Risk and Protective Factors for Childhood Obesity in the Home Food Environment

家庭食品环境中儿童肥胖的风险和保护因素

• 批准号: 8303677
• 负责人: Jerica M Berge
• 金额: $ 25.55万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-05 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8303677
• 关键词: Address; Adolescent Nutrition; Age; Area; Behavior; Biometry; Caregivers; Child; Child Nutrition; Childhood; Clinic; Clinical; Communication; Complex; Computers; Conflict (Psychology); Cross-Sectional Studies; Development; Diet; Dietary intake; Eating; Eating Behavior; Emotional; Environment; Epidemiology; Equipment and supply inventories; Family; Family Practice; Family dynamics; Family member; Focus Groups; Food; Future; Gender; Goals; Health; Health Food; Healthcare; Home environment; Hour; Individual; Influentials; Interdisciplinary Study; Interpersonal Relations; Intervention; Intervention Studies; Interview; Investigation; Iowa; Knowledge; Left; Life; Low income; Manuals; Measures; Methods; Minority; Mission; Obesity; Office Nursing; Overweight; Parenting behavior; Parents; Primary Care Physician; Primary Health Care; Public Health; Recruitment Activity; Research; Research Personnel; Risk; Risk Factors; Shapes; Siblings; Social Sciences; Source; Staging; Structure; Testing; United States National Institutes of Health; Video Recording; Weight; Youth; aged; base; burden of illness; high risk; innovation; insight; laptop; novel; nutrition; obesity in children; obesity prevention; obesity risk; planetary Atmosphere; prevent; primary care setting; programs; tool

DESCRIPTION (provided by applicant): Childhood obesity has almost tripled in the last two decades and is considered one of the most serious health problems facing youth, with minority and low-income children at disproportionately higher risk. Although previous research has provided a good understanding of individual level risk factors (e.g. food choices) that contribute to childhood obesity, the connection between the home food environment and interpersonal interactions (e.g. support, communication, conflict) that exist in the home environment related to eating behaviors and childhood obesity has been largely overlooked. The primary objective of this application is to identify how the home food environment and the interpersonal interactions among family members related to eating behaviors create risk or protective factors for childhood obesity. The proposed two year cross-sectional study, stratified by weight status (e.g. normal weight vs. overweight/obese), uses an innovative mixed methods approach to collect direct observational data (video-recorded family meals, home food inventory), qualitative data (interviews with caregivers), and quantitative data (BMI, dietary intake) in order to provide an in depth description of the home food environment and examine associations with child weight status and dietary intake. Sixty overweight/obese children (e85th BMI %tile for age and gender) and 60 normal weight children (>5th %tile BMI <85th for age and gender), ages 6-12, will be recruited from primary care clinics to participate in an in-home observation study with their families. The one week in-home observation will include: (a) video- recordings of family meals for eight consecutive days via a laptop computer, (b) an observational assessment of the home food environment, (c) an in-depth qualitative interview with caregivers (at least one caregiver, and two when available), (d) anthropometric measures of target child, two caregivers (when available) and closest aged sibling (when available), and (e) three 24-hour dietary recalls on the target child conducted with the primary caregiver. The in-home observations will acquire family level, dyadic level and individual level data. By triangulating these data sources, a comprehensive and in-depth look at the home food environment will be possible and complex family dynamics will be able to be assessed. The novel risk and protective factors identified in this study will be used to develop an R01 family-based intervention study with ethnically/racially diverse children ages 6-12, who are at greatest risk for overweight and obesity. The results from the proposed study are expected to identify critical new targets for interventions that can be implemented in partnership with primary care clinics and other health care settings with families to prevent childhood overweight and obesity. The interdisciplinary research team brings expertise from family social science, child and adolescent nutrition, obesity prevention, family medicine, epidemiology and biostatistics. Findings from the proposed study will move the field forward in conceptualizing the home food environment more comprehensively, in order to create research-informed interventions that are more effective in preventing childhood obesity. PUBLIC HEALTH RELEVANCE: This innovative study uses in-home observations (video-recorded family meals, home food inventory, interviews) of the home food environment to obtain a more comprehensive understanding of the risk and protective factors for childhood obesity in the home environment. The results are expected to directly inform the creation of interventions to prevent childhood obesity.

描述（由申请人提供）：过去二十年中，儿童肥胖症几乎增加了两倍，被认为是青少年面临的最严重的健康问题之一，少数族裔和低收入儿童面临的风险尤其高。尽管先前的研究对导致儿童肥胖的个人层面风险因素（例如食物选择）提供了很好的理解，但家庭食物环境与家庭环境中存在的与饮食行为和儿童肥胖相关的人际互动（例如支持、沟通、冲突）之间的联系在很大程度上被忽视了。该应用程序的主要目标是确定家庭食物环境以及与饮食行为相关的家庭成员之间的人际互动如何产生儿童肥胖的风险或保护因素。拟议的为期两年的横断面研究，按体重状况（例如正常体重与超重/肥胖）分层，使用创新的混合方法收集直接观察数据（视频记录的家庭膳食、家庭食品库存）、定性数据（与护理人员的访谈）和定量数据（BMI、饮食摄入量），以便提供 深入描述家庭食物环境并检查与儿童体重状况和饮食摄入量的关联。将从初级保健诊所招募 60 名 6-12 岁的超重/肥胖儿童（年龄和性别的 BMI %e85%）和 60 名正常体重儿童（年龄和性别的 BMI >5%<85%），与家人一起参加家庭观察研究。为期一周的家庭观察将包括：(a) 通过笔记本电脑连续八天的家庭膳食视频记录，(b) 对家庭食物环境的观察评估，(c) 对看护者（至少一名看护者，如果有的话两名）进行深入的定性访谈，(d) 对目标儿童、两名看护者（如果有的话）和最年长的兄弟姐妹（如果有的话）进行人体测量，以及 (e) 与主要照顾者一起对目标儿童进行 3 次 24 小时饮食回忆。家庭观察将获取家庭层面、二元层面和个人层面的数据。通过对这些数据源进行三角测量，将有可能全面、深入地了解家庭食物环境，并评估复杂的家庭动态。本研究中确定的新风险和保护因素将用于开展一项基于家庭的 R01 干预研究，对象为 6-12 岁的种族/种族不同儿童，这些儿童超重和肥胖的风险最大。拟议研究的结果预计将确定重要的新干预目标，这些干预措施可以与初级保健诊所和其他医疗保健机构以及家庭合作实施，以预防儿童超重和肥胖。跨学科研究团队带来了家庭社会科学、儿童和青少年营养、肥胖预防、家庭医学、流行病学和生物统计学的专业知识。拟议研究的结果将推动该领域更全面地概念化家庭食品环境，从而制定更有效预防儿童肥胖的研究知情干预措施。 公共健康相关性：这项创新研究利用家庭食物环境的家庭观察（视频记录的家庭膳食、家庭食物库存、访谈）来更全面地了解家庭环境中儿童肥胖的风险和保护因素。预计结果将直接为制定预防儿童肥胖的干预措施提供信息。