Testing a Multilevel, Multicomponent, Multigenerational Dietary Intervention to Improve Southeast Asian Children's Diets

测试多层次、多成分、多代饮食干预措施以改善东南亚儿童的饮食

• 批准号: 10391025
• 负责人: Kim M. Gans
• 金额: $ 29.88万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-07 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10391025
• 关键词: Address; Adult; Affect; Age; Asian; Behavior; Behavioral; Body Weight decreased; Body mass index; Cambodian; Caring; Carotenoids; Child; Child Health; Child Nutrition; Chronic; Chronic Disease; Clinical; Clinical Trials; Communities; Community Health Aides; County; Dermal; Diet; Dietary Intervention; Dietary Practices; Disease; Dose; Education; Emotions; Ethnic group; Exhibits; Family; Fatty acid glycerol esters; Feasibility Studies; Feedback; Food; Food Access; Frequencies; Funding; Future; Gestational Diabetes; Glycosylated hemoglobin A; Goals; Guilt; Health Food; Healthy Eating; Height; Home; Individual; Insulin Resistance; Intervention; Intervention Studies; Measures; Method Acceptability; Methods; Mission; Modeling; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Parents; Participant; Philosophy; Pilot Projects; Poverty; Prevalence; Publishing; Race; Randomized; Reducing diet; Refugees; Research; Rhode Island; Risk; Risk Factors; Scientific Advances and Accomplishments; Secondary to; Structure; Subgroup; Telephone; Testing; Text Messaging; Time; Training; Trauma; Treatment Efficacy; Unhealthy Diet; Weight Gain; Woman; Work; arm; attentional control; base; behavior change; community based participatory research; community clinic; community intervention; community partnership; design; dietary; early onset; effective intervention; efficacious intervention; energy balance; ethnic disparity; ethnic minority; ethnic minority population; experience; feasibility testing; feasibility trial; financial incentive; food environment; good diet; grandparent; health disparity; high risk; implementation fidelity; implementation framework; implementation intervention; improved; indexing; innovation; intergenerational; motivational enhancement therapy; multi-component intervention; nutrition education; prevent; primary outcome; process evaluation; racial and ethnic; racial disparity; recruit; secondary outcome; social; social cognitive theory; southeast Asian; stem; sugar; transmission process; treatment arm; waist circumference

Background. Poor diet quality is a significant and critical problem for Southeast Asian (SEA) children whose families came to the US as refugees [e.g., Hmong, Cambodian, Laotian, Vietnamese]. SEA children are disproportionately burdened by higher rates of obesity and increased risk of other diet-related chronic diseases like type 2 diabetes relative to other Asian subgroups, Whites and “Other” races. Although dietary interventions have been shown to prevent/delay onset of diet-related chronic diseases, to our knowledge, there are no dietary interventions developed specifically for SEA children. Thus, there is an urgent need for dietary interventions that leverage state-of-the-art methods to address existing health disparities affecting SEA children and to advance scientific understanding of gaps in intervention research. Overview of Proposal. This proposal reflects our eight year (ongoing) academic-community research partnership with the Center for SEA in Rhode Island, formative work with SEA families, and our extensive experience conducting successful dietary interventions with underserved health disparity groups. The current study is a pilot feasibility study that tests an innovative multilevel, multicomponent, multigenerational dietary intervention to improve diet quality among SEA children. Conceptual Model. The Community Energy Balance and Family-Centered Action Model of Intervention Layout and Implementation frameworks provide the intervention rationale and structure. These frameworks propose that for disparity ethnic minority groups like SEA, multilevel, multicomponent, intergenerational interventions are the most effective intervention approach for changing and sustaining individual-level behavior change. Social cognitive theory and popular education philosophy inform the intervention content. Overview of Research Plan. 75 SEA families with children ages 6 to 11 years will be recruited from Providence County, Rhode Island. Adult-child pairs will be randomized to: (1) financial incentive only arm that will receive weekly $15 financial incentive coupons to subsidize purchase of healthy foods at a local SEA grocery store; or (2) financial incentive plus twice-monthly, family-based group nutrition education at the Center for SEA led by SEA community health workers; three motivational interviewing (MI) calls by trained community health workers; dietary norms messaging for adults (via weekly text messages) and for children (via Infographics at nutrition education sessions); and weekly $15 financial incentive coupons to subsidize purchase of healthy foods at SEA grocery stores; or (3) an Academic Engagement attention control arm that will follow the structure of the financial incentive plus nutrition education, MI and text messages and infographics arm. The primary outcomes are study feasibility and clinically meaningful improvement in child’s diet quality (measured by healthy eating index). Secondary outcomes are clinically meaningful changes in children’s body mass (~ 2kg weight loss or no weight gain), HbA1c (0.5%) and parent’s diet quality, HbA1c and the home food environment. These study findings will be used to inform a future, larger clinical trial.

背景。饮食质量差是东南亚（SEA）儿童的一个重大且关键的问题 家庭以难民的身份来到美国[例如，苗族，柬埔寨，老挝，越南语]。海洋儿童是 肥胖率更高，其他与饮食有关的慢性疾病的风险增加不成比例地燃烧 类似于2型糖尿病，相对于其他亚洲亚组，白人和“其他”种族。虽然饮食干预措施 据我们所知 专为海洋儿童制定的饮食干预措施。那迫切需要饮食 利用最新方法来解决影响海洋的现有健康差异的干预措施 儿童并提高对干预研究中差距的科学理解。建议概述。这 提案反映了我们与海洋中心的八年（正在进行的）学术社区研究合作伙伴关系 在罗德岛州，与海家庭的形成性工作以及我们的丰富经验成功饮食 干预服务不足的健康差异群体。当前的研究是一项试验性可行性研究，测试 创新的多级，多组分，多代饮食干预措施，以提高海洋饮食质量 孩子们。概念模型。社区能源平衡和以家庭为中心的行动模型 干预布局和实施框架提供了干预的理由和结构。这些 框架建议，对于海洋，多级，多组分等差异少数民族， 代际干预措施是改变和维持的最有效的干预方法 个人级别的行为改变。社会认知理论和大众教育哲学告知 干预内容。研究计划概述。 75个有6至11岁儿童的海洋家庭将是 从罗德岛的普罗维登斯县招募。成人对成年对将被随机分配到：（1）经济激励措施 只有每周收到$ 15的财务激励优惠券才能补贴购买健康食品的手臂 当地的海杂货店； （2）经济激励加上两次基于家庭的集体营养教育两次 海洋社区卫生工作者领导的海洋中心；训练有素的三个动机访谈（MI）电话 社区卫生工作者；成人的饮食规范消息传递（通过每周短信）和儿童（通过 营养教育课程的信息图）；和每周15美元的经济激励优惠券以补贴 在海上杂货店购买健康食品；或（3）学术参与注意力控制部门 将遵循财务激励以及营养教育，MI和短信的结构以及 信息图表臂。主要结果是研究可行性和儿童的临床意义改善 饮食质量（通过健康饮食指数衡量）。次要结果是临床上有意义的变化 儿童体重（〜2kg减肥或不体重增加），HBA1C（0.5％）和父母的饮食质量，HBA1C和 家庭食品环境。这些研究发现将用于为未来的更大的临床试验提供信息。