Eleanor Mackey - Academia.edu (original) (raw)

Papers by Eleanor Mackey

Nutrients

Produce prescription programs aim to improve food insecurity (FI) and nutrition but their effecti... more Produce prescription programs aim to improve food insecurity (FI) and nutrition but their effectiveness is unclear. We conducted a pilot study to demonstrate the feasibility and explore the potential impact of a family-based, home-delivery produce prescription and nutrition education program. We measured enrollment, satisfaction, participation, and retention as measure of feasibility. Adult participants answered pre-post self-report questionnaires assessing FI, child and adult fruit and vegetable intake, and culinary literacy and self-efficacy. To understand participants’ lived experiences, qualitative interviews were conducted at the 6-month time point. Twenty-five families were enrolled. Feasibility measures indicate participants were generally satisfied with the program but there were important barriers to participation. Qualitative data revealed themes around reduced food hardship, healthy eating, budget flexibility, and family bonding. Fruit and vegetable consumption increased ...

Pediatric Rheumatology, 2021

Children, 2021

Background: Bariatric surgery is the most effective current treatment option for patients with se... more Background: Bariatric surgery is the most effective current treatment option for patients with severe obesity. More children and adolescents are having surgery, many whose parents have also had surgery. The current study examines whether parental surgery status moderates the association between perceived social support, emotional eating, food addiction and weight loss following surgery, with those whose parents have had surgery evidencing a stronger relationship between the psychosocial factors and weight loss as compared to their peers. Methods: Participants were 228 children and adolescents undergoing sleeve gastrectomy between 2014 and 2019 at one institution. Children and adolescents completed self-report measures of perceived family social support, emotional eating, and food addiction at their pre-surgical psychological evaluation. Change in body mass index (BMI) from pre-surgery to 3, 6, and 12 months post-surgery was assessed at follow-up clinic visits. Parents reported their...

Obesity, 2021

Neurocognitive differences in pediatric obesity may be underpinned by cortical structural alterat... more Neurocognitive differences in pediatric obesity may be underpinned by cortical structural alterations. Differences in cortical thickness associated with severe obesity were examined, and preliminary evidence was sought for changes following vertical sleeve gastrectomy (VSG).

Journal of the American Academy of Child & Adolescent Psychiatry, 2021

Diabetes, 2020

Parents of T1D preschoolers must balance nutrition, insulin needs, and eating behaviors of this a... more Parents of T1D preschoolers must balance nutrition, insulin needs, and eating behaviors of this age group. The present study examined the relationship between parent feeding practices, child mealtime behavior, and glycemic control in T1D preschoolers. 36 parent-child dyads (2-5 y, T1D≥1 y) were part of a baseline assessment for a RCT (M child age=4.7 y; M A1c=8.3; M parent age=36.3 y). Parent feeding practices and child mealtime behaviors were measured using the Structure and Control in Parent Feeding Questionnaire (SCPF Table 1) and the Behavioral Pediatrics Feeding Assessment Scale (BPFAS Table 1). Glycemic control measured with CGM. Descriptive statistics for glycemic control, parent and child behaviors are in Table 1. Greater frequency of problematic child behavior at mealtime was associated with greater reports of control-based feeding practices (restriction and pressure to eat; r=.44, p<.01) and greater problematic feeding practices as a whole (r=.37, p<.05). There was a...

Journal of Pediatric Psychology, 2020

Objective Management of type 1 diabetes (T1D) may be difficult for adolescents, who often fail to... more Objective Management of type 1 diabetes (T1D) may be difficult for adolescents, who often fail to meet glycemic targets. Adolescents are also at an increased risk for negative affect (i.e., anxiety, depressive symptoms) and are prone to disordered eating behaviors (DEB). This study hypothesized that negative affect would be associated with DEB, self-management, and glycemic control, but that this would be moderated by negative urgency (the urge to engage in impulsive behaviors in response to negative affect), such that this relationship would be significant only for those with higher negative urgency. Methods The Eating in Adolescents with T1D Study recruited 100 caregiver-adolescent dyads (55% male youth, 48% Caucasian) to complete questionnaires reporting on the adolescent’s negative affect, negative urgency, DEB, and diabetes management. Glycemic control 3–4 months following survey completion was extracted from the medical record. Results A total of 61% of adolescents reported el...

