Testing a Multilevel, Multicomponent, Multigenerational Dietary Intervention to Improve Southeast Asian Children's Diets

测试多层次、多成分、多代饮食干预措施以改善东南亚儿童的饮食

• 批准号: 10584609
• 负责人: Kim M. Gans
• 金额: $ 27.24万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-07 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10584609
• 关键词: Address; Adult; Adult Children; Affect; Age; Asian; Behavior; Behavioral; Body Weight decreased; Body mass index; Cambodian; Carotenoids; Child; Child Health; Child Nutrition; Chronic; Chronic Disease; Clinical; Clinical Trials; Communities; Community Health Aides; Community Healthcare; County; Dermal; Diet; Dietary Intervention; Dietary Practices; Disease; Disparity; Disparity population; Dose; Education; Emotions; Ethnic Population; Exhibits; Family; Fatty acid glycerol esters; Feasibility Studies; Feedback; Food; Food Access; Frequencies; Funding; Future; Gestational Diabetes; Glycosylated hemoglobin A; Goals; Guilt; Health Food; Healthy Eating; Height; Home; Individual; Insulin Resistance; Intervention; Intervention Studies; Measures; Methods; Mission; Modeling; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Parents; Participant; Philosophy; Pilot Projects; Poverty; Prevalence; Publishing; Race; Randomized; Reducing diet; Refugees; Research; Rhode Island; Risk; Risk Factors; Scientific Advances and Accomplishments; Structure; Subgroup; Telephone; Testing; Text Messaging; Training; Trauma; Treatment Efficacy; Unhealthy Diet; Vietnamese; Weight Gain; Woman; Work; acceptability and feasibility; arm; attentional control; behavior change; community based participatory research; community clinic; community intervention; community partnership; design; dietary; early onset; effective intervention; efficacious intervention; energy balance; ethnic disparity; ethnic minority; ethnic minority population; experience; feasibility testing; feasibility trial; financial incentive; food environment; good diet; grandparent; health disparity; health disparity populations; high risk; implementation fidelity; implementation framework; implementation intervention; improved; indexing; innovation; intergenerational; intervention refinement; motivational enhancement therapy; multi-component intervention; nutrition education; prevent; primary outcome; process evaluation; racial minority; racial population; recruit; secondary outcome; social; social cognitive theory; southeast Asian; stem; sugar; transmission process; treatment arm; waist circumference

Background. Poor diet quality is a significant and critical problem for Southeast Asian (SEA) children whose families came to the US as refugees [e.g., Hmong, Cambodian, Laotian, Vietnamese]. SEA children are disproportionately burdened by higher rates of obesity and increased risk of other diet-related chronic diseases like type 2 diabetes relative to other Asian subgroups, Whites and “Other” races. Although dietary interventions have been shown to prevent/delay onset of diet-related chronic diseases, to our knowledge, there are no dietary interventions developed specifically for SEA children. Thus, there is an urgent need for dietary interventions that leverage state-of-the-art methods to address existing health disparities affecting SEA children and to advance scientific understanding of gaps in intervention research. Overview of Proposal. This proposal reflects our eight year (ongoing) academic-community research partnership with the Center for SEA in Rhode Island, formative work with SEA families, and our extensive experience conducting successful dietary interventions with underserved health disparity groups. The current study is a pilot feasibility study that tests an innovative multilevel, multicomponent, multigenerational dietary intervention to improve diet quality among SEA children. Conceptual Model. The Community Energy Balance and Family-Centered Action Model of Intervention Layout and Implementation frameworks provide the intervention rationale and structure. These frameworks propose that for disparity ethnic minority groups like SEA, multilevel, multicomponent, intergenerational interventions are the most effective intervention approach for changing and sustaining individual-level behavior change. Social cognitive theory and popular education philosophy inform the intervention content. Overview of Research Plan. 75 SEA families with children ages 6 to 11 years will be recruited from Providence County, Rhode Island. Adult-child pairs will be randomized to: (1) financial incentive only arm that will receive weekly $15 financial incentive coupons to subsidize purchase of healthy foods at a local SEA grocery store; or (2) financial incentive plus twice-monthly, family-based group nutrition education at the Center for SEA led by SEA community health workers; three motivational interviewing (MI) calls by trained community health workers; dietary norms messaging for adults (via weekly text messages) and for children (via Infographics at nutrition education sessions); and weekly $15 financial incentive coupons to subsidize purchase of healthy foods at SEA grocery stores; or (3) an Academic Engagement attention control arm that will follow the structure of the financial incentive plus nutrition education, MI and text messages and infographics arm. The primary outcomes are study feasibility and clinically meaningful improvement in child’s diet quality (measured by healthy eating index). Secondary outcomes are clinically meaningful changes in children’s body mass (~ 2kg weight loss or no weight gain), HbA1c (0.5%) and parent’s diet quality, HbA1c and the home food environment. These study findings will be used to inform a future, larger clinical trial.

背景：饮食质量差对于东南亚 (SEA) 儿童来说是一个重大而关键的问题。 家庭作为难民来到美国 [例如，苗族、柬埔寨、老挝、越南儿童]。 肥胖率较高和其他与饮食相关的慢性疾病风险增加带来了不成比例的负担 就像 2 型糖尿病相对于其他亚洲亚群、白人和“其他”种族一样，尽管饮食干预。 已被证明可以预防/延迟与饮食相关的慢性疾病的发作，据我们所知，没有 因此，迫切需要针对东南亚儿童的饮食干预。 利用最先进的方法来解决影响 SEA 的现有健康差异的干预措施 儿童并促进对干预研究差距的科学理解。 我们与该中心的八年（持续）学术界研究伙伴关系反映了 SEA 的提案 在罗德岛州，与 SEA 家庭的形成性工作，以及我们在成功饮食方面的丰富经验 当前的研究是一项试点可行性研究，旨在测试对服务不足的健康差异群体的干预措施。 创新的多层次、多成分、多代饮食干预，以改善东南亚地区的饮食质量 社区能量平衡和以家庭为中心的行动模型。 干预布局和实施框架提供了干预的理由和结构。 框架建议，对于像东南亚这样的不平等少数民族群体，多层次、多组成部分、 代际干预是改变和维持现状最有效的干预方法 个人层面的行为改变。 研究计划概述 75 个有 6 至 11 岁儿童的 SEA 家庭。 从罗德岛州普罗维登斯县招募的成人-儿童对将被随机分配到：（1）经济奖励。 唯一每周获得 15 美元经济奖励券以补贴购买健康食品的手臂 当地 SEA 杂货店；或 (2) 经济奖励加上每月两次的家庭团体营养教育 由 SEA 社区卫生工作者领导的 SEA 中心；由经过培训的人员进行的三次动机访谈 (MI) 电话 社区卫生工作者向成人（通过每周短信）和儿童（通过 以及每周 15 美元的经济奖励券进行补贴 在 SEA 杂货店购买健康食品；或 (3) 学术参与注意力控制臂 将遵循经济激励加上营养教育、MI 和短信的结构 信息图表臂的主要结果是研究可行性和对儿童的临床意义的改善。 饮食质量（通过健康饮食指数衡量）是有临床意义的变化。 儿童的体重（体重减轻约 2 公斤或体重没有增加）、HbA1c (0.5%) 以及父母的饮食质量、HbA1c 和 这些研究结果将用于为未来更大规模的临床试验提供信息。