Intervention to promote physical activation and improve sleep and feeding practices in infants for preventing obesity early in life (The Baby-Act Trial)

促进身体激活、改善婴儿睡眠和喂养习惯的干预措施，以预防生命早期肥胖（婴儿法案试验）

• 批准号: 10203764
• 负责人: CRISTINA PALACIOS
• 金额: $ 34.91万
• 依托单位: UNIVERSITY OF PUERTO RICO MED SCIENCES
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-01 至 2022-09-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10203764
• 关键词: 5 year old; Address; Adherence; Adopted; Adult; Affect; Age; Age-Months; Area; Behavior; Birth; Blood specimen; Breast Feeding; Caregivers; Child; Child Rearing; Childhood; Clinic; Clinical effectiveness; Communities; Conceptions; Cues; Data; Diabetes Mellitus; Diet; Dietary Practices; Disease; Education; Educational Curriculum; Educational Materials; Family; Fibrinogen; Food; Fostering; Future; Goals; Growth; Guidelines; Health; Helping Behavior; Hispanics; Hour; Hypertension; Infant; Intake; Intervention; Juice; Knowledge; Life; Manuscripts; Measures; Modification; Monitor; Mothers; Multimedia; Nutritional; Obesity; Outcome; Overweight; Participant; Physical activity; Policies; Population; Pregnancy Trimesters; Pregnant Women; Puerto Rico; Questionnaires; Randomized; Randomized Controlled Trials; Records; Reporting; Research; Risk; Risk Factors; Satiation; Site; Sleep; Solid; Special Supplemental Nutrition Program for Women, Infants, and Children; Stress; System; Technology; Telephone; Testing; Third Pregnancy Trimester; Translating; Weight; Weight Gain; Woman; arm; base; cohort; community intervention; cost; cost effective; critical period; empowerment; feeding; follow-up; health disparity; improved; infancy; infant adiposity; intervention cost; lifestyle intervention; minority health; multi-component intervention; novel; nutrition; obesity development; obesity prevention; obesity risk; overweight child; physical inactivity; prevent; programs; rapid infant weight gain; rapid weight gain; skills; successful intervention; theories; treatment arm; treatment as usual; trend; tv watching; usual care arm; web platform

Project Summary Infant obesity is increasing in the U.S., particularly among Hispanics. Rapid weight gain during critical periods of infancy increases the risk of obesity in childhood, continuing into adulthood and increasing the risk of chromic diseases such as diabetes and hypertension. This serious health threat could be prevented through multifaceted interventions during infancy that address multiple risk factors associated with early obesity development. Current evidence suggests that trials should focus particularly on risk factors related to physical activity, sleep, nutrition, satiety, stress and increasing parenting skills, and should be delivered at multiple levels, using population-level programs to be translatable, cost-effective and sustainable. To this end, interventions carried out within the federal WIC program provide a potentially powerful way of fostering early healthy behaviors and helping in preventing obesity. Successful interventions done as part of the WIC program could be translated into their policies, since each state develops its own educational materials and determines how nutritional education is implemented. Our goal is to test the clinical effectiveness of a multi-faceted and multi-leveled intervention focusing on three main areas: physical activity (i.e., infant activation, sleep and screen time), nutrition and growth monitoring, framed in the Health Self-Empowerment Theory, and delivered through the WIC Program using a multi-media approach. The physical activity and growth-monitoring components are new to the WIC curriculum, while the nutrition component is based on WIC guidelines but delivered differently (through self- empowerment-based messages and multi-media based). For this, we will conduct a cluster-randomized controlled trial among pregnant women participants of the Puerto Rico WIC (PR-WIC) program. An equal number of clinics will be randomized to the control (usual care) arm or to the WIC+ (usual care + intervention) arm in the San Juan area. The lifestyle intervention will focus on age-appropriate infant physical activation, healthy sleep and limiting screen time, healthy dietary patterns and growth monitoring. The content will be delivered with a multi-media approach (web-platform, mobile messages and phone follow-up). Participation in the intervention will begin in the last trimester of pregnancy and continue until the infant is 12 months old. We have already pilot-tested the information of this intervention among 10 mother-infant dyads during their first year of life, with excellent acceptability. We will determine the extent to which the intervention may impact adequate weight gain, infant activity and nutrition from birth to 12 months of age compared to the control arm. We will also evaluate the cost of this intervention as a modification of the current WIC curriculum. Such approach has not been tested before among infants. If successful, this intervention could be adopted as a policy-supported best practice by the PR-WIC program to help prevent infant obesity. This will help improve minority health and eliminate health disparities among Hispanics and other at-risk groups.

项目概要 在美国，婴儿肥胖症正在增加，尤其是西班牙裔婴儿。关键时期体重快速增加 婴儿期会增加儿童期肥胖的风险，并持续到成年期并增加慢性病的风险 糖尿病和高血压等疾病。这种严重的健康威胁可以通过多方面来预防 婴儿期的干预措施可解决与早期肥胖发展相关的多种危险因素。当前的 有证据表明，试验应特别关注与体力活动、睡眠、营养、 饱腹感、压力和提高育儿技能，应利用人口水平在多个层面上提供 计划具有可转化性、成本效益和可持续性。为此，在内部开展的干预措施 联邦 WIC 计划提供了一种潜在的强有力的方式来培养早期健康行为并帮助 预防肥胖。作为 WIC 计划一部分的成功干预措施可以转化为 政策，因为每个州都制定自己的教育材料并确定营养教育的方式 实施的。我们的目标是检验多方位、多层次干预的临床效果 重点关注三个主要领域：身体活动（即婴儿活动、睡眠和屏幕时间）、营养和 成长监测，以健康自我赋权理论为框架，并通过 WIC 计划提供 使用多媒体方法。身体活动和生长监测组件对于 WIC 来说是新的 课程，而营养部分则基于 WIC 指南，但以不同的方式提供（通过自我学习） 基于授权的消息和基于多媒体的）。为此，我们将进行整群随机 在波多黎各 WIC (PR-WIC) 计划的孕妇参与者中进行的对照试验。一个平等的 诊所数量将被随机分配到对照（常规护理）组或 WIC+（常规护理 + 干预）组 手臂在圣胡安地区。生活方式干预将侧重于适合年龄的婴儿身体激活， 健康的睡眠和限制屏幕时间、健康的饮食模式和生长监测。内容将是 通过多媒体方式（网络平台、移动消息和电话跟进）进行交付。参与 干预将从怀孕的最后三个月开始，一直持续到婴儿 12 个月大。我们 已经在 10 名母婴二人第一年对这一干预措施的信息进行了试点测试 的生活，具有极好的接受度。我们将确定干预措施可能影响充分的程度 与对照组相比，从出生到 12 个月大的体重增加、婴儿活动和营养。我们还将 评估作为当前 WIC 课程修改的干预措施的成本。这种做法并没有 之前在婴儿中进行过测试。如果成功，这种干预措施可以作为政策支持的最佳措施 PR-WIC 计划的实践有助于预防婴儿肥胖。这将有助于改善少数族裔的健康状况 消除西班牙裔和其他高危群体之间的健康差距。