Developmental Cognitive Neuroscience, 2019

Biological Psychiatry, 2019

Clinical Practice in Pediatric Psychology, 2018

The Society of Pediatric Psychology (SPP) outlines the need to devise strategies to develop and r... more The Society of Pediatric Psychology (SPP) outlines the need to devise strategies to develop and retain the future generation of pediatric psychologists within its strategic objectives. The primary aim of the study was to evaluate the use and perceived value of the training initiatives offered by SPP and to examine differences based on trainee demographics (e.g., gender, race/ethnicity, type of training program). The training initiatives fall into 4 categories: leadership, networking, awards/funding, and publications/newsletters. A brief questionnaire assessing use and perceived value of training initiatives, as well as number of presentations and outcomes, was sent via e-mail to the SPP division listservs. One-hundred and 34 trainees completed the questionnaire. Descriptive statistics, Pearson correlations, and multiple regressions were used to examine the associations between demographic variables, use and perceived value, and outcomes (e.g., publications and presentations). Within this sample, initiatives were well known and utilized. With few exceptions, training initiatives were rated as having moderate to high perceived value. There were significant associations between the number of initiatives which respondents had utilized and indicators of career success, including authored publications, F(7, 102) = 5.45, p < .001 and conference presentations, F(7, 99) = 9.47, p < .001. SPP training initiatives have a high perceived value, and use of initiatives is associated with indicators of career success. Results highlight the importance of continually assessing the initiatives for perceived benefit and value in order to optimize resource allocation, increase visibility of initiatives, and meeting the training needs of a diverse body of pediatric psychology trainees.

Journal of pediatric psychology, 2018

Quality of life (QoL) is an important outcome to evaluate in adolescents with severe obesity, yet... more Quality of life (QoL) is an important outcome to evaluate in adolescents with severe obesity, yet intrapersonal predictors of QoL are understudied. The current study assessed whether difficulty with impulse control when experiencing a negative mood (negative urgency) is associated with poorer QoL, mediated by more emotional eating and food addiction. Participants consisted of 69 primarily female (71%), minority (76%) adolescents aged 13-21 (M age = 16.5, SD = 1.5) with severe obesity presenting for prebariatric surgery psychological evaluations. Structural Equation Modeling was used to appraise a model of the association of adolescent report of negative urgency with more emotional eating (Emotional Eating Scale for Children) and food addiction (Yale Food Addiction Scale) and poorer weight-related QoL (Impact of Weight on Quality of Life-Kids). Greater difficulty controlling behavior when experiencing a negative mood was significantly associated with poorer weight-related QoL, and th...

Childhood obesity (Print), 2018

Executive and motivational dysfunction have been associated with pediatric obesity. Poor sleep qu... more Executive and motivational dysfunction have been associated with pediatric obesity. Poor sleep quality and psychopathology, often comorbid with obesity, are also associated with executive and motivational dysfunction. We examined the contribution of these comorbid factors to the association between obesity and executive function and reward-related decision-making. Seven- to 18-year-old children with and without obesity performed a working memory task with low and high loads, a response inhibition task, and a probabilistic reward-related decision-making task. Parents filled out standardized measures of executive function in everyday behavior, sleep health, and psychiatric symptoms. Analyses controlled for age, gender, IQ, and parental education. Children with obesity showed worse working memory performance under higher load (p = 0.007), and worse parent-reported behavioral regulation (p = 0.05) and metacognition (p = 0.04) in everyday behavior and their reward-related decision-making...

Pediatrics, 2018

Severe obesity is associated with higher risk of psychiatric difficulties. Bariatric surgery is t... more Severe obesity is associated with higher risk of psychiatric difficulties. Bariatric surgery is the most effective treatment of severe obesity. Few guidelines exist regarding the association of psychiatric diagnoses in adolescents and outcomes after surgery because of the lack of longitudinal research. Our objective is to evaluate the rates of psychiatric diagnoses in adolescents undergoing surgery compared with those not receiving surgery and the association of preoperative psychiatric diagnoses with postsurgical weight loss outcomes. Adolescents ( = 222) referred for psychological evaluation at one institution for bariatric surgery (2009-2017) completed semistructured clinical interviews to assess the presence and number of psychiatric diagnoses. Comparison analyses were conducted between those who did not end up receiving surgery ( = 53) and those who did ( = 169). Using longitudinal modeling, we assessed the association of preoperative diagnoses with weight loss outcomes between...

