of Family Meals |
Mealtime importance was assessed with the following 4 items: “It is important that our family eat at least one meal a day together” (reverse scored); “Different schedules make it hard to eat meals together on a regular basis”; “In our family, it is often difficult to find a time when family members can sit down to a meal together”; and “In our family, children are expected to be home for dinner” (reverse scored). Response options were on a 4-point Likert scale ranging from strongly disagree to strongly agree. Scores were dichotomized at the sample median (M=9) with lower scores on the meal importance scale reflecting greater importance on mealtimes (two-week test-retest r=0.72a)
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| Frequency of Adolescent Media Use at Meals |
Electronic media use at mealtimes was examined with five items in which parents reported the frequency with which their adolescent engaged “watching TV or movies,” “playing with hand-held games,” “talking on the phone,” “text messaging,” or “listening to music with headphones” during family meals. Response options included ‘never or rarely,’ ‘sometimes,’ ‘usually,’ and ‘always’ (item test-retest correlations=0.61 to 0.75). A summary measure was created and dichotomized at the sample median (M=6) with lower scores reflecting never/rarely using electronics during meals.
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| Parent Limit Setting on Media Use at Family Meals |
Rules regarding mealtime media use was assessed with “Do you set limits (have rules, including no use) on your child’s media use (TV, cell phone, texting, etc.) at family meals?” (yes/no; test-retest r=0.87a).
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| Frequency of Family Meals |
Parents were asked, “During the past seven days, how many times did all, or most, of your family living in your house eat a meal together?” Response options included: never, 1–2 times, 3–4 times, 5–6 times, 7 times, and more than 7 times (Test-retest r=0.83a).36 The three highest categories were collapsed to allow for meaningful comparisons between parents who had infrequent or occasional family meals with families who had more regular family meals.37
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| Parent Pressure-to-Eat |
Pressure-to-eat food-related parenting practices were measured using all four items from the Pressure-to-Eat Subscale of the Child Feeding Questionnaire (CFQ).6 Self-report items included: 1) “My child should always eat all the food on his/her plate,” 2)“I have to be especially careful to make sure my child eats enough,” 3)“If my child says, “I’m not hungry, I try to get him/her to eat anyway,” and 4) “If I did not guide or regulate my child’s eating, my child would eat much less than he/she should.” Individual items were measured using a 4-point Likert scale, with each point on the scale represented by a word anchor (disagree, slightly disagree, slightly agree, and agree). Parent agreement with a particular statement was defined as a response of slightly agree or agree. An overall parental pressure-to eat scale was created by averaging responses to each of these four questions to assign an overall pressure score ranging from 1 (low pressure) to 4 (high pressure) and dichotomized at the 75th percentile (P75=2.75) with lower scores reflecting no pressure. (Test-retest r= 0.73a, Cronbach’s alpha = 0.70).
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| Parent Restriction of Eating |
Restrictive food-related parenting practices were measured using six items from the eight-item Restriction Subscale of the CFQ.6 The six self-report items included:1) “I have to be sure that my child does not eat too many high fat foods,” 2)“I have to be sure that my child does not eat too many sweets (candy, ice cream, cake or pastries),” 3) “I have to be sure that my child does not eat too much of his/her favorite foods,”4) “If I did not guide or regulate my child’s eating, he/she would eat too much of his/her favorite foods,” 5) “I intentionally keep some foods out of my child’s reach,” and 6) “If I did not guide or regulate my child’s eating, he/she would eat too many junk foods.” Individual items were measured using a 4-point Likert scale, with each point on the scale represented by a word anchor (disagree, slightly disagree, slightly agree, and agree). Parent agreement with a particular statement was defined as a response of slightly agree or agree. An overall parental restriction scale was created by averaging responses to each of these six questions to assign an overall restriction score ranging from 1 (low restriction) to 4 (high restriction) and dichotomized at the 75th percentile (P75=3.2) with lower scores reflecting no restriction. (Test-retest r= 0.72a, Cronbach’s alpha = 0.86).
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| Family Physical Activity Environment (parent report) |
| Frequency of physical activity with child |
Frequency of parents engaging in physical activity with their child was assessed with the following questions,38 “In a typical week, how many hours do you spend: [None, Less than ½ hour, ½ – 2 hours, 2 ½ – 4 hours, 4 ½ – 6 hours, 6+ hours} Being physically active with your child (e.g., throwing a ball around, taking a walk or bike ride together)?” Three categories were creating with the first level being the “Never” category, then collapsing the next three levels (Less than ½ hour – 4 hours) into “Sometimes”, and collapsing the highest two levels (4 ½ – 6+ hours) to “Often”. (Test-retest r=0.58a).
