A Multi-Level Intervention to Promote Healthy Beverage Intake through Childcare

通过儿童保育促进健康饮料摄入的多层次干预

基本信息

批准号：
10305536
负责人：
Anisha Indravadan Patel
金额：
$ 68.37万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-24 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10305536
关键词：
5 year old Adult Affect Age Beverages Body mass index California Calories Caregivers Child Cluster randomized trial Consumption Counseling Development Early Intervention Education Energy Intake Environment Family Food Future Goals Health Height Home Hour Intake Intervention Juice Latino Liquid substance Low income Magic Measurement Measures Mediating Mediator of activation protein Metabolic Modeling Motivation Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Overweight Parents Pilot Projects Policies Prevention Prevention strategy Provider Public Health Randomized Controlled Trials Research Risk Science Self Administration Self Efficacy Source Surveys Treatment Efficacy Water consumption Weight aged base behavior change cardiometabolism comorbidity dietary early childhood efficacy outcomes efficacy testing expectation food environment improved intervention effect non-alcoholic fatty liver disease nutrition obesity in children obesity prevention post intervention prevent primary outcome secondary outcome social social cognitive theory sugar sweetened beverage wasting

项目摘要

PROJECT SUMMARY There is little debate that sugar-sweetened beverages (SSBs; drinks with added sugar) lack nutrition, are a major source of added sugar and calories, and promote obesity and poor cardiometabolic health, especially when consumed during early childhood. Nearly half of children aged 2-5 drink SSBs on a daily basis, with heavier consumption in low-income Latino children. After decades of research, it is clear that there is no single “magic bullet” for solving obesity. What we need are bundled interventions that combine incremental changes that transform food environments with targeted behavior changes that steer people towards those healthy options. Childcare centers, which serve 12.5 million children per year, provide an efficient way to intervene early by engaging childcare providers and parents to make resonant, mutually reinforcing changes in both the home and childcare environment. Interventions that promote water consumption in place of SSBs have shown promise for preventing childhood obesity in schoolchildren. Yet, no studies have examined whether interventions to promote intake of water instead of SSBs in childcare could prevent childhood obesity at an even earlier stage of development. The proposed cluster-randomized controlled trial will test the efficacy of an intervention called Healthy Drinks, Healthy Futures (Bebidas Saludables, Futuros Saludables) that is culturally adapted for Latino children and families. Following the Social-Ecological Model and Social Learning Theory, the intervention supports complementary changes in the childcare and home food environments that promote water consumption while reducing SSB availability. This is combined with education for childcare providers and children, and a one-on-one brief motivational counseling intervention with parents to reduce SSB intake and encourage water consumption in the home. Fourteen childcare centers serving low-income, predominately Latino children (n=420) will participate in this trial. The primary outcome is child BMI z-score (BMI standard deviation score). Key secondary outcomes are intake of water and beverage calories at centers and at home. Outcomes will be captured using anthropometrics (weight, height), plate waste measurements (water and caloric intake at centers), and Automated Self-Administered 24-hour dietary recalls (water and caloric intake at home) at baseline, 6, and 12 months post-intervention. Surveys of childcare providers and parents will allow us to explore possible mediators of the intervention effect. We hypothesize that the childcare-based healthy beverage intervention will increase intake of water and reduce beverage calories consumed at both childcare and at home. BMI z-score will also improve among children in intervention centers vs. control centers. If shown to be effective, the Healthy Drinks, Healthy Futures intervention will offer a strategy for intervening early to prevent obesity for millions of low-income children attending childcare centers. Findings from this study will contribute to the science of multilevel obesity prevention, and inform the implementation of state, federal, and local policies to promote healthy beverage intake in childcare centers.

项目摘要几乎没有争论说糖甜的卧室（SSB；添加糖的饮料）缺乏营养，是一个添加糖和卡路里的主要来源，促进肥胖症和心脏代谢健康不良，尤其是童年时期食用时。每天有近一半的2-5岁饮料SSB的儿童，低收入拉丁裔儿童的较重的消费。经过数十年的研究，很明显没有单一用于解决对象的“魔术子弹”。我们需要的是结合增量变化的捆绑干预措施这种行为改变了食物环境选项。每年为1,250万儿童提供服务的育儿中心，提供了一种干预的有效方法通过让育儿提供者和父母与共同的共鸣，相互加强的变化，以提前家庭和育儿环境。促进水消耗代替SSB的干预措施已显示预防学童中儿童肥胖的承诺。但是，尚无研究检查是否促进摄入水而不是在育儿中的SSB的干预措施可以防止儿童肥胖甚至更早的发展阶段。拟议的集群随机对照试验将测试干预措施称为健康饮料，健康期货（Bebidas saludables，Futuros Saludables）适用于拉丁裔儿童和家庭。遵循社会生态模型和社会学习理论，干预支持促进托儿和家庭食品环境的完全改变水消耗同时降低SSB的可用性。这与托儿服务提供者的教育相结合儿童，以及与父母进行一对一的简短动机咨询干预，以减少SSB的摄入量和鼓励家中的水量消耗。 14个育儿中心，主要服务于低收入，主要是拉丁裔儿童（n = 420）将参加这项试验。主要结果是儿童BMI Z分数（BMI标准偏差得分）。关键的次要结果是在中心和家里摄入水和卧室卡路里。结果将使用拟人测量学（重量，身高），板块垃圾测量（水和板块）捕获中心的热量摄入量），以及自动化自我管理的24小时饮食召回（水和热量摄入量干预后6个和12个月的基线时）。育儿提供者和父母的调查将允许我们探索干预效果的可能调解人。我们假设基于育儿的健康饮料干预将增加水的摄入量并减少两种托儿的床位卡路里在家里。 BMI Z分数也将在干预中心与控制中心的儿童中有所改善。如果显示为了有效，健康的饮料，健康的期货干预将为早期干预提供策略预防数以百万计的低收入儿童参加育儿中心的肥胖。这项研究的发现将为预防多层次肥胖的科学做出贡献，并告知州，联邦和促进育儿中心健康床位摄入量的当地政策。