Journal of clinical psychology in medical settings, Jan 12, 2018

Young children with T1D frequently display challenging eating behaviors interfering with diabetes... more Young children with T1D frequently display challenging eating behaviors interfering with diabetes management. The current study explored the feasibility and acceptability of a behavioral parent feeding training session with young children with type 1 diabetes. As part of a larger intervention pilot focused on healthy eating and physical activity, 9 young children (M = 4.22) with type 1 diabetes (T1D) and their mothers participated in a novel/non-preferred food training session. Parents were taught strategies and then were given an opportunity to use the strategies with their child. The paradigm was video recorded and content was coded for parent and child behavior. Feasibility was high, and all parents rated the feeding session as acceptable. All parents demonstrated using at least one behavioral feeding skill (M = 3.38, SD = 1.60). All 9 (100%) children touched at least one of their non-preferred foods (M = 2.05, SD = 0.75), and 5 (56%) ate at least one novel/non-preferred food (M ...

Journal of diabetes research, 2018

To characterize the intake of macronutrient and fiber in adolescents with type 1 diabetes (T1D) a... more To characterize the intake of macronutrient and fiber in adolescents with type 1 diabetes (T1D) and examine their association with health indicators. Baseline data from an RCT were examined. Adolescent-parent dyads ( = 257, mean age 12 ± 1.2 years, 49.4% girls) reported dietary intake via two separate 24-hour recall interviews during a two-week period. Demographic and medical variables were abstracted from questionnaires and medical charts. Controlling for demographic and diet variables, a higher percentage of daily energy intake from fats was associated with poorer HbA1c. In contrast, an association between higher percent of energy intake from proteins and carbohydrates was found with higher systolic and diastolic BP, respectively. Many early adolescents with T1D did not meet diabetes nutritional guidelines. Lower adherence to nutritional guidelines, specifically more than recommended energy intake from fats, was associated with poorer HbA1c. Addressing nutritional guidelines and i...

Clinical practice in pediatric psychology, 2018

Nutrition is a critical component of diabetes and other chronic diseases for young children. Howe... more Nutrition is a critical component of diabetes and other chronic diseases for young children. However, nutritional intake is burdensome to measure accurately and easily, making it difficult to evaluate in research or clinical contexts. This pilot study examined the feasibility and acceptability of having parents of young children with T1D use the Remote Food Photography Method (RFPM) to measure breakfast nutrition. Participants were 9 mothers of children ages 2-5 years (M=4.2), with a T1D duration of at least 1 year (M=2.4 years at diagnosis), representing diverse backgrounds (55.6% Caucasian; 44.4% African American; 55.6% married). During baseline and follow-up of a healthy eating and physical activity intervention for children with T1D, parents used the RFPM to capture before and after images of their children's breakfast. Feasibility and acceptability were assessed by adherence to taking photos, percent of usable photos, and participant satisfaction. The RFPM was feasible acro...

Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners, Jan 25, 2018

This study reports the feasibility and acceptability of a healthy eating and physical-activity-fo... more This study reports the feasibility and acceptability of a healthy eating and physical-activity-focused behavioral intervention for parents of young children with type 1 diabetes (T1D). Ten parents of young children (age 2-5 years) with T1D enrolled. The intervention included six behavioral sessions (five by telephone), diabetes nursing consultation, parent coach contact, text messages, and a study website. Analyses explored feasibility, acceptability, and preliminary findings. There was evidence of high acceptability (mean parent satisfaction = 1.11, very satisfied). Although most participants completed all of the assessments, there were some barriers to data collection devices. The number of participants within the American Diabetes Association recommended glycemic range doubled; there was no significant change in hemoglobin A1c, diet, or physical activity. There was evidence of feasibility and acceptability and initial evidence of change in hypothesized directions. Minor changes w...

Obesity (Silver Spring, Md.), Nov 1, 2017

Neurocognitive deficits in pediatric obesity relate to poor developmental outcomes. We sought pre... more Neurocognitive deficits in pediatric obesity relate to poor developmental outcomes. We sought preliminary evidence for changes in brain and cognitive functioning relevant to obesogenic behavior following vertical sleeve gastrectomy (VSG) in adolescents relative to wait-listed (WL) and healthy controls (HC). Thirty-six adolescents underwent fMRI twice 4 months apart, during executive, reward, and episodic memory encoding, in addition to behavioral testing for reward-related decision making. VSG adolescents lost weight, while WL gained weight and HC did not change between time points. Gains in executive and reward-related performance were larger in VSG than control groups. Group × Time interaction (P < 0.05 corrected) in left prefrontal cortex during N-back showed greater presurgical activation and postsurgical reduction comparable to HC levels but increased in WL between time points. Similarly, left striatal parametric response to reward value reduced after surgery to HC levels; W...