Priya Fielding-Singh’s research while affiliated with University of Utah and other places

Objective The objective of this study was to identify pretreatment predictors of weight loss in a 12‐month behavioral obesity treatment that restricted either fat or carbohydrates. Methods Participants were 436 adults with overweight or obesity from the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) trial. Signal detection analysis was used to identify which combinations of 51 pretreatment demographic, clinical, behavioral, and psychosocial variables, along with diet type (healthy low‐fat vs. healthy low‐carbohydrate), formed subgroups that varied in proportion of those achieving at least 5% weight loss at 12 months. Results Overall, 51% of participants achieved at least 5% weight loss at 12 months, with eight subgroups identified through signal detection. Diet type was not a key factor. Among racial and ethnic minority participants, the best predictors of weight loss were lower levels of emotional eating, less friend discouragement, and presence of metabolic syndrome. Among non‐Hispanic White participants, the best predictors were high confidence in participating fully in the intervention, more family encouragement, and lower outcome expectations. Conclusions We found that psychosocial and clinical factors, along with race and ethnicity, successfully differentiated subgroups that varied in their 12‐month weight loss. Given the heterogeneity in response to behavioral obesity treatment, these results can help generate hypotheses to move intervention science toward a precision medicine approach by matching individuals to their most suitable obesity treatments.

Introduction The purpose of this descriptive study was to explore the relationship between the experience of institutional betrayal (IB) during childbirth and postpartum mental health. Methods Women who had given birth within the last 3 years in the United States as of June 2021 were recruited via Qualtrics to complete an online survey. Participants (N = 588) answered questions about their birth experiences, including adverse medical events and experiences of IB. Multiple logistic regressions examined whether experiencing one or more types of IB was associated with receiving a diagnosis of a postpartum mental health condition, controlling for other theoretically relevant covariates. Results More than one‐third (39%) of respondents experienced one or more types of IB during childbirth, with a mean (SD) of 1.7 (0.47) and maximum of 2. Experiencing IB increased the odds of a postpartum mental health condition diagnosis by 2.86 (95% CI, 1.63‐5.05; P < .001). Discussion The findings suggest that experiencing IB may be one mechanism driving negative postpartum mental health outcomes. Health care providers and policymakers should be aware of the role that IB can play in women's birth experiences and consider how strategies to decrease instances of IB during childbirth may improve postpartum mental health.

Weight change trajectory from diet and lifestyle interventions typically involves rapid weight loss followed by a weight plateau after approximately 6 months. Changing from one weight-loss diet to another at the time of the plateau could instigate renewed weight loss. Therefore, our secondary analysis aimed to assess trajectory of weight loss in a 12-month, randomized, cross-over study. Forty-two adults were randomized to eat a healthy low-fat or healthy low-carbohydrate diet for 6 months then switched to the opposite diet for an additional 6 months. Regardless of diet assignment, participants experienced rapid initial weight loss, which slowed between 3 to 6 months. After switching diets at 6 months, weight modestly decreased until 9 months, but at a rate slower than the initial 3 months and slower than the rate from 3 to 6 months. This suggests that the weight loss plateau typically seen at 6 months is physiological and cannot be overcome by simply switching to a different weight-loss diet.

Background Eating a high-quality diet or adhering to a given dietary strategy may influence weight loss. However, these 2 factors have not been examined concurrently for those following macronutrient-limiting diets. Objective To determine whether improvement in dietary quality, change in dietary macronutrient composition, or the combination of these factors is associated with differential weight loss when following a healthy low-carbohydrate (HLC) or healthy low-fat (HLF) diet. Design Generally healthy adults were randomly assigned to HLC or HLF diets for 12 mo (n = 609) as part of a randomized controlled weight loss study. Participants with complete 24-h dietary recall data at baseline and 12-mo were included in this secondary analysis (total N = 448; N = 224 HLC, N = 224 HLF). Participants were divided into 4 subgroups according to 12-mo change in HEI-2010 score [above median = high quality (HQ) and below median = low quality (LQ)] and 12-mo change in macronutrient intake [below median = high adherence (HA) and above median = low adherence (LA) for net carbohydrate (g) or fat (g) for HLC and HLF, respectively]. Baseline to 12-mo changes in mean BMI were compared for those in HQ/HA, HQ/LA, LQ/HA subgroups with the LQ/LA subgroup within HLC and HLF. Results For HLC, changes (95 % confidence level [CI]) in mean BMI were -1.15 kg/m² (-2.04, -0.26) for HQ/HA, -0.30 (-1.22, 0.61) for HQ/LA, and -0.80 (-1.74, 0.14) for LQ/HA compared with the LQ/LA subgroup. For HLF, changes (95% CI) in mean BMI were -1.11kg/m² (-2.10, -0.11) for HQ/HA, -0.26 (-1.26, 0.75) for HQ/LA, and -0.66 (-1.74, 0.41) for LQ/HA compared with the LQ/LA subgroup. Conclusion Within both HLC and HLF diet arms, 12-mo decrease in BMI was significantly greater in HQ/HA subgroups relative to LQ/LA subgroups. Neither HQ nor HA alone were significantly different than LQ/LA subgroups. Results of this analysis support the combination of dietary adherence and high-quality diets for weight loss. Clinical Trial Registry clinicaltrials.gov (Identifier: NCT01826591).

