Developing tailored home environment interventions to address childhood obesity

制定量身定制的家庭环境干预措施来解决儿童肥胖问题

• 批准号: 7588606
• 负责人: Kim M. Gans
• 金额: $ 24.17万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7588606
• 关键词: 7 year old; Address; African American; Behavior; Blue Cross; Blue Shield; Child; Child Behavior; Cognitive; Counseling; Data; Development; Diabetes Mellitus; Diet; Dose; Eating; Effectiveness; Environment; Evaluation; Exercise; Family; Feasibility Studies; Focus Groups; Funding; Future; Goals; Health; Health Insurance; Health Planning; Healthcare; Heart Diseases; Hispanics; Home environment; Income; Insurance Carriers; Intervention; Intervention Studies; Latino; Life Style; Low income; Malignant Neoplasms; Maps; Measures; Mediating; Methods; Minority; Monitor; Neighborhoods; New England; Nutritionist; Obesity; Outcome; Outcome Measure; Overweight; Parents; Performance; Physical activity; Pilot Projects; Population; Prevalence; Prevention; Preventive Intervention; Process; Psychosocial Influences; Public Health; Randomized Controlled Trials; Research; Research Personnel; Risk; Social Behavior; Target Populations; Telephone; Testing; Time; Weight maintenance regimen; Writing; Youth; aged; base; design; efficacy testing; insight; instrument; literacy; obesity in children; obesity prevention; prevent; public health relevance; secondary outcome; social; therapy development; tool

DESCRIPTION (provided by investigator): Obesity is a serious health problem in the US that increases risk of certain cancers, heart disease and diabetes. Childhood obesity is particularly prevalent in low income, Black and Latino children. The prevention and treatment of overweight in youth hinges on helping families develop new lifestyles and create supportive environments in which healthful eating and physical activity (PA) can be promoted. There is a pressing need to develop and test childhood obesity prevention and treatment approaches for low income and minority families that are effective, but also culturally acceptable and sustainable. The purposes of the current proposed R21 project are to: 1). conduct formative research to inform the development of culturally appropriate evaluation tools and family-tailored interventions for low income ethnically diverse parents of children aged 2-5; and 2). conduct a pilot feasibility study to inform the design and implementation of a future RCT. In Year 01, we will conduct formative research including: a). Focus groups with WIC nutritionists to explore their insights into educating low income parents of young children about diet, PA and childhood obesity prevention; b). Focus groups with target audience parents to determine target behaviors, performance objectives, personal and external determinants, change objectives and intervention methods/strategies re. healthy eating, PA and weight control; c). Cognitive assessment testing with target audience parents on existing instruments for measuring children's dietary and PA behaviors, the social and physical home environment and relevant psychosocial issues to revise these tools so they are culturally and linguistically appropriate. This information will be used to develop intervention and evaluation tools. In Year 02, we will conduct a pilot feasibility study to inform the future RCT. The pilot study will: a). determine the feasibility of subject recruitment and retention methods, interventions, process and outcome evaluation methods and measures; b) implement process evaluation to determine implementation fidelity including dose and its' relationship with primary and secondary outcome measures; c). Explore relationships between primary and secondary outcome measures and potential mediating variables In the pilot study, 50 parent-child pairs will receive the tailored intervention, which will be delivered to parents will include: a family exercise video, a TV monitor, 4 sets of culturally and linguistically appropriate individually tailored low literacy written materials interspersed with telephone counseling calls that will be delivered three times over a 20 week period to the parent/family. The intervention will focus on helping parents to develop new lifestyles and create supportive environments to promote/facilitate healthful eating and PA in their children. At the end of Year 02, we will compile all qualitative and quantitative formative, process and outcome evaluation data and apply it using an intervention mapping approach to plan a future RCT that will test the efficacy of tailored home-based interventions on BMI measures, dietary and PA behaviors of children, and the social and physical home environment. PUBLIC HEALTH RELEVANCE: Childhood obesity is a serious health problem in the US as the prevalence is high and increasing, especially in low income as well as African American and Hispanic children. The proposed project will conduct formative research and a feasibility study to inform a future randomized controlled trial that will test the effectiveness of sustainable interventions to prevent/treat childhood obesity in low income, ethnically diverse families.

描述（研究人员提供）：肥胖是美国的严重健康问题，可增加某些癌症，心脏病和糖尿病的风险。儿童肥胖症在低收入，黑人和拉丁裔儿童中尤为普遍。在青年铰链中预防和治疗超重，以帮助家庭发展新的生活方式并创造支持性的环境，在这些环境中，可以促进健康的饮食和体育锻炼（PA）。为了开发和测试儿童肥胖症预防和治疗方法的迫切需求，这些肥胖症和治疗方法是有效但在文化上可接受且可持续的少数群体家庭的需求。当前建议的R21项目的目的为：1）。进行形成性研究，以告知针对2-5岁儿童的低收入种族多样化父母的文化适当评估工具和家庭规划的干预措施；和2）。进行试点可行性研究，以告知未来RCT的设计和实施。在第01年，我们将进行形成性研究，包括：a）。与WIC营养学家的焦点小组探索他们的见解，以教育幼儿的低收入父母有关饮食，PA和儿童肥胖症的预防； b）。与目标受众父母的焦点小组确定目标行为，绩效目标，个人和外部决定因素，改变目标和干预方法/策略。健康饮食，PA和体重控制； c）。与目标受众的认知评估测试有关现有工具，以衡量儿童的饮食和PA行为，社会和身体家庭环境以及相关的社会心理问题，以修改这些工具，以便在文化上和语言上适当。此信息将用于开发干预和评估工具。在02年，我们将进行一项试点可行性研究，以告知未来的RCT。试点研究将：a）。确定受试者招募和保留方法，干预，过程和结果评估方法和措施的可行性； b）实施过程评估以确定实施忠诚度，包括剂量及其与主要和次要结果指标的关系； c）。在试点研究中，探索主要和次要结局措施与潜在的介导变量之间的关系，50个亲子对将接受量身定制的干预措施，将提供给父母：家庭练习视频，电视监视器，一套文化和语言上的4套文化和语言上适当的个人练习和个人适当的个人训练的低识字材料，这些书面量身定制的辅导材料将涉及每周的家庭，这将是20周的时间。干预措施将着重于帮助父母发展新的生活方式，并创造支持环境，以促进/促进健康的饮食和孩子。在02年底，我们将汇编所有定性和定量的形成性，过程和结果评估数据，并使用一种干预映射方法来计划未来的RCT，该方法将测试基于BMI措施，饮食和PA行为的基于家庭基于家庭的干预措施的功效，以及社交和身体家庭环境。公共卫生相关性：儿童肥胖在美国是一个严重的健康问题，因为患病率很高，尤其是在低收入以及非裔美国人和西班牙裔儿童中。拟议的项目将进行形成性研究和可行性研究，以告知未来的随机对照试验，该试验将测试可持续干预措施以预防/治疗低收入，种族多样化家庭的儿童肥胖的有效性。