ONE PATH: Optimizing Nutrition Education for Parents And Teachers for Healthy Growth

一条路径：优化家长和老师的营养教育以促进健康成长

• 批准号: 10149999
• 负责人: Jennifer Savage Williams
• 金额: $ 64.6万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-05 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10149999
• 关键词: 4 year old; 5 year old; Academy; Address; Affect; American; Appetite Regulation; Area; Awareness; Body mass index; Caregivers; Caring; Categories; Child; Child Care; Child Development; Child Rearing; Childhood; County; Cues; Data; Desire for food; Development; E-learning; Eating; Education; Educational Curriculum; Educational process of instructing; Enrollment; Environment; Epidemic; Ethnic Origin; Evidence based intervention; Evidence based program; Exercise; Family; Food Intake Regulation; Fostering; Funding; Future; Goals; Growth; Head Start Program; Health Care Costs; Home; Home environment; Home visitation; Hunger; Hyperphagia; Individual; Informal Social Control; Infrastructure; Intervention; Laboratories; Learning; Life; Low income; Maternal and Child Health; Methodology; Methods; Mission; Modeling; National Institute of Diabetes and Digestive and Kidney Diseases; Nursery Schools; Obesity; Outcome; Parenting Education; Parents; Participant; Pediatrics; Pennsylvania; Physical activity; Play; Policies; Preschool Child; Prevention program; Prevention strategy; Provider; Public Health; Race; Randomized; Randomized, Controlled Trials; Recommendation; Recording of previous events; Regulation; Research; Research Personnel; Rural; Rural Population; Sampling; School-Age Population; Schools; Self Assessment; Site; Structure; Subgroup; Temperament; Testing; Training; Translating; Trust; United States; United States National Institutes of Health; Vulnerable Populations; Weight; Weight Gain; Work; attentional control; clinically significant; cohort; community setting; cost; cost effective; critical developmental period; design; early childhood; economic disparity; educational atmosphere; efficacious intervention; efficacy testing; evidence base; experience; experimental study; feeding; food environment; food security; high risk; improved; innovation; intervention effect; member; mindfulness; multi-component intervention; multidisciplinary; multiphase optimization strategy; nutrition; nutrition education; obesity development; obesity in children; obesity prevention; prevent; preventive intervention; primary outcome; programs; response; rural area; rural counties; rural poverty; secondary outcome; sex; skills; teacher; treatment effect; underserved area; virtual

PROJECT SUMMARY/ABSTRACT Childhood obesity is a serious and costly health problem in the United States that disproportionately affects economically disadvantaged children living in rural, low-income areas. Despite this, virtually no effective preventive strategies target the childcare setting, where many children eat 75% of their meals. Responsive feeding (RF) practices, which provide structure and limits while allowing the child to exercise some autonomy, foster the development of self-regulation of food intake. RF has been shown to be a promising target of interventions, but these trials have focused primarily on the home environment. Strategies to improve the food environment and promote RF and child appetite regulation in multiple settings are needed. The ONE PATH study will rigorously test the effect of adding RF and appetite regulation components to an existing, evidence-based program that intervenes on the childcare setting environment. An innovative methodological framework, Multiphase Optimization Strategy (MOST), will be used to identify which intervention components improve RF and children’s appetite regulation among rural, low-income children enrolled in Head Start. Using a factorial design, Head Start classrooms (n=48) will be randomized to receive or not receive three components: a) RF training for early childhood education (ECE) providers, delivered via online module; b) RF training for parents, delivered at home by Extension educators; and c) child self- regulation curriculum, delivered in Head Start classrooms. The interventions will take place over the course of one school year (~9 months), spanning three cohorts. Intervention component efficacy will be determined by evaluating caregiver feeding practices and child appetite regulation (primary outcomes) and changes in childcare and home environments, and child BMI z-score (secondary outcomes). This study will yield an optimized intervention comprised of effective and efficient components that will be “packaged” and tested in a future RCT. The proposed research will improve the evidence base needed to translate lessons learned in the laboratory to community settings where children eat, optimizing the care of preschool-aged children. To successfully complete this study, we have assembled a transdisciplinary team, including researchers, educators, and Extension professionals. Advisory board members will represent the American Academy of Pediatrics (AAP), Penn State Cooperative Extension - Better Kid Care, and Pennsylvania Head Start. Our multi-disciplinary team has a history of working together and are well suited to design and test this multi-site, multi-component intervention. We have experiences implementing interventions in the home and classroom settings, with access to Head Start children in 7 rural counties in Pennsylvania. This application has several unique features/strengths including: public health/clinical significance, targeting RF of ECE providers, engaging parents in ECE care, and using innovative methods to optimize our intervention. This research compliments the over-reaching goal of NIH to improve maternal/child health and it is consistent with the NIDDK mission.

项目总结/摘要 在美国，儿童肥胖是一个严重且代价高昂的健康问题， 生活在农村、低收入地区的经济弱势儿童。尽管如此，几乎没有有效的 预防战略针对儿童保育环境，因为许多儿童75%的膳食都是在那里吃的。响应 喂养（RF）的做法，提供结构和限制，同时允许儿童行使一定的自主权， 促进食物摄入的自我调节。RF已被证明是一个有前途的目标， 干预措施，但这些试验主要集中在家庭环境。改善食物的策略 环境和促进RF和儿童食欲调节在多个设置是必要的。 ONE PATH研究将严格测试将RF和食欲调节成分添加到 现有的、以证据为基础的方案，对儿童保育环境进行干预。一个创新 方法框架，多阶段优化战略（MOST），将用于确定 干预成分改善农村低收入儿童的RF和儿童食欲调节 参加了"先声夺人“使用析因设计，将学前班教室（n=48）随机接受或 （a）为幼儿教育提供者提供的RF培训，通过 在线模块; B）由推广教育工作者在家中为父母提供RF培训;以及c）儿童自我- 监管课程，在头开始教室交付。这些干预措施将在 一个学年（约9个月），跨越三个队列。干预成分的有效性将由以下因素确定： 评估看护者的喂养实践和儿童食欲调节（主要结局）以及 儿童保育和家庭环境，以及儿童BMI z评分（次要结局）。这项研究将产生一个 优化的干预措施由有效和高效的组成部分组成，这些组成部分将被“打包”并在一个 未来的RCT拟议的研究将改善将在2008年取得的经验教训转化为现实所需的证据基础。 从实验室到儿童就餐的社区环境，优化学龄前儿童的护理。 为了成功完成这项研究，我们组建了一个跨学科的团队，包括研究人员， 教育工作者和推广专业人员。顾问委员会成员将代表美国科学院 儿科（AAP），宾夕法尼亚州合作推广-更好的儿童护理，和宾夕法尼亚州领先。我们 多学科团队具有合作的历史，非常适合设计和测试这种多站点， 多元干预。我们有在家庭和教室实施干预措施的经验 在宾夕法尼亚州的7个农村县，该应用程序具有多个 独特的功能/优势包括：公共卫生/临床意义，针对早期教育提供者的RF， 幼儿教育护理的父母，并使用创新的方法来优化我们的干预。这项研究称赞 国家卫生研究所的目标是改善孕产妇/儿童健康，这与国家卫生研究所的使命一致。