Defining behaviors and the stress response among positive deviants for childhood obesity

儿童肥胖正向偏差行为的定义和压力反应

基本信息

批准号：
10056118
负责人：
Byron A Foster
金额：
$ 11.55万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-15 至 2022-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10056118
关键词：
11 year old 5 year old Address Adolescence Age Award Behavior Biological Biological Markers Blood Blood Pressure C-reactive protein Case-Control Studies Categories Child Child Behavior Clinical Research Clinical Trials Communities Complex Data Data Analyses Data Collection Data Set Diet Environment Family Fostering Goals Hair Health Hydrocortisone Interleukin-6 Intervention Interview Latino Learning Measurement Measures Medical Records Mentored Patient-Oriented Research Career Development Award Methods Minority Obesity Oregon Outcome Parents Physical activity Population Principal Investigator Research Research Institute Resources Rural Sampling School-Age Population Self Efficacy Social support Spottings Stress Structure Testing Translating Translational Research Weight Weight maintenance regimen Work allostatic load base biological adaptation to stress built environment design deviant disparity reduction early childhood effective intervention effectiveness testing experience healthy weight high risk improved insight low socioeconomic status lower income families novel novel strategies obesity in children perceived stress personalized intervention preadolescence psychologic psychological stressor recruit response rural setting skills social culture stressor suburb success synergism therapy design urban setting waist circumference

项目摘要

PROJECT SUMMARY This R03 award seeks to identify existing successful strategies to address childhood obesity in low socioeconomic status populations. A small proportion (10-15%) of children with obesity in early childhood achieve a healthy weight by adolescence. The goal of the overall project is to identify what behaviors these children and their families, termed positive deviants, have implemented that has been effective. By learning from what is already working among communities at high risk of continued obesity, interventions can be adapted to be more relevant and effective for families of children with obesity. The paucity of interventions shown to be effective for low socioeconomic status families and the increasing disparities in obesity for this population underscore the need to identify effective strategies. Aim 1 will use existing medical record data to examine weight trajectories from pre-adolescent, school aged children and categorize children into those who have a negative BMI slope towards a healthy weight (positive deviants) and children with a flat or increasing BMI slope (controls). Families are recruited to participate in a case-control study using mixed methods to define the skills and behaviors used to address their child's weight. In aim 2, we examine the biologic response to stress using cortisol, interleukin-6 and C-reactive protein, comparing positive deviants and controls to test the hypothesis that positive deviants, despite experiencing similar stressors, have a different biologic response to stress than controls. The completion of these aims will directly inform the design of an obesity-focused clinical trial testing the effectiveness of positive deviance- derived strategies paired with interventions designed to mitigate stress using biologic markers to personalize interventions. The project will occur in an exceptional research environment for using the resources of the Oregon Clinical and Translational Research Institute (OCTRI) to assist with data abstraction from a large medical record to generate the dataset. Dr. Foster (PI) has recently completed a similar project during his K23 award, with this project designed to build on the lessons learned during the K23 and strategically expand as a step towards an R01 application for testing the effectiveness of interventions designed using this approach.

项目概要该 R03 奖项旨在确定解决低收入儿童肥胖问题的现有成功策略。社会经济地位人群。一小部分（10-15%）儿童在幼儿期患有肥胖症到青春期时达到健康的体重。整个项目的目标是确定这些行为是什么被称为积极越轨者的儿童及其家庭已经实施了这一措施，并取得了成效。通过学习根据在持续肥胖高风险社区中已经发挥的作用，可以采取干预措施适应肥胖儿童的家庭更加相关和有效。干预措施的缺乏事实证明，对于社会经济地位较低的家庭以及肥胖差异日益扩大的家庭来说是有效的人们强调需要确定有效的战略。目标 1 将使用现有的医疗记录数据来检查青春期前、学龄期的体重轨迹儿童，并将儿童分类为 BMI 向健康体重倾斜的负值（正值）异常者）和 BMI 斜率持平或增加的儿童（对照）。招募家庭参加病例对照研究使用混合方法来定义用于解决孩子体重问题的技能和行为。在目标 2 中，我们使用皮质醇、白细胞介素 6 和 C 反应蛋白检查对压力的生物反应，比较正偏差和对照，以检验正偏差的假设，尽管经历过相似的压力源，对压力的生物反应与对照组不同。这些目标的完成将直接为以肥胖为重点的临床试验的设计提供信息，测试正偏差的有效性- 派生策略与旨在使用生物标记减轻压力的干预措施相结合，以实现个性化干预措施。该项目将在一个特殊的研究环境中进行，以利用俄勒冈临床中心的资源和转化研究所 (OCTRI) 协助从大量医疗记录中提取数据生成数据集。 Foster 博士（PI）最近在获得 K23 奖项期间完成了一个类似的项目，其中该项目旨在借鉴 K23 期间吸取的经验教训并进行战略性扩展，作为迈向 R01 应用程序用于测试使用此方法设计的干预措施的有效性。