Healthy Child Weight Through Improved Parent Practices and Environmental Change

通过改善家长的做法和环境变化来保持儿童的健康体重

基本信息

批准号：
7687891
负责人：
Dianne Stanton Ward
金额：
$ 73.21万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-15 至 2012-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7687891
关键词：
Active Learning Address Adopted Affect Age Anthropometry Behavior Biometry Body fat Child Child Behavior Child Care Child health care Clinical Psychology Coercion Communication Counseling County Data Development Diet Dietary intake Eating Educational process of instructing Epidemiology Equation Exercise Family Group Homes Health Communication Health Status Home environment Intervention Knowledge Lead Learning Life Low income Maintenance Measurement Measures Methods Modeling Mothers Motivation North Carolina Obesity Outcome Overweight Parenting behavior Parents Physical activity Physical environment Preschool Child Prevalence Prevention Preventive Intervention Randomized Randomized Controlled Trials Recommendation Recruitment Activity Regression Analysis Research Research Personnel Science Self Determination Series Soaps Social Environment Socialization Stress Surveys Techniques Telephone Testing Time Management Translating Upper arm Weight Weight Gain Work base critical period design efficacy testing efficacy trial environmental change experience foster parent improved innovation intervention effect motivational enhancement therapy nutrition obesity prevention peer preference prevent primary outcome programs psychosocial public health relevance research study skills social theories therapy design

项目摘要

DESCRIPTION (provided by investigator): The early years between ages 3 -7 have been described as a critical period in the development of obesity. The importance of the family on the development of eating and physical activity behaviors in young children has been emphasized by experts, yet to date no obesity prevention interventions incorporating a strong family focus with emphasis on improved parenting practices have been developed. The work proposed here will address this gap by testing the efficacy of a 12-mo parent-focused intervention designed to change multiple aspects of children's home environments (both social and physical), which in turn will reduced percent body fat (%BF) in children. Subjects will be 280 parent-child pairs recruited through child care settings that cater to lower income families. Following baseline measures, pairs will be randomized into intervention or control. The intervention will first focus on teaching more effective parenting skills (time management, communication, etc.); then showing how specific parenting practices can influence a child's physical and social environment and encourage healthier behaviors. The intervention will be delivered through group sessions and home-based telephone calls (group chats and tailored calls) facilitated by a certified parent educator. Group sessions will use multiple teaching strategies such as "Parentela Novellas" (soap opera-like videos which provides models for skills practice). Sessions will also provide separate child activities that build off the coercion hypothesis and prepare children to receive new parenting practices. Group phone chats will build peer support among parents and tailored counseling calls will use motivational interviewing techniques to help parents overcome barriers to implementing new behaviors. The intervention is guided by Darling and Steinberg's Integrative Model of parenting (1993) which highlights the importance of parenting values, style and practices in child socialization. In addition, Self-Determination Theory (Ryan, 2000) is used to create a program that fosters parents' autonomous motivation to adopt new parenting style and practices. The result is a intervention that will help parents learn skills to reduce their parenting-related stress and create a home environment that supports the development of healthy-weight behaviors. The primary outcome, %BF in children, will be assessed using anthropometry and a validated prediction equation (Denzenberg, 1999). Analyses will include baseline measurements of the outcome as a covariate. Secondary measures include child and mother diet and physical activity, parenting style and practices, parenting stress, and home environment. Maintenance of intervention effect will be assessed following a 12-mo no-intervention period. This intervention will create the intensive exposure necessary to make life-altering changes in parent and child behavior that will result in reduced body fat. Plans are based on extensive formative work, and the research will be lead by a group of very experienced investigators. PUBLIC HEALTH RELEVANCE: Efforts are needed to assure that young children develop healthy eating and physical activity behaviors for healthy weight development. Parent behavior affects both the social and physical home environment, creating the context within which these behaviors develop. Few programs exist to prevent obesity and fewer still have used a family-focused approach. This application describes an innovative, theory-driven intervention designed to help parents implement more effective parenting behaviors and reduce their parenting-related stress, while also creating a home environment that supports the development of healthy weight practices in their preschool children.

描述（由研究者提供）：3 -7 岁之间的早年被描述为肥胖发展的关键时期。专家强调了家庭对幼儿饮食和身体活动行为发展的重要性，但迄今为止，还没有制定出以家庭为重点并强调改善养育方式的肥胖预防干预措施。这里提出的工作将通过测试为期 12 个月的以家长为中心的干预措施的有效性来解决这一差距，该干预措施旨在改变儿童家庭环境的多个方面（社会和身体），从而减少儿童的体脂百分比 (%BF)。孩子们。受试者将是通过面向低收入家庭的托儿机构招募的 280 对亲子。根据基线测量，配对将被随机分为干预组或对照组。干预措施首先将侧重于教授更有效的育儿技能（时间管理、沟通等）；然后展示具体的养育做法如何影响孩子的身体和社会环境并鼓励更健康的行为。干预措施将通过由经过认证的家长教育工作者主持的小组会议和家庭电话（群聊和定制电话）进行。小组课程将使用多种教学策略，例如“Parentela Novellas”（类似肥皂剧的视频，提供技能练习的模型）。会议还将提供单独的儿童活动，以强制假设为基础，让孩子们做好接受新的育儿实践的准备。群组电话聊天将在家长之间建立同伴支持，定制的咨询电话将使用动机访谈技术来帮助家长克服实施新行为的障碍。该干预以达林和斯坦伯格的养育综合模型（1993）为指导，该模型强调了养育价值观、风格和实践在儿童社会化中的重要性。此外，自我决定理论（Ryan，2000）被用来创建一个项目，培养父母采用新的养育方式和做法的自主动机。其结果是一项干预措施将帮助父母学习技能，减少与养育相关的压力，并创造一个支持健康体重行为发展的家庭环境。主要结果，即儿童的 %BF，将使用人体测量学和经过验证的预测方程进行评估（Denzenberg，1999）。分析将包括结果的基线测量作为协变量。次要指标包括儿童和母亲的饮食和身体活动、养育方式和做法、养育压力和家庭环境。干预效果的维持情况将在 12 个月的无干预期后进行评估。这种干预措施将产生必要的密集暴露，从而改变父母和孩子的行为，从而改变生活，从而减少体脂。计划以广泛的形成工作为基础，研究将由一组非常有经验的研究人员领导。公共卫生相关性：需要努力确保幼儿养成健康的饮食和身体活动行为，以促进健康的体重发展。父母的行为会影响社会和物质家庭环境，为这些行为的发展创造环境。很少有预防肥胖的计划，而且采用以家庭为中心的方法的计划也更少。该应用程序描述了一种创新的、理论驱动的干预措施，旨在帮助父母实施更有效的育儿行为并减轻与育儿相关的压力，同时还创造一个支持学龄前儿童健康体重实践发展的家庭环境。