Reducing Sugared Fruit Drinks in Alaska Native Children

减少阿拉斯加原住民儿童的含糖水果饮料

基本信息

批准号：
10115247
负责人：
Donald Leslie Chi
金额：
$ 1.44万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-01 至 2021-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10115247
关键词：
Address Age Alaska Alaska Native American Heart Association American Indians Behavior Behavioral trial Belief Beverages Biological Markers Caregivers Child Chronic Communication Communities Community Health Aides Consumption Data Dental Dental Care Dental caries Development Diet Disease Elements Enhancers Ensure Evidence based program Exercise Family Focus Groups Food Fruit Goals Group Interviews Hair Health Health Promotion Health education Healthy People 2020 Home environment Hour Indigenous Infant Intake Interdisciplinary Study Intervention Lead Learning Life Maintenance Manuals Manuscripts Measures Milk Misinformation Modeling Morbidity - disease rate Mouth Diseases National Institute of Dental and Craniofacial Research Native Americans Oral health Outcome Output Paper Participant Persons Population Price Program Sustainability Public Health Quality of life Research Resources Risk Factors Rural Sampling Schools Selection Bias Self Efficacy Services Social support Structure Systemic disease Taste Perception Testing Time Training Update Vulnerable Populations Water Weight Work Yukon Kuskokwim Yukon-Kuskokwim Delta Yup&apos ik active method arm base behavior change caregiver education community planning early childhood experience health inequalities healthy lifestyle improved indigenous community member middle childhood nutrition primary outcome program dissemination programs recruit research study response social cognitive theory sugar systematic review tool treatment arm

项目摘要

Project Abstract Yup’ik children in Alaska’s YK Delta consume an average of 50 teaspoons of sugar each day, 16 times the American Heart Association’s recommended maximum. Most of this sugar is from fruit drinks like Tang and Kool-Aid consumed at home. Consequently, Yup’ik children experience tooth decay rates that are 16x the U.S. average and suffer from oral health inequalities compared to children from communities that are better off. Tooth decay is a multifactorial disease, but our pilot work shows sugared fruit drinks are the key risk factor. YK Delta communities have expressed a desire to target sugared fruit drinks that continue to harm their children. This study is a culmination of over 5 years of engaged research within YK Delta communities to co-develop a culturally-appropriate, feasible, and sustainable program to address persisting public health problems caused by sugared fruit drinks. We propose a 2-arm quasi-experimental behavioral trial in 3 small, isolated Alaska Native communities to test the hypothesis that Community Health Worker-led health education and self- efficacy training for caregivers will decrease child added sugar intake. We will introduce families to sugar-free water enhancers that will be made available through local stores. The Specific Aims are to: (1) Complete pre- intervention activities and finalize the intervention; (2) Implement the intervention and assess outcomes; and (3) Identify intervention improvement opportunities and disseminate findings. This application builds on previous R56 research by the study team and will for the first time seek to change sugared fruit drink intake in Alaska Native communities. 3 communities will be assigned to 1 of 2 arms based on the order communities were recruited into the study. In Communities A and B, 136 Yup’ik children ages 0-10 years will be recruited to test the 6-month culturally-adapted, 5-session intervention consisting of interactive health education and self- efficacy training delivered in-person by an indigenous Community Health Worker. In Community C, 56 children will be recruited to a comparison condition in which health education with the same culturally-adapted content is delivered by mail. Health education will address misinformation about sugared fruit drinks and promote sugar-free water enhancers. Self-efficacy training will empower caregivers to sustain behavior change over time. Local stores in all 3 communities will stock sugar-free water enhancers (Tang, Kool-Aid, and other popular flavors) as a tool to help shift children from sugared fruit drinks. The primary outcomes at the child level are sugared fruit drink intake (24-hour food recalls) and added sugar intake (validated, non-invasive biomarker) and will be measured at baseline and at 1, 3, 6, and 12 months. The Yukon Kuskokwim Health Corporation will maintain and disseminate the program if it works to address a critical problem facing 15,000+ Alaska Native children in the YK Delta. Moreover, it can be adapted to meet the needs of other populations with similar problems, including the millions of indigenous children in the Lower 48.

项目摘要 Yup’ik的孩子在阿拉斯加的YK Delta中平均每天消耗50茶匙糖，是16倍的糖美国心脏协会的建议最大。大多数糖来自唐和饮料 Kool-Aid在家消耗。因此，Yup’ik儿童经历了16倍美国的蛀牙率与社区的儿童相比，平均水平和遭受口腔健康不平等的不平等。蛀牙是一种多因素疾病，但我们的试点工作表明，加糖果酒是关键的危险因素。 yk 三角洲社区表示希望以继续伤害其子女的糖果饮料为目标。这项研究是YK三角洲社区中5年以上参与研究的高潮，以共同开发在文化上适当，可行和可持续的计划，以解决持续的公共卫生问题通过加糖的果实饮料。我们在3个小的，孤立的阿拉斯加提出了2臂准实验性行为试验土著社区检验以社区卫生工作者领导的健康教育和自我为生的假设对护理人员的疗效培训将减少儿童添加的糖摄入量。我们将向家庭介绍无糖通过当地商店提供的水增强剂。具体目的是：（1）完整的预 - 干预活动并确定干预措施；（2）实施干预和评估结果；和（3）确定改善干预机会并传播发现。此应用程序建立在研究团队的先前R56研究，将首次寻求更改Supared Frut Drafd摄入量阿拉斯加土著社区。 3个社区将根据订单社区分配给2个武器中的1个被招募到研究中。在社区A和B中，将招募136岁的Yup’ik Yup’ik儿童。测试由互动健康教育和自我组成的6个月的文化适应，5份干预措施一名土著社区卫生工作者面对面进行的疗效培训。在社区C中，有56个孩子将招募到一个比较条件，在这种情况下，具有相同文化适应性内容的健康教育通过邮件交付。健康教育将解决有关加糖果酒的错误信息并促进无糖增强剂。自我效能训练将使照顾者能够维持行为改变时间。所有3个社区的当地商店将库存无糖的水增强剂（Tang，Kool-Aid和其他流行口味）是一种工具，可以帮助儿童摆脱糖果饮料。孩子的主要结果水平是加糖果酒摄入量（24小时食物召回）和添加的糖摄入量（经过验证，无创生物标志物），将在基线和1、3、6和12个月时进行测量。育空Kuskokwim健康如果公司可以解决15,000多以上的关键问题，将维护和传播该计划 YK三角洲的阿拉斯加原住民。此外，它可以适应其他人群的需求有类似的问题，包括48个较低的数百万本地儿童。