Family-based Intervention for Preventing Obesity and Reducing Cancer Risk in Chil

以家庭为基础的预防儿童肥胖和降低癌症风险的干预措施

• 批准号: 8739622
• 负责人: Temitope O Erinosho
• 金额: $ 11.07万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-23 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8739622
• 关键词: 5 year old; Adult; Affect; Behavior; Behavior Therapy; Body mass index; Breast; Cancer Prevention Intervention; Cause of Death; Cessation of life; Characteristics; Child; Childhood; Colorectal; Communication; Data; Development; Diet; Dietary intake; Eating; Educational process of instructing; Educational workshop; Effectiveness; Elderly; Equation; Family; Family history of; Foundations; Funding; Goals; Grant; Health; Home environment; Incidence; Intervention; Journals; K-Series Research Career Programs; Kidney; Life; Link; Low income; Malignant Neoplasms; Measures; Mediating; Mentorship; Methods; Minority Groups; Modeling; North Carolina; Obesity; Obesity associated cancer; Outcome; Outcome Study; Parenting behavior; Parents; Peer Review; Personal Satisfaction; Persons; Physical activity; Play; Postmenopause; Preschool Child; Preventive Intervention; Problem Solving; Psychosocial Factor; Public Health; Randomized Controlled Trials; Regression Analysis; Research; Research Personnel; Resources; Risk; Risk Factors; Role; Sampling; Series; Shapes; Social support; Solid; Students; Surveys; Testing; Time; Underserved Population; United States; Universities; Weight; Weight Gain; Work; Writing; arm; base; cancer risk; career; design; early childhood; efficacy testing; experience; follow-up; grandparent; improved; indexing; innovation; intervention effect; lifetime risk; meetings; nutrition; obesity in children; obesity prevention; obesity risk; post intervention; prevent; psychosocial; secondary outcome; sedentary; self esteem; skills; therapy design; working group

DESCRIPTION (provided by applicant): My experience to date has provided a solid foundation in early childhood obesity prevention, particularly in childcare settings, that will sere as a natural launching point for expansion into cancer prevention interventions designed to reach low-income preschool children with a family history of obesity-related cancers. My long-term career goal is to become a successful, independent, externally-funded research investigator, specializing in designing and implementing family-based interventions for the prevention of obesity in childhood that can reduce the lifetime risk for obesity-related cancers, particularly among at-risk and underserved populations. My short-term goals are to: 1) develop scientific and technical skills in: mechanisms linking nutrition, physical activity, and obesity to cancer; and developing and implementing family-based behavioral interventions to prevent obesity in childhood to reduce the incidence of obesity-related cancers in later life among low-income children with a 1st or 2nd degree family history of obesity-related cancers; 2) develop skills for writing grants to become an independent investigator and compete for peer-reviewed funding; and 3) enhance my communication skills through presentations at scientific meetings, writing for peer-reviewed journals, and teaching students. To acquire these skills, I have proposed to take graduate-level courses, participate in workshops, including a research working group and seminars, and develop and pilot-test a behavioral intervention, under the mentorship of a team of accomplished senior researchers at the University of North Carolina-Chapel Hill (UNC-Chapel Hill). RESEARCH Purpose: Obesity contributes to about one-third of all cancer deaths. Having a family history of obesity-related cancers further elevates one's risk for obesity-related cancers. Interventions to prevent the onset of obesity early in life are critical for preventing/reducing the risk of obesity-related cancers in adulthood. Few interventions have focused on preventing obesity in preschool children, particularly those from low-income families, who have a family history of obesity-related cancers. The purpose of the proposed study is to develop and pilot-test a 16-week, family-based intervention that uses the life skills approach to promote healthy weight gain in low-income preschool children (3-5 years old) who have a 1st or 2nd degree family history of obesity- related cancers, to prevent/reduce their risk for obesity-related cancers in adulthood. Methods: Formative research data will be collected to develop the intervention. The intervention will be pilot-tested in a randomized controlled trial among 106 low-income families/parent-child dyads, with change in children's weight status as the primary study outcome. Secondary outcomes include change in: a) children's dietary intakes and physical activity levels; b) parental psychosocial characteristics, and parenting practices related to diet and physical activity; and c), parental dietary intakes, physical activity and weight status. Study outcomes will be assessed at baseline, 16-weeks post-intervention, and at a 2-month follow-up. Statistical Analysis: Multiple regression analyses will be conducted to assess change in child and parent outcomes, respectively, between the intervention and control arm over the16-week intervention, and at the 2-month follow-up, controlling for demographic characteristics. Structural equation modeling will be used to determine whether the effects of the intervention on children's diet and physical activity are mediated by changes in the targeted parental psychosocial variables and parenting practices related to diet and physical activity. ExpectedOutcomes/Hypothesis: At the end of the16-week intervention, children in the intervention arm will have: a) healthier weight gain; b) healthier dietary intakes, as measured by higher Healthy Eating Index-2005 (HEI-2005) scores; and c) higher levels of physical activity, compared to children in the control arm. Parents in the intervention arm will also have: a) improved psychosocial well-being; b) improved parenting practices; c) higher HEI-2005 scores; d) higher physical activity levels; and e) healthier weight gain than parents in the control arm. Study findings will provide information that will be useful in testing the efficacy of the intervenion in a larger sample of low-income families with preschool children. THE ENVIRONMENT UNC-Chapel Hill is a leading educational and research university in the United States with ample resources to support the candidate in acquiring all of the skills proposed for the career development award.

