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: 9149235
• 负责人: Kirsten Davison
• 金额: $ 62.48万
• 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/9149235
• 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; minority children; novel; novel strategies; nutrition; nutrition education; obesity in children; obesity prevention; peer; programs; 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（由申请人提供）：在美国，近四分之一的学龄前儿童超重或肥胖，因为幼儿肥胖与糖尿病、高血压、心脏病和糖尿病等直接和长期的健康后果有关。更重要的是，肥胖对健康的影响在低收入和少数族裔儿童中尤为严重，因为儿童的饮食、身体活动、屏幕和睡眠行为已深深根植于家庭，从而有效地影响了家庭。父母和家庭照顾者儿童肥胖预防对其成功至关重要，但事实证明，针对幼儿的有效家庭干预措施仍然具有挑战性，为此，我们开发并测试了一种基于社区参与性研究的预防肥胖的新方法。 CBPR），我们的方法承认父母是家庭专家，让他们作为共同研究人员，并将由此产生的以赋权为中心的干预措施 - 健康生活社区 (CHL) - 嵌入 Head Start，这是一个覆盖超过 100 万低收入人群的国家护理系统基于我们对 CHL 的成功试点评估，并与我们的 Head Start 合作伙伴（包括每年为 2000 多名儿童提供服务的 18 个中心）合作，我们将扩大 CBPR 方法，让 3 至 5 岁儿童的家长和 Head Start 参与进来。启动工作人员改进 CHL 以适应新的环境 为了确保这项工作的及时翻译，我们将使用实际行为试验 (PBT) 来测试 CHL 的有效性，并实现以下具体目标：(1) 利用 CBPR 来调整和改进 CHL。为了在新环境中实施；(2) 使用分组随机对照试验测试 CHL 的功效；以及 (3) 检查 CHL 与环境因素（包括社会经济、食物和身体活动环境）对 CHL 功效的相互作用。 ，包括体重指数和四项目标健康行为（饮食、体力活动、屏幕时间和睡眠），将使用 Head Start 的现有数据系统对参与中心的所有儿童进行评估。这项研究的主要创新包括参与。家长和工作人员参与过程，一种偏离营养和育儿教育传统模式并解决更广泛家庭现实的干预措施，以及利用现有的启蒙数据系统来评估CHL，所有这些都支持未来的传播和可持续性。