Alison Mellin's research while affiliated with University of Minnesota Duluth and other places

To examine associations between family meal frequency and developmental assets and high-risk behaviors among a national sample of adolescents. Anonymous surveys were distributed to 99,462 sixth to 12th grade students from public and alternative schools in 213 cities and 25 states across the United States. Logistic regression analyses tested differences in assets and high-risk behaviors by family dinner frequency. Consistent positive associations were found between the frequency of family dinners and all developmental assets, including both external (e.g., support, boundaries and expectations; odds ratio [OR] 2.1-3.7) and internal assets (e.g., commitment to learning, positive values, social competencies, and positive identity; OR 1.8-2.6); relationships were attenuated, but remained significant after adjusting for demographics and general family communication and support. Consistent inverse relationships were found between the frequency of family dinners and all high-risk behaviors measured (i.e., substance use, sexual activity, depression/suicide, antisocial behaviors, violence, school problems, binge eating/purging, and excessive weight loss; OR .36-.58), relationships were attenuated, but remained significant after adjusting for demographics and family factors. The findings of the present study suggest that the frequency of family dinner is an external developmental asset or protective factor that may curtail high-risk behaviors among youth. Creative and realistic strategies for enhancing and supporting family meals, given the context within which different families live, should be explored to promote healthy adolescent development. Family rituals such as regular mealtimes may ease the stress of daily living in the fast-paced families of today's society.

To explore familial eating patterns and weight-related concerns among families of adolescent girls with type 1 diabetes mellitus (DM) and to examine associations with disordered eating behaviors among the girls. Interviews were conducted with 30 adolescent girls (ages 13-20 years), who had DM for at least 1 year, and separately with their parents. Eighty-four percent of the girls were Caucasian, 13% were African-American, and 3% were Hispanic. The sample included 15 girls who reported (on a questionnaire) engaging in disordered eating behaviors (DE) and a matched comparison group of girls who reported no disordered eating (Non-DE). The semi-structured interview questions focused on adolescent and parent perceptions of the impact of DM on family roles, relationships, and routines, as well as who does what in managing the DM. A content analysis of the interviews identified themes regarding family meal patterns and weight-related issues. Although variation was found, more than one-half (57%) of the families were classified as having a high level of meal structure (e.g., frequent family meals). Families with DE girls were more likely to be classified as having a low level of meal structure (e.g., infrequent family meals) than families with Non-DE girls. Weight concerns were common; nearly half (48%) of all families were classified as having a high level of weight-related concerns (e.g., at least one member having a high desire to lose weight). The prevalence of families with a parent engaging in behaviors to lose weight and/or making negative comments about eating or weight was higher in families of DE girls than Non-DE girls. The combination of low family meal structure and high familial weight concerns was much more prevalent in families with DE girls (58%) than in families of non-DE girls (7%). Interactions around food and weight appear common in many families of adolescent girls with DM. Whereas frequent family meals may help to defend against disordered eating in youth with DM, family weight concerns and behaviors appear to be risk factors for disordered eating.

This study explored opinions, concerns, and recommendations regarding care of Type 1 diabetes in schools. Thirty adolescent females and their parents participated in semi- structured, individual interviews that were audiotaped, transcribed, coded, and qualitatively analyzed. Responses emerged in three categories: knowledge/training of school staff; foods offered/available at school; and school rules. Participants expressed concerns that school personnel, particularly classroom teachers, possess limited knowledge of diabetes; that healthy food/beverage options are limited in the cafeteria, vending machines, and classrooms; and that school rules impede self-care of diabetes. Implications for enhancing diabetes management at school are noted.

To explore parents' perceptions of the impact of type 1 diabetes mellitus (DM) on the family and to better understand parent-child conflict, parental worries, and coping strategies related to the management of DM in adolescence. Semistructured interviews were conducted with the parents of 30 adolescent girls who had DM for at least 1 year. Using standard procedures for content analysis, themes were identified from the parents' discussions. Although parents reported worries, conflicts, and negative impacts of the DM on their family, they also recognized positive aspects of the DM (e.g., it promotes adolescent responsibility) and had strategies to cope with its challenges (e.g., letting go of perfectionism in disease management, keeping a positive attitude). Findings from this study can be used by clinicians to assess parents' concerns about DM and to help them discover ways to cope with their worries and stay involved with the disease's management. Considering the parents' perspective will likely lead to parents feeling understood by the health care team and will help to reduce their worries.

