Food Insecurity and Family-based Treatment for Pediatric Obesity

粮食不安全和儿童肥胖的家庭治疗

• 批准号: 10314573
• 负责人: Genevieve Davison
• 金额: $ 4.6万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10314573
• 关键词: Address; Age; Asthma; Behavior; Behavior Therapy; Behavioral; Body Weight Changes; Body Weight decreased; Budgets; Buffers; Cardiovascular Diseases; Centers for Disease Control and Prevention (U.S.); Child; Child Rearing; Cholesterol; Clinical Trials; Cohort Studies; Coronary heart disease; Data; Demographic Factors; Dropout; Eating; Enrollment; Ethnic Origin; Family; Food; Funding; Habits; Health; Health Services; Health Status; Household; Housing; Hypertension; Income; Lead; Link; Low income; Measures; Obesity; Outcome; Parents; Pattern; Physical activity; Pilot Projects; Play; Poverty; Probability; Psychological reinforcement; Psychology; Psychosocial Factor; Race; Research; Research Project Grants; Resources; Rewards; Risk; Risk Factors; Role; Sampling; Social Work; Stimulus; System; Techniques; Transportation; Treatment outcome; United States; Weight; base; behavior change; cognitive capacity; demographics; discounting; effective therapy; evidence base; food insecurity; housing instability; improved; lower income families; novel; nutrition; obesity in children; obesity risk; obesity treatment; obesogenic; psychologic; skills; social health determinants; theories; treatment effect; treatment response; treatment risk

Project Summary/Abstract Pediatric obesity puts children at risk for long-term, negative health outcomes including cardiovascular disease, high blood pressure, and stoke, and disproportionately impacts children from low-income families. Low-income families are also at increased risk for food insecurity. Consistent with the “scarcity mindset” theory of poverty, food insecurity is associated with increased discounting of delayed rewards and increased present bias. It is also associated with increased food reinforcement, and decreased likelihood of meal planning. These factors are in turn associated with increased risk for obesity. Despite the seriousness of this issue, little research has examined the role food insecurity and its psychological correlates play in behavioral treatments for pediatric obesity. Family-based treatment (FBT) for pediatric obesity is an effective treatment for childhood obesity that targets parent-child dyads and achieves long-lasting weight change in children through behavior change techniques such as reinforcement, stimulus control, preplanning, and parenting skills. However, low-income households have shown reduced treatment response in similar behavioral obesity treatments and are at elevated risk for treatment drop-out. The proposed study will examine food insecurity in 208 parent-child dyads enrolled in a CDC-funded pilot study seeking to adapt FBT for low-income families that will include a unique emphasis on budgeting and meal planning, which has been shown to predict greater weight loss in previous studies of obesity treatment, as well as a referral system to link families with social determinants of health (SDOH) needs, such as food insecurity, to resources. The proposed study will 1) characterize parents with and without food insecurity using baseline data based on weight and health status, demographics (SES, race, ethnicity), other social determinants of health needs (e.g. housing, utilities, transportation), scarcity mindset (delay discounting, relative reinforcing efficacy of food, financial planning horizon, perceived probability of living to age 75), family nutrition and physical activity, and meal planning behavior; 2) determine the degree to which food insecurity and scarcity mindset (in parents) moderate weight change after 3 and 6 months of treatment for parents and children enrolled in FBT; and 3) determine whether increased meal planning and SDOH service receipt moderate the relationship between food insecurity and/or scarcity mindset, and weight change. By characterizing the association between food insecurity and weight outcomes in FBT, this study will help guide the adaptation of FBT for low-income families and improve treatment for a subset of children at disproportionate risk for obesity.

项目摘要/摘要 儿童肥胖使儿童面临包括心血管疾病在内的长期负面健康后果的风险， 高血压和中风，对来自低收入家庭的儿童影响不成比例。低收入者 家庭也面临着更大的粮食不安全风险。与贫困的“稀缺心态”理论相一致， 粮食不安全与延迟奖励的折扣增加和目前的偏见增加有关。它是 也与食物强化和减少饮食计划的可能性有关。这些因素 反过来又与肥胖风险的增加有关。尽管这个问题很严重，但几乎没有研究 研究了食物不安全及其心理相关因素在儿童行为治疗中的作用 肥胖。儿童肥胖的家庭治疗(FBT)是一种治疗儿童肥胖的有效方法， 以亲子二人为目标，通过行为改变实现儿童长期体重变化 强化、刺激控制、预先计划和育儿技巧等技巧。然而，低收入者 家庭在类似的行为肥胖症治疗中表现出治疗反应降低，并处于 治疗中断的风险增加。这项拟议的研究将调查208个亲子二人组中的食物不安全问题 参加CDC资助的一项试点研究，寻求使FBT适应低收入家庭，该研究将包括一个独特的 强调预算和饮食计划，这在过去的几年中被证明可以预测更大的减肥效果 肥胖症治疗研究，以及将家庭与健康的社会决定因素联系起来的转介系统 (SDOH)需求，如粮食不安全，对资源的影响。拟议的研究将1)描述父母的特征和 使用基于体重和健康状况、人口统计数据的基线数据(SES、种族、 种族)、卫生需求的其他社会决定因素(例如住房、公用事业、交通)、稀缺心态 (延迟折扣、食物的相对强化效果、财务规划范围、感知的生存概率 到75岁)，家庭营养和体力活动，以及饮食计划行为；2)决定以下因素的程度 食物不安全和匮乏心态(在父母中)在治疗3个月和6个月后体重适度变化 参加FBT的父母和儿童；以及3)确定增加的膳食计划和SDOH服务 收据缓和了粮食不安全和/或匮乏心态与体重变化之间的关系。通过 这项研究描述了食物不安全和FBT的体重结果之间的联系，这将有助于指导 为低收入家庭适应FBT并改善部分儿童的治疗 肥胖的风险不成比例。