Improving nutrition and physical activity environments in home-based child care

改善家庭托儿所的营养和身体活动环境

基本信息

批准号：
9462272
负责人：
Kim M. Gans
金额：
$ 8.2万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9462272
关键词：
5 year old Affect Age Behavior Calories Caring Child Child Care Child Support Chronic Disease Cluster randomized trial Communities Computers Control Groups Controlled Environment Counseling Cues Development Diet Dose Effectiveness Effectiveness of Interventions Enrollment Environment Evaluation Evidence based intervention Evidence based practice Family Food Health Professional Healthy Eating High Prevalence Hispanics Home environment Hour Intervention Intervention Studies Intervention Trial Latino Low income Measures Mediating Mediator of activation protein Methods Mothers Nursery Schools Obesity Outcome Measure Parents Physical activity Policies Practice Guidelines Prevalence Preventive Intervention Process Professional counselor Provider Recommendation Regulation Reporting Research Rhode Island Risk Surveys Time Toy Training Treatment Efficacy base collaborative environment early childhood effective intervention efficacy trial empowered ethnic minority population experience group intervention high risk improved indexing innovation interest intervention effect minority children multi-component intervention nutrition obesity in children obesity prevention patient home care peer peer support portability prevent primary outcome public health relevance racial and ethnic racial minority secondary outcome sedentary sedentary lifestyle social training opportunity tv watching

项目摘要

DESCRIPTION (provided by applicant): Child care facilities are prime settings for healthy eating and physical activity (PA) interventions with preschoolers because over 70% of U. S. children under the age of six attend out-of-home child care averaging 35 hours per week and consuming 50-75% of their daily calories there. Preschool years are critical times when dietary and PA behaviors are established. Unhealthy food and PA behaviors contribute to the high prevalence rates of childhood obesity and associated chronic diseases that disproportionately affect low-income and racial and ethnic minority children. Improving child care environments is a recommended strategy for improving children's diets, PA and for preventing obesity; and childcare intervention studies have been shown to be effective. However these studies have predominantly used expensive experts to deliver the intervention and were time and labor-intensive. Moreover, almost all of these studies were conducted in childcare centers and not in family child care homes (FCCHs), which provide care for 25% of U.S. and 28% of R.I. preschoolers. FCCHs are less regulated than centers and most do not meet national nutrition or PA diet or PA recommendations and, family child care providers (FCCPs). They also have limited access to 'best practices' training or technical assistance. RI is in particular need of suh interventions due to its recent C+ national childcare report card rating for its nutrition and PA regulations, and a recent state-wide survey of RI FCCPs also supports the need for, and interest in, childhood obesity prevention. Through the proposed research, our team will adapt components of previous evidence-based interventions to create a new innovative intervention in both English and Spanish to improve food and PA environments of FCCH. The intervention will integrate: a) support from peer counselors with child care experience who will serve as team leaders for groups of FCCPs; b) tailored print and video materials; and c) a set of portable active toys. A cluster-randomized trial with 132 FCCHs will evaluate the effectiveness of the intervention with a Steering Committee and Community Advisory Board guiding all aspects. The Specific Aims of the study are to: 1) Conduct formative research to inform the development and adaptation of the FCCH intervention. 2) Conduct a cluster-randomized trial of the intervention's efficacy with 66 FCCPs and a control intervention with 66 demographically-matched FCCPs to evaluate its impact on: a) Children's overall dietary quality at FCCHs; b) Children's PA and sedentary behaviors at FCCHs; and c) the physical and social food and PA environments of FCCHs. We will also conduct extensive mixed-methods process evaluation to determine fidelity, dose, acceptability, context, and unintended consequences; explore the relationship between outcome measures and intervention dose as well as with mediating/moderating variables, and explore the intervention effect on child BMI. If proven effective, this intervention has the potental to be replicated and widely disseminated throughout RI and the US, where improvements in the childcare environment are a high priority.

描述（由申请人提供）：儿童保育设施是健康饮食和体育锻炼的主要环境（PA）与学龄前儿童进行干预措施，因为超过70％的美国六岁以下儿童每周参加35小时并消耗在那里的每日卡路里的50-75％。学龄前是建立饮食和PA行为的关键时期。不健康的食物和PA行为导致儿童肥胖症的高流行率和相关的慢性疾病，这些疾病不成比例地影响低收入，种族和种族和少数民族儿童。改善儿童保育环境是改善儿童饮食，宾夕法尼亚州和预防肥胖症的推荐策略；育儿干预研究已被证明是有效的。但是，这些研究主要使用昂贵的专家进行干预，并且是时间和劳动力密集的。此外，几乎所有这些研究都是在托儿中心而不是在家庭托儿所（FCCH）中进行的，这些研究可为美国25％和28％的R.I.学龄前儿童提供护理。 FCCH的监管程度不如中心，大多数人不符合国家营养，PA Diet或PA建议，以及家庭儿童保育提供者（FCCP）。他们也有限获得“最佳实践”培训或技术帮助。 RI特别需要SUH干预措施，因为其最近的C+国家托儿报告卡对其营养和PA法规的评级，并且最近对RI FCCP的最新调查也支持了对儿童肥胖症预防的需求和兴趣。通过拟议的研究，我们的团队将适应以前基于证据的干预措施的组成部分，以对英语和西班牙语进行新的创新干预，以改善FCCH的食物和PA环境。干预措施将整合：a）拥有儿童保育经验的同伴辅导员的支持，他们将担任FCCP团体的团队负责人； b）量身定制的印刷品和视频材料； c）一组便携式活动玩具。一项由132个FCCH的集群随机试验将通过指导委员会和社区顾问委员会指导各个方面的干预措施评估干预措施的有效性。该研究的具体目的是：1）进行形成性研究以告知FCCH干预的发展和适应。 2）对66个FCCP的干预效果进行集群的试验，并使用66个人口统计学匹配的FCCP进行对照干预措施，以评估其影响：a）FCCHS儿童的整体饮食质量； b）FCCHS的儿童PA和久坐行为； c）FCCH的物理和社交食品以及PA的环境。我们还将进行广泛的混合方法评估，以确定保真度，剂量，可接受性，背景和意外后果；探索结果指标与干预剂量以及中介/调节变量之间的关系，并探索对儿童BMI的干预效果。如果被证明有效，则这种干预措施将重复复制并在整个RI和美国进行广泛传播，在育儿环境中有所改善是当务之急。