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

• 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
• 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

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 在那里我很少有争论说糖粉饮料（SSB；添加糖的饮料）缺乏营养，是一种 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 在童年时期食用近一半的2-5岁儿童 几十年来，低收入拉丁裔儿童的消费量较重。 解决肥胖的“魔术子弹”。 通过有针对性的行为改变食物环境，使人们转向健康的人 选择的育儿中心。 早期，通过让育儿提供者和父母与两者进行共鸣，相互加强变化。 促进SSB的家庭和育儿环境 预防童年时期的学童的承诺。 在育儿中促进水而不是SSB的干预措施可以观察到 甚至早期的发展阶段。 干预量为健康的饮料，健康的期货（Bebidas Saludables，Futuros Saludables） 适用于拉丁裔儿童和家庭。 干预支持育儿和家庭食品环境的辅助性变化，以促进 消耗的同时减少SSB的可用性。 儿童，以及与Parents的单一简短动机咨询干预，以减少SSB摄入量和 鼓励家庭消耗的14个育儿中心 拉丁裔儿童（n = 420）将参加此试验。 偏差得分）。 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 在基线，6个月和12个月后的育儿提供者和父母的调查 为了探索国际效应的可能调解人。 饮料摄入水中的摄入量并减少饮料卡路里卡路里卡路里卡路里caloth育儿 在家中，在家中，BMI Z得分也将在间隔中心与控制中心的情况下改善 为了有效，健康的饮料，健康的未来意图的意图将提供干预，将为Arly提供 预防数百万低收入儿童参加育儿中心的肥胖症。 为预防多层次肥胖的科学做出贡献，并实施 促进育儿中心健康摄入量的当地政策。