Preventing Obesity through Intervention during Infancy

通过婴儿期干预预防肥胖

基本信息

批准号：
10400350
负责人：
Ian M Paul
金额：
$ 11.65万
依托单位：
PENNSYLVANIA STATE UNIV HERSHEY MED CTR
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：
2021-08-01 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10400350
关键词：
1 year old 2 year old 3 year old 5 year old 6 year old 9 year old Address Adolescent Advisory Committees Age Appetite Regulation Area Behavior Behavior Therapy Behavioral Birth Birth Order Body mass index Child Child Behavior Child Rearing Clinic Visits Collection Cues Data Data Collection Data Set Development Diet Distress Early intervention trials Eating Behavior Educational Curriculum Enrollment Environment Epidemic Evaluation Exhibits Genetic Grant Growth Home Home visitation Hunger Infant Informal Social Control Intervention Length Life Link Long-Term Effects Measurement Metabolic Mothers Obesity Outcome Overweight Parent-Child Relations Parents Participant Pattern Physical activity Play Prevalence Prevention Prevention approach Prevention strategy Prevention trial Preventive service Primary Prevention Punishment Randomized Controlled Trials Recommendation Research Rewards Risk Safety Satiation School-Age Population Schools Secure Siblings Sleep Testing Time Time trend United States Visit Weight base cognitive development cohort comorbidity critical developmental period developmental plasticity dietary early childhood elementary school emotion regulation experience feeding group intervention improved infancy intervention effect microbiome components middle childhood multilevel analysis nursing intervention obesity in children obesity prevention obesity risk obesogenic overweight child prevent preventive intervention primary outcome prospective rapid infant weight gain rapid weight gain recruit response sedentary lifestyle success therapy design virtual

项目摘要

PROJECT SUMMARY/ABSTRACT This competitive renewal application seeks to continue the longitudinal evaluation of children participating in the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study, an ongoing, prospective, randomized, controlled trial testing a responsive parenting (RP) intervention designed for the primary prevention of obesity versus a home safety control. In the US, 23% of 2-5 year olds are already overweight and 9% are already obese. By ages 6-11 years, 34% of US children are overweight and 17% are obese, highlighting the need for early life preventive interventions with sustained effects. With virtually no effective prevention approaches to date, we began INSIGHT by recruiting a birth cohort of 279 infants and parents who received four home visits during the first year after birth followed by annual clinic visits through age 3 years. The INSIGHT curriculum includes RP messages through age 2 years about infant feeding, sleep, interactive play, emotion regulation, and normal growth patterns; these areas were selected based on evidence linking them to obesity risk and their potential to be modified. Thus far, results from INSIGHT have been very positive: RP infants had lower mean weight-for-length at 1 year than controls and were less likely to be overweight at age 1 year (p<.05 for both). At age 3 years our primary outcome, body mass index (BMI) z- score, was significantly lower in the RP group than control (-0.13 vs. +0.15; p=.04). A multilevel model fit for the entire intervention period with a cubic time trend confirmed a main effect for intervention group (p=.0003). These results make INSIGHT the most successful early intervention trial for the prevention of childhood obesity to date. RP group children also have demonstrated improved sleep duration and behaviors, dietary content, and emotion regulation. INSIGHT has retained over 83% of participants through age 3 years, but the long-term effects of the RP intervention have not yet been assessed. The high rates of obesity among school age children in the US and the complete lack of existing early life primary preventive interventions with sustained effects form the scientific premise for this competitive renewal application, which proposes to test the sustained efficacy and long-term effects of our RP intervention on child BMI. Following attainment of annual growth measurements from participants from ages 5 through 9 years, we will use multilevel modeling to examine BMI growth curves from early childhood to age 9, and hypothesize that RP effects will persist across time points. We further expect that RP group parents will utilize more responsive parenting practices, and RP group children will exhibit greater self-regulation of eating behaviors (inhibitory control and appetite regulation), better sleep, more physical activity, and less sedentary behavior at the study's primary assessment point which occurs when participants are 6 years old.

项目概要/摘要这项竞争性续签申请旨在继续对参与的儿童进行纵向评估在干预护士启动婴儿健康轨迹成长 (INSIGHT) 研究中，这是一项正在进行的、前瞻性、随机、对照试验测试了专为儿童设计的响应式育儿 (RP) 干预措施肥胖的一级预防与家庭安全控制。在美国，23% 的 2-5 岁儿童已经超重，9% 已经肥胖。 6 至 11 岁期间，34% 的美国儿童超重，17% 超重肥胖，强调需要采取具有持续效果的早期预防干预措施。几乎没有迄今为止有效的预防方法，我们通过招募 279 名婴儿的出生队列开始 INSIGHT，父母在出生后的第一年接受了四次家访，随后每年通过年龄3岁。 INSIGHT 课程包括 2 岁以下有关婴儿喂养、睡眠、互动游戏、情绪调节和正常的成长模式；这些领域是根据证据选择的将它们与肥胖风险及其改变的潜力联系起来。到目前为止，INSIGHT 的结果非常好阳性：RP 婴儿 1 岁时的平均身长体重比对照组低，并且不太可能 1 岁时超重（两者 p<.05）。 3 岁时，我们的主要结果是体重指数 (BMI) z- RP 组的评分显着低于对照组（-0.13 vs. +0.15；p=.04）。多层次模型适合整个干预期的三次时间趋势证实了干预组的主效应（p=.0003）。这些结果使 INSIGHT 成为预防儿童肥胖最成功的早期干预试验迄今为止。 RP 组儿童的睡眠持续时间和行为、饮食内容、和情绪调节。 INSIGHT 保留了超过 83% 的参与者到 3 岁，但长期来看 RP 干预的效果尚未评估。美国学龄儿童的肥胖率很高，并且完全缺乏现有的早期生活具有持续效果的初级预防干预措施构成了这种竞争性更新的科学前提申请，旨在测试我们的 RP 干预对儿童的持续功效和长期影响体重指数。在对 5 至 9 岁参与者进行年度生长测量后，我们将使用多水平模型来检查从幼儿期到 9 岁的 BMI 增长曲线，并假设 RP 效应将在不同时间点持续存在。我们进一步期望 RP 小组家长将利用更具响应性的养育方式，RP 组的孩子将表现出更强的饮食行为自我调节能力（抑制性控制和食欲调节）、更好的睡眠、更多的体力活动以及更少的久坐行为主要评估点发生在参与者 6 岁时。