Preventing childhood obesity through a family-based mindfulness intervention

通过基于家庭的正念干预预防儿童肥胖

• 批准号: 8512273
• 负责人: Rajita Sinha
• 金额: $ 23.71万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8512273
• 关键词: 5 year old; Adult; Age; Basic Science; Behavior Therapy; Behavioral; Biological; Body mass index; Child; Child Behavior; Child Development; Child Guidance Clinics; Childhood; Cholesterol; Chronic; Clinic; Clinical; Code; Communities; Control Groups; Counseling; Data; Development; Diabetes Mellitus; Eating; Eating Behavior; Empathy; Endocrinology; Environment; Exercise Physiology; Face; Family; Food; Glucose; Goals; Heart Diseases; Home environment; Hydrocortisone; Hyperphagia; Insulin; Interdisciplinary Study; Intervention; Interview; Kinesiology; Laboratories; Low income; Malignant Neoplasms; Measures; Mediator of activation protein; Metabolic; Modeling; Nursery Schools; Obesity; Overweight; Parenting behavior; Parents; Pattern; Physical activity; Prevention; Prevention program; Public Health; Questionnaires; Randomized; Reading; Recruitment Activity; Relative (related person); Reporting; Risk; Risk Factors; Stress; Testing; Time; aged; base; biological adaptation to stress; cohesion; diabetes risk; efficacy trial; ethnic minority population; follow-up; high risk; improved; innovation; intervention effect; middle childhood; mindfulness; mindfulness-based stress reduction; multidisciplinary; novel; novel strategies; nutrition; obesity in children; post intervention; preference; prevent; programs; public health relevance; response; satisfaction; stress related disorder; stressor

DESCRIPTION (provided by applicant): Childhood obesity is a serious public health problem. Childhood obesity is associated with obesity in adulthood and increased risk for diabetes, heart disease, and some cancers. Notably, obesity is particularly common in low-income ethnic minority children and children of obese parents. Preschool-aged children (aged 2-5 years) are just beginning to form patterns of eating and physical activity (PA) preferences and so this is an ideal age to target in prevention programs, particularly family-based programs which can improve food and activity choices offered to young children at home. Significant basic research indicates parent stress as a risk factor for child obesity. This risk may be exacerbated in low-income families who face multiple chronic stressors. Mindfulness-based stress reduction (MBSR) is an empirically-supported treatment that reduces stress in adults. However, the potential effects of MBSR on parent stress and child obesity have not been tested. The goal of the proposed study is to test initial feasibility and obtain effect sizes for a parenting-focused version of MBSR plus nutrition and physical activity counseling to reduce parent stress and prevent obesity in at-risk 2-5 year olds from low-income urban families. We hypothesize that MBSR plus nutrition and PA counseling (MBSR+N) for parents will decrease parent stress, improve parenting, increase healthy eating and PA, and prevent obesity in children of highly stressed low-income obese parents. The proposed study brings together a multidisciplinary team of experts in child development, behavioral interventions for obesity, pediatric endocrinology, nutrition, and exercise physiology to pilot test the feasibility and initial efficac of MBSR+N in an urban community-based clinic. 60 overweight parents of 2-5 year olds reporting high stress levels will be recruited from a child guidance clinic serving a low-income urban community. Parents will be randomly assigned to receive either an 8 week MBSR+N intervention (based on the MBSR plus nutrition and PA intervention for adults developed by Dr. Sinha, co-PI) or to a contact control+N group. At pre- and post-intervention and at a 6 month and 1 year follow-up, we will collect questionnaire, clinical interview, and biological measures of parent and child stress (including cortisol response to a laboratory stressor), parenting, parent and child eating behavior and PA, and child BMI percentile scores. We will also collect data on parent BMI and metabolic variables (e.g., glucose). We will assess feasibility and acceptability of MBSR+N and will test initial intervention effects and determine effect sizes to plan for an adequately- powered long-term efficacy trial of MBSR+N. The study will provide: 1. Initial efficacy data for MBSR+N, 2. Pilot data for a R01 proposal to conduct a large long-term trial of MBSR+N, 3. Evidence of acceptability of MBSR+N in a real-world community clinic setting, and 4. Longitudinal data on the development of obesity in at-risk children. If effective, MBSR+N could be a novel strategy to reduce stress and obesity in high risk adults and simultaneously prevent overweight/obesity in their young children.

描述（由申请人提供）：儿童肥胖是一个严重的公共卫生问题。儿童肥胖与成年时的肥胖有关，糖尿病，心脏病和某些癌症的风险增加。值得注意的是，在低收入少数族裔儿童和肥胖父母的子女中，肥胖尤其常见。学龄前儿童（2-5岁）刚刚开始形成饮食和体育锻炼的模式（PA）偏好，因此这是针对预防计划的理想年龄，尤其是基于家庭的计划，尤其是可以改善为家中幼儿提供的食物和活动选择。重大的基础研究表明，父母的压力是儿童肥胖症的危险因素。在面对多个慢性压力源的低收入家庭中，这种风险可能会加剧。基于正念的压力减轻（MBSR）是一种经验支持的治疗方法，可减少成人的压力。但是，尚未测试MBSR对父母压力和儿童肥胖症的潜在影响。拟议的研究的目的是测试最初的可行性并获得针对育儿版本的MBSR以及营养和体育锻炼咨询的效果大小，以减轻父母的压力并防止低收入城市家庭的2-5岁危险中的肥胖症。我们假设MBSR加上营养和PA咨询（MBSR+N）将减轻父母的压力，改善育儿，增加健康饮食和PA，并防止低收入低收入肥胖父母的孩子的肥胖症。 拟议的研究汇集了一个多学科儿童发育专家，肥胖，小儿内分泌学，营养和运动生理学的行为干预措施，以测试MBSR+N在城市社区诊所中的可行性和初始效率。 60名2-5岁年龄段的超重父母报告将从为低收入城市社区服务的儿童指导诊所招募高压力水平。父母将被随机分配接受为期8周的MBSR+N干预措施（基于MBSR加营养和PA干预，由Sinha博士，Co-Pi开发的成人）或接触控制+N组。在干预前后，在6个月零1年的随访中，我们将收集问卷，临床访谈和生物学指标 父母和儿童压力（包括对实验室压力源的皮质醇反应），育儿，父母和儿童饮食行为以及PA以及BMI百分位数。我们还将收集有关父BMI和代谢变量（例如葡萄糖）的数据。我们将评估MBSR+N的可行性和可接受性，并将测试初始干预效果，并确定效应大小，以计划MBSR+N的足够功率长期疗效试验。该研究将提供：1。MBSR+N的初始疗效数据，2。R01提案的试点数据，以进行MBSR+N，3。的长期长期试验，3。MBSR+N在现实世界中社区诊所的可接受性证据，以及4。纵向数据在现实风险的儿童中的纵向数据。如果有效，MBSR+N可能是减少高风险成年人压力和肥胖的新型策略，并同时防止年幼的孩子超重/肥胖。