iAmHealthy Parents First

我健康父母第一

基本信息

批准号：
10582548
负责人：
Christie Befort
金额：
$ 76.58万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-03 至 2025-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10582548
关键词：
Address Adult Affect Age Area Behavior Therapy Behavioral Behavioral Model Body Weight Changes Body Weight decreased Body mass index Cardiovascular Diseases Child Child Behavior Childhood Clinic Code Commuting Data Daughter Development Diabetes Mellitus Diet Dietary intake Effectiveness Evidence based intervention Face Family Food Fostering Future Genetic Habits Health and Behavior in Children Health behavior Home Home environment Hour Inherited Intervention Interview Leadership Malignant Neoplasms Mediator Medical Mentored Clinical Scientist Development Program Modeling Monitor Morbidity - disease rate Nurses Nursing Assessment Obesity Outcome Parents Participant Physical activity Play Population Primary Care Quality of life Randomized Reporting Research Risk Factors Running Rural Rural Community Rural Population Schedule Schools Side Site Structure Subgroup Technology Testing Time Travel Waiting Lists Weight Weight maintenance regimen Work acceptability and feasibility arm behavior change design dissemination strategy effectiveness evaluation effectiveness study elementary school evidence base experience food environment fruits and vegetables group intervention health care settings implementation strategy improved innovation interest lifestyle intervention low socioeconomic status mHealth moderate-to-vigorous physical activity mortality obesity in children obesity treatment post intervention programs randomized trial recruit retention rate rural Americans rural area rural dwellers rural families rural health clinic rural healthcare secondary outcome sugar sweetened beverage theories therapy design treatment effect treatment program tv watching weight loss intervention

项目摘要

Project Summary/Abstract Both children and adults in rural areas have higher obesity rates than their urban counterparts. With less access to evidence-based weight loss interventions, obesity poses a major risk factor contributing to elevated morbidity and mortality from cardiovascular disease, diabetes, and cancer among rural Americans. Obesity runs in families due to multiple factors including hereditary components, home environment, and behavioral modeling around dietary intake, physical activity, and screen time. Thus, targeting the rural family unit has the potential to enhance weight loss for adults and children simultaneously. Previous research from our team indicates that mHealth is feasible and acceptable for the delivery of obesity interventions to rural families as this type of intervention lowers child Body Mass Index z score (BMIz) and helps children and families to significantly change their health behaviors. The current application extends this work in a new and innovative direction, targeting parents first with an empirically supported obesity intervention, and then moving on to treat the family unit. In a randomized trial, we propose to compare a 4-month parent-only intervention followed by a 6-month family based behavioral group intervention (iAmHealthy-Parents First) to a parent wait-list control followed by the family based behavioral group intervention (iAmHealthy). Parent/child dyads will be recruited from both rural elementary schools and rural medical clinics in 8 towns. Each town will consist of a single site and will recruit 30 parent/child dyads, 15 of whom will be randomly assigned to iAmHealthy-Parents First and 15 to iAmHealthy, for a total of 240 parents and 240 children. Each rural town will have a population < 20,000 and/or the Rural Urban Commuting Area Codes of 4 or greater, and for the purposes of the study will include a nurse at a rural health clinic partnering with a nurse at a rural elementary school to make a single site. In Aim 1 we propose to study effectiveness through change in child BMIz and parent percent weight loss from baseline to month 10 (post-intervention), as well as through change in diet, change in physical activity and change in parent and child weight related quality of life. In Aim 2, we propose to assess mediators and moderators that we believe are specifically important to the treatment model and to the rural population. In Aim 3 we propose to explore the reach and representativeness of the intervention, and to explore a concept we have found key in both our adult and pediatric trials – nurse engagement. Our experience suggests that nurse engagement plays a key role in recruitment, retention, and engagement of the families, and here we propose to assess nurse engagement as well as foster it through the development of a Rural Nurse Engagement Collaborative. This exploratory aim will provide critical pragmatic data to inform future studies aimed at testing local implementation and dissemination strategies. The iAmHealthy Parents First intervention is an easily scalable, widely disseminable obesity intervention option which could significantly improve the way we treat obesity among rural families.

项目概要/摘要农村地区的儿童和成人的肥胖率都高于城市邻居，而且肥胖率也较低。对于基于证据的减肥干预措施，肥胖是导致发病率升高的主要危险因素美国农村地区的心血管疾病、糖尿病和癌症死亡率与家庭有关。由于多种因素，包括遗传因素、家庭环境和周围的行为模式因此，以农村家庭为单位有可能提高饮食摄入量、体力活动和屏幕时间。我们团队之前的研究表明，移动健康可以同时帮助成人和儿童减肥。向农村家庭提供肥胖干预措施是可行且可接受的，因为此类干预措施降低了儿童体重指数 z 分数 (BMIz) 并帮助儿童和家庭显着改变他们的健康当前的应用程序将这项工作扩展到一个新的创新方向，首先针对父母。进行经验支持的肥胖干预，然后继续以随机方式治疗家庭单位。试验中，我们建议比较为期 4 个月的仅由家长进行的干预，以及随后为期 6 个月的基于家庭的行为干预团体干预（iAmHealthy-Parents First）先进行家长等候名单控制，然后是基于家庭的干预行为团体干预（iAmHealthy）将从两个农村小学招募家长/儿童。 8 个镇的学校和农村医疗诊所将由一个站点组成，并招募 30 名家长/儿童。双人组，其中 15 人将被随机分配到 iAmHealthy-Parents First，15 人将被随机分配到 iAmHealthy，总共每个乡村城镇有 240 名父母和 240 名儿童，人口少于 20,000 人和/或城乡通勤。区号为 4 或更大，并且出于研究目的，将包括合作的乡村卫生诊所的护士在目标 1 中，我们建议研究有效性。通过儿童 BMIz 和父母体重减轻百分比从基线到第 10 个月（干预后）的变化，以及通过饮食的改变、体力活动的改变以及父母和孩子体重相关质量的改变在目标 2 中，我们建议评估我们认为特别重要的调解者和调节者。在目标 3 中，我们建议探讨治疗模式和农村人口的影响范围和代表性。干预措施，并探索我们在成人和儿科试验中发现的关键概念——护士我们的经验表明，护士敬业度在招聘、保留和保留方面发挥着关键作用。家庭的参与度，在这里我们建议评估护士的参与度并通过农村护士参与合作社的发展这一探索性目标将提供重要的务实信息。数据为旨在测试当地实施和传播策略的未来研究提供信息。家长优先干预是一种易于扩展、广泛传播的肥胖干预方案，可以改善我们治疗农村家庭肥胖的方式。