Autism Spectrum Disorder Diagnosis and Other Child, Family, and Community Risk Factors for Obesity among Children and Adolescents Aged 10–17 Years in the United States: A Mediation Analysis
- 1 January 2023
- journal article
- research article
- Published by Mary Ann Liebert Inc in Childhood Obesity
- Vol. 19 (1), 57-67
- https://doi.org/10.1089/chi.2021.0260
Abstract
Background: This study explored whether there are mediated effects of child and family risk in the association between community and organizational risk and obesity among children and adolescents aged 10–17 years using 2017–2018 National Survey of Children's Health (NSCH) data, addressing autism spectrum disorder (ASD) and co-occurring conditions. Methods: This cross-sectional study (N = 27,157) used 2017–2018 NSCH data. Frequency distributions and chi-square tests were used to describe participants with and without ASD. Cumulative risk indices were created for child, family, community, and organizational level risk, and mediation analyses were conducted in a two-mediator model (X1: community risk, X2: organizational risk, M1: child risk, M2: family risk) for the dichotomous outcome (Y: obesity). Path analyses were performed using generalized structural equation modeling in Stata 16.0. Results: Direct effects for all four risk indices were associated with obesity in single index models (all p < 0.001); only child and family risk indices were associated with obesity in a full model with all four risk indices (both p < 0.001). When child and family risk indices were assessed as mediators, the indirect effects of community and organizational risk were significant (all p < 0.0001). The total effect of community risk on obesity was significant with family risk as a mediator (p = 0.002). The total effect of organizational risk was not significant with either mediator. Conclusion: Findings suggest that child and family factors play a strong role in obesity risk and that ASD contributes to this risk. Community risk may be another strong predictor of obesity, mediated by family risk. Additional research on social-ecological risk factors for obesity is needed to identify leverage points to improve obesity risk in children and adolescents with and without ASD.Keywords
This publication has 33 references indexed in Scilit:
- Smart food policies for obesity preventionThe Lancet, 2015
- The relative contribution of layers of the Social Ecological Model to childhood obesityPublic Health Nutrition, 2014
- Profile and predictors of service needs for families of children with autism spectrum disordersAutism, 2014
- A closer examination of the relationship between children's weight status and the food and physical activity environmentPreventive Medicine, 2013
- Parent perceptions of autism severity: Exploring the social ecological contextDisability and Health Journal, 2012
- The ‘Fractionable Autism Triad’: A Review of Evidence from Behavioural, Genetic, Cognitive and Neural ResearchNeuropsychology Review, 2008
- The Medical HomePEDIATRICS, 2002
- The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology, 1986
- The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology, 1986
- Toward an experimental ecology of human development.American Psychologist, 1977