Enhanced Primary Care Nutrition and Screen time Education to Prevent Obesity in Latino Infants

加强初级保健营养和屏幕时间教育以预防拉丁裔婴儿肥胖

• 批准号: 9356567
• 负责人: Amy Laura Beck
• 金额: $ 19.02万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9356567
• 关键词: Address; Adolescence; Adult; Affect; Age; Anthropology; Area; Award; Behavior; Behavior Therapy; Behavioral; Biostatistical Methods; California; Calories; Caring; Child; Child Nutrition; Childhood; Clinic; Clinical; Clinical Research; Clinical Sciences; Comorbidity; Conflict (Psychology); Consumption; Control Groups; Development Plans; Diabetes Mellitus; Diet; Dietary Assessment; Dietary intake; Eating; Education; Enrollment; Epidemiology; Feedback; Fellowship; Food; Fruit; General Hospitals; Goals; Habits; Health; Health Educators; Health Policy; Health Services; Health behavior; Heart Diseases; Hispanics; Home environment; Home visitation; Individual; Infant; Institutes; International; Intervention; Intervention Studies; Intervention Trial; Interview; Juice; K-Series Research Career Programs; Knowledge; Language; Latino; Learning Module; Life; Linguistics; Link; Literature; Longevity; Low income; Mentors; Mentorship; Minority Groups; Modeling; Mothers; Motivation; NCI Scholars Program; Non obese; Not Hispanic or Latino; Nursery Schools; Nutrient; Obesity; Outcome; Outpatients; Parents; Participant; Pattern; Pediatric Hospitals; Pediatric Research; Pediatrics; Population; Positioning Attribute; Preparation; Prevention Research; Prevention strategy; Preventive service; Primary Health Care; Process; Psychology; Public Health; Public Health Schools; Public Hospitals; Publications; Publishing; Qualitative Methods; Questionnaires; Randomized Controlled Trials; Recommendation; Recruitment Activity; Reproducibility; Research; Research Personnel; Research Training; Resources; Risk; Risk Factors; Safety; San Francisco; Site; Source; Structure; Television; Testing; Time; Toddler; Training; Translational Research; United States; Universities; Visit; Weight Gain; base; bilingualism; cardiovascular risk factor; career; career development; cost; design; early childhood; experience; faculty mentor; feeding; fruits and vegetables; high risk; improved; infancy; literacy; nutrition; obesity in children; obesity prevention; obesity risk; obesity treatment; pediatric department; pediatrician; prevent; primary outcome; programs; public health relevance; secondary outcome; skills; sugar; sweetened beverage; tv watching

 DESCRIPTION (provided by applicant): Primary Care Based Feeding and Screen Time Education to Prevent Obesity in Latino Infants Latino children experience higher rates of obesity than non-Hispanic white children, a disparity that emerges in infancy. Among Latino children, those with Spanish-speaking parents are at highest risk for obesity. Research has shown that optimal feeding strategies in early life and avoidance of screen time may lower the risk of childhood obesity, which in turn, reduces the risk of obesity and its comorbidities through adulthood. However, few interventions have sought to promote optimal infant feeding and screen time practices among Spanish-speaking Latino parents. In addition, most interventions in the literature that address infant obesity prevention have been conducted through home visits or special trips to the intervention site by parents, approaches that may not be sustainable in low-resource settings due to cost and the burden on participants. Given that infants are expected to have 7 well-child visits in the first year of life, primary care is an ideal setting in which to ofer parental education on infant feeding and screen time recommendations. The overall objective of this proposal is to design, pilot test, and refine a Spanish-language, culturally appropriate, primary care-based intervention to prevent obesity in Latino infants born to Spanish-speaking mothers. Our overarching hypothesis is that focused education on infant feeding and screen time avoidance will lead to use of optimal infant feeding and screen time practices among Spanish-speaking Latino mothers and result in less weight gain in the first year of life. In preparation for submitting an R01 application to test this hypothesis, we propose research with the following specific aims to be conducted at the San Francisco General Hospital (SFGH) outpatient pediatric clinic: Aim 1: Use the Information-Motivation-Behavioral Skills model to design 5 group educational modules that promote optimal infant feeding and screen time practices among Spanish-speaking Latino mothers; Aim 2: Use a pilot randomized-controlled trial (RCT) to test a yearlong intervention in which the 5 modules (Aim 1) are provided to Spanish-speaking Latino mothers just after well-child visits at ages 2 weeks, and 2, 4, 6, and 12 months (primary outcomes will include use of responsive feeding practices, infant dietary intake, and infant active and passive television viewing time; secondary outcomes will be infant anthropometrics); Aim 3: Use qualitative methods to assess how individual components of the intervention from Aim 2 affected feeding and screen time practices. By the conclusion of this award, we will have a scalable and potentially reproducible intervention for infant feeding and screen time practices, one that is linguistically and culturally appropriate for Spanish-speaking Latino parents and aims to reduce weight gain in the first year of life while promoting habits that protect against obesity across the lifespan. Dr. Amy Beck, PI for this mentored career development award, is a bilingual pediatrician with considerable clinical experience caring for low-income Latino children and a deep commitment to improving health outcomes in this population. Dr. Beck is a pediatric attending at SFGH (a public hospital affiliated with UCSF that serves a majority Latino population) where she provides both general pediatric care and also is the co-director of the pediatric obesity clinic. With respect to her research background, Dr. Beck holds a MPH and completed a General Pediatrics research fellowship at the University of California, San Francisco (UCSF). During her fellowship, Dr. Beck used both quantitative and qualitative methods to investigate risk factors for obesity among Latino children. She has 5 first-author publications, of which 4 directly inform this proposal. She is currently conducting two pilot intervention studies in obesity prevention and treatment for Latino children. Her long-term career goal is to be an independent investigator in the field of obesity prevention with a focus on improving preventive services for low-income Latino children. To accomplish this goal, Dr. Beck must strengthen her skills in biostatistics and qualitative methods and acquire new skills in dietary analysis and RCTs of behavioral interventions. Dr. Beck has formed an interdisciplinary team of faculty mentors and consultants with expertise in general pediatrics, nutrition, psychology, anthropology, Latino health, pediatric obesity, and health policy. Her primary mentor, Dr. Michael Cabana, is an internationally respected health services researcher and the Division Chief of General Pediatrics at UCSF. Dr. Cabana has extensive expertise in the design and conduct of RCTs in the ambulatory setting and a strong track record of mentorship. In addition to her mentored research plan and ongoing tutorials with her diverse mentorship team, Dr. Beck will take advantage of UCSF's numerous opportunities for research training. She will enroll in additional courses offered through the Training in Clinical Research Program that cover specific areas of her career development plan. She will also take a course at the UC Berkeley School of Public Health on dietary assessment. Finally, she will attend seminars offered by the Division of General Pediatrics and participate in the K scholars program offered by the Clinical and Translational Science Institute at UCSF. Dr. Beck has the full support of the UCSF Department of Pediatrics and the Division of General Pediatrics for this proposed award. By the conclusion of this award, Dr. Beck will be well positioned as an independent investigator in the field of childhood obesity prevention research.

 描述（由申请人提供）：基于初级保健的喂养和屏幕时间教育，以防止拉丁裔婴儿肥胖拉丁裔儿童的肥胖率高于非西班牙裔白色儿童，这种差异出现在婴儿期。在拉丁裔儿童中，那些父母讲西班牙语的儿童患肥胖症的风险最高。研究表明，早期的最佳喂养策略和避免屏幕时间可能会降低儿童肥胖的风险，这反过来又会降低肥胖及其合并症的风险， 成年然而，很少