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.

项目概要/摘要 最初的 1000 天（受孕到 2 岁）被认为是预防肥胖的关键时期， 目前缺乏针对高危家庭的有效、可持续的家访计划（HVP）。 其他与儿童发展相关的问题是早期儿童肥胖的潜在创新机会 该项目的总体目标是减少儿童超重和肥胖的发生率。 从而长期降低 1 岁以下儿童和成人的肥胖率。 研究小组成员的工作证明了嵌入儿童早期肥胖的可能性 婴儿出生第一年的现有家访计划 (HVP+) 中的预防 (ECHO) 计划。 五种与肥胖相关的行为（即母乳喂养、引入固体食物、限制果汁、睡眠习惯、 通过简短的互动课程，利用行为改变策略和 通过提供与支持健康行为的社区资源的联系来实现生态方法。 计划深受家庭欢迎，母亲母乳喂养时间更长，婴儿夜醒次数减少， 接受果汁的可能性较小，并且 12 个月时的身长体重 (WFL) z 分数较低。 迫切需要替代性和创新性、一致且可持续的数字交付方法，尤其是 在无法进行面对面家访的情况下，对家中进行了定性访谈。 来自佛罗里达州 (FL) 孕产妇、婴儿早期儿童家访 (MIECHV) 计划的访客 (n=27) 以及 透露他们非常愿意在高危家庭中使用数字学习。 拟议研究的具体目标是 a) 开发、完善和进行早期可用性测试 母亲 (n=30) 参与 FL MIECHV 的儿童肥胖预防数字学习模块；以及 b) 对为期 12 个月的数字增强型早期儿童肥胖预防干预进行试点随机对照试验 （HVP+E），50对母婴（25 HVP+E/25标准HVP）参加FL MIECHV确定 HVP+E 干预以及研究招募、实施和评估的可行性和可接受性 并获得儿童 WFL z 分数干预的初步效果数据（初级 成果）、母亲喂养方式、儿童睡眠和屏幕时间（次要成果）。 母婴二人 (n=50) 参加孕产妇、婴儿早期儿童家访 (MIECHV) 父母或分娩后一个月内的计划将被随机分配到标准家庭 探视计划 (HVP) 或数字化交付的肥胖预防强化家访计划 (HVP+E) 为期一年的 HVP+E 内容也将得到扩展，以支持母亲参与父亲和其他人的参与。 家庭成员的目标行为将在研究开始时以及 6 岁和 12 岁时接受评估。 如果有效，该干预措施有可能通过儿童早期肥胖对公共健康产生影响。 在服务不足的人群中进行预防，并通过全国范围内的家访计划进行传播。