Preventing Childhood Obesity through Early Feeding and Parenting Guidance

描述（由申请人提供）：婴儿的早期和快速生长与幼儿的早期发育和持续肥胖密切相关。大量研究表明，儿童肥胖/超重与严重健康后果的风险增加有关，包括不利的身体、心理、行为或社会后果。最近的研究表明，肥胖甚至对很小的孩子也有负面影响，随着肥胖儿童年龄的增长，肥胖会导致健康问题。医学研究所（IOM）最近关于儿童早期肥胖预防政策的报告（2011年）推荐了五种预防肥胖的方法：评估、监测和跟踪从出生到5岁的生长；增加幼儿的体力活动，减少久坐行为；支持母乳喂养并对儿童的喂养提示作出反应；限制看屏幕的时间；促进幼儿的适龄睡眠。基于该研究小组之前的工作，并与一个主要的城市卫生部门合作，我们建议测试一种干预措施，该干预措施结合了IOM的所有建议，以防止高危婴儿肥胖的发展。干预将由卫生专业人员指导，并由社区卫生工作者（CHW）在公共卫生护士（PHN）的监督下，对德克萨斯州休斯顿妇女、婴儿和儿童特殊补充营养计划（WIC）的墨西哥裔美国妇女和儿童进行家访。干预将持续2年，随访1年，总共测量3年。本研究的目的是

DESCRIPTION (provided by applicant): Early and rapid growth in infants is strongly associated with early development and persistence of obesity in young children. Substantial research has linked child obesity/overweight to increased risks for serious health outcomes, which include adverse physical, psychological, behavioral, or social consequences. Recent studies have indicated that obesity has negative outcomes even on very young children and contributes to health problems as obese children age. The Institute of Medicine's (IOM) recent report (2011) on early childhood obesity prevention policies, recommends five approaches to preventing obesity: assess, monitor, and track growth from birth to age 5; increase physical activity and decrease sedentary behavior in young children; support breastfeeding and be responsive to children's feeding cues; limit screen time; and promote age appropriate sleep for young children. Based on the previous work by this research team, and in collaboration with a major urban health department, we propose to test an intervention that incorporates all the IOM's recommendations to prevent the development of obesity in at-risk infants. The intervention will be guided by health professionals and delivered through home visits by community health workers (CHW), supervised by public health nurses (PHN), to Mexican-American women and children who are clients of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program in Houston, TX. The intervention will occur for 2 years with 1 year of follow-up, for a total of 3 years of measurements. The goal of this study is to compare the effectiveness of structured CHW- provided home visits, using an intervention created through community-based participatory research, to standard care received through WIC office visits in preventing the development of overweight (weight/length >85th percentile) and obesity (weight/length >95th percentile) in infants during their first 2 years of life. The proposed study will provide prospective data on the effects of an intervention to prevent childhood obesity in children at high risk for obesity due to ethnicity, income, and maternal BMI. We will be able to demonstrate the effectiveness of a common community approach in preventing obesity during the first 2 years of life as well as the intervention's persistence from age 2 to 3. This easy to implement obesity-prevention intervention can be adopted for many locales and diverse communities.