Enhancing Caregiver-Infant Communication to Prevent Obesity

加强护理人员与婴儿的沟通以预防肥胖

基本信息

批准号：
9247024
负责人：
Eric Hodges
金额：
$ 19万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-04-01 至 2019-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9247024
关键词：
Adult Age Age-Months American Sign Language Area Behavioral Belief Birth Caregivers Child Childhood Chronic Communication Control Groups Cues Data Data Collection Development Early Intervention Eating Eating Behavior Energy Intake Energy Metabolism Enrollment Environmental Risk Factor Equilibrium Feeding behaviors Future Genetic Growth Health Health Care Costs Hearing Home visitation Hunger Individual Individual Differences Infant Infant Development Informal Social Control Intake Intention Intervention Intervention Studies Language Length Life Light Measures Methods Modeling Mothers North Carolina Nutritional Nutritional Requirements Obesity Parents Patient Self-Report Physiological Pilot Projects Prevalence Prevention Prevention program Primary Health Care Process Randomized Recruitment Activity Regulation Relative Risks Reporting Satiation Science Sign Language Sinus Arrhythmia Societies Socioeconomic Status Testing Thirst Time Training Translations Visit Weight cost design dyadic interaction early childhood feeding infancy innovation insight novel obesity in children obesity prevention obesity risk prevent programs public health relevance respiratory response teacher

项目摘要

DESCRIPTION (provided by applicant): Once obese as an infant, the relative risk of remaining obese appears to rise with increasing age. Thus, the early years of life have been posited as an important target period for obesity prevention. Widely viewed as a response to genetic, interpersonal, and environmental factors, obesity fundamentally reflects an imbalance between energy intake and expenditure. Self-regulation of energy intake aligned with physiologic need is essential to this balance. The process(es) by which infants begin to disassociate eating behavior from physiologic need is unclear, thus it is crucial to better understand predictors of individual differences in self- regulation of energy intake. It is well established that autonomic regulation may support infant behavioral regulation, suggesting that autonomic function may be a critical area to consider here. Moreover, self- regulation is strongly influenced by dyadic interaction quality during infancy, and findings reveal that more responsive interactions are associated with more effective autonomic regulation. A chronic mismatch between a caregiver's feeding behavior and the infant's state (feeding in the absence of hunger and/or feeding beyond fullness), is thought to contribute to obesity by undermining the infant's capacity to self-regulate intake; the current proposal will be the first to examine the effects on autonomic regulation. We propose an intervention to enrich the capacity of mother-infant dyads to perform their respective interactive tasks. We plan to teach mothers American Sign Language (ASL) signs indicative of hunger, thirst, and satiety, which they will in turn teach their preverba infant. This training in ASL will be augmented with targeted information for mothers about infants' capacities to self-regulate energy intake in response to hunger and satiety and communicate those states with intention. Mothers also will be taught about expected development of infants' eating behaviors and nutritional requirements to support healthy growth. Using a two-group randomized repeated measures design, this study aims to 1) evaluate the feasibility and acceptability of the intervention and study methods, including recruitment, enrollment, and data collection (self- report, anthropometrics, video observations, and respiratory sinus arrhythmia [RSA]) for infants and their mothers; 2) evaluate the initial impact o the intervention on observed feeding interactions, reported infant feeding behaviors and maternal feeding behaviors/beliefs, and infant nutritional intake and growth; and, 3) explore preliminary data on concordance between dyadic feeding interactions and autonomic regulation in both mothers and infants (RSA). In addition to a variety of self-report and anthropometric measures, this study will use integrated behavioral (video) and physiologic (RSA) measures to better understand feeding dynamics and their relationship with obesity risk. Understanding these processes is essential for developing appropriate preventions, or interventions, that will help reduce the prevalence of early childhood obesity and its extension into later childhood and beyond.

描述（由适用提供）：一旦肥胖为婴儿，剩余肥胖的相对风险似乎随着年龄的增长而增加。这是生命的早期被指定为预防肥胖症的重要目标时期。肥胖从根本上反映出能量摄入和支出之间的不平衡，被广泛认为是对遗传，人际和环境因素的反应。能量摄入与生理需求一致的自我调节对于这种平衡至关重要。婴儿开始与生理需求脱离饮食行为的过程（ES）尚不清楚，因此更好地了解能量摄入自我调节的个体差异的预测指标至关重要。众所周知，自主法规可以支持婴儿行为调节，这表明自主功能可能是这里要考虑的关键领域。此外，自我调节在婴儿期间受到二元相互作用质量的强烈影响，发现表明，更响应的相互作用与更有效的自主神经调节有关。看护人的喂养行为与婴儿的状态之间的长期不匹配（在没有饥饿和/或饱满以外的喂养的情况下喂食）被认为是通过破坏婴儿自我调节摄入量的能力而导致肥胖的；当前的提案将是第一个研究对自主法规的影响的提案。我们提出了一种干预措施，以丰富母亲二元组执行各自互动任务的能力。我们计划教母亲美国手语（ASL）的标志，表明饥饿，第三和饱腹感，而这反过来又教他们的preverba婴儿。在ASL中进行的这种培训将为母亲提供有关婴儿自我调节能量摄入能力以应对饥饿和饱腹感的能力并有意与这些国家进行交流的有针对性信息。母亲还将教授关于婴儿饮食行为和营养要求的预期发展以支持健康的成长。本研究使用两组随机重复措施设计，目的是1）评估干预和研究方法的可行性和可接受性，包括招募，入学和数据收集（自我报告，人类学，视频观察，视频观察和呼吸鼻窦心律失常[RSA] [RSA] [RSA]）； 2）评估最初的影响o干预对观察到的喂养相互作用，报告的婴儿喂养行为和孕产妇的喂养行为/信念以及婴儿的营养摄入和生长； 3）探讨母亲和婴儿（RSA）中二元喂养相互作用与自主神经调节之间一致性的初步数据。除了各种自我报告和人体测量测量外，本研究还将使用综合行为（视频）和生理（RSA）测量方法更好地了解进食动力及其与肥胖风险的关系。了解这些过程对于制定适当的预防或干预措施至关重要，这将有助于减少幼儿肥胖症的流行及其扩展到幼儿期及以后。