Do Community Schools Work for High-Needs Students? Evaluating Integrated Student Support Services and Outcomes for Equity

Education Sciences · 2025-08-12 · 2 citations

This study examines whether and how community schools’ integrated student support services (academic, socioemotional, health, and family support) contributed to improving whole-child/youth development and reducing systemic inequalities of students’ learning/wellness outcomes across New York State under the Every Student Succeeds Act (ESSA). Applying a quasi-experimental method with propensity score matching to the state’s 2018–2023 school survey and report card databases, it provides new evidence on the efficacy of community school programs on average and by subgroups (race/ethnicity, poverty, disability, English language learner, and housing status). The results of matched comparisons between community schools and non-community schools are mixed, after considering their differences in terms of student demographics and baseline conditions. Overall, community schools showed policy implementation fidelity with more state funding, policy-aligned practices, and school-based health centers/clinics. However, community schools had no discernable impacts on academic achievement and chronic absenteeism overall, except that the operation of school-based health centers was associated with a reduction in absenteeism. In contrast, community schools had more positive impacts on high school graduation rates, particularly among disadvantaged minority students; the impacts are attributable to policy-aligned practices, set-aside funding, and school-based health center dental programs. Educational policy and research implications are discussed.

Confronting Pediatric Weight‐Based Cybervictimization: Time for Action

Obesity Science & Practice · 2025-06-01

Weight-based victimization represents a critical challenge for youth, particularly those with obesity, and has been linked to a range of negative psychological, academic, and behavioral outcomes. While research has extensively examined in-person victimization, the rise of digital platforms has given way to weight-based cybervictimization, which remains understudied. This paper highlights the urgent need for research, prevention, and intervention strategies focused on weight-based cybervictimization, emphasizing its harmful effects and its overlap with traditional forms of victimization. It identifies gaps in the existing literature, particularly regarding the inconsistent use of assessment tools and terminology in research on weight-based victimization, and proposes the necessity for culturally relevant and validated measurement tools that accurately capture youth experiences. Finally, it aims to inform best practices for healthcare providers, educators, and parents by promoting strategies that effectively address and mitigate the impact of weight-based victimization among youth.

Pediatric Obesity Treatment Improves Young Adult Health

JAMA Pediatrics · 2025-01-21 · 3 citations

Fetal exposure to gestational diabetes severity and postnatal infant feeding in the first year of life associated with preadolescent obesity: a prospective cohort

Obesity · 2025-03-12 · 3 citations

OBJECTIVE: This study sought to evaluate the distinct impact of fetal exposure to gestational diabetes (GDM) severity, as well as the impact of infant breastfeeding (BF) and sugary beverage intake, on preadolescent overweight and obesity, accounting for other established risk factors. METHODS: This analysis included 850 mother-infant dyads exposed to GDM who reported monthly infant BF duration and intensity, as well as sugary beverage intake (sugar-sweetened beverages [SSB] and 100% fruit juice [FJ]) during the first year of life, BMI measured at ages 6 to 11 years, and GDM severity variables (i.e., diagnosis time, treatment, and glycemic control). Preadolescent weight and height from electronic health records classified the following BMI percentiles: normal weight, <85th percentile (referent); overweight (85th to <95th percentile); obesity (≥95th percentile); moderate obesity (100 to <120% of 95th percentile); and severe obesity (≥120% of 95th percentile). Log-binomial regression models estimated adjusted relative risk (aRR) and 95% CI of BMI categories associated with fetal exposure to GDM severity and infant diet (inadequate BF, <6 months or adequate BF, ≥6 months, combined with or without SSB/FJ intake). RESULTS: Among preadolescents, 17.6% had overweight, 18.2% had moderate obesity, and 7.6% had severe obesity. Compared with adequate BF with no SSB/FJ, aRR (95% CI) of developing obesity was 1.55 (95% CI: 1.05-2.30) for inadequate BF with SSB/FJ intake and 1.50 (95% CI: 1.01-2.21) for adequate BF with SSB/FJ intake, independent of GDM severity and covariates. The aRR (95% CI) of developing severe obesity was 3.80 (95% CI: 1.55-9.29) for inadequate BF with SSB/FJ intake versus adequate BF without SSB/FJ intake. CONCLUSIONS: BF adequacy and avoidance of sugary beverages in early life are modifiable lifestyle behaviors that may combat preadolescent obesity in infants exposed to GDM, suggesting potential longer-term benefits on child cardiometabolic health.

Using Metabolic Testing to Personalize Behavioral Obesity Treatment

Obesity Science & Practice · 2025-03-11 · 1 citations

Background: There are large individual differences in weight loss and maintenance. Metabolic testing can provide phenotypical information that can be used to personalize treatment so that people remain in negative energy balance during weight loss and remain in energy balance during maintenance. Behavioral testing can assess the reinforcing value and change in the temporal window related to the personalized diet and exercise program to motivate people to maintain engagement in healthier eating and activity programs. Objective: Provide an expository overview of how metabolic testing can be used to personalize weight control. Ideas about incorporating behavioral economic concepts are also included. Methods: A broad overview of how resting metabolic rate, thermic effect of food and respiratory quotient can be used to improve weight control. Also discussed are behavioral economic principles that can maximize adherence to diet and activity protocols. Results: Research suggests that measuring metabolic rate can be used to set calorie goals for weight loss and maintenance, thermic effect of food to increase energy expenditure, and respiratory quotient to guide macronutrient composition of the diet and maximize fat loss. Developing programs that foster a strong motivation to eat healthier and be active can maximize treatment success. Conclusion: Incorporating metabolic measures can personalize behavioral weight loss programs, and the use of behavioral economic principles can increase the probability of adherence and long-term success in weight control.

