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

• 批准号: 7918737
• 负责人: Dianne Stanton Ward
• 金额: $ 71.77万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7918737
• 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; Weight; Weight Gain; Work; arm; 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

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。专家们强调了家庭对幼儿饮食和体育锻炼行为发展的重要性，但迄今为止，还没有开发出肥大的预防干预措施，这些干预措施纳入了强烈的家庭重点，重点是改善育儿习惯。这里提出的工作将通过测试以12个MO父母为中心的干预措施的功效来解决这一差距，旨在改变儿童家庭环境的多个方面（社交和身体），这又可以降低儿童体内脂肪百分比（％BF）。受试者将通过迎合低收入家庭的托儿场所招募280对亲子对。遵循基线措施，对将对干预或对照。干预将首先关注更有效的育儿技能（时间管理，沟通等）；然后展示特定的育儿实践如何影响孩子的身体和社会环境，并鼓励更健康的行为。干预将通过由认证的家长教育者促进的小组会议和基于家庭的电话（小组聊天和量身定制的电话）进行。小组会议将使用多种教学策略，例如“ parentela novellas”（类似于肥皂剧的视频，可提供技能练习模型）。会议还将提供单独的儿童活动，以建立胁迫假设，并准备儿童接受新的育儿惯例。小组电话聊天将在父母之间建立同伴支持，量身定制的咨询电话将使用激励性的面试技术来帮助父母克服实施新行为的障碍。这项干预措施以达令和斯坦伯格的养育综合模型（1993）为指导，该模型突出了育儿价值观，风格和实践在儿童社交化中的重要性。此外，自决理论（Ryan，2000）用于创建一个程序，以促进父母的自主动机采用新的育儿风格和实践。结果是一种干预措施，将帮助父母学习技能，以减少与育儿相关的压力，并创造一个支持健康重量行为的家庭环境。儿童中的主要结果（BF％bf）将使用人体测量法和经过验证的预测方程进行评估（Denzenberg，1999）。分析将包括对结果作为协变量的基线测量。次要措施包括儿童和母亲饮食以及体育锻炼，育儿风格和实践，育儿压力以及家庭环境。在12个月不干预期之后，将评估干预效果的维持。这种干预措施将创造经过深入的暴露，以改变父母和儿童行为的改变，从而导致体内脂肪减少。计划基于广泛的形成性工作，该研究将由一群经验丰富的研究人员领导。 公共卫生相关性：需要努力以确保幼儿发展健康的饮食和体育锻炼行为以发展健康体重。父母行为会影响社会和物理家庭环境，从而创造出这些行为发展的上下文。很少有防止肥胖症的程序，而更少的人仍然使用以家庭为中心的方法。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少与育儿相关的压力，同时还创造了一个家庭环境，以支持学龄前儿童健康体重实践的发展。