A pilot feasibility study of digitally delivered modules focused on preventing the development of obesity during the first year of life within an existing statewide home visitation program

对数字交付模块进行试点可行性研究，重点是在现有的全州家访计划中预防生命第一年发生肥胖

• 批准号: 10667696
• 负责人: Amy R Mobley
• 金额: $ 27.12万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-07 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10667696
• 关键词: 1 year old; Abbreviations; Address; Adult; Affect; Age; Attitude; Behavior; Biometry; Birth; Breast Feeding; COVID-19; Cellular Phone; Child; Child Development; Childhood; Communities; Conceptions; Data; E-learning; Educational Curriculum; Enrollment; Evaluation; Family; Family member; Fathers; Feasibility Studies; Florida; Foundations; Friends; Future; Goals; Health; Health Personnel; Home; Home visitation; Image; Infant; Interdisciplinary Study; Intervention; Interview; Juice; Learning Module; Length; Life; Low income; Mediator; Methods; Modeling; Mothers; Nurses; Obesity; Overweight; Parents; Pediatrics; Persons; Pilot Projects; Population Heterogeneity; Prevalence; Prevention program; Protocols documentation; Psychology; Public Health; Randomized; Research; Resources; Risk; Risk Factors; Schedule; Series; Sleep; Social Network; Social Workers; Solid; Technology; Testing; Training; Treatment Efficacy; Underserved Population; Weight; Work; acceptability and feasibility; behavior change; cardiovascular disorder risk; comorbidity; cost effective; critical period; digital; digital delivery; digital intervention; digital technology; early childhood; evidence base; feeding; high risk; improved; innovation; literacy; lower income families; member; novel strategies; nutrition; obesity development; obesity in children; obesity prevention; obesity risk; obesogenic; pilot trial; preference; prevent; preventive intervention; primary outcome; programs; randomized trial; recruit; response; secondary outcome; skills; treatment effect; trend; tv watching; usability

PROJECT SUMMARY/ABSTRACT The first 1,000 days (conception to age 2) have been deemed a critical period for obesity prevention yet, effective, sustainable efforts are lacking. Current home visitation programs (HVP) targeting at-risk families for other child development related issues are a potential innovative opportunity for early childhood obesity prevention. The overall goal of the project is to reduce the prevalence of overweight and obesity in children under the age of 1 year thereby reducing obesity rates of older children and adults in the long term. Prior pilot work by members of the research team demonstrated feasibility of embedding an early childhood obesity prevention (ECHO) program in an existing home visitation program (HVP+) during an infant’s first year of life. Five obesity-associated behaviors (i.e., breastfeeding, introduction to solids, limiting juice, sleep routines, screen time) were emphasized through brief interactive lessons utilizing behavior change strategies and an ecological approach by providing linkages to community resources that support healthy behaviors. The pilot program was well received by families, mothers breastfed longer, infants had fewer nocturnal awakenings, were less likely to receive juice, and had a lower weight-for-length (WFL) z-score at 12 months. However, there is a critical need for alternative and innovative, consistent, and sustainable digital delivery methods especially during times when face-to-face home visits are not feasible. Qualitative interviews were conducted with home visitors (n=27) from Florida’s (FL) Maternal, Infant Early Childhood Home Visitation (MIECHV) Program and revealed that they were highly receptive to using digital learning with at-risk families. The specific aims of the proposed research are to a) Develop, refine, and conduct usability testing of early childhood obesity prevention digital learning modules with mothers (n=30) participating in FL MIECHV; and b) Conduct a pilot RCT of a 12 month digitally-enhanced early childhood obesity prevention intervention (HVP+E), with 50 mother-infant pairs (25 HVP+E/25 standard HVP) participating in FL MIECHV to determine feasibility and acceptability of the HVP+E intervention and study recruitment, implementation and evaluation protocols; and obtain data on preliminary efficacy of the intervention on children’s WFL z-scores (primary outcome), maternal feeding practices, child sleep and screen time (secondary outcomes). Mother-infant dyads (n=50) enrolled in the Maternal, Infant Early Childhood Home Visitation (MIECHV) Program parentally or within one month of giving birth will be randomized to receive either the standard home visitation program (HVP) or the digitally delivered obesity prevention-enhanced home visitation program (HVP+E) for 1 year. HVP+E content will also be expanded to support mothers in engaging fathers and other family members in target behaviors. Mother-infant dyads will be assessed at study entry and at 6 and 12 months. If efficacious, the intervention has potential for public health impact through early childhood obesity prevention in an underserved population, and dissemination through home visitation programs nationwide.

项目摘要/摘要 最初的1,000天（至2岁的受孕）被认为是预防肥胖症的关键时期 缺乏有效，可持续的努力。目前针对高危家庭的家庭探视计划（HVP） 其他与儿童发展有关的问题是幼儿对象的潜在创新机会 预防。该项目的总体目标是减少儿童超重和肥胖的患病率 从长远来看，1岁以下的年龄降低了年龄较大的儿童和成人的肥胖率。先前的飞行员 研究小组成员的工作证明了嵌入幼儿肥胖的可行性 在婴儿第一年的现有家庭探视计划（HVP+）中的预防计划（ECHO）计划。 五种与肥胖相关的行为（即母乳喂养，固体介绍，限制果汁，睡眠习惯， 屏幕时间）通过使用行为改变策略的简短互动课来强调） 通过与支持健康行为的社区资源的联系，生态方法。飞行员 计划受到家庭的好评，母亲母乳喂养的时间更长，婴儿的夜间觉醒较少， 接受果汁的可能性较小，并且在12个月时的重量长度（WFL）Z分数较低。但是，那里 特别需要替代，创新，一致和可持续的数字交付方法 在面对面的家庭访问不可行的时候。定性访谈是在家进行的 来自佛罗里达州（FL）的母亲，婴儿早期家庭探视（MIECECHV）计划的游客（n = 27）和 揭示他们非常接受与高危家族一起使用数字学习。 拟议研究的具体目的是a）开发，完善和进行早期可用性测试 与母亲的儿童肥胖预防数字学习模块（n = 30）参加了FL MIECHV；和b） 进行12个月以数字增强的早期肥胖预防干预的飞行员RCT （HVP+E），有50对母亲对（25 HVP+E/25标准HVP）参加FL MIECHV HVP+E干预和研究招聘，实施和评估的可行性和可接受性 协议；并获取有关儿童WFL Z得分（主要）干预效率的初步效率的数据（主要） 结果），孕产妇喂养实践，儿童睡眠和筛查时间（次要结果）。 孕产妇的幼儿幼儿探访（MIECHV）的母亲二元组（n = 50）（n = 50） 养育计划或分娩后的一个月内将被随机分配以接收标准房屋 访问计划（HVP）或数字化肥胖预防增强的家庭探视计划 （HVP+E）一年。 HVP+E内容还将扩展，以支持母亲参与父亲和其他 目标行为的家庭成员。母亲二元组将在研究入学时进行评估，在6和12中进行评估 月份。如果有效，干预措施有可能通过幼儿肥胖来产生公共卫生的影响 在服务不足的人群中进行预防，并通过全国范围内的家庭探视计划传播。