Adaptation of an Evidence-based Family Program for Obesity Prevention in Health Care Context: Testing Outcomes and Mechanisms with First-time Military Parents and their Infants

医疗保健背景下预防肥胖的循证家庭计划的调整：与首次当兵的父母及其婴儿一起测试结果和机制

• 批准号: 10675016
• 负责人: MARK Ethan FEINBERG
• 金额: $ 74.65万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675016
• 关键词: Address; Adolescent; Adult; Behavior; Biological Markers; Birth; Birth Weight; Characteristics; Child; Child Rearing; Childhood; Clinic; Clinical; Conflict (Psychology); Couples; Data; Data Collection; Decision Making; Development; Discipline of obstetrics; Electronic Health Record; Extended Family; Family; Family Practice; Family Relationship; Family Violence; Family health status; Family member; Fathers; Financial Hardship; Florida; Fostering; Foundations; Future; Goals; Health; Health Promotion; Health behavior change; Healthcare; Home visitation; Hospitals; Infant; Inflammatory; Informal Social Control; Infrastructure; Intervention; Intervention Studies; Interview; Length; Life Style; Mediation; Medical Records; Mental Health; Military Personnel; Modality; Modeling; Mothers; Motivation; Nevada; Nurses; Obesity; Outcome; Overweight; Parents; Participant; Pathway interactions; Perinatal; Physical activity; Physicians; Population; Population Heterogeneity; Postpartum Period; Pregnancy; Premature Birth; Prevention program; Problem behavior; Randomized; Recommendation; Regulation; Research; Sampling; Schools; Series; Siblings; Sleep; Stress; Testing; Time; Weight; Work; active duty; base; coping; cost; cost effective; economic impact; efficacy evaluation; efficacy testing; ethnic diversity; evidence base; experience; feeding; follow-up; healthy lifestyle; high risk; improved; infant adiposity; innovation; insight; intergenerational; intervention delivery; maternal depression; maternal stress; member; military family; military health system; nutrition; obesity prevention; obesity risk; online version; overweight child; patient engagement; perinatal period; postpartum weight; preventive intervention; primary care clinic; primary outcome; programs; psychosocial; racial diversity; randomized trial; rapid infant weight gain; recruit; secondary outcome; service member; skills; stressor; success; transmission process; tv watching

PROJECT SUMMARY The proposed study will test the efficacy of a family-focused preventive intervention in improving healthy lifestyles among first-time parents in military families and reducing obesity risk among their infants. The ultimate goals of the intervention are to reduce rapid infant weight gain, an early indicator of future obesity risk, and new mothers’ postpartum weight retention, a contributor to intergenerational obesity transmission. In three trials, the Family Foundations (FF) program—consisting of a series of classes delivered in a health care context before and after birth—has demonstrated robust, replicated, long-term impact on family relationships (coparenting, parenting, family violence) and on parent and child internalizing and externalizing problems through at least 7 years after birth. The theoretical “active ingredient” of FF, validated by mediation analysis of program impact, is support for the development of a cohesive, supportive coparenting relationship. In the proposed study, we will test an adapted version of FF (termed “FF+”) that broadens the coparenting approach to help parents’ cooperate and support each other in establishing and maintaining healthy family lifestyle behaviors and specific health-promoting parenting strategies. We propose to test FF+ in military families, who experience overweight/obesity at levels similar to their civilian counterparts. Recruitment and intervention will be conducted within obstetric clinics in three Military Health System hospitals. Recruitment, intervention delivery, data collection, and follow-up will be facilitated by the military context. Aim 1. To assess the efficacy of the adapted FF+ program in a randomized trial. 250 families will be randomized to FF+ or control conditions. Data will be collected in home visits at pre-test during pregnancy, post-test at 6 months postpartum, and follow-up at 12 months postpartum, with additional data obtained from electronic health records. Aim 2. To test mediation pathways. Aim 3. To assess whether baseline parent characteristics, program delivery fidelity, or participant engagement moderate program effects on outcomes.

项目摘要 拟议的研究将测试以家庭为中心的预防性干预的效率 军人家庭中首次父母的健康生活方式，并降低其肥胖风险 婴儿。干预的最终目标是减少婴儿的快速体重增加，这是一个早期的指标 未来的肥胖风险和新母亲的产后体重保留，这是代际的贡献者 肥胖传播。在三个试验中，家庭基金会（FF）计划 - 一系列一系列 出生前后在医疗保健环境中分娩的课程表现出强大的，复制的， 长期对家庭关系（共同养育，育儿，家庭暴力）以及父母的影响 儿童在出生后至少7年之前将儿童内在化和外在化问题。理论上的“主动” FF的成分”，通过对程序影响的调解分析验证，支持开发 凝聚力，支持性的共同关系。在拟议的研究中，我们将测试适应版的 FF（称为“ FF+”）扩大了共同责任的方法，以帮助父母合作和支持每个 在建立和维持健康的家庭生活方式行为和特定健康促进的其他方面 育儿策略。我们建议在军人家庭中测试FF+，他们在 与平民同行类似的水平。招聘和干预将在 三家军事卫生系统医院的产科诊所。招聘，干预交付，数据 收集和随访将由军事背景准备。 目的1。在随机试验中评估改编的FF+程序的效率。 250个家庭将是 随机分配到FF+或控制条件。数据将在预测试期间的主访问中收集 怀孕，产后6个月的测试后，产后12个月，还有其他数据 从电子健康记录获得。目标2。测试调解途径。目标3。评估是否 基线父母特征，计划交付保真度或参与中等计划 对结果的影响。