Nutritional Health Attitudes and Behaviors and Their Associations with the Risk of Overweight/Obesity among Michigan Migrant and Seasonal Head Start Staff
Authors: Song SuJin , Nieves Violeta , Song Won O 
Published: November 2023

Little is known about non‐family child care providers’ nutritional health attitudes and behaviors associated with their own weight status, despite their important roles in the nutritional health status of children as role models, educators, program deliverers, and information mediators. The aim of this study was to investigate specific patterns of nutritional health attitudes and behaviors and their associations with the prevalence of overweight/obesity among Michigan Migrant and Seasonal Head Start (MMSHS) staff. A total of 307 staff members aged ≥ 18 years working in 17 MMSHS centers were included in the 2013 nutritional needs assessment. An online survey questionnaire was used to collect data on sociodemographics, actual and perceived weight status, nutrition knowledge, food availability and food security status, and nutritional health attitudes and behaviors of staff. Actual weight status was categorized into normal weight (18.5 ≤ BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2), and obesity (BMI ≥ 30 kg/m2) based on the definition of the CDC. Factor analysis was performed to investigate specific patterns of nutritional health attitudes and behaviors among MMSHS staff. Multivariate logistic regression was conducted to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of overweight/obesity across tertiles of pattern scores taking the lowest tertile group as the reference group after adjustment for potential confounding variables. Three patterns of nutritional health attitudes and behaviors were identified among MMSHS staff: 1) weight loss practices with weight dissatisfaction, 2) healthy eating behaviors, and 3) accurate awareness of nutrition in health. These patterns were associated with sociodemographics, weight perception, nutrition knowledge, food availability, or food security status. After adjusting for potential confounding variables, the scores of pattern 1, which was characterized by weight loss practices with weight dissatisfaction, were positively associated with the prevalence of overweight/obesity (Tertile 2 vs. Tertile 1: OR = 5.81, 95% CI = 2.81–12.05; Tertile 3 vs. Tertile 1: OR = 14.89, 95% CI = 6.18–35.92). The OR for overweight/obesity in individuals with the highest scores of healthy eating behaviors (Pattern 2) was 0.37 (95% CI = 0.19–0.75) compared with those with the lowest scores as the reference group. However, one's accurate awareness of nutrition in health (Pattern 3) was not associated with overweight/obesity status. Nutritional health attitudes and behaviors of MMSHS staff were associated with their weight status. Our findings support that additional nutrition education or health interventions targeting MMSHS staff are urgently necessary. Ultimately, these efforts might be an efficient and effective non‐invasive approach for improving the nutritional health status of young children enrolled in MMSHS programs.Support or Funding InformationThis study was supported by Michigan Telamon Corporation, MSU Extension, Julian Samora Research Institute, and CAMP at MSU.