Background Traumatic childbirth experiences are common in the United States – affecting a third to a fourth of mothers – with significant negative impacts on maternal health. Yet most research on traumatic childbirth focuses on white mothers’ experiences. Drawing on a racially and ethnically diverse sample of mothers who experienced traumatic childbirth, this exploratory qualitative study examined Black, Latina, and Asian mothers' traumatic birth experiences and the role of obstetric racism in shaping these experiences. Methods In‐depth, semi‐structured interviews were conducted in 2019–2020 with 30 mothers who identified as women of color (37% Black, 40% Latina, and 23% Asian) who gave birth in the US and self‐identified as having experienced a traumatic childbirth. Data were analyzed using qualitative content analysis. Results Mothers reported obstetric racism as core to their traumatic birth experiences. This racism manifested through practitioners' use of gendered and racialized stereotypes, denying and delegitimizing mothers' needs. Mothers shared key consequences of the obstetric racism they experienced, including postpartum anxiety and depression, increased medical mistrust, and decreased desire for future children. Conclusions Mothers' reports suggest that obstetric racism played a role in their traumatic birth experiences. Particularly, practitioners' deployment of gendered and racialized stereotypes influenced mothers' treatment during birth. These findings point to opportunities to address obstetric racism during childbirth and improve patients' experiences through enhancing their agency and empowerment. The findings, in addition, highlight the need for increased practitioner training in anti‐racist practice and cultural humility.

Objective This study examined how lower‐income mothers engage in emotion work in order to feel like good mothers within broader contexts of stigmatization, economic insecurity, and precarity. Background Despite the pervasiveness of the intensive mothering ideology, research shows that lower‐income mothers in the United States also routinely diverge from the ideology's norms due to structural and cultural factors. In doing so, these mothers simultaneously work to reframe and negotiate what it means to be a good mother. While scholarship reveals how mothers cognitively and behaviorally carry out this work, less attention has been paid to how mothers perform this work on an emotional level. Method Drawing on in‐depth interviews with 33 lower‐income mothers in the San Francisco Bay Area, this study investigated, through the lens of maternal foodwork, how mothers work on their emotions to feel like good mothers. Data were analyzed abductively. Results Mothers worked on their emotions as part of an effort to negotiate what good mothering looks like and to feel like good mothers as they performed maternal foodwork. To do so, mothers engaged in the gendered and classed emotion work strategy of downscaling. Downscaling involved working to inhibit negative emotions and evoke positive ones. Downscaling was facilitated by three key approaches: reflecting on harder times, redefining good foodwork, and leveraging social comparison. Conclusion Downscaling serves as a rational, effective emotion work strategy to help mothers navigate ongoing hardships, cultivate a positive maternal identity, and feel like good mothers within contexts of stigmatization, economic insecurity, and precarity.

Widespread inequities in diet and nutrition present a pressing public health problem. Sociologists working to illuminate the causes and contours of these inequities often center the role of family foodwork, or the multifaceted domestic labor that supports eating, including planning and preparing meals. Mounting sociological scholarship on foodwork considers how food's meanings are socially patterned to reflect broader social structures, ideologies and institutions that influence their manifestation and families' resources to enact them. Here, we present three core contributions from the sociology of foodwork that can advance essential transdisciplinary conversations around nutrition disparities as well as efforts to tackle these disparities. We lay out how (1) family foodwork is historically rooted in broader structures of capitalist exploitation and women's subordination, and today remains gendered through normative discourses equating “good” feeding with “good” mothering; (2) the moralization of foodwork is buttressed by an ideological context idealizing homecooked meals and lamenting foodwork's decline, and; (3) foodwork—and societal evaluations of it—are shaped and stratified by intersecting gendered, classed, and racial inequalities. After reviewing each contribution and its importance for addressing nutrition inequities, we conclude by advocating for a closer conversation across disciplines and highlighting important future directions for sociologists.