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| Frequency of helping child be physically active |
Frequency of parents helping their child to be physically active was assessed by asking,39 “In a typical week, how many hours do you spend: [None, Less than ½ hour, ½ – 2 hours, 2 ½ – 4 hours, 4 ½ – 6 hours, 6+ hours] helping your child to be physically active (e.g., driving them to the gym or sport practice, watching them play a sport)?” Three categories were creating with the first level being the “Never” category, then collapsing the next three levels (Less than ½ hour – 4 hours) into “Sometimes”, and collapsing the highest two levels (4 ½ – 6+ hours) to “Often”. (Test-retest r= 0.62a)
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| Frequency of watching TV with child |
Frequency of parent watching TV with their child was assessed by asking,39 “In a typical week, how many hours do you spend: [None, Less than ½ hour, ½ – 2 hours, 2 ½ – 4 hours, 4 ½ – 6 hours, 6+ hours] watching TV/movies together with your child?” Three categories were creating with the first level being the “Never” category, then collapsing the next three levels (Less than ½ hour – 4 hours) into “Sometimes”, and collapsing the highest two levels (4 ½ – 6+ hours) to “Often”. (Test-retest r= 0.53a)
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| Adolescent Dietary Intake, Fast Food Consumption, Weight Control Behaviors, Physical Activity, Sedentary Behaviors, BMI (Outcome Variables): |
| Adolescent fruit/vegetable intake |
Dietary intake was assessed in EAT 2010 adolescents with the 149-item Youth and Adolescent Food Frequency Questionnaire (YAQ).40 For fruit and vegetable intake, daily servings were defined as the equivalent of one-half cup. Validity and reliability of the YAQ have been previously tested with youth and found to be within acceptable ranges for dietary assessment tools.40,41 Responses to questions on the frequency of intake of fruits (n=14; excluding fruit juice) and vegetables (n=20; excluding french fries), were summed to assess average total daily intake.
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| Adolescent frequency of eating at a fast-food restaurant |
Adolescent fast food intake was assessed with the question: “In the past week, how often did you eat something from a fast food restaurant (McDonald’s Burger King, Hardee’s, etc.)?” Response options were never, 1–2 times 3–4 times, 5–6 times, 7 times and more than 7 times. Responses were scored as: 0, 1.5, 3.5, 5.5, 7 and 9 times/week (Test-retest r = 0.38).
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| Adolescent Unhealthy Weight Control Behaviors |
Adolescent unhealthy weight control behaviors (UWCBs) were assessed with the question, “Have you done any of the following things in order to lose weight or keep from gaining weight during the past year?”: (1) fasted, (2) ate very little food, (3) used a food substitute (powder or a special drink), (4) skipped meals, and (5) smoked more cigarettes. UWCBs was coded as a dichotomous variable (presence of any behavior versus none), based on our previous research.42, Test-retest reliability was high for UWCBs (85%).
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| Adolescent physical activity |
Physical activity questions were adapted from the Godin Leisure-Time Exercise Questionnaire.43 EAT 2010 adolescents were asked: “In a usual week, how many hours do you spend doing the following activities: (1) strenuous exercise (e.g. biking fast, aerobics, jogging, basketball, swimming laps, soccer, rollerblading) (2) moderate exercise (e.g. walking quickly, easy bicycling, volleyball, skiing, dancing, skateboarding, snowboarding).” Response options ranged from “none” to “6+ hours a week”. (Test-retest r = 0.73). Items were summed together to assess average hours of moderate and vigorous physical activity per week.
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| Adolescent sedentary behavior |
Adolescents were asked, “In your free time on an average weekday (Monday-Friday), how many hours do you spend doing the following activities?…[hours = 0, ½, 1, 2, 3, 4, 5+].”15 The activities assessed included: Watching TV/DVDs/videos, Using a computer (not for homework), and Xbox/Play-Station/other electronic games that you play when sitting (Test-retest r = 0.84). This same question was asked for weekends (Test-retest r = 0.77). For each sedentary behavior an “hours per week” variable was created by multiplying the weekday hours per day by 5 and adding it to the weekend hours per day multiplied by 2. Students who reported 5+ hours of use were coded as having 6 hours. Total sedentary behavior per week was calculated as the sum of the three individual behaviors per week.
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| Adolescent Body Mass Index (BMI) percentile |
Height and weight measurements were taken at school by trained research staff in a private area with standardized equipment and procedures. Adolescents were asked to remove shoes and outerwear (e.g., heavy sweaters). BMI values were calculated according to the following formula: weight (kg)/height (meters)2 and converted to percentiles, standardized for sex and age based on CDC guidelines.44,45
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| Covariates: |
| Sociodemographic characteristics |
Adolescents’ and parents’ race/ethnicity, age, sex and parents’ educational attainment were assessed by self-report in adolescents and parents respectively.
Race/ethnicity was assessed with the item, ”Do you think of yourself as 1) white, 2) black or African-American, 3) Hispanic or Latino, 4) Asian-American, 5) Hawaiian or Pacific Islander, or 6) American Indian or Native American?,” and respondents were asked to check all that apply. Participants who checked “white” and another option were included in the “other” category. Those who checked two non-white options were categorized as “mixed/other race”. Additionally, those checking “Hawaiian/Pacific Islander” or “American Indian/Native American” were also categorized as “mixed/other race” due to their small numbers in this dataset. Highest level of parent educational attainment was used as a proxy for socio-economic status. This has been done in our prior papers using the F-EAT sample as well, based on previous research suggesting this is a good indicator of SES.46,47 Highest level of parent education attainment was assessed using the following question, “What is the highest level of education that you have completed?”. Response options included: less than high school, high school/GED, vocational/technical school, associate degree, bachelor degree, graduate or professional degree. Parent and adolescent age was calculated using self-reported birth date and survey completion date. Parent and adolescent sex was assessed with the item, “Are you…[male/female]?” Parent BMI was assessed using parent self-report of height and weight (Test-retest r =0.97a). BMI was calculated using the standard formula, weight (kg)/height (meters)2 and taking the average between both surveys filled out for siblings.
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