Linking Primary Care, Communities and Families to Prevent Obesity Among Preschool

描述(由申请人提供)： 肥胖是美国的头号营养问题。由于儿童因超重和肥胖而承受着最大的终生健康风险，因此针对他们的干预措施是高度优先的。为了响应RFA-HL-10-004“儿童肥胖预防和治疗研究联盟”，我们建议成立明尼苏达州儿童肥胖预防中心，由一个在社区、学校、初级保健和家庭儿童肥胖干预方面拥有丰富经验的跨学科调查小组组成。该中心的目标是将社区环境中开发的初级保健、家庭和基于社区的干预策略的新颖整合转化为一个全面的计划，将不同环境中的干预策略联系起来，以促进低收入种族多样化儿童在食物摄入、体力活动和体重方面的持续模式变化。这一目标将通过迭代的三阶段系列研究活动来实现。在第一阶段，我们将开发和试点多环境联动干预措施。30名儿童和他们的父母将被随机分为两组，一组是常规护理，包括1)来自初级保健提供者的消息，并有后续电话，以帮助采用行为和家庭环境信息；2)社区育儿课程，帮助父母发展围绕家庭环境管理的育儿行为技能，以及行为塑造和加强他们孩子的行为，包括进食、体力活动和屏幕时间；3)社区食物和体力活动资源部分，以增加社区环境机会，并直接将家庭与社区资源联系起来；4)家庭倡导者协调初级保健和育儿课程建议，并通过电话和家访支持与社区食物和体力活动资源的链接，在第二阶段，我们将进行一项为期3年的随机试验，以评估综合、关联干预对500名3-5岁儿童及其父母的儿童肥胖、饮食和体力活动的影响。在第三阶段，我们将进行数据分析，参与促进干预组成部分可持续性的活动，并在当地和全国范围内传播研究成果。相关性：明尼苏达州儿童肥胖预防中心的目标是将在社区环境中制定的初级保健、家庭和社区干预策略的新颖整合转化为一个全面的计划，该计划将不同环境中的干预策略联系起来，以促进食物摄入和身体活动的持续变化，以预防高危低收入、种族多样化的学龄前儿童肥胖。

DESCRIPTION (provided by applicant): Obesity is the number one nutritional problem in the US. Because children bear the greatest lifetime health risk from overweight and obesity, interventions targeting them are of high priority. In response to RFA-HL- 10-004 "Childhood Obesity Prevention and Treatment Research Consortium", we propose the creation of the Minnesota Center for Pediatric Obesity Prevention, comprised of an interdisciplinary investigative team with extensive experience in community, school, primary care, and family pediatric obesity interventions. The goal of this Center is to translate a novel integration of primary care, home, and community-based intervention strategies developed in community settings into a comprehensive program that links intervention strategies across settings to promote sustained patterns of change in food intake, physical activity, and body weight among low income ethnically diverse children. This goal will be met through an iterative three phase series of research activities. In Phase 1, we will develop and pilot test a linked multi-setting intervention. Thirty children and their parents will be randomized to either usual care of the linked integrated intervention consisting of 1) messages from the primary care provider, with follow-up phone calls to assist with adoption of the behavioral and home environment messages; 2) community parenting classes to help parents develop parenting behavioral skills around home environment management and behavioral shaping and reinforcement of their child's behaviors, including eating, physical activity and screen time; 3) a community food and physical activity resource component to enhance neighborhood environmental opportunities and directly link families with neighborhood resources; and 4) a family advocate to coordinate primary care and parenting class recommendations and support the link to neighborhood food and physical activity resources via phone and home visits, in Phase II, we will conduct a 3-year randomized trial to evaluate the impact of the integrated, linked intervention on childhood obesity, diet, and physical activity among 500 3-5 year old children and their parents. In Phase III, we will conduct data analysis, engage in activities to promote sustainability of the intervention components, and disseminate research findings locally and nationally. RELEVANCE: The goal of the Minnesota Center for Pediatric Obesity Prevention is to translate a novel integration of primary care, home and community-based intervention strategies developed in community settings into a comprehensive program that links intervention strategies across settings to promote sustained patterns of change in food intake and physical activity to prevent obesity among at-risk low income, ethnically diverse preschool children.