Identifying the Ideal Dose of Structured Summer Programming for Mitigating Accelerated Summer BMI Gain

确定结构化夏季计划的理想剂量，以缓解夏季体重指数加速增长

• 批准号: 10653609
• 负责人: Robert G Weaver
• 金额: $ 57.1万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10653609
• 关键词: 8 year old; Acceleration; Address; Adult; Behavior; Body mass index; COVID-19 pandemic; Child; Communities; Development; Diet; Dose; Environment; Health; Health Policy; Individual Adjustment; Intervention; Monitor; Nutrient; Obesity; Obesity Epidemic; Outcome; Overweight; Participant; Pharmacologic Substance; Phase III Clinical Trials; Physical activity; Public Health; Quasi-experiment; Randomized; Research; Schedule; Schools; Selection Bias; Sleep; Structure; Testing; Time; Weight; Weight Gain; Work; contextual factors; cost effectiveness; dietary supplements; dosage; group intervention; health goals; implementation determinants; implementation evaluation; implementation outcomes; innovation; novel; obesity in children; obesogenic; prevent; programs; response; school disruption; sedentary; tv watching; virtual

Summer is a period of accelerated BMI gain for children (5-12yrs). Studies show that virtually all increases in BMI occur during the summer, no matter children’s’ weight status (i.e., normal weight, overweight, or obese) at summer entry. Our research team recently developed the Structured Days Hypothesis (SDH), which may explain accelerated summer BMI gain. The SDH posits that structure, defined as pre-planned, segmented, and adult-supervised compulsory environments, protect children against obesogenic behaviors and prevent excessive BMI gain. The SDH draws upon the ‘filled-time perspective’, which posits that time filled with favorable activities cannot be filled with unfavorable activities. In the context of the SDH, this means that children engage in more obesogenic behaviors that lead to increased weight gain during times that are less-structured (e.g., summer days) compared to times that are more structured (e.g., school days). Based on the SDH, pre-existing community-operated summer day camps (e.g., B&G Club, YMCA), may exert a positive influence on summer BMI gain by limiting children’s engagement in obesogenic behaviors. Recent preliminary studies show that children engage in healthier behaviors on days that they attend summer day camps, and that BMI gain does not accelerate for these children. A major weakness in the rigor of these preliminary studies is that they cannot identify the dose-response relationship between structured summer programming and summer BMI gain. Dose-response studies can definitively identify the smallest dose at which a useful effect is observed while simultaneously revealing the maximum dose beyond which there is no further beneficial effect. In the same way determining the effective dose of structure to mitigate negative health outcomes is necessary to inform feasible, scalable interventions and health policy. The proposed randomized dose-response study will identify the dose-response relationship between amount of summer programming and summer BMI gain. The impact of 4 weeks (n=90, 20 days), 6 weeks (n=90, 30 days), and 8 weeks (n=90, 40 days) of summer programming compared to no program (n=90) will be evaluated. We will also conduct comprehensive implementation monitoring to evaluate implementation, and to identify factors associated with children’s summer BMI gain and obesogenic behaviors. The aims of the study are to: Aim 1. Evaluate structured summer programming’s impact on children’s BMI gain and obesogenic behaviors. Aim 2. Evaluate implementation and contextual factors and their relationship with children’s summer BMI gain and obesogenic behaviors. Aim 3. Determine the cost effectiveness of 4, 6, 8 weeks of summer programming for mitigating accelerated summer BMI gain. This work is significant as it addresses a critical public health goal – reducing obesity – through programing during a timeframe – summer vacation – when substantial, long-lasting negative effects occur. This application is innovative because of the focus on identifying the dose-response relationship between structured summer programming and summer BMI gain. This innovation addresses a weakness in the rigor of previous studies and is critical for identifying the ideal dose of summer programming for mitigating accelerated summer BMI gain.

夏天是儿童（5-12岁）加速BMI的时期。研究表明，BMI几乎所有增加 在夏季，无论儿童的体重状况如何（即正常体重，超重或肥胖）在夏季进入。我们的 研究小组最近开发了结构化的假设（SDH），可以解释加速的夏季BMI 获得。该结构的SDH物品定义为预先计划，分段和成人监督的强制性 环境，保护儿童免受肥胖行为的影响，并防止过多的BMI增益。 SDH借鉴 “填充时间的观点”认为，充满有利活动的时间不能充满不利 活动。在SDH的背景下，这意味着儿童从事更多的肥胖行为，导致 与更多的时间相比 结构化（例如上学时）。基于SDH，现有的社区经营的夏季营地（例如B＆G 俱乐部，YMCA），可能会通过限制儿童参与肥胖来对夏季BMI产生积极影响 行为。最近的初步研究表明，儿童在夏季参加的日子从事更健康的行为 一日营，而BMI收益并不能加速这些孩子。这些初步的严谨性的主要弱点 研究是，他们无法识别结构化夏季编程与 夏季BMI获得。剂量反应研究可以明确地识别观察到有用效果的最小剂量 同时揭示了最大剂量，超出其没有进一步的有益作用。以同样的方式 确定结构的有效剂量以减轻负面健康结果，以告知可行的可行，可扩展 干预和卫生政策。拟议的随机剂量反应研究将确定剂量反应 夏季节目数量与夏季BMI收益之间的关系。 4周的影响（n = 90，20天）， 与无计划相比，夏季编程的6周（n = 90、30天）和8周（n = 90、40天）将 进行评估。我们还将进行全面的实施监控以评估实施，并 确定与儿童夏季BMI增益和肥胖行为相关的因素。该研究的目的是： AIM 1。评估结构化夏季节目对儿童BMI增益和肥胖行为的影响。 目标2。评估实施和上下文因素及其与儿童夏季BMI收益的关系 肥胖行为。目标3。确定4、6、8周夏季节目的成本效益以减轻 加速的夏季BMI收益。这项工作非常重要，因为它解决了一个关键的公共卫生目标 - 减少肥胖症 - 通过在时间范围内进行编程 - 暑假 - 发生实质性，持久的负面影响。这 应用具有创新性，因为重点是识别结构化夏季之间的剂量反应关系 编程和夏季BMI收益。这项创新解决了以前研究严格的弱点，是 确定夏季编程的理想剂量至关重要，以减轻加速的夏季BMI增益。