Nutrition Knowledge‐Attitude‐Behavior Is Inversely Associated with the Risk of Obesity Among Staff Working in Michigan Migrant and Seasonal Head Start Centers
Authors: Song SuJin , Farabi Nabila , Hill Kaitlyn Moorhead , Knox Amanda R. , Lim Yuen Mei , Galdamez Imelda , Aguilar‐Corrales Andrea , Song Won O. 
Published: November 2023

Children enrolled in Migrant and Seasonal Head Start (MSHS) programs have a higher prevalence of overweight and obesity (OW/OB) than their counterparts. Caregivers of MSHS children, such as parents and staff working in MSHS centers also have high rates of OW/OB. However, little is known about nutrition Knowledge‐Attitude‐Behavior (KAB) and its association with OW/OB among their caregivers, including parents and staff. The aim of this study was to examine nutrition KAB and its association with OW/OB among caregivers of children enrolled in Michigan MSHS programs. In order to assess nutrition KAB and identify needs and barriers to nutrition education, we collected quantitative and qualitative data from caregivers of MSHS children at 17 Michigan MSHS centers in summer, 2016. The quantitative data used in this study were collected from 134 parents who had children enrolled in Michigan MSHS programs and 269 staff currently working in Michigan MSHS centers using a survey questionnaire, which included information on sociodemographic, lifestyle, and nutrition KAB. The nutrition KAB score of each participant was calculated using 20 questions and then individual nutrition KAB scores were categorized into tertiles. The OW (25≤ BMI <30 kg/m2) and OB (BMI ≥30 kg/m2) were defined based on caregivers' self‐reported height and weight. Multivariate logistic regression was conducted to estimate the odds ratios (ORs) and 95 % confidence intervals (CIs) of OW/OB across the tertiles of nutrition KAB scores taking the lowest tertile as the reference group after adjustment for potential confounding variables. Both parents and staff showed a high prevalence of OW/OB, 74.6% and 79.2%, respectively. Parents had significantly lower socioeconomic status and nutrition KAB scores than staff. The mean nutrition KAB score in parents and staff were 13.1 and 14.7 out of 20.0, respectively (p<0.05). Parents with higher nutrition KAB score were more likely to have higher education level, less people in household, less eating out, and higher vigorous physical activity level than those with lower scores. Among staff, higher nutrition KAB scores were associated with older age and higher income. After controlling of covariates, staff who had higher nutrition KAB scores showed lower OR (0.37, 95% CI: 0.15–0.90) of OB compared to those with lower scores, whereas nutrition KAB scores in parents were not associated with the risk of OW/OB. Nutrition KAB is related to the risk of OB among staff working in MSHS centers, but not among parents. Our findings suggest that nutrition education programs targeting MSHS staff are needed to improve their own weight status, and possibly children's nutritional health, as MSHS children spend long hours at MSHS centers. Future studies are needed to identify risk factors of OW/OB among MSHS children and their parents and provide effective nutrition intervention for MSHS families' health and well‐being.Support or Funding InformationThis study was supported by Michigan Telamon Corporation, Michigan State University Extension, and Michigan State University College Assistance Migrant Program.