PALS-CATCH Intervention for Obesity Prevention Among At-Risk Toddlers

PALS-CATCH 预防高危幼儿肥胖的干预措施

• 批准号: 8969509
• 负责人: SUSAN LANDRY
• 金额: $ 23.1万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8969509
• 关键词: 4 year old; 5 year old; Address; Affect; African American; Age; Attention; Behavior; Behavioral; Body mass index; Caregivers; Caring; Child; Child Development; Child Rearing; Child health care; Chronic Disease; Communication; Computers; Consumption; Control Groups; Cooperative Behavior; Cues; Development; Diet; Dietary intake; Eating; Educational Curriculum; Educational process of instructing; Environment; Epidemic; Evidence based program; Family; Food; Gender; Growth; Habits; Health Food; Health Promotion; Hispanics; Home environment; Home visitation; Hour; House Call; Informal Social Control; Intake; Intervention; Knowledge; Lead; Learning; Life; Low income; Measurement; Measures; Mediating; Medicaid; Modeling; Monitor; Nursery Schools; Obesity; Outcome; Outcome Measure; Overweight; Parents; Pattern; Physical activity; Play; Population; Prevention approach; Program Effectiveness; Psychosocial Factor; Public Health; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Risk; Schedule; Schools; Self Efficacy; Sleep; Specific qualifier value; Surveys; Testing; Texas; Time; Toddler; United States Dept. of Health and Human Services; Vegetables; Weight; base; behavioral outcome; disorder prevention; early childhood; efficacy trial; energy balance; evidence base; experience; feeding; fruits and vegetables; group intervention; improved; lifestyle intervention; nutrition; obesity in children; obesity management; obesity prevention; post intervention; pressure; primary outcome; programs; psychosocial; public health relevance; research study; scaffold; sedentary; skills; sugar; sweetened beverage; trial design; tv watching

 DESCRIPTION (provided by applicant): In Texas, even the youngest children are affected by the obesity epidemic with 32% of 2 to 5 year old children overweight or obese before they enter school. The home environment and parenting skills and practices during the very early years of a child's life are critically important to establish obesity prevention behaviors such as healthy eating, physical activity, and adequate duration of sleep. However, parents lack these skills and interventions targeting the child's familiar environment, their home, are sparse. The overall aim of this study is to pilot test an integrated, culturally sensitive home-based program targeting predominantly low- income, African American and Hispanic parents to improve parenting skills for obesity prevention and control among toddlers ages 2 to 3 years. The program, PALS-CATCH, will integrate strategies from two research proven programs - Play and Learn Strategies (PALS) and the Coordinated Approach to Child Health (CATCH). This experimental study will target parents of toddlers in their home setting, teaching them how to be responsive and sensitive to their young child's cues, provide opportunities and assure consistency in young children's schedules for mealtime, activity, and sleep, thus facilitating child's development of self-regulation and other developmental outcomes to facilitate healthy eating, activity, and sleep patterns. Our specific aims are: Aim 1. To evaluate the feasibility and acceptability of PALS-CATCH among predominantly low-income, African American and Hispanic overweight or obese toddlers ages 2 to 3 years and their parents. Aim 2. To determine the effect of PALS-CATCH on child energy balance-related behaviors. We will use a randomized controlled trial (RCT) design to pilot test PALS-CATCH among 60 low-income, African American and Hispanic parent-child dyads where the child is overweight or obese (BMI >85th percentile for age and gender). We hypothesize that post-intervention, as compared to those in the control group, children of parents receiving PALS-CATCH will decrease: a) BMI z-score, and b) ounces of sugar-sweetened beverages consumed per day, and increase: e) number of servings of fruits and vegetables consumed per day and, f) mean minutes of physical activity including moderate-to-vigorous physical activity per day. As part of our secondary aims, we will evaluate the effects of PALS-CATCH on parent and child psychosocial and behavioral outcomes including parenting skills, responsiveness, and child self-regulation behaviors related to diet, physical activity, screen time and sleep. We will also examine the extent to which these factors mediate the improvements in child BMI, dietary and physical activity behaviors. Pre and post-intervention measurements will be conducted using child anthropometric measurements, parent-reported 24-hour dietary recalls for child dietary intake, accelerometers for child physical activity, video observations measuring parent responsiveness behaviors and, parent surveys measuring home environmental, and psychosocial factors. Results from the pilot will be used obtain effect sizes to power a RO1 to determine the efficacy of PALS-CATCH for toddlers.

 描述（由申请人提供）：在得克萨斯州，即使是最小的儿童也受到肥胖流行病的影响，32%的2至5岁儿童在入学前超重或肥胖。在儿童生命的最初几年，家庭环境和育儿技能和实践对于建立预防肥胖的行为至关重要，如健康饮食，体育活动和充足的睡眠时间。然而，父母缺乏这些技能，针对儿童熟悉的环境-他们的家-的干预措施很少。本研究的总体目的是对一项综合的、文化敏感的家庭计划进行试点测试，该计划主要针对低收入、非洲裔美国人和西班牙裔父母，以提高2至3岁幼儿预防和控制肥胖的育儿技能。该方案，PALS-CATCH，将整合两个研究证明的方案-玩耍和学习战略（帕尔斯）和儿童健康协调方法（CATCH）。这项实验研究将针对幼儿的父母在他们的家庭环境中，教他们如何对幼儿的暗示做出反应和敏感，提供机会并确保幼儿的进餐时间，活动和睡眠时间表的一致性，从而促进儿童的自我调节和其他发展成果的发展，以促进健康的饮食，活动和睡眠模式。我们的具体目标是：目标1。评估PALS-CATCH在主要是低收入、非洲裔美国人和西班牙裔超重或肥胖的2至3岁幼儿及其父母中的可行性和可接受性。目标二。确定PALS-CATCH对儿童能量平衡相关行为的影响。我们将使用随机对照试验（RCT）设计，在60个低收入、非洲裔美国人和西班牙裔父母-子女对中对PALS-CATCH进行初步测试，这些父母-子女对中的儿童超重或肥胖（BMI >年龄和性别的第85百分位数）。我们假设干预后，与对照组相比，接受PALS-CATCH的父母的孩子将减少：a）BMI z评分，和B）每天消耗的含糖饮料盎司，并增加：e）每天消耗的水果和蔬菜的数量，和f）每天体力活动的平均分钟数，包括中度到剧烈的体力活动。作为我们次要目标的一部分，我们将评估PALS-CATCH对父母和孩子的心理社会和行为结果的影响，包括育儿技能，反应能力以及与饮食，体育活动，屏幕时间和睡眠相关的儿童自我调节行为。我们还将研究这些因素在多大程度上介导儿童BMI，饮食和体育活动行为的改善。干预前后的测量将使用儿童人体测量、家长报告的儿童24小时饮食摄入量回忆、儿童体力活动加速计、视频 测量父母反应行为的观察，测量家庭环境和心理社会因素的父母调查。试验结果将用于获得效应量，以确定PALS-CATCH对幼儿的疗效。