| Popis: |
Background: Chaos has implications for child health that may extend to childhood obesity. Yet, results from studies describing associations between chaos and childhood obesity are mixed. Challenges to studying chaos-obesity relationships may include inconsistencies in how chaos is operationalized and reliance on caregiver perceptions. Furthermore, multiple pathways may link chaos to obesity, though few have been empirically examined.Methods: We conducted a concurrent mixed methods analysis of quantitative and qualitative data describing home and neighborhood chaos among a diverse cohort of 283 caregiver-toddlers dyads from Ohio. We examined the underlying structure of environmental and household chaos using exploratory factor analysis then sought to validate the structure using qualitative field notes. We generated total scores for factors of chaos and described their distributions overall and according to cohort characteristics. Additionally, we conducted a thematic content analysis of brief ethnographies to identify potential pathways linking chaos to childhood obesity with the intention to direct future research efforts.Results: Dyads varied according to household composition, income, education, and race/ethnicity. We found evidence for a multi-factor structure for chaos, which included disorganization and neighborhood noise. Household disorganization scores ranged from 8-18 and were on average 11.37 (SD = 2.58). Neighborhood noise scores ranged from 4-12 and were on average 6.93 (SD = 1.89). Both disorganization and neighborhood noise were associated with indicators of socioeconomic disadvantage, such as food insecurity and lower income-to-poverty ratio, though only disorganization was associated with additional social factors within homes, such as caregiver mental health and overall health. Finally, we identified unique themes from brief ethnographies which future contextualize the social and material environments in which chaos was observed, including child behavior and caregiver-child interactions.Conclusions: Chaos is a complex construct composed of multiple factors and the mechanisms linking chaos to childhood obesity may be equally complex. Future studies of chaos-obesity relationships may require greater specificity when operationalizing chaos and empirical study of pathways, like child behavior and caregiver-child interactions, may inform future obesity prevention strategies. |
