Shift-and-persist: A protective factor for elevated BMI among low-socioeconomic-status children

Authors


  • Funding agencies: Funding for this study came from the Patrick and Catherine Weldon Donaghue Medical Research Foundation; The Kresge Foundation, Emerging and Promising Practices; and an R01 from the National Institute for Child and Human Development (1R01 HD070740).

  • Disclosure: The authors declared no conflict of interest.

Correspondence: Stacey Kallem (Stacey.Kallem@yale.edu)

Abstract

Objective

Low socioeconomic status (SES) is associated with many adverse health outcomes, including childhood overweight and obesity. However, little is understood about why some children defy this trend by maintaining a healthy weight despite living in obesogenic environments. The objective of this study is to test the hypothesis that the psychological strategy of “shift-and-persist” protects low-SES children from overweight and obesity. Shift-and-persist involves dealing with stressors by reframing them more positively while at the same time persisting in optimistic thoughts about the future.

Design and Methods

Middle school children (N = 1,523, ages 9-15) enrolled in a school-based obesity prevention trial completed health surveys and physical assessments. Multiple linear regression analysis was used to examine the role of SES, shift-and-persist strategies, and their interaction on BMI z-scores, while controlling for student race/ethnicity, gender, and reported diet and physical activity.

Results

Among children reporting engaging in less frequent shift-and-persist strategies, lower SES was associated with significantly higher BMI z-scores (P < 0.05). However, among children reporting engaging in more frequent shift-and-persist strategies, there was no association of SES with BMI z-score (P = 0.16), suggesting that shift-and-persist strategies may be protective against the association between SES and BMI.

Conclusions

Interventions aimed at improving psychological resilience among children of low SES may provide a complementary approach to prevent childhood overweight and obesity among at-risk populations.

Ancillary