Reducing Childhood Obesity Using Ecological Momentary Intervention (EMI) and Video Feedback atFamily Meals

使用生态瞬时干预 (EMI) 和家庭用餐时的视频反馈减少儿童肥胖

• 批准号: 10417376
• 负责人: Jerica M Berge
• 金额: $ 115.95万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10417376
• 关键词: Adult; African American; Age; Atmosphere; Behavior; Body mass index; Cellular Phone; Child; Clinic; Communities; Community Health Aides; Coping Skills; Cross-Sectional Studies; Data Collection; Diet; Dietary intake; Ecological momentary assessment; Education; Environment; Ethnic Origin; Evidence based intervention; Family; Family member; Feedback; Fibrinogen; Frequencies; Health Technology; Health behavior; Healthy Eating; High Prevalence; Hispanic; Home; Home visitation; Household; Income; Individual; Intervention; Intervention Studies; Longitudinal Studies; Low income; Maintenance; Measures; Methodology; Methods; Minority; Modeling; Native Americans; Obesity; Outcome; Overweight; Parents; Participant; Pattern; Phase; Pilot Projects; Primary Health Care; Procedures; Protocols documentation; Race; Randomized; Readiness; Research; Risk; Self Efficacy; Siblings; Socioeconomic Status; Stress; Systems Theory; Testing; Time; Visit; Weight; arm; base; behavior change; clinical practice; cost effective; cost effectiveness; dietary; effectiveness trial; family support; feeding; food environment; food quality; implementation intervention; indexing; innovation; intervention effect; mHealth; meetings; obesity in children; obesity risk; obesity treatment; post intervention; primary care setting; primary outcome; recruit; secondary outcome; sex; success; three-arm study; video visit

Abstract The low to moderate success with childhood obesity interventions to date and the persistent obesity disparities across race/ethnicity and socioeconomic status indicate the need to approach childhood obesity in a new and innovative way. Building on the last three decades of research on childhood obesity, the main objective of the proposed study is to utilize state-of-the-art intervention methods including ecological momentary intervention (EMI), video feedback, and home visiting methods in partnership with primary care clinics and Community Health Workers (CHWs) to examine whether increasing the quality of family meals (i.e., dietary quality, interpersonal atmosphere) and quantity of family meals (i.e., frequency of meals) reduces childhood obesity. Numerous studies have shown significant associations between family meal frequency and child weight and weight-related behaviors (e.g., better diet quality, lower weight status). Research has also shown that the quality of family meals, including dietary quality of the food served at family meals and the interpersonal atmosphere during family meals, is associated with decreased childhood obesity risk. In addition, prior intervention research has shown that immediate feedback on health behaviors (e.g., EMI, video feedback) increases the likelihood of behavior change. Thus, the proposed individual randomized controlled effectiveness trial, based on our pilot study, tests combinations of the above factors (i.e., EMI, home visiting, video feedback) across three study arms: (1) EMI; (2) EMI+Home Visiting (HV); and (3) EMI+HV+Video Feedback. All arms will receive 16 weeks of EMI family meal tip messages delivered via smartphones. Arms 2 and 3 will additionally receive home visiting (eight in-home visits; eight “Try it Yourself” activities) focused on family meal quality and quantity and a family meal prep activity delivered by a CHW simultaneously with the 16 weeks of EMI. Arm 3 will additionally receive eight weeks of video feedback focused on family meal behavior(s)/patterns delivered by a CHW during the eight in-home visits. All arms will receive an 8-week maintenance phase allowing for progressively less support of families so they can increase self-efficacy and sustainability of behavior change. The intervention will be carried out for 6 months with children with overweight/obesity (i.e., BMI ≥85%ile) who are ages 5-8 years (n=510), from low income and diverse households (i.e., African American, Hispanic, Native American, White), and their families. Eligible children will be recruited through primary care clinics. Drawing on Family Systems Theory, the intervention aims to change individual and family-level behaviors. Specifically, the intervention will be delivered to the family unit and primary outcomes will include child weight (i.e., BMI %ile) and diet quality (i.e., Healthy Eating Index). Secondary outcomes will include parent and other family member’s weight and weight-related behaviors. This study will change clinical practice by creating a new model for childhood obesity treatment in primary care using CHWs as interventionists and mobile health technology to intervene in real-time on parental stress and the home food environment to reduce childhood obesity.

抽象的 迄今为止，儿童肥胖干预措施的成功率较低到中等，并且肥胖差异持续存在 跨种族/族裔和社会经济地位的调查表明，需要以一种新的方式来解决儿童肥胖问题。 创新的方式。以过去三十年对儿童肥胖的研究为基础，该项目的主要目标是 拟议的研究是利用最先进的干预方法，包括生态瞬时干预 (EMI)、视频反馈和与初级保健诊所和社区合作的家访方法 卫生工作者 (CHW) 检查是否提高家庭膳食质量（即膳食质量、 人际氛围）和家庭进餐数量（即进餐频率）可以减少儿童肥胖。 大量研究表明，家庭进餐频率与儿童体重和体重之间存在显着相关性。 与体重相关的行为（例如，更好的饮食质量、较低的体重状况）。研究还表明， 家庭用餐的质量，包括家庭用餐时提供的食物的饮食质量和人际关系 家庭用餐时的氛围与儿童肥胖风险降低有关。另外，之前 干预研究表明，对健康行为的即时反馈（例如 EMI、视频反馈） 增加行为改变的可能性。因此，建议的个体随机对照有效性 试验基于我们的试点研究，测试上述因素的组合（即 EMI、家访、视频反馈） 跨越三个研究分支：(1) EMI； （2）EMI+上门（HV）； (3)EMI+HV+视频反馈。所有手臂都会 接收通过智能手机发送的 16 周 EMI 家庭用餐提示消息。第 2 臂和第 3 臂还将 接受家访（八次家访；八次“自己尝试”活动），重点关注家庭膳食质量和 在 16 周的 EMI 期间，CHW 同时提供数量和家庭膳食准备活动。第 3 臂 此外还将收到八周的视频反馈，重点关注家庭用餐行为/模式 由社区卫生工作者在八次家访期间进行。所有手臂都将接受为期 8 周的维护阶段，以便 逐渐减少家庭的支持，以便他们能够提高自我效能和行为改变的可持续性。 该干预将对超重/肥胖（即BMI≥85%ile）儿童进行为期6个月的干预 年龄 5-8 岁 (n=510)，来自低收入和多元化家庭（即非裔美国人、西班牙裔、土著人） 美国人、白人）和他们的家人。符合条件的儿童将通过初级保健诊所招募。借鉴 家庭系统理论中，干预的目的是改变个人和家庭层面的行为。具体来说， 干预将针对家庭单位进行，主要结果将包括儿童体重（即 BMI %ile） 和饮食质量（即健康饮食指数）。次要结果将包括父母和其他家庭成员的 体重和与体重相关的行为。这项研究将通过创建新模型来改变临床实践 使用社区卫生工作者作为干预者和移动医疗技术在初级保健中治疗儿童肥胖症 实时干预父母压力和家庭饮食环境，以减少儿童肥胖。