Community Partnering to Encourage Healthy Beverage Intake through Child Care

描述（由申请人提供）：社区合作通过儿童保健鼓励健康饮料的摄入全脂牛奶、果汁和含糖饮料的不适当摄入与儿童肥胖、肥胖相关的并发症和龋齿有关，但很少有经过证实的干预措施来促进儿童摄入符合国家指南的健康饮料。儿童保育机构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。我们的总体目标是利用社区参与式研究（CBPR；一种研究人员与社区成员合作进行研究的方法）的原则来开发、试点测试和检查基于儿童护理的干预措施的可接受性、可行性、可持续性和初步结果，以鼓励儿童摄入与年龄相适应的、指南推荐的饮料。我们的中心假设是多层次的干预，包括教育策略，以鼓励摄入指南推荐的饮料；在儿童保育和家庭中增加无铅、氟化饮用水的可及性；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，减少儿童肥胖。为了准备提交R01拨款申请来验证这一假设，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导建议饮料摄入量的障碍和促进因素；目的2：设计、试点测试和评估基于儿童护理的健康饮料干预的初步结果；目标3：在评估干预的可行性、可接受性和可持续性的基础上完善干预措施。在Aim 1中，我们将对幼儿工作人员和家长进行访谈，并观察幼儿设施，以探索影响儿童饮料摄入的因素以及健康饮料消费的障碍和促进因素。在目标2中，我们将使用社区合作伙伴的反馈和目标1的发现来设计、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样化的加州县的一家有执照的托儿中心和两家托儿之家进行。比较设施将根据干预设施的特点进行匹配。在目标3中，我们将评估干预措施的可行性、可接受性和可持续性——基于我们对儿童保育设施的观察、汇报会议、家长/员工调查和社区反馈——以便为未来更大规模的随机对照试验改进干预措施，在本奖项结束前提出R01申请。这项职业发展奖将使帕特尔博士能够加强她在传播和实施科学方面的技能，并获得政策和体制战略方面的新技能，以便将证据转化为实践、制定测量方法、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.