Addressing Poverty-Related Barriers to Prevent Obesity Beginning in Infancy

解决与贫困有关的障碍，从婴儿期开始预防肥胖

基本信息

批准号：
8759440
负责人：
Rachel Sharon Gross
金额：
$ 13.59万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2019-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8759440
关键词：
Address Affect Age Behavioral Biometry Capital Child Child health care Childhood Clinical Research Code Complex Data Data Analyses Development Diet Early Intervention Education Energy Intake Evaluation Family Food Funding Goals Grant Hispanics Individual Infant Informal Social Control Intervention Interview Knowledge Lead Length Life Life Cycle Stages Link Low income Measures Mediating Mediator of activation protein Medical Staff Mental Depression Mental Health Mentors Methodology Methods Modeling Mothers Obesity Outcome Parenting behavior Patients Pattern Pediatrics Population Poverty Prevention Preventive Preventive Intervention Primary Health Care Public Health Qualitative Research Research Methodology Research Personnel Risk Science Social support Solid Specialist Staging Structure Surveys Testing Training Treatment Efficacy Weight Work Writing base behavior change career development cohort cost design developmental psychology efficacy testing evidence base feeding health literacy human capital improved infancy innovation longitudinal analysis multidisciplinary nutrition obesity in children obesity prevention obesity risk patient oriented research practical application prevent primary care setting professor programs psychosocial public health relevance skills stressor success therapy design therapy development

项目摘要

DESCRIPTION (provided by applicant): Maternal-infant feeding style, defined as a mother's approach to regulating infant feeding, is a critical, potentially modifiable mediator linking povery and child obesity. Evidence has documented that poverty-related risks directly impact feeding styles and create barriers to intervention engagement. This suggests the need to address both risks and barriers to improve intervention impact. Pediatric platforms represent an opportunity to address these risks and barriers due to their ability to access low-income families with poverty-related risks beginning in early infancy. The candidate proposes a mentored support period of five years to acquire expertise in developing strategies to improve obesity prevention in the context of poverty beginning during infancy. The candidate is an Assistant Professor of Pediatrics with the long-term goal of becoming an independent clinical research investigator. This goal will be achieved through training from expert multidisciplinary mentors from the fields of developmental-behavioral pediatrics, applied developmental psychology, nutrition science and biostatistics, formal coursework and other career development activities. She will gain advanced skills in: 1) applying theoretical frameworks from developmental psychology to patient-oriented research addressing poverty-related risks; 2) state-of-the-art methodologies for assessing maternal-infant feeding interactions; 3) complex quantitative longitudinal data analysis with repeated measures; 4) qualitative research methodologies to identify barriers and facilitators of intervention engagement with low-income families; 5) intervention development and evaluation; and 6) grant writing. The practical application of these goals will be accomplished through three study aims. In Aim 1, Dr. Gross will conduct a secondary analysis of longitudinal data from a large ongoing study of an early obesity prevention intervention to systematically describe the relationships between poverty-related risks and maternal-infant feeding styles and the degree to which these styles impact caloric intake and infant weight trajectories. In Aim 2, Dr. Gross will use qualitative methodologies to inform the conceptualization and development of strategies to address poverty-related risks and barriers that can be incorporated into a behavior change intervention and integrated into a population-scalable primary care-based platform. In Aim 3, Dr. Gross will pilot test these strategies for feasibility of implementation and obtaining preliminary estimates of effect size. The successful execution of this proposal will lead to an R01 application to test the efficacy of an obesity prevention intervention that addresses poverty-related risks and barriers using a population-scalable primary care-based platform to increase responsive maternal-infant feeding styles and reduce early child obesity.

描述（由申请人提供）：定义为母亲调节婴儿喂养的方法的产妇喂养样式，是一个关键的，潜在的可修改的调解人，将肥胖和儿童肥胖联系起来。有证据表明，与贫困相关的风险直接影响喂养方式并为干预参与造成障碍。这表明需要解决改善干预影响的风险和障碍。小儿平台代表了解决这些风险和障碍的机会，因为它们能够从早期阶段开始具有与贫困相关风险的低收入家庭。候选人提出了五年的指导支持期，以获取在婴儿期开始贫困的情况下制定策略以改善肥胖症的策略的专业知识。候选人是儿科助理教授，其长期目标是成为独立的临床研究研究者。这一目标将通过从发育行为的儿科，应用心理学，营养科学和生物统计学，正式课程和其他职业发展活动的专家多学科导师的培训来实现。她将获得以下方面的高级技能：1）将理论框架从发育心理学到面向患者的研究，以应对与贫困相关的风险； 2）评估产妇喂养相互作用的最先进方法； 3）复杂的定量纵向数据分析，并重复测量； 4）定性研究方法，以确定与低收入家庭干预参与的障碍和促进者； 5）干预开发和评估；和6）赠款写作。这些目标的实际应用将通过三个研究目的来实现。在AIM 1中，Gross博士将对纵向数据进行二次分析，该数据正在进行的大量研究对早期肥胖预防干预措施的研究，以系统地描述与贫困相关的风险与孕妇侵害喂养方式之间的关系以及这些风格影响热量摄入量和婴儿体重轨迹的程度。在AIM 2中，Gross博士将使用定性方法来告知策略的概念化和制定，以解决与贫困相关的风险和障碍，这些风险和障碍可以纳入行为改变干预措施并将其整合到基于人群的基于初级保健的平台中。在AIM 3中，Gross博士将试行这些策略，以实施可行性并获得效应大小的初步估计。该提案的成功执行将导致R01应用于测试肥胖预防干预措施的功效，该干预措施使用基于人群的初级保健平台来解决与贫困相关的风险和障碍，以提高反应迅速的产妇喂养风格并减少早期儿童肥胖。