Neighborhood deprivation and early childhood obesity: Characterizing longitudinal pathways & identifying multilevel mediators and moderators

项目摘要/摘要 肥胖的儿童更有可能成为肥胖的成年人，他们患心脏病的风险更高，而且 低收入家庭的儿童患肥胖症的风险更大。一些工作已经将 社区特征和儿童肥胖，但对纵向影响知之甚少 社区剥夺对低收入儿童体重轨迹的影响。此外，几乎没有人 研究纳入了邻里、家庭和个人层面的因素，以了解复杂和 导致儿童肥胖的多层次途径。在童年早期理解这些过程是至关重要的。 因为肥胖的早期出现可能会为终身健康风险设定轨迹。我的长期目标是工作 作为独立研究人员，调查对儿童健康和发展的多层次影响，重点是 关于肥胖症，为预防干预和人口健康战略提供信息。本K01指导研究 科学家发展奖将填补儿童肥胖、邻里分析、 自律和健康，以及翻译研究的交集。我敬业的专家导师团队 纽约大学医学院和哥伦比亚大学将监督我的培训活动，包括结构化的 导师会议；导师指导指导；参加研讨会和讲习班；实践学习； 还有课业。互补性的一组研究研究将确定 邻里剥夺与儿童早期体重指数(BMI)轨迹的关系 儿童的家庭和邻居的社会背景和执行功能技能是中等的还是居中的 这些协会在农村和城市背景下都是如此。我的主要假设是更大的社区 剥夺会预测儿童早期体重增加更多，儿童的社会背景和执行能力 函数将塑造这种关系。为了验证这一假设，我将首先确定邻居的纵向效应 贫困对农村低收入人群儿童体重指数轨迹的影响。其次，我将确定社交 社区和家庭的环境因素(例如，安全、集体社交和地理隔离) (例如，收入和教育)水平缓和了邻里剥夺与BMI轨迹的关系。第三，我 将表征儿童的执行功能技能如何调节和调节 BMI轨迹的邻里剥夺。最后，我将把这些分析复制到一个高度贫困的城市 儿童样本。这个项目采用了一种创新的跨学科方法，是第一个研究 社区剥夺、社会背景和执行功能预测儿童BMI的复杂方式 轨迹。通过这些研究和培训经验，我将过渡到一名独立研究员，并 将准备申请R01来研究儿童肥胖的多水平机制和调节因素 并对执行功能的改善可以缓冲肥胖风险这一假设进行实验测试 在一项正在进行的大规模有效性研究的背景下，来自弱势社区的儿童。

PROJECT SUMMARY/ABSTRACT Obese children are more likely to become obese adults who are at greater risk for heart disease and early death, and children from low-income families are at greater risk for developing obesity. Some work has linked neighborhood characteristics and obesity in children, but little is known about the longitudinal effects (and mechanisms) of neighborhood deprivation on the weight trajectories of low-income children. Moreover, few studies have incorporated neighborhood, family, and individual level factors to understand the complex and multilevel pathways leading to childhood obesity. Understanding these processes early in childhood is critical as the early emergence of obesity can set the trajectory for life long health risks. My long-term goal is to work as an independent researcher investigating multilevel influences on child health and development, with a focus on obesity, to inform preventive interventions and population health strategies. This K01 Mentored Research Scientist Development Award will fill critical training gaps in childhood obesity, neighborhood analysis, the intersection of self-regulation and health, and translational research. My dedicated and expert team of mentors at the NYU School of Medicine and Columbia University will oversee my training activities including structured mentorship meetings; mentor-guided instruction; participation in seminars and workshops; hands-on learning; and coursework. The complementary set of research studies will identify longitudinal associations of neighborhood deprivation with early childhood body mass index (BMI) trajectories and determine the ways in which children’s family and neighborhood social context and executive function skills moderate or mediate these associations in both rural and urban contexts. My primary hypothesis is that greater neighborhood deprivation will predict greater weight gain in early childhood and that children’s social context and executive function will shape this relation. To test this hypothesis, I will first identify longitudinal effects of neighborhood deprivation on children’s BMI trajectories in a rural low-income sample. Second, I will determine how social context factors at the neighborhood (e.g. safety, collective socialization, and geographic isolation) and family (e.g. income and education) levels moderate relations of neighborhood deprivation to BMI trajectories. Third, I will characterize the ways in which children’s executive function skills mediate and moderate relations of neighborhood deprivation to BMI trajectories. Finally, I will replicate these analyses in a high-poverty urban sample of children. This project takes an innovative, interdisciplinary approach and is the first to examine the complex ways in which neighborhood deprivation, social context, and executive function predict children’s BMI trajectories. Through these research and training experiences I will transition to an independent researcher and will be prepared to apply for an R01 to investigate multilevel mechanisms and moderators of childhood obesity and to experimentally test the hypothesis that improvements in executive function could buffer obesity risk in children from disadvantaged neighborhoods within the context of an ongoing large-scale effectiveness study.