Strong Families Start at Home/Familias Fuertes Comienzan en Casa: A novel Video and Motivational Interviewing Intervention to improve diet quality of low-income, ethnically diverse children

强大的家庭从家庭开始/Familias Fuertes Comienzan en Casa：新颖的视频和动机访谈干预措施，旨在改善低收入、种族多样化儿童的饮食质量

• 批准号: 10585437
• 负责人: ALISON TOVAR
• 金额: $ 55.85万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-08 至 2028-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585437
• 关键词: 5 year old; Address; Adolescence; Adult; Attention; Behavior; Beverages; Body mass index; COVID-19; Cardiometabolic Disease; Cardiovascular Diseases; Carotenoids; Cessation of life; Child; Child Rearing; Clip; Communities; Community Health Aides; Cues; Dermal; Desire for food; Diet; Dietary Fiber; Dietary intake; Dose; Eating; Enrollment; Equipment and supply inventories; Exposure to; Family; Feedback; Food; Food Access; Health; Health Food; Healthy Eating; High Prevalence; Home; Home visitation; Hour; Intervention; Knowledge; Latinx; Latinx population; Learning; Life; Low income; Measurement; Measures; Mediator; Morbidity - disease rate; Motivation; Nursery Schools; Obesity; Outcome Measure; Parents; Participant; Population Heterogeneity; Preparation; Preschool Child; Primary Prevention; Printing; Public Health; Randomized, Controlled Trials; Reduce health disparities; Research; Resources; Risk Factors; Satiation; School-Age Population; Self Efficacy; Shapes; Signal Transduction; Strategic Planning; System; Telephone; Testing; Text Messaging; Time; Training; Unhealthy Diet; United States National Institutes of Health; Work; acceptability and feasibility; comparison group; contextual factors; cooking; cost; dietary; disorder prevention; efficacy evaluation; efficacy testing; energy balance; ethnic diversity; experience; feasibility testing; feasibility trial; feeding; food environment; food quality; food resource; food security; fruits and vegetables; group intervention; improved; indexing; intervention delivery; intervention effect; motivational enhancement therapy; novel; pilot test; precision nutrition; preventive intervention; primary outcome; public health relevance; screening; secondary outcome; social determinants; social health determinants; trait; trial design

The diets of US children are suboptimal and effective primary prevention interventions are urgently needed to shape dietary behaviors early in life, especially among Latinx families, who experience higher prevalence of obesity and cardiovascular disease. The community energy balance framework suggests the need to intervene at multiple levels, while addressing cultural and contextual factors, to effectively impact diet quality for disease prevention including: 1) Child level, including appetitive traits (satiety responsiveness (sensitivity to internal satiety signals), food responsiveness (sensitivity to external food cues), and food fussiness; 2) Parent level including the food parenting practices they use to feed children; 3) Home level including the availability and accessibility of food, and; 4) Broader context including social determinants, food security/access to healthy foods. While there have been several interventions aimed at improving the diet quality of young children, few have targeted more than one of these levels and almost none are tailored to a child’s appetitive traits, culturally appropriate, and convenient for busy, working Latinx families. Further, most have only focused on what parents should not be doing, rather than supporting what they should be doing. This proposal will build on our recently completed R34 pilot feasibility trial (R34HL140229-01A1) to test the efficacy of a novel home-based intervention with 257 Latinx families of preschool children. The proposed 6-month intervention will include: 1) Three home visits by a community health worker (CHW) trained in brief motivational interviewing that include in-home cooking demonstrations to prepare a meal involving the child; using a family meal-time video to provide feedback on food parenting; 2) Screening for social-determinants of health and connecting families to federal/state/local resources; 3)Text-messages (2x/wk); 4) Tailored materials/messages; and 5) Three CHW phone calls to reinforce food parenting, food resource management and healthy eating. Specific Aims are to: Improve quality of the dietary intakes of 2–5-year-old children (Aim 1); Improve food parenting practices (Aim 2); and Improve the home availability of healthy foods (Aim 3). Exploratory aims will assess: the relationship between outcome measures and intervention dose; the relationship between outcome measures and potential mediators and moderators and the intervention’s effect on child BMI. This study fills an important research gap by targeting the home food environment with positive food parenting while acknowledging a child’s appetitive traits. It also meets the NIH call for needed research to reduce health disparities among Latinx populations and has the potential for high public health impact.

美国儿童的饮食不理想，有效的初级预防干预措施尚不完善 迫切需要在生命早期塑造饮食行为，特别是在拉丁裔家庭中， 肥胖和心血管疾病的患病率较高。 平衡框架表明需要在多个层面进行干预，同时解决文化问题 和背景因素，以有效影响饮食质量以预防疾病，包括： 1) 儿童 水平，包括食欲特征（饱腹感反应性（对内部饱腹感信号的敏感性）， 食物反应性（对外部食物线索的敏感性）和食物​​挑剔程度；2）家长水平； 3) 家庭层面，包括他们用来喂养孩子的食物育儿实践； 食物的供应和获取；4) 更广泛的背景，包括社会决定因素、食物 尽管已经采取了一些干预措施来实现安全/获得健康食品。 改善幼儿的饮食质量，很少有目标超过其中一个水平 几乎没有一个是根据孩子的食欲特征量身定制的、文化上合适的、方便的 此外，对于忙碌的拉丁裔工作家庭来说，大多数人只关注父母不应该做的事情。 该提案将建立在我们的基础上。 最近完成了 R34 试点可行性试验（R34HL140229-01A1），以测试一种新型药物的功效 对 257 个学龄前儿童的拉丁裔家庭进行家庭干预 拟议为期 6 个月。 干预措施将包括： 1) 由受过培训的社区卫生工作者 (CHW) 进行 3 次家访 简短的励志访谈，包括准备饭菜的家庭烹饪演示 让孩子参与；使用家庭进餐视频提供有关食物养育的反馈； 筛查健康的社会决定因素并将家庭与联邦/州/地方联系起来 资源；3) 短信（2 次/周）；4) 定制材料/消息；以及 5) 三个 CHW； 电话加强食品育儿、食品资源管理和健康饮食。 具体目标是： 提高 2-5 岁儿童的膳食摄入质量（目标 1）； 改善食品育儿实践（目标 2）；以及 提高健康食品的家庭供应量； （目标 3）。探索性目标将评估：结果测量与结果之间的关系。 干预剂量；结果测量与潜在中介因素之间的关系以及 这项研究填补了一项重要的研究空白。 通过积极的食物养育来瞄准家庭食物环境，同时欣赏 它也满足了美国国立卫生研究院（NIH）对降低健康状况进行必要研究的呼吁。 拉丁裔人口之间的差异，并有可能对公共卫生产生重大影响。