Turn Up the HEAT - Healthy Eating and Activity Time in Summer Day Camps

描述(由申请者提供)：夏令营(SDC)是一个潜在的环境，可以在学年期间扩大针对儿童的健康和健康努力。 儿童发展中心每年为1430多万青少年(12岁)提供服务，是在学年以外最大的有组织机构，儿童可以在这里进行健康饮食(即每天食用水果[F]、蔬菜[V]、水[W])和体育活动(PA)。2011年，全国课后协会发布了被称为健康饮食和体力活动(HEPA)标准的儿童肥胖政策，呼吁SDC确保注册的儿童每天摄入FV和W，并进行60分钟的中等到剧烈的PA(MVPA)。从我们广泛的试点工作中，我们确定了SDC需要支持才能达到HEPA标准的两个领域。首先，大多数儿童健康教育中心不提供膳食或零食，而是由父母决定每天给孩子打包什么食物作为午餐和零食。为了解决这个问题，我们开发了一种基于行为选择理论的创新的HE干预措施--健康午餐盒挑战(HLC)。HLC是一项低成本的每周奖励计划，奖励将健康物品打包为零食/午餐(即F、V、W)的儿童。其次，我们开发了我们的创新PA干预方法(5ms并让美国发挥)，以满足项目负责人和员工促进PA所需的基本技能。这些重点是让美国发挥原则，删除和消除，减少团队规模，让不参与的工作人员/孩子参与活动，并有效利用空间、设备和规则。我们的长远目标是增加符合HEPA标准的SDC的数目。其目的是评估旨在提高儿童PA水平和改善儿童在SDC带来和消费的食物/饮料质量的多组分干预措施的有效性。HEPA干预使用培训培训员的模式，由SDC领导人培训其工作人员进行交付，并将干预措施纳入常规做法。我们将通过一项为期4年的随机对照试验对HEPA干预进行评估，试验对象为20个SDC。这项研究的一个重要特点将是评估在最后一年取消研究支助(例如，培训、助推器)后干预措施的维持情况以及与实施有关的费用。目的1.评估HEPA干预措施对以下方面的影响：1A：参加夏令营的儿童达到PA标准(即e60min MVPA/d)的比例；2A：夏令营儿童和工作人员携带和消费的符合HE标准的食物(如增加水果、蔬菜、水)的比例；3A：从夏初到夏末儿童年龄-性别特定BMI百分位数的变化。目的2：评价HEPA干预措施的成本-效果；目的3.评价夏令营HEPA干预措施的维持性。这项拟议的研究意义重大，因为儿童保健中心有可能惠及数百万儿童。这项研究具有创新性，因为还没有人对这一重要的背景和时间框架(暑假)进行研究。

DESCRIPTION (provided by applicant): Summer day camps (SDCs) represent a potential setting for the extension of health and wellness efforts targeting children during the school year. SDCs serve more than 14.3 million youth (<12yrs) annually and are the single largest organized setting, outside of the school year, where children can engage in healthy eating (i.e., consumption of fruits [F], vegetables [V], water [W] daily) and physical activity (PA). In 2011, th National Afterschool Association released childhood obesity policies referred to as the Healthy Eating and Physical Activity (HEPA) Standards, that call upon SDCs to ensure the children enrolled consume a serving of FV and W daily and engage in 60 minutes of moderate-to-vigorous PA (MVPA). From our extensive pilot work, we identified two areas SDCs' require support to meet the HEPA Standards. First, the majority of SDCs do not provide meals or snacks; rather, parents decide what types of foods are packed daily for their child to eat for lunch and snacks. To address this, we developed an innovative HE intervention for this setting - the Healthy Lunchbox Challenge (HLC) - grounded in Behavioral Choice Theory. The HLC is a low-cost weekly incentive program that awards points to children for packing healthy items for snacks/lunch (i.e., F, V, W). Second, we developed our innovative PA intervention approach (5 Ms and LET US Play) to address fundamental skills program leaders and staff require to facilitate PA. These focus on the LET US Play principles of removing lines and elimination, reducing team sizes, getting uninvolved staff/kids involved in activities, and using space, equipment, and rules effectively. Our long-term goal is to increase the number of SDCs that meet the HEPA Standards. The objective is to evaluate the effectiveness of a multi-component intervention designed to increase children's PA levels and improve the quality of foods/beverages children bring and consume in SDCs. The HEPA intervention uses a train-the-trainer model with SDC leaders to train their staff to deliver and integrate the intervention into routine practice. We will evaluate the HEPA intervention using a 4-year randomized controlled trial with 20 SDCs. An important feature of the study will be the evaluation of maintenance of the intervention after the removal of research support (e.g., training, boosters) during the final year as well as costs associated with implementation. Aim 1. Evaluate the impact of the HEPA interventions on: 1A: The proportion of children meeting the PA Standard (i.e., e60min MVPA/d) while attending summer day camp; 2A: The proportion of foods meeting the HE Standards (e.g., increase fruit, vegetable, water) children and staff bring and consume at the summer day camp; and 3A: Changes in children's age-sex specific BMI percentile from the start to end of summer. Aim 2: Evaluate the cost-effectiveness of the HEPA intervention; and Aim 3. Evaluate the maintenance of the HEPA intervention in summer day camps. The proposed study is significant because SDCs have the potential to reach millions of children. This research is innovative because no research has been conducted on this important setting and timeframe (summer vacation).