描述(申请人提供)：我到目前为止的经验为儿童早期肥胖的预防提供了坚实的基础，特别是在托儿环境中，这将成为扩展到癌症预防干预措施的自然起点，旨在帮助有肥胖相关癌症家族病史的低收入学龄前儿童。我的长期职业目标是成为一名成功的、独立的、由外部资助的研究调查员，专门设计和实施以家庭为基础的干预措施，以预防儿童肥胖，从而降低肥胖相关癌症的终身风险，特别是在高危和服务不足的人群中。我的短期目标是：1)在以下方面发展科学和技术技能：将营养、体力活动和肥胖与 该计划包括：1)开发和实施预防儿童肥胖的家庭行为干预措施，以降低有1级或2级肥胖相关癌症家族史的低收入儿童晚年肥胖相关癌症的发病率；2)培养撰写助学金的技能，以便成为一名独立的研究人员并争取同行评议的资助；3)通过在科学会议上发表演讲、为同行评议的期刊撰稿以及教授学生，增强我的沟通能力。为了获得这些技能，我提议在北卡罗来纳大学教堂山分校(北卡罗来纳大学教堂山分校)一个经验丰富的高级研究人员团队的指导下，参加研究生级别的课程，参加研讨会，包括研究工作组和研讨会，并开发和试行行为干预。研究目的：在所有癌症死亡中，肥胖约占三分之一。有肥胖相关癌症家族史会进一步增加患肥胖相关癌症的风险。预防早年肥胖的干预措施对于预防/降低成年后肥胖相关癌症的风险至关重要。很少有干预措施侧重于预防学龄前儿童肥胖，特别是那些来自低收入家庭的儿童，他们有肥胖相关癌症的家族病史。这项拟议研究的目的是开发和试行为期16周的基于家庭的干预措施，使用生活技能方法促进具有一级或二级肥胖相关癌症家族史的低收入学龄前儿童(3-5岁)的健康体重增加，以预防/降低他们成年后患肥胖相关癌症的风险。方法：收集形成性研究数据进行干预。这项干预措施将在106个低收入家庭/亲子二人组中进行随机对照试验，主要研究结果是儿童体重状况的变化。次要结果包括：a)儿童的膳食摄入量和体力活动水平；b)父母的心理社会特征以及与饮食和体力活动有关的育儿做法；c)父母的膳食摄入量、体力活动和体重状况。学习 结果将在基线、干预后16周和2个月的随访时进行评估。统计分析：将进行多元回归分析，以评估儿童和父母结果的变化，分别在干预16周和2个月随访期间，控制人口统计学特征。结构性 将使用方程模型来确定干预对儿童饮食和体力活动的影响是否通过与饮食和体力活动有关的目标父母心理社会变量和育儿做法的变化来调节。预期结果/假设：在为期16周的干预结束时，与对照组儿童相比，干预组儿童将有：a)更健康的体重增加；b)更健康的饮食摄入量，通过更高的健康饮食指数(HEI-2005)得分衡量；以及c)更高的体力活动水平。干预组的父母还将有：a)改善心理社会健康；b)改善育儿实践；c)更高的HEI-2005分数；d)更高的体力活动水平；以及e)比对照组的父母更健康的体重增加。研究结果将提供有用的信息，用于在更大样本的有学龄前儿童的低收入家庭中测试干预的有效性。环境北卡罗来纳大学教堂山分校是美国一所领先的教育和研究大学，拥有充足的资源支持候选人获得职业发展奖所建议的所有技能。