Eating in the absence of hunger is not associated with weight, self-reported eating behaviors, or well-being in pregnant adults: Prospective cohort study

PLoS ONE · 2025-06-24

OBJECTIVE: Eating in the absence of hunger (EAH) refers to consuming food after reaching satiation and is considered a risk factor for weight gain. This study examined relations of EAH with pregnancy-related weight outcomes, self-reported eating behaviors, and indicators of well-being. METHODS: EAH was measured in participants (n = 46) during their 2nd pregnancy trimester. Energy intake and percent of food consumed following a standardized meal was calculated for all foods, and separately for sweet (desserts) and savory (salty snacks) foods. Early pregnancy BMI, gestational weight gain, and postpartum weight change were calculated from measured height and weight from <12 weeks gestation to 1 year postpartum. Participants reported eating behaviors (Dutch Eating Behavior Questionnaire), depressive symptoms (Edinburgh Postnatal Depression Scale), stress (Perceived Stress Scale), and sleep quality (Pittsburgh Sleep Quality Index) < 28 weeks gestation. Linear and logistic regression models estimated relationships between the variables of interest. RESULTS: Primarily null estimates did not provide consistent evidence of associations of eating behaviors or indicators of well-being with EAH, or of EAH with pregnancy-related weight outcomes. CONCLUSIONS: EAH in pregnancy was not related to weight change, eating behaviors, depressive symptoms, sleep quality, or stress. Future studies in larger samples and diverse developmental periods are needed to determine the utility of laboratory-assessed EAH as a risk factor for weight gain. TRIAL REGISTRATION: ClinicalTrials.gov NCT02217462.

Midchildhood Obesity After Exposure to Gestational Diabetes Mellitus: The SWIFT Study in Youth

Diabetes Care · 2025-12-11

OBJECTIVE: To assess how treatment type, diagnosis timing, and meeting of glycemic targets in gestational diabetes mellitus (GDM) affect childhood obesity risk. RESEARCH DESIGN AND METHODS: This study included 809 mothers with GDM, treated with diet or glyburide, who enrolled at 6-9 weeks postdelivery in a prospective cohort (2008-2011) and their children who had a BMI measurement between ages 5 and 11 years, after exclusion of mothers with diabetes diagnosis postdelivery. Mothers' GDM diagnosis timing (early [<24 weeks gestation] vs. standard [≥24 weeks]), treatment type, and meeting of self-monitored glycemic targets, along with children's weight and height at ages 5-11 years, were obtained from Kaiser Permanente Northern California electronic health records. Log-binomial regression models estimated adjusted relative risks (aRRs) and 95% CIs of childhood obesity, adjusting for covariates including glycemic targets and maternal prepregnancy BMI. RESULTS: Participants were multiethnic (77% Asian, Black, or Hispanic), with a mean (SD) prepregnancy BMI of 29.4 (7.2) kg/m2. GDM was diagnosed early (<24 weeks) in 20%, glyburide treatment was provided to 27%, and glycemic targets were met by 70% of participants. Child BMI percentiles were obtained at a mean (SD) age of 9.5 (1.5) years (58% normal weight, 17% overweight, and 25% obesity). In a joint analysis of GDM treatment type and diagnosis timing, compared with standard diagnosis and dietary treatment (referent), the aRR (95% CI) of childhood obesity was 1.58 (1.19-2.12) with early diagnosis and glyburide treatment and 1.53 (1.15-2.04) with early diagnosis and dietary treatment. CONCLUSIONS: Children exposed to GDM diagnosed before the standard time frame of 24 weeks, regardless of treatment type, meeting of glycemic targets, or maternal prepregnancy BMI, are more likely to develop obesity up to 11 years later.

Eating in the absence of hunger is not associated with weight, self-reported eating behaviors, or well-being in pregnant adults: Prospective cohort study

