Community Partnering to Encourage Healthy Beverage Intake through Child Care

描述(申请人提供)：社区合作，通过儿童保育鼓励健康饮料的摄入全脂牛奶、果汁和含糖饮料的不当摄入与儿童肥胖症、肥胖相关的合并症和龋齿有关，然而，很少有被证明有效的干预措施来促进儿童摄入符合国家指南的健康饮料。托儿设施为影响儿童和家庭的健康饮料摄入量提供了一个潜在的场所。我们的总体目标是使用以社区为基础的参与性研究(CBPR；研究人员与社区成员合作进行研究的方法)的原则来开发、试点测试和检查以儿童保育为基础的干预措施的可接受性、可行性、可持续性和初步结果，以鼓励儿童摄入适合年龄的指南推荐的饮料。我们的中心假设是，多层次的干预措施包括鼓励摄入指南推荐的饮料的教育战略；在儿童保育和家庭中更多地获得无铅、含氟的饮用水；以及基于证据的儿童保育和家庭饮料政策将导致更健康的饮料摄入量和减少儿童肥胖。为了准备提交R01拨款申请以验证这一假设，我们提出了以下具体目标：目标1：调查0-5岁儿童的饮料消费模式以及指南推荐饮料摄入量的障碍和促进者；目标2：设计、中试测试并评估以儿童为基础的健康饮料干预的初步结果；以及目标3：基于干预可行性、可接受性和可持续性的评估改进干预措施。在目标1中，我们将与幼儿工作人员和家长进行访谈，并观察幼儿设施，以探讨影响儿童饮料摄入量的因素，以及健康饮料消费的障碍和促进者。在目标2中，我们将利用社区合作伙伴的反馈和来自目标1的调查结果来设计、试点测试和评估健康饮料干预的初步结果(例如，儿童体重指数、饮料摄入量、儿童保育饮料政策)，在一个种族和社会经济多元化的加利福尼亚州县的一个有执照的托儿中心和两个托儿所进行健康饮料干预的初步结果。比较设施将根据干预设施的特点进行匹配。在目标3中，我们将评估干预的可行性、可接受性和可持续性--基于我们对托儿机构、汇报会议、家长/工作人员调查和社区反馈的观察--以完善未来更大规模随机对照试验的干预措施，该试验将在本奖项结束前在R01申请中提出。这一职业发展奖将使Patel博士能够加强她在传播和实施科学方面的技能，并获得政策和机构战略方面的新技能，以将证据转化为实践、衡量发展、纵向和分层建模以及成本效益分析。在这个奖项结束时，帕特尔博士将很好地将证据转化为预防儿童肥胖症的实践。

DESCRIPTION (provided by applicant): Community Partnering to Encourage Healthy Beverage Intake through Child Care Inappropriate intake of whole milk, fruit juice, and sugar-sweetened beverages is associated with childhood obesity, obesity-related co morbidities, and dental caries, yet there are few proven interventions to promote child intake of healthy beverages consistent with national guidelines. Child care facilities provide a potential venue for influencing healthy beverage intake in children and families. Our overall objective is to use principles of community-based participatory research (CBPR; an approach in which researchers partner with community members to conduct research) to develop, pilot test, and examine the acceptability, feasibility, sustainability, and preliminary outcomes of a child care-based intervention to encourage child intake of age-appropriate, guideline-recommended beverages. Our central hypothesis is that a multi-level intervention consisting of educational strategies to encourage intake of guideline-recommended beverages; increased accessibility of lead-free, fluoridated, drinking water in child care and at home; and evidence-based child care and home beverage policies will lead to healthier beverage intake and reduced childhood obesity. In preparation for submitting an R01 grant application to test this hypothesis, we propose the following specific aims: Aim 1: Investigate beverage consumption patterns as well as barriers and facilitators to guideline-recommended beverage intake among 0-5 year olds; Aim 2: Design, pilot test, and evaluate the preliminary outcomes of a child care-based healthy beverage intervention; and Aim 3: Refine the intervention based on an evaluation of intervention feasibility, acceptability, and sustainability. In Aim 1, we will conduct interviews with child care staff and parents and observe child care facilities to explore factors that influence children's beverage intake and barriers and facilitators to healthy beverage consumption. In Aim 2, we will use community partner feedback and findings from Aim 1 to design, pilot test, and evaluate preliminary outcomes (e.g., child BMI, beverage intake, child care beverage policies) of a healthy beverage intervention in a licensed child care center and 2 child care homes in an ethnically and socioeconomically diverse California county. Comparison facilities will be matched on intervention facility characteristics. In Aim 3, we will evaluate the feasibility, acceptability, and sustainability of the intervention - based on our observations of child care facilities, debriefing sessions, parent/staff surveys, and community feedback - in order to refine the intervention for a future larger randomized controlled trial, to be proposed in an R01 application before the end of this award. This career development award will allow Dr. Patel to strengthen her skills in dissemination and implementation sciences and to acquire new skills in policy and institututional strategies to translate evidence into practice, measurement development, longitudinal and hierarchical modeling, and cost-effectiveness analysis. At the end of this award, Dr. Patel will be well positioned to translate evidence into practice to prevent childhood obesity.