Differences in the association of social support for healthy eating and for physical activity with adolescent obesity by school-level socioeconomic status in central Texas middle schools
Understanding the growing body of evidence of social support with obesity-related behaviors, this study examined if the associations of parent, peer and teacher social support for healthy eating (HE) and for physical activity (PA) with obesity among adolescents differed across low (LSLS), medium (MSLS), and high (HSLS) school-level SES. This study is based on a secondary analysis of cross-sectional baseline data collected in 2009 from the Central Texas CATCH Middle School Study, a coordinated school health study that collected height and weight and questionnaire data about PA, HE, and social support from 2,826 8 th grade students attending 30 public middle schools in five central Texas urban school districts. Pearson chi-square and one-way ANOVA were conducted to assess statistical differences of covariates (gender, race/ethnicity, individual-level SES, and BMI) with school-level SES. Adjusting for covariates, multiple linear regressions and multiple logistic regressions were conducted to analyze the association of school-level SES with social support and social support with obesity across school-level SES respectively. Strong trends persisted among all social support measures by school-level SES. A positive trend existed with higher levels of support reported at higher levels of school SES for parental support for HE [HSLS: 2.71 (2.63, 2.79), LSLS: 2.46 (2.38, 2.55)] and PA [HSLS: 2.37 (2.29, 2.45), LSLS: 2.00 (1.93, 2.08)] and peer support for PA [HSLS: 2.01 (1.91, 2.11), LSLS: 1.85 (1.75, 1.95)]. An opposite trend existed for teacher social support for healthy eating [HSLS: 0.94 (0.84, 1.03), LSLS: 1.42 (1.32, 1.52)] and PA [HSLS: 1.32 (1.22, 1.42), LSLS: 1.54 (1.44, 1.65)] and peer support for HE [HSLS: 1.00 (0.91, 1.10), LSLS: 1.14 (1.05, 1.24)]. In addition, the association between obesity with PA social support from all sources tended to decrease as levels of school SES increased with significant findings for support from parents at LSLS [1.17 (1.003, 1.36), p=0.045], peers at MSLS [0.85 (0.74, 0.98), p=0.03], and teachers at LSLS [0.85 (0.74, 0.97), p=0.02] and HSLS [0.80 (0.66, 0.96, p=0.02]. Future research must focus on increasing parental and peer social support at LSLS schools and understanding the role of the school’s social environment on obesity and obesity-related behaviors.
Tung, Melissa Yu-Ling, "Differences in the association of social support for healthy eating and for physical activity with adolescent obesity by school-level socioeconomic status in central Texas middle schools" (2015). Texas Medical Center Dissertations (via ProQuest). AAI1597551.