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

描述（由申请人提供）： 肥胖是美国第一大营养问题。由于儿童一生中因超重和肥胖而面临的健康风险最大，因此针对他们的干预措施具有高度优先性。为了响应 RFA-HL-10-004“儿童肥胖预防和治疗研究联盟”，我们建议创建明尼苏达州儿童肥胖预防中心，该中心由在社区、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团队组成。该中心的目标是将社区环境中开发的初级保健、家庭和社区干预策略的新颖整合转化为一个综合计划，将跨环境的干预策略联系起来，以促进低收入种族多样化儿童食物摄入、身体活动和体重的持续变化模式。这一目标将通过一系列迭代的三阶段研究活动来实现。在第一阶段，我们将开发并试点测试关联的多环境干预措施。三十名儿童及其父母将被随机分配到相关综合干预的常规护理中，其中包括：1）来自初级保健提供者的信息，以及后续电话，以协助采用行为和家庭环境信息； 2) 社区育儿课程，帮助家长围绕家庭环境管理、行为塑造和强化孩子的行为（包括饮食、体力活动和屏幕时间）培养育儿行为技能； 3) 社区食品和体育活动资源组成部分，以增强邻里环境机会并将家庭与邻里资源直接联系起来； 4）家庭倡导者协调初级保健和育儿课程的建议，并通过电话和家访支持与社区食品和体育活动资源的联系，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、关联的干预措施对500名3-5岁儿童及其父母的儿童肥胖、饮食和体育活动的影响。在第三阶段，我们将进行数据分析，开展促进干预措施可持续性的活动，并在当地和全国传播研究成果。相关性：明尼苏达州小儿肥胖预防中心的目标是将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项综合计划，该计划将跨环境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模式，从而预防高危低收入、种族多样化学龄前儿童的肥胖。

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.