Healthy Start: An innovative, multi-level intervention with family child care providers and families to improve the dietary behaviors of preschool children

健康开始：与家庭托儿服务提供者和家庭进行创新的多层次干预，以改善学龄前儿童的饮食行为

• 批准号: 10620978
• 负责人: Kim M. Gans
• 金额: $ 33.44万
• 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: 2023-07-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10620978
• 关键词: Address; Adult; Affect; Attention; Behavior; Beverages; Body mass index; Cardiometabolic Disease; Cardiovascular Diseases; Caring; Carotenoids; Cessation of life; Child; Child Behavior; Child Care; Chronic; Clinical Trials; Cluster randomized trial; Complement; Consumption; Cues; Data; Dermal; Diabetes Mellitus; Diet; Dietary Fiber; Dietary Intervention; Dietary Practices; Dietary intake; Disease; Eating; Eating Behavior; Enrollment; Environment; Extended Family; Family; Family member; Food; Food Preferences; Foundations; Fruit; Future; Health; Heart; Home; Home environment; Intervention; Interview; Latinx; Licensing; Low income; Mission; Morbidity - disease rate; National Institute of Diabetes and Digestive and Kidney Diseases; Nursery Schools; Nutritional Study; Obesity; Outcome; Parents; Physical activity; Preschool Child; Prevention; Printing; Protocols documentation; Provider; Randomized, Controlled Trials; Research; Risk Factors; Shapes; Suggestion; Time; Training; Trust; Vegetables; Weight; acceptability and feasibility; care providers; comparison intervention; cost; dietary; effective intervention; efficacy testing; empowerment; ethnic diversity; ethnic minority; ethnic minority population; feasibility research; feasibility testing; flexibility; follow-up; food environment; frontier; high risk; improved; innovation; intervention refinement; minority children; multi-component intervention; novel; nutrition; obesity prevention; obesity risk; patient home care; pilot test; pilot trial; preventive intervention; primary outcome; public health relevance; response; secondary outcome; sedentary lifestyle; smartphone application; social; trend

The preschool years are a critical time for shaping food preferences and eating behaviors which, in turn, affect dietary behaviors in adults and life-long risks for obesity, diabetes, cardiovascular disease and other chronic conditions. Unfortunately, many US children, especially low-income and ethnic minorities, have dietary patterns associated with obesity and increased morbidity. Thus, to improve child diet quality, it is essential to develop effective targeted interventions in settings where children (especially higher risk children) spend time. There is a national call for dietary interventions that span multiple settings including the childcare and home environments. In response to PAS-20-160, we build upon our efficacious Healthy Start intervention with family childcare home (FCCH) providers (FCCP) to pilot a novel, 8-month multilevel tailored intervention to reach families through FCCH. This would be the first study to incorporate family-based intervention components into FCCH. FCCH are a promising intervention setting as parents trust FCCPs as extended family members and FCCP feel comfortable talking to parents about children’s diet, but want more training to do so effectively. The 8-month intervention will include an adapted version of the Healthy Start intervention for English and Spanish-speaking FCCP as well as FCCP training to deliver nutrition messages to parents using an existing childcare App, complemented with FCCH environmental cues and tailored print and videos for parents. Specific Aims are to: SA.1. Conduct formative research with FCCP and parents to inform refinement of the multi-level intervention. SA.2. Conduct a pilot trial with 40 FCCP and 80 parents with 18-54-month-old children to evaluate feasibility and acceptability of intervention and study protocols, and preliminary efficacy of the nutrition intervention compared to an attention-matched control on: a). children’s dietary quality at FCCH and home, b). social/physical FCCH and home food environments, c). children’s dermal carotenoid levels and z-BMI scores. SA3. Conduct post qualitative interviews with parents, FCCP, coaches, staff & partners to assess the intervention’s acceptability and suggestions for improvement. In sum, feasible and effective interventions to improve young children’s diets are urgently needed. The FCCH is a novel and untapped setting to intervene with both FCCP and parents simultaneously to affect children’s diets in both the childcare and home settings, which has the potential to more fully impact the child’s overall diet and weight status. This pilot feasibility research of a novel, multi-level intervention will inform a future full-scale cluster RCT, which will fill important research gaps and move the frontier of nutrition research forward.

学前班是塑造食物偏好和饮食行为的关键时期 反过来，这会影响成年人的饮食行为和肥胖，糖尿病，终身风险 心血管疾病和其他慢性病。不幸的是，许多美国孩子 特别是低收入和少数民族，具有与肥胖和 发病率增加。为了提高儿童饮食质量，必须有效发展 在儿童（尤其是较高风险儿童）花费时间的环境中进行的针对性干预措施。 有一个全国性的饮食干预措施涵盖了多种环境，包括 育儿和家庭环境。为了回应PAS-20-160，我们以高效为基础 与家庭育儿房屋（FCCH）提供商（FCCP）的健康开始干预，以试行一本小说， 8个月的多级量身定制干预措施通过FCCH到达家庭。这将是第一个 将基于家庭的干预组件纳入FCCH的研究。 FCCH是一个有前途的 作为父母的干预设置，将FCCP作为大家庭成员和FCCP感觉 舒适地与父母谈论孩子的饮食习惯，但希望有更多的培训有效地进行。 8个月的干预措施将包括适合健康的开始干预的版本 英语和西班牙语的FCCP以及FCCP培训，以向营养信息传递给 父母使用现有的育儿应用程序，并通过FCCH环境提示完成 为父母量身定制的印刷品和视频。具体目标是：SA.1。进行格式研究 与FCCP和父母一起，将多层干预的细化告知。 SA.2。进行飞行员 与40名FCCP和80个父母的试验，有18-54个月大的孩子，以评估可行性和 干预和研究方案的可接受性以及营养的初步效率 与注意力匹配的控制相比：a）。 FCCH的儿童饮食质量 和家，b）。社交/物理FCCH和家庭食品环境，c）。儿童真皮 类胡萝卜素水平和Z-BMI得分。 SA3。与父母进行定性访谈后， FCCP，教练，员工和合作伙伴评估干预的可接受性和建议 改进。总而言之，可行有效的改善幼儿饮食的干预措施是 迫切需要。 FCCH是一种新颖且未开发的设置，可与FCCP和 父母只是在育儿和家庭环境中影响儿童饮食 有可能更充分地影响孩子的整体饮食和体重状况。这个飞行员 对新颖的多层次干预的可行性研究将为未来的全尺度集群RCT提供信息， 这将填补重要的研究空白，并推动营养研究的前沿。