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.

项目概要 拟议的研究将测试以家庭为中心的预防干预措施在改善 军人家庭初为父母的健康生活方式以及降低他们的肥胖风险 干预的最终目标是减少婴儿体重快速增加，这是体重增加的早期指标。 未来的肥胖风险和新妈妈的产后体重保留，这是代际遗传的一个因素 在三项试验中，家庭基金会 (FF) 计划由一系列项目组成。 在出生前和出生后的医疗保健背景下提供的课程已被证明是稳健的、可重复的、 对家庭关系（共同养育、养育子女、家庭暴力）以及父母和子女的长期影响 孩子出生后至少 7 年内的内化和外化问题。 FF 的“成分”，通过项目影响的中介分析得到验证，是支持开发 在拟议的研究中，我们将测试一种有凝聚力、支持性的共同养育关系。 FF（称为“FF+”）拓宽了共同养育方式，帮助父母合作并支持彼此 其他建立和维持健康的家庭生活方式行为和特定的健康促进 我们建议在超重/肥胖的军人家庭中测试 FF+。 招聘和干预将在与他们的文职人员相似的级别内进行。 三个军事卫生系统医院的产科诊所 招募、干预实施、数据。 军事背景将有助于收集和后续行动。 目标 1. 将在 250 个家庭中进行随机试验，评估改编后的 FF+ 计划的功效。 随机分配至 FF+ 或对照条件，数据将在预测试期间的家访中收集。 怀孕、产后 6 个月后测试、产后 12 个月随访，以及其他数据 从电子健康记录中获取 目标 2. 测试中介路径 目标 3. 评估是否存在。 基线家长特征、计划交付保真度或参与者参与度中等计划 对结果的影响。