title: Maternal perception of neighborhood safety as a predictor of child weight status: The moderating effect of gender and assessment of potential mediators.
abstract: OBJECTIVE
  To determine if there is a relationship between maternal perception of neighborhood safety in 3(rd) grade and weight status in 5(th) grade children, to test if gender moderates this relationship, and to identify potential mediators.
  
  
  METHODS
  Data from 868 children and their mothers involved in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD-SECCYD) were used to examine the relationship between maternal perception of neighborhood safety in the 3(rd) grade and child body mass index (BMI) z-score in the 5(th) grade. Multiple regression models tested this relationship, the effect of gender, and potential mediating variables (time outdoors in neighborhood, television viewing, child behavior problems and puberty status).
  
  
  RESULTS
  Neighborhood safety ratings in the least safe tertile, compared with the safest tertile, were associated with an increased risk of obesity independent of gender, race and income-to-needs ratio (OR=1.59; 95% confidence interval [CI]: 1.03, 2.46), and higher child BMI z-scores among girls, but not boys, compared with the safest tertile (beta=0.33; 95% CI: 0.09, 0.57). Neither amount of time spent outdoors in the neighborhood, television viewing, child behavior problems (internalizing or externalizing), nor puberty status altered the relationship.
  
  
  CONCLUSIONS
  Maternal perception of the neighborhood as unsafe in 3(rd) grade independently predicted a higher risk of obesity, and a higher BMI z-score among girls, but not boys, in the 5(th) grade. The relationship was not explained by several potential mediators. Further investigation is needed to explore these gender differences and potential mediators.
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Bacha
authors.forename: Danielle
authors.initials: D
authors.lastname: Appugliese
authors.forename: Sharon
authors.initials: S
authors.lastname: Coleman
authors.forename: Niko
authors.initials: N
authors.lastname: Kaciroti
authors.forename: Robert H
authors.initials: RH
authors.lastname: Bradley
authors.forename: Robert F
authors.initials: RF
authors.lastname: Corwyn
authors.forename: Julie C
authors.initials: JC
authors.lastname: Lumeng
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D016009:Chi-Square Distribution; D002648:Child; D002652:Child Behavior; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008425:Maternal Behavior; D009035:Mothers / Q000523:psychology*; D009765:Obesity / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D016017:Odds Ratio; D010465:Perception; D011627:Puberty / Q000523:psychology; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D057185:Sedentary Behavior; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013690:Television; D014481:United States