Preventing Childhood Obesity Through Youth Empowerment: A Cluster RCT of the H2GO! Program

项目总结/摘要 在美国，超过三分之一的儿童超重或肥胖，并面临短期和长期健康风险。 这些后果包括糖尿病、高血压、心脏病和某些类型的癌症。实质性 有证据表明，减少含糖饮料（SSB）的消费是一个重要的饮食目标 儿童肥胖症的预防缺乏针对SSB的有效行为干预，特别是 在低收入和少数民族的早期和青春期前的青年谁有较高的SSB摄入量， 肥胖风险。青年赋权干预措施具有催化儿童行为改变的潜力 肥胖干预背景下，可能特别吸引低收入和少数民族青年。 然而，很少有关于青年赋权健康干预措施的研究采用了严格的研究设计， 审查了增强权能作为变革的媒介/机制。针对这一差距，我们与 美国男孩和女孩俱乐部（BGC），这是一个全国性的课后护理系统，覆盖400万青少年 每年，制定和试点测试以社区为基础的青年赋权干预措施，以减少SSB 摄入量和预防儿童肥胖。干预措施以赋权理论为基础， 通过健康课程进行消费，通过培养青年的信心和技能增强他们的权能; 通过培养批判性思维增强青年权能的叙事会议，以及青年主导的活动， 通过各种机会增强青年的权能，使其在家庭中产生变化。H2GO！干预 由BGC员工在BGC内提供。基于我们成功的H2 GO！试点研究，我们 现在定位测试H2 GO的功效！与地中海行动中的BGC网络合作进行干预， 每年为超过16万名儿童提供服务。采用整群随机设计，共10个 BGC网站将被随机分配到H2 GO！干预或等待名单，通常的护理条件。共 将入组450对亲子对（每个研究中心N=45对亲子对）。将在基线时收集数据，2 月龄、6个月和12个月，包括儿童人体测量学、SSB和饮水量，以及青少年 赋能该提案的具体目的包括：1）测试H2 GO的功效！儿童BMI干预 z评分使用群集随机对照试验; 2）测试H2 GO！对儿童SSB的干预 3）研究青年赋权作为干预效果的中介因素。时发现的问题 一项提案将提供证据，证明青年赋权是减少SSB摄入和肥胖风险的一种方法 并为制定儿童肥胖预防干预模式的长期目标做出贡献， 这是通过以青年为基础的环境进行传播的有利条件。

Project Summary/Abstract Over one-third of children in the U.S. are overweight or obese and at risk for short-term and long-term health consequences, including diabetes, hypertension, heart disease and certain types of cancer. Substantial evidence exists on reducing sugar-sweetened beverage (SSB) consumption as a critical dietary target for childhood obesity prevention. Efficacious behavioral interventions targeting SSBs are lacking, particularly among low-income and ethnic minority early and pre-adolescent youth who have higher SSB intake and obesity risk. Youth empowerment interventions hold potential for catalyzing behavior change in childhood obesity intervention contexts and may be particularly engaging for low-income and ethnic minority youth. However, few studies of youth empowerment health interventions have utilized rigorous study designs or examined empowerment as a mediator/mechanism of change. To this gap, we worked collaboratively with Boys and Girls Clubs of America (BGCs), a national system of afterschool care that reaches 4 million youth annually, to develop and pilot-test a community-based youth empowerment intervention on reducing SSB intake and preventing childhood obesity. Grounded in Empowerment Theory, the intervention targets SSB consumption through health sessions that empower youth through developing their confidence and skills; narrative sessions that empower youth through cultivating critical thinking, and youth-led activities that empower youth through opportunities to produce change within their families. The resulting H2GO! intervention is designed to be delivered within BGCs by BGC staff. Building on our successful pilot study of H2GO!, we are now positioned to test the efficacy of the H2GO! intervention in collaboration with the BGC network in MA, which collectively serves over 160,000 children each year. Using a cluster-randomized design, a total of 10 BGC sites will be randomly assigned to the H2GO! intervention or a wait-list, usual care condition. A total of 450 parent-child pairs (N=45 parent-child pairs per site) will be enrolled. Data will be collected at baseline, 2 months, 6 months, and 12 months and include child anthropometrics, SSB and water intake, and youth empowerment. Specific aims of the proposal include: 1) test the efficacy of the H2GO! intervention on child BMI z scores using a cluster randomized controlled trial; 2) test the efficacy of the H2GO! intervention on child SSB and water intake; 3) examine youth empowerment as a mediator of intervention effects. Findings from this proposal will provide evidence of youth empowerment as an approach to reduce SSB intake and obesity risk and contribute to a long-term goal of producing an intervention model for childhood obesity prevention that is well-positioned for dissemination through youth-based settings.