Growing Right Onto Wellness (GROW): Changing Early Childhood BMI Trajectories

健康成长 (GROW)：改变幼儿期 BMI 轨迹

• 批准号: 8463600
• 负责人: Shari Barkin
• 金额: $ 209.56万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-20 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8463600
• 关键词: Address; Adherence; Adolescent; Adult; Affect; Age; Alleles; Behavior; Biolectric Impedance; Child; Childhood; Communities; County; Data; Diet; Educational Curriculum; Energy Intake; Family; Focus Groups; Food Preferences; Genetic; Genetic Predisposition to Disease; Genetic Risk; Goals; Habits; Health; Intervention; Life Style; Low income; Macronutrients Nutrition; Maintenance; Measures; Monitor; Morbidity - disease rate; Neighborhoods; Nursery Schools; Obesity; Outcome; Overweight; Parents; Pattern; Pediatrics; Phase; Physical activity; Pilot Projects; Population; Preschool Child; Principal Investigator; Problem Solving; Public Health; Questionnaires; Randomized; Randomized Controlled Trials; Recommendation; Recreation; Relative (related person); Research; Risk; Saliva; Schools; Single Nucleotide Polymorphism; Social Network; System; Testing; Time; Weight; Wellness Program; actigraphy; base; early childhood; genetic risk factor; group intervention; high risk; high risk parents; improved; indexing; innovation; interest; intervention effect; lifestyle intervention; literacy; mortality; nutrition; obesity prevention; prevent; primary outcome; programs; sedentary; skills; success; tool; waist circumference

DESCRIPTION (provided by applicant): Food preferences and activity habits set in early childhood can profoundly influence lifelong trajectories for Body l\/lass Index (BMI) and health. Specifically, rapid BMI gain in early childhood has been established to affect adulthood mortality and morbidity. Unfortunately, the longer such unhealthy patterns are in place, the more difficult it can be to reverse them. Therefore, healthy lifestyle interventions targeted at children as early as preschool 'have enormous potential to affect lifelong health. Furthermore, nutrition and activity patterns are determined not only at the child level, but within the family and the community. Building on the success of an existing partnership between Vanderbilt Pediatrics and Metro Parks and Recreation in Nashville, TN, we will conduct and evaluate an intervention intended to prevent obesity in preschoolers in an approach that affects multiple levels of risk and is both family-based and community centered. Prior to launching a large randomized controlled trial (RCT), formative research (focus groups and pilot studies) will be conducted to refine the intervention components. In the RCT, 600 parent-preschool children dyads from low income neighborhoods will be randomly assigned to one of two conditions. In the intervention condition, groups of parent-child dyads will participate in an empirically tested, literacy-sensitive, skills building curriculum to improve: 1) caloric intake with appropriate macronutrients, and 2) routine physical activity for both parent and child. The intervention condition will occur in community centers and utilize tools including goal setting, self-monitoring, and problem solving. In the control condition parent-child dyad groups will receive a literacy promotion/school success curriculum. Both conditions will have 90-minute sessions in: 1) an initiation phase (weekly for 3 months); 2) a maintenance phase (biweekly for 6 months); and 3) a sustainability phase (monthly for 27 months). The primary outcome of interest will be early childhood BMI trajectories measured at multiple time points over the three year RCT. Additional measures collected throughout the study from children and parents will include: bioelectrical impedance; waist circumference; actigraphy; 3-day diet recalls; questionnaires; social network data; and saliva to assess a genetic risk score associated with obesity. RELEVANCE: Pediatric obesity prevention must occur in preschool given that 60% of oven/weight preschoolers will go on to become overweight adolescents. By conducting and testing trials in public community centers, exportable interventions could result allowing for a macro-level system change to address this expanding public health crisis.

描述（由申请人提供）： 幼儿时期设定的食物偏好和活动习惯可以深刻影响终生的身体指数（BMI）和健康轨迹。具体而言，儿童早期体重指数的快速增加已被确定会影响成年期的死亡率和发病率。不幸的是，这种不健康的模式存在的时间越长，扭转它们就越困难。因此，针对学龄前儿童的健康生活方式干预措施“具有影响终生健康的巨大潜力。”此外，营养和活动模式不仅在儿童层面决定，而且在家庭和社区内部决定。基于范德比尔特儿科中心与田纳西州纳什维尔大都会公园和娱乐中心之间现有合作伙伴关系的成功，我们将开展和评估旨在预防学龄前儿童肥胖的干预措施，其方法影响多个风险级别，并且既以家庭为基础，又以社区为中心。在启动大型随机对照试验（RCT）之前，将进行形成性研究（焦点小组和试点研究）以完善干预措施。在随机对照试验中，来自低收入社区的 600 名家长和学龄前儿童将被随机分配到以下两种情况之一。在干预条件下，亲子二人组将参加经过实证检验的、识字敏感的技能培养课程，以提高：1）热量摄入和适当的常量营养素，2）父母和孩子的日常体育活动。干预条件将在社区中心进行，并利用目标设定、自我监控和解决问题等工具。在控制条件下，亲子二人组将接受识字促进/学校成功课程。两种情况都将在以下阶段进行 90 分钟的课程： 1) 启动阶段（每周一次，持续 3 个月）； 2) 维持阶段（每两周一次，持续 6 个月）； 3) 可持续发展阶段（每月一次，持续 27 个月）。我们感兴趣的主要结果是三年随机对照试验中多个时间点测量的早期儿童体重指数轨迹。在整个研究过程中从儿童和家长那里收集的其他测量结果包括：生物电阻抗；腰围；体动记录仪； 3天饮食回忆；问卷调查；社交网络数据；和唾液来评估与肥胖相关的遗传风险评分。相关性：鉴于 60% 的体重/体重学龄前儿童将继续成为超重青少年，因此必须在学前班预防儿童肥胖。通过在公共社区中心进行和测试试验，可能会产生可输出的干预措施，从而实现宏观层面的系统变革，以解决这一不断扩大的公共卫生危机。