Empowerment as a mechanism for change in childhood obesity prevention

赋权作为儿童肥胖预防变革的机制

• 批准号: 9033240
• 负责人: Kirsten Davison
• 金额: $ 70.53万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-25 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9033240
• 关键词: 5 year old; Address; Adoption; Area; Awareness; Behavior; Behavioral trial; Body mass index; Boston; Child; Child Rearing; Chronic; Collaborations; Communities; Coupled; Decision Making; Development; Diabetes Mellitus; Diet; Enrollment; Ensure; Environment; Environmental Risk Factor; Evaluation; Family; Family Caregiver; Family health status; Food; Future; Head Start Program; Health; Health Status; Health behavior; Home environment; Information Systems; Intervention; Left; Letters; Life; Link; Low income; Measures; Media Campaign; Mediator of activation protein; Modeling; Neighborhoods; Nursery Schools; Obesity; Outcome; Overweight; Ownership; Parenting Education; Parents; Physical activity; Plant Roots; Population; Positioning Attribute; Prevalence; Prevention program; Preventive; Process; Protocols documentation; Randomized Controlled Trials; Recruitment Activity; Research Personnel; Risk; Selection Bias; Single Parent; Sleep; Specialist; System; Testing; Translations; Unemployment; Use Effectiveness; Work; aged; base; cancer type; care systems; community based participatory research; community intervention; cost; design; effective intervention; efficacy testing; empowerment; ethnic minority population; evidence base; experience; healthy lifestyle; high risk; housing instability; hypertensive heart disease; innovation; intervention effect; novel; novel strategies; nutrition; nutrition education; obesity in children; obesity prevention; peer; programs; public health relevance; response; scale up; skills; socioeconomics; stressor; success; theories; tv watching

 DESCRIPTION (provided by applicant): Nearly one in four preschool-aged children in the US is overweight or obese. This problem is significant because obesity in young children is linked with immediate and long-term health consequences including diabetes, hypertension, heart disease and certain types of cancer. What is more, the health effects of obesity are disproportionately experienced among low-income and ethnic minority children. Given that children's emerging dietary, physical activity, screen-based and sleep behaviors are deeply rooted in the family, effectively engaging parents and family caregivers in childhood obesity prevention is crucial to its success. Yet family engagement has proven challenging and effective family interventions targeting young children remain elusive. In response, we have developed and tested a new approach to obesity prevention in families. Grounded in community-based participatory research (CBPR), our approach recognizes parents as family experts, engages them as co-researchers and embeds the resulting empowerment-focused intervention - Communities for Healthy Living (CHL) - into Head Start, a national system of care reaching over one million low-income families. Building on our successful pilot assessment of CHL, and in collaboration with our Head Start partners including 18 centers serving over 2000 children each year, we will expand our CBPR approach to engage parents of 3- to-5-year old children and Head Start staff to refine adapt CHL to a new setting. To ensure the timely translation of this work, we will test CHL effectiveness using a practical behavioral trial (PBT) and addressing the following specific aims: (1) utilize CBPR to adapt and refine CHL for implementation in a new setting; (2) test the efficacy of CHL using a group randomized controlled trial; and (3) examine the interplay between CHL and environmental factors, including the socioeconomic, food and physical activity environments, on CHL efficacy. Child outcomes, including Body Mass Index and four target health behaviors (diet, physical activity, screen time, and sleep), will be assessed for all children enrolled in the participating centers using Head Start's existing data system. Primary innovations of this study include the engagement of parents and staff in the participatory process, an intervention that deviates from the traditional model of nutrition and parenting education and addresses broader family realities, and the utilization of existing Head Start data systems to evaluate CHL, all of which support future dissemination and sustainability.

 描述（由适用提供）：在美国，近四分之一的学龄前儿童超重或肥胖。这个问题很重要，因为幼儿的肥胖与包括糖尿病，高血压，心脏病和某些类型的癌症在内的直接和长期健康后果有关。更重要的是，在低收入和少数民族儿童中，肥胖的健康影响不成比例。鉴于儿童的新兴饮食，体育锻炼，基于屏幕的睡眠和睡眠行为扎根于家庭，因此有效地吸引了父母和家庭护理人员，从而在儿童肥胖症的预防中有效地吸引了其成功至关重要。然而，家庭参与已被证明是挑战，针对幼儿的有效家庭干预措施仍然难以捉摸。作为回应，我们开发了一种新的家庭预防肥胖症方法。基于社区参与研究（CBPR），我们的方法将父母承认为家庭专家，将他们作为共同研究者参与其中，并嵌入由赋予授权的授权干预措施 - 健康生活的社区（CHL） - 成为一种国家护理体系，达到了超过一百万个低收入家庭的国家护理体系。在我们成功对CHL的飞行员评估的基础上，并与我们的首席伙伴合作，包括每年为2000多名儿童服务的18个中心，我们将扩大我们的CBPR方法，以与3至5岁的孩子的父母与父母联系，并首席启动人员将Aff Aft Aft Aft Aft Aft Aft Aft Aft Aft Adapt Chl到新环境中。为了确保及时翻译这项工作，我们将使用实用的行为试验（PBT）测试CHL有效性，并解决以下特定目的：（1）利用CBPR适应和完善CHL在新环境中实施； （2）使用组随机对照试验测试CHL的有效性； （3）检查CHL与环境因素之间的相互作用，包括社会经济，食品和体育锻炼环境，在CHL效率方面。将使用Head Start的现有数据系统评估儿童结果，包括体重指数和四种目标健康行为（饮食，体育锻炼，筛查时间和睡眠）。这项研究的主要创新包括父母和员工参与参与过程，这种干预措施偏离了传统的营养和育儿教育模式，并解决了更广泛的家庭现实，以及使用现有的Head Start数据系统来评估CHL，所有这些都支持未来的传播和可持续性。