Health Outcomes in Preschool: INnovations for Obesity Prevention (HOP-IN)

学前班的健康成果：预防肥胖的创新 (HOP-IN)

• 批准号: 10451552
• 负责人: Amber Fyfe-Johnson
• 金额: $ 13.11万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-20 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451552
• 关键词: 7 year old; Academic achievement; Accelerometer; Adult; Age; American Heart Association; Area; Behavior; Body mass index; Cardiovascular Diseases; Child; Childhood; Communities; Control Groups; Cost Effectiveness Analysis; Cost-Benefit Analysis; Cost-Benefit Data; Costs and Benefits; Country; Development Plans; Eating; Educational Curriculum; Educational process of instructing; Enrollment; Goals; Growth; Guidelines; Habits; Health; Healthcare; Home environment; Hour; Individual; Intervention; Journals; Life; Location; Measures; Mentors; Modeling; Morbid Obesity; National Heart, Lung, and Blood Institute; Natural experiment; Non-Insulin-Dependent Diabetes Mellitus; Nursery Schools; Obesity; Observational Study; Outcome; Outcome Measure; Overweight; Performance; Persons; Physical activity; Play; Policies; Policy Analysis; Positioning Attribute; Prevention; Principal Investigator; Public Health; Publishing; Research; Research Personnel; Risk Factors; Sampling; Schools; Site; Sleep; Societies; Standardization; Strategic Planning; Structure; System; Time; Training; Trees; United States; Waiting Lists; Washington; Weight; Youth; actigraphy; adequate sleep; aged; base; cardiometabolism; cardiovascular health; cardiovascular risk factor; career; career development; cost; cost effective; cost effectiveness; critical period; early childhood; economic implication; economic outcome; epidemiology study; experience; frontier; innovation; metropolitan; mortality; negative affect; novel; obesity in children; obesity prevention; obesity treatment; overweight child; peer; prevent; primary outcome; prospective; recruit; secondary outcome; sedentary lifestyle; sleep quality; sleep quantity; success; sugar; sweetened beverage; symposium; teacher

PROJECT SUMMARY/ABSTRACT Childhood obesity is a critical public health threat, and a major risk factor for accelerating cardiometabolic health conditions in childhood and adulthood. In addition, obesity in childhood negatively impacts academic achievement, which predicts lifetime health outcomes and has dramatic economic implications. Daycare settings have been identified as a high impact target for early childhood obesity intervention. On average, 75% of preschool-aged children in the United States spend 35 hours per week in daycare, and childcare settings have the ability to offer children healthy meals, increase opportunities for physical activity, and promote adequate sleep – all of which help to prevent obesity. Although preschool settings offer regular opportunities for physical activity, most children in daycare do not meet current guidelines. In 2014, only 12% of daycare centers in Washington State met goals for physical activity, and only 22% for outdoor time. Because children who spend more time outdoors are more physically active than those who spend more time indoors, preschools with outdoor- and play-based curricula may help to increase physical activity. The only published study on this topic found that Swedish children in outdoor preschools were less likely to be overweight and slept longer than their peers in indoor preschools. However, the study was cross-sectional, recruited a small sample, did not examine academic achievement or cost implications, and was conducted in a country with different healthcare and educational systems than the United States. For this K01 application, we propose a prospective observational study that leverages a natural experiment to evaluate the impact of an outdoor preschool model on health outcomes and academic achievement. We will partner with Tiny Trees, a preschool in Seattle, Washington, with an entirely outdoor, play-based curriculum. We will recruit 100 children ages 3-5 who attend Tiny Trees, and 100 children from the Tiny Trees waitlist who are currently attending a traditional indoor preschool. We will collect objective and subjective measures of physical activity, sleep, body mass index, and academic performance over the course of the 3-year study period. We will also perform a cost-benefit analysis to evaluate the Tiny Trees outdoor preschool model for longer-term sustainability. Our Specific Aims are to: 1) compare within-person change in health and academic outcomes between Tiny Trees enrollees (intervention) and waitlisted children (control), 2) estimate the short- and long-term cost-benefit of the Tiny Trees outdoor preschool model, and 3) complete a rigorous mentored career development plan that will position the Principal Investigator to conduct groundbreaking research in interventions to prevent childhood obesity, establish cost-benefit estimates of interventions to inform policy, and launch a successful career as an independent investigator. This proposal aligns with the National Heart, Lung, and Blood Institute agenda by prioritizing novel epidemiological research to prevent childhood obesity, a critical risk factor for cardiovascular disease, and will yield much-needed cost- benefit data to examine the capacity for obesity prevention and sustainability of an outdoor preschool model.

项目概要/摘要 儿童肥胖是一个严重的公共卫生威胁，也是加速心脏代谢健康的主要风险因素 此外，儿童时期的肥胖会对学业产生负面影响。 成就，它可以预测一生的健康结果，并对日托环境产生巨大的经济影响。 平均 75% 被确定为早期儿童肥胖干预的高影响目标。 美国的学龄前儿童每周在日托中心度过 35 个小时，托儿机构已 为儿童提供健康膳食、增加体育活动机会并促进充足的能力的能力 睡眠——所有这些都有助于预防肥胖，尽管学前班提供定期的体育锻炼机会。 2014 年，只有 12% 的日托中心儿童不符合现行准则。 华盛顿州达到了体育活动目标，但只有 22% 的人达到了户外活动目标，因为孩子们花的时间多。 与那些花更多时间在室内的人相比，更多时间在户外的人更活跃，学前班 基于户外和游戏的课程可能有助于增加身体活动，这是关于该主题的唯一已发表的研究。 研究发现，在户外幼儿园的瑞典儿童超重的可能性较小，而且睡眠时间也比他们的孩子长。 然而，这项研究是横断面的，只招募了一小部分样本，没有进行调查。 学术成就或成本影响，并且是在具有不同医疗保健和条件的国家进行的 对于这个 K01 应用，我们提出了一个前瞻性观察。 研究利用自然实验来评估户外学前班模式对健康的影响 我们将与华盛顿州西雅图的一所幼儿园 Tiny Trees 合作， 我们将招募 100 名 3 至 5 岁的孩子参加 Tiny Trees 课程，以及 100 名完全户外的、以游戏为基础的课程。 我们将收集目前正在传统室内幼儿园就读的 Tiny Trees 候补名单中的孩子。 体力活动、睡眠、体重指数和学习成绩的客观和主观测量 在为期 3 年的研究期间，我们还将进行成本效益分析来评估小树。 长期可持续发展的户外学前班模式我们的具体目标是：1) 进行内部比较。 小树计划参与者（干预）和候补儿童之间健康和学业成绩的变化 （对照），2) 估计 Tiny Trees 户外幼儿园模式的短期和长期成本效益，以及 3) 完成严格指导的职业发展计划，使首席研究员能够进行 预防儿童肥胖干预措施的开创性研究，建立了成本效益估计 干预措施为政策提供信息，并作为独立调查员开启成功的职业生涯。 通过优先考虑新颖的流行病学研究，与国家心肺血液研究所的议程保持一致 预防儿童肥胖，这是心血管疾病的一个关键危险因素，并将产生急需的成本 效益数据来检验户外学前班模式预防肥胖的能力和可持续性。