Quantitative and qualitative methods were used to investigate interdisciplinary practices of 116 early intervention faculty. Results indicated that faculty engaged in a small amount of interdisciplinary teaching in their preservice programs. No significant differences were found in the amount of interdisciplinary teaching that faculty from four different discipline groups provided. Quantitative results indicated work environment variables were the strongest predictors of level of interdisciplinary collaboration. A content analysis revealed the most frequently reported hindrance to interdisciplinary collaboration was the work environment and the most frequently reported facilitator was the extent to which faculty value interdisciplinary collaboration. Findings suggest that policy supporting interdisciplinary service delivery has outstripped the field's capacity to prepare personnel using interdisciplinary practices.

This study describes body image and weight concern attitudes of pre-adolescent African-American (AA) girls and their parent/caregivers. Cross-sectional survey data were collected from 189 low-income 8- to 10-year-old AA girls and 179 parents/caregivers of AA girls from 2 urban areas, Memphis and Minneapolis/St. Paul. Results demonstrated that most AA girls were either happy with their weight, or did not think about it at all. However, 20% of girls would like to be larger than their current size, and 50% would like to be smaller. Girls in Minneapolis/St. Paul were more likely than Memphis girls to report weight dissatisfaction. One third of parents reported concerns that their daughters were too heavy. Seventy-two percent of parents reported that they were trying to lose weight. Discussions include possible regional differences in weight concern among AA girls, and implications for obesity prevention programs.

To compare overweight and non-overweight youth on a selection of self-reported eating, physical activity, dieting, educational, and emotional variables and identify familial factors that serve as protective forces against unhealthy behaviors and psychosocial difficulties among overweight adolescents. Data were taken from a 1996 cross-sectional school-based survey of 9957 adolescents in grades 7, 9, and 11. Based on self-reported heights and weights, respondents were categorized as "overweight" (body mass index) > or =85th percentile or "non-overweight." Student's t-tests were used to compare the non-overweight and overweight sample on the self-reported health-related behaviors and psychosocial variables. Logistic and linear regressions were used to identify familial factors associated with a reduced risk of engaging in unhealthy behaviors and experiencing psychosocial distress. Overweight adolescents reported engaging in significantly more unhealthy behaviors and experiencing more psychosocial distress than their non-overweight peers. Among the overweight youth, higher levels of reported family connectedness and parental expectations and moderate levels of parental monitoring were associated with the lowest levels of unhealthy behaviors and psychosocial distress. Satisfying and developmentally appropriate parent-adolescent relationships are associated with reduced behavioral and psychosocial risk factors associated with overweight during adolescence.

This study examines the prevalence of specific weight control practices/disordered eating behaviors and associations with sociodemographic characteristics, BMI and weight perceptions, family functioning, and metabolic control among adolescent females and males with type 1 diabetes. The study population included 70 adolescent females and 73 adolescent males with type 1 diabetes who completed the AHEAD (Assessing Health and Eating among Adolescents with Diabetes) survey. Data on BMI and glycosylated hemoglobin (HbA(1c)) were drawn from medical records. Unhealthy weight control practices were reported by 37.9% of the females and by 15.9% of the males. Among the females, 10.3% reported skipping insulin and 7.4% reported taking less insulin to control their weight. Only one male reported doing either of these behaviors. Weight control/disordered eating behaviors were not associated with age, parental level of education, family structure, or race/ethnicity. Higher levels of weight dissatisfaction tended to be associated with unhealthy weight control/disordered eating; associations with BMI were inconsistent. Family cohesion was negatively associated with disordered eating among females (r = -0.52; P < 0.001) and males (r = -0.41; P < 0.001), but correlations with other measures of family environment (control, independence, and responsibility for diabetes management) were not significant. Correlations between disordered eating and HbA(1c) levels were significant among females (r = 0.33; P < 0.01) and males (r = 0.26; P < 0.05). Special attention is needed for youth with weight concerns and those from less cohesive families to assist in the development of healthy diabetes management behaviors.