Identifying the Ideal Dose of Structured Summer Programming for Mitigating Accelerated Summer BMI Gain

确定结构化夏季计划的理想剂量，以缓解夏季体重指数加速增长

• 批准号: 10653609
• 负责人: Robert G Weaver
• 金额: $ 57.1万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10653609
• 关键词: 8 year old; Acceleration; Address; Adult; Behavior; Body mass index; COVID-19 pandemic; Child; Communities; Development; Diet; Dose; Environment; Health; Health Policy; Individual Adjustment; Intervention; Monitor; Nutrient; Obesity; Obesity Epidemic; Outcome; Overweight; Participant; Pharmacologic Substance; Phase III Clinical Trials; Physical activity; Public Health; Quasi-experiment; Randomized; Research; Schedule; Schools; Selection Bias; Sleep; Structure; Testing; Time; Weight; Weight Gain; Work; contextual factors; cost effectiveness; dietary supplements; dosage; group intervention; health goals; implementation determinants; implementation evaluation; implementation outcomes; innovation; novel; obesity in children; obesogenic; prevent; programs; response; school disruption; sedentary; tv watching; virtual

Summer is a period of accelerated BMI gain for children (5-12yrs). Studies show that virtually all increases in BMI occur during the summer, no matter children’s’ weight status (i.e., normal weight, overweight, or obese) at summer entry. Our research team recently developed the Structured Days Hypothesis (SDH), which may explain accelerated summer BMI gain. The SDH posits that structure, defined as pre-planned, segmented, and adult-supervised compulsory environments, protect children against obesogenic behaviors and prevent excessive BMI gain. The SDH draws upon the ‘filled-time perspective’, which posits that time filled with favorable activities cannot be filled with unfavorable activities. In the context of the SDH, this means that children engage in more obesogenic behaviors that lead to increased weight gain during times that are less-structured (e.g., summer days) compared to times that are more structured (e.g., school days). Based on the SDH, pre-existing community-operated summer day camps (e.g., B&G Club, YMCA), may exert a positive influence on summer BMI gain by limiting children’s engagement in obesogenic behaviors. Recent preliminary studies show that children engage in healthier behaviors on days that they attend summer day camps, and that BMI gain does not accelerate for these children. A major weakness in the rigor of these preliminary studies is that they cannot identify the dose-response relationship between structured summer programming and summer BMI gain. Dose-response studies can definitively identify the smallest dose at which a useful effect is observed while simultaneously revealing the maximum dose beyond which there is no further beneficial effect. In the same way determining the effective dose of structure to mitigate negative health outcomes is necessary to inform feasible, scalable interventions and health policy. The proposed randomized dose-response study will identify the dose-response relationship between amount of summer programming and summer BMI gain. The impact of 4 weeks (n=90, 20 days), 6 weeks (n=90, 30 days), and 8 weeks (n=90, 40 days) of summer programming compared to no program (n=90) will be evaluated. We will also conduct comprehensive implementation monitoring to evaluate implementation, and to identify factors associated with children’s summer BMI gain and obesogenic behaviors. The aims of the study are to: Aim 1. Evaluate structured summer programming’s impact on children’s BMI gain and obesogenic behaviors. Aim 2. Evaluate implementation and contextual factors and their relationship with children’s summer BMI gain and obesogenic behaviors. Aim 3. Determine the cost effectiveness of 4, 6, 8 weeks of summer programming for mitigating accelerated summer BMI gain. This work is significant as it addresses a critical public health goal – reducing obesity – through programing during a timeframe – summer vacation – when substantial, long-lasting negative effects occur. This application is innovative because of the focus on identifying the dose-response relationship between structured summer programming and summer BMI gain. This innovation addresses a weakness in the rigor of previous studies and is critical for identifying the ideal dose of summer programming for mitigating accelerated summer BMI gain.

夏季是儿童（5-12 岁）BMI 加速增长的时期 研究表明，几乎所有 BMI 的增长都会发生。 在夏季，无论儿童在夏季入学时的体重状况（即正常体重、超重或肥胖）。 研究小组最近提出了结构化日假说（SDH），这可能解释夏季体重指数加速 SDH 的定位被定义为预先计划的、分段的和成人监督的强制性的。 SDH 利用的方法是保护儿童免受肥胖行为的影响并防止 BMI 过度增加。 “充实时间观点”，认为充满有利活动的时间不能充满不利活动 在 SDH 的背景下，这意味着儿童会从事更多导致肥胖的行为。 与安排较多的时间相比，安排较少的时间（例如夏季）体重增加增加 基于 SDH、现有社区运营的夏令营（例如 B&G）。 俱乐部、YMCA）可能通过限制儿童参与致肥胖活动对夏季 BMI 增加产生积极影响 最近的初步研究表明，孩子们在暑假期间表现出更健康的行为。 日间营，并且这些孩子的体重指数增长并没有加速，这是这些初步测试严格性的一个主要弱点。 研究表明，他们无法确定结构化夏季计划和 夏季 BMI 增益的剂量反应研究可以明确地确定观察到有效效果的最小剂量。 同时以同样的方式揭示最大剂量，超过该剂量就没有进一步的有益效果。 确定减轻负面健康后果的结构的有效剂量对于提供可行的、可扩展的信息是必要的 拟议的随机剂量反应研究将确定剂量反应。 夏季编程量与夏季 BMI 增益之间的关系 4 周（n=90、20 天）的影响， 6 周（n=90, 30 天）和 8 周（n=90, 40 天）的暑期项目与没有项目（n=90）相比，将 我们还将进行全面的实施监测，以评估实施情况，并进行评估。 确定与儿童夏季体重指数增加和肥胖行为相关的因素该研究的目的是： 目标 1. 评估结构化暑期计划对儿童 BMI 增加和肥胖行为的影响。 目标 2. 评估实施和背景因素及其与儿童夏季 BMI 增长和体重的关系 目标 3. 确定 4、6、8 周的夏季计划对于缓解肥胖行为的成本效益。 这项工作意义重大，因为它实现了夏季 BMI 的加速增长——减少肥胖。 通过在暑假期间进行编程，此时会产生重大、持久的负面影响。 该应用程序具有创新性，因为重点在于确定结构化夏季之间的剂量反应关系 这项创新解决了先前研究的严格性中的弱点，并且是。 对于确定夏季计划的理想剂量以缓解夏季体重指数加速增长至关重要。