UNC Libraries · 2025-07-03

OBJECTIVE: Eating in the absence of hunger (EAH) refers to consuming food after reaching satiation and is considered a risk factor for weight gain. This study examined relations of EAH with pregnancy-related weight outcomes, self-reported eating behaviors, and indicators of well-being. METHODS: EAH was measured in participants (n&thinsp;=&thinsp;46) during their 2nd pregnancy trimester. Energy intake and percent of food consumed following a standardized meal was calculated for all foods, and separately for sweet (desserts) and savory (salty snacks) foods. Early pregnancy BMI, gestational weight gain, and postpartum weight change were calculated from measured height and weight from &lt;12 weeks gestation to 1 year postpartum. Participants reported eating behaviors (Dutch Eating Behavior Questionnaire), depressive symptoms (Edinburgh Postnatal Depression Scale), stress (Perceived Stress Scale), and sleep quality (Pittsburgh Sleep Quality Index) &lt; 28 weeks gestation. Linear and logistic regression models estimated relationships between the variables of interest. RESULTS: Primarily null estimates did not provide consistent evidence of associations of eating behaviors or indicators of well-being with EAH, or of EAH with pregnancy-related weight outcomes. CONCLUSIONS: EAH in pregnancy was not related to weight change, eating behaviors, depressive symptoms, sleep quality, or stress. Future studies in larger samples and diverse developmental periods are needed to determine the utility of laboratory-assessed EAH as a risk factor for weight gain. TRIAL REGISTRATION: ClinicalTrials.gov NCT02217462.

Mid-Childhood Obesity Following Exposure to Gestational Diabetes: The SWIFT Study in Youth

2025-12-11

&lt;p dir="ltr"&gt;Objective &lt;/p&gt;&lt;p dir="ltr"&gt;Assess how gestational diabetes mellitus (GDM) treatment type, diagnosis timing, and meeting glycemic targets affect childhood obesity risk.&lt;/p&gt;&lt;p dir="ltr"&gt;Research Design and Methods&lt;/p&gt;&lt;p dir="ltr"&gt;This study included 809 mothers with GDM, treated by diet or glyburide, who enrolled at 6-9 weeks post-delivery in a prospective cohort (2008-2011), and their children who had a BMI measurement between ages 5 and 11 years, after exclusion of mothers with diabetes diagnosis post-delivery. GDM diagnosis timing, early (&lt;24wks gestation) vs. standard (≥24wks), treatment type, self-monitored glycemia meeting targets, weight and height at ages 5-11 years were obtained from Kaiser Permanente Northern California electronic health records. Log-binomial regression models estimated relative risks (aRR) and (95%CI) of child obesity adjusting for covariates, including glycemic targets and maternal pre-pregnancy BMI.&lt;/p&gt;&lt;p dir="ltr"&gt;Results&lt;/p&gt;&lt;p dir="ltr"&gt;Participants were multiethnic (77% Asian, Black or Hispanic), mean(SD) pre-pregnancy BMI 29.4(7.2) kg/m2, GDM diagnosed early (&lt;24 wks) in 20%, glyburide treatment provided to 27%, and glycemic targets met by 70% of participants. Child BMI percentiles were obtained at mean age(SD) 9.5(1.5) years: 58% normal weight, 17% overweight and 25% obese. In a joint analysis of GDM treatment type and diagnosis timing, compared to standard diagnosis and diet treatment (referent), aRR(95%CI) of child obesity with early diagnosis and glyburide treatment was 1.58(1.19-2.12) and early diagnosis and diet treatment was 1.53(1.15-2.04). &lt;/p&gt;&lt;p dir="ltr"&gt;Conclusions&lt;/p&gt;&lt;p dir="ltr"&gt;Children exposed to GDM diagnosed prior to the standard timeframe of 24 weeks, regardless of treatment type, meeting glycemic targets, or maternal pre-pregnancy BMI, are more likely to develop obesity up to 11 years later. &lt;/p&gt;&lt;p&gt;&lt;br&gt;&lt;/p&gt;&lt;p&gt;&lt;br&gt;&lt;/p&gt;

Restricting Advertisements for High-Fat, High-Sugar Foods during Children's Television Programs: Attitudes in a US Population-Based Sample

UNC Libraries · 2025-11-11

BACKGROUND: Children in the United States (US) are frequently exposed to advertisements for high-fat, high-sugar (HFHS) foods, which is linked to greater demand for and consumption of those foods. Restricting advertisements for HFHS foods may be a viable obesity prevention strategy-however, public support for policy change is unclear. METHODS: A secondary analysis of the 2012 Annenberg National Health Communication Survey was conducted. Respondents (N&thinsp;=&thinsp;1838) were 53.2% female, mean age 50.0&thinsp;&plusmn;&thinsp;16.5 years. Race/ethnic composition was 76.8% white, 7.4% black, 9.2% Hispanic, and 6.6% other. The percentage of respondents supporting and opposing the regulation was calculated and logistic regression models identified predictors of support. Potential predictors included sociodemographic variables, attitudes towards other health regulations (e.g., smoking bans in public places), and various health behaviors (e.g., fruit and vegetable intake). RESULTS: A total of 56.3% of respondents supported or strongly supported advertisement restrictions, while only 8.2% strongly opposed. Approximately 20% had no opinion. Greatest support was found among respondents who supported smoking bans in public settings (OR&thinsp;=&thinsp;4.3), who supported banning trans fats in restaurants (OR&thinsp;=&thinsp;1.7), and who were older (OR&thinsp;=&thinsp;1.7). CONCLUSION: The US adult population appears to have an appetite for restricting HFHS advertising to children, with more than half the populace supporting such a policy in 2012. This may be an opportune time to implement and rigorously evaluate such childhood obesity prevention strategies.