Preventing childhood obesity through a family-based mindfulness intervention

通过基于家庭的正念干预预防儿童肥胖

• 批准号: 8512273
• 负责人: Rajita Sinha
• 金额: $ 23.71万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8512273
• 关键词: 5 year old; Adult; Age; Basic Science; Behavior Therapy; Behavioral; Biological; Body mass index; Child; Child Behavior; Child Development; Child Guidance Clinics; Childhood; Cholesterol; Chronic; Clinic; Clinical; Code; Communities; Control Groups; Counseling; Data; Development; Diabetes Mellitus; Eating; Eating Behavior; Empathy; Endocrinology; Environment; Exercise Physiology; Face; Family; Food; Glucose; Goals; Heart Diseases; Home environment; Hydrocortisone; Hyperphagia; Insulin; Interdisciplinary Study; Intervention; Interview; Kinesiology; Laboratories; Low income; Malignant Neoplasms; Measures; Mediator of activation protein; Metabolic; Modeling; Nursery Schools; Obesity; Overweight; Parenting behavior; Parents; Pattern; Physical activity; Prevention; Prevention program; Public Health; Questionnaires; Randomized; Reading; Recruitment Activity; Relative (related person); Reporting; Risk; Risk Factors; Stress; Testing; Time; aged; base; biological adaptation to stress; cohesion; diabetes risk; efficacy trial; ethnic minority population; follow-up; high risk; improved; innovation; intervention effect; middle childhood; mindfulness; mindfulness-based stress reduction; multidisciplinary; novel; novel strategies; nutrition; obesity in children; post intervention; preference; prevent; programs; public health relevance; response; satisfaction; stress related disorder; stressor

DESCRIPTION (provided by applicant): Childhood obesity is a serious public health problem. Childhood obesity is associated with obesity in adulthood and increased risk for diabetes, heart disease, and some cancers. Notably, obesity is particularly common in low-income ethnic minority children and children of obese parents. Preschool-aged children (aged 2-5 years) are just beginning to form patterns of eating and physical activity (PA) preferences and so this is an ideal age to target in prevention programs, particularly family-based programs which can improve food and activity choices offered to young children at home. Significant basic research indicates parent stress as a risk factor for child obesity. This risk may be exacerbated in low-income families who face multiple chronic stressors. Mindfulness-based stress reduction (MBSR) is an empirically-supported treatment that reduces stress in adults. However, the potential effects of MBSR on parent stress and child obesity have not been tested. The goal of the proposed study is to test initial feasibility and obtain effect sizes for a parenting-focused version of MBSR plus nutrition and physical activity counseling to reduce parent stress and prevent obesity in at-risk 2-5 year olds from low-income urban families. We hypothesize that MBSR plus nutrition and PA counseling (MBSR+N) for parents will decrease parent stress, improve parenting, increase healthy eating and PA, and prevent obesity in children of highly stressed low-income obese parents. The proposed study brings together a multidisciplinary team of experts in child development, behavioral interventions for obesity, pediatric endocrinology, nutrition, and exercise physiology to pilot test the feasibility and initial efficac of MBSR+N in an urban community-based clinic. 60 overweight parents of 2-5 year olds reporting high stress levels will be recruited from a child guidance clinic serving a low-income urban community. Parents will be randomly assigned to receive either an 8 week MBSR+N intervention (based on the MBSR plus nutrition and PA intervention for adults developed by Dr. Sinha, co-PI) or to a contact control+N group. At pre- and post-intervention and at a 6 month and 1 year follow-up, we will collect questionnaire, clinical interview, and biological measures of parent and child stress (including cortisol response to a laboratory stressor), parenting, parent and child eating behavior and PA, and child BMI percentile scores. We will also collect data on parent BMI and metabolic variables (e.g., glucose). We will assess feasibility and acceptability of MBSR+N and will test initial intervention effects and determine effect sizes to plan for an adequately- powered long-term efficacy trial of MBSR+N. The study will provide: 1. Initial efficacy data for MBSR+N, 2. Pilot data for a R01 proposal to conduct a large long-term trial of MBSR+N, 3. Evidence of acceptability of MBSR+N in a real-world community clinic setting, and 4. Longitudinal data on the development of obesity in at-risk children. If effective, MBSR+N could be a novel strategy to reduce stress and obesity in high risk adults and simultaneously prevent overweight/obesity in their young children.

描述（由申请人提供）：儿童肥胖是一个严重的公共卫生问题。儿童期肥胖与成年期肥胖有关，并增加患糖尿病、心脏病和某些癌症的风险。值得注意的是，肥胖在低收入少数民族儿童和肥胖父母的孩子中尤为常见。学龄前儿童（2-5 岁）刚刚开始形成饮食和身体活动 (PA) 偏好模式，因此这是预防计划的理想目标年龄，特别是基于家庭的计划，可以改善为幼儿提供的食物和活动选择。重要的基础研究表明，父母的压力是儿童肥胖的危险因素。在面临多种慢性压力源的低收入家庭中，这种风险可能会加剧。基于正念的减压（MBSR）是一种基于经验的治疗方法，可减轻成年人的压力。然而，MBSR 对父母压力和儿童肥胖的潜在影响尚未得到测试。拟议研究的目标是测试初步可行性并获得以育儿为中心的 MBSR 加上营养和身体活动咨询的效果大小，以减轻父母的压力并预防低收入城市家庭的 2-5 岁高危儿童的肥胖。我们假设，针对父母的MBSR加上营养和PA咨询（MBSR+N）将减轻父母的压力，改善养育方式，增加健康饮食和PA，并预防高压力的低收入肥胖父母的孩子的肥胖。 拟议的研究汇集了儿童发育、肥胖行为干预、儿科内分泌学、营养学和运动生理学方面的多学科专家团队，以在城市社区诊所中试点测试 MBSR+N 的可行性和初步疗效。将从为低收入城市社区提供服务的儿童指导诊所招募 60 名报告压力水平较高的 2-5 岁超重家长。家长将被随机分配接受为期 8 周的 MBSR+N 干预（基于共同 PI Sinha 博士开发的针对成人的 MBSR 加营养和 PA 干预）或接触对照组+N 组。在干预前和干预后以及 6 个月和 1 年的随访中，我们将收集以下患者的问卷调查、临床访谈和生物学测量： 父母和孩子的压力（包括皮质醇对实验室压力源的反应）、养育方式、父母和孩子的饮食行为和 PA，以及儿童 BMI 百分位数得分。我们还将收集有关父母 BMI 和代谢变量（例如葡萄糖）的数据。我们将评估 MBSR+N 的可行性和可接受性，并将测试初始干预效果并确定效果大小，以规划充分有力的 MBSR+N 长期疗效试验。该研究将提供：1. MBSR+N 的初始疗效数据，2. 进行 MBSR+N 大型长期试验的 R01 提案的试点数据，3. MBSR+N 在现实社区诊所环境中的可接受性证据，以及 4. 高危儿童肥胖发展的纵向数据。如果有效，MBSR+N 可能成为一种新策略，可以减轻高危成年人的压力和肥胖，同时预防幼儿超重/肥胖。