title: Association between the Family Nutrition and Physical Activity Screening Tool and obesity severity in youth referred to weight management.
abstract: The Family Nutrition and Physical Activity Screening Tool (FNPA) evaluates family behavioural and environmental factors associated with pediatric obesity, but it is unknown if FNPA scores differ among youth across obesity severities. Our aim was to determine the association between the FNPA and obesity severity in youth referred to weight management.
  
  
  
  Upon initiating treatment, height, weight, and the FNPA were collected according to standard procedures. Cut-points for overweight/obesity, severe obesity (SO) class 2, and SO class 3 were calculated. FNPA scores were compared across weight status groups using analysis of covariance, and odds of SO across FNPA quartiles were evaluated with multiple logistic regression.
  
  
  
  Participants included 564 5-18year old who initiated treatment and completed the FNPA. After adjustment, FNPA scores differed by weight status with higher/healthier scores in youth with overweight/obesity (56.6±8.5) when compared to those with SO class 2 (55.0±7.1; p=0.015) or SO class 3 (53.6±9.0; p<0.001). Compared to those in the highest FNPA quartile, youth in the 2nd quartile had 1.8 (95% CI: 1.1, 2.9) times higher odds of SO, and those in the lowest FNPA quartile had 2.1 (95% CI: 1.3, 3.4) times higher odds of SO. Youth with SO had unhealthier subscale scores among 6 of 10 constructs, including nutritional, physical activity, sedentary, and sleep behaviours.
  
  
  
  Results suggest a consistent inverse relationship between the FNPA and adiposity among youth presenting for weight management. The FNPA is a useful metric for programs and clinicians targeting family behaviours and the home environment to combat obesity.
authors.affiliation: Helen DeVos Children's Hospital, Healthy Weight Center | MC 232, 330 Barclay Ave. NE, Suite 303, Grand Rapids, MI 49503, United States; Michigan State University, 220 Trowbridge Rd., East Lansing, MI 48824, United States. Electronic address: jared.tucker@helendevoschildrens.org.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Tucker
authors.affiliation: Michigan State University, 220 Trowbridge Rd., East Lansing, MI 48824, United States; Health Net of West Michigan, 620 Century Ave. SW #210, Grand Rapids, MI 49503, United States. Electronic address: kathleenhoward@comcast.net.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Howard
authors.affiliation: University of Wyoming, Division of Kinesiology and Health, Corbett Building 115, Dept. 3196, 1000 E. University Ave., Laramie, WY 82071, United States. Electronic address: eguseman@uwyo.edu.
authors.forename: Emily H
authors.initials: EH
authors.lastname: Guseman
authors.affiliation: Grand Valley State University, Department of Movement Science, 4400-A Kindschi Hall of Science, Allendale, MI 49401, United States. Electronic address: yeekimbo@gmail.com.
authors.forename: Kimbo E
authors.initials: KE
authors.lastname: Yee
authors.affiliation: Health Net of West Michigan, 620 Century Ave. SW #210, Grand Rapids, MI 49503, United States. Electronic address: hsaturley@healthnetwm.org.
authors.forename: Heather
authors.initials: H
authors.lastname: Saturley
authors.affiliation: Michigan State University, 220 Trowbridge Rd., East Lansing, MI 48824, United States. Electronic address: Joey.Eisenmann@radiology.msu.edu.
authors.forename: Joey C
authors.initials: JC
authors.lastname: Eisenmann
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015444:Exercise / Q000502:physiology*; D005190:Family; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009752:Nutritional Status; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012017:Referral and Consultation; D012720:Severity of Illness Index; D061217:Weight Reduction Programs
keywords: Family; Health behaviour; Home environment; Pediatric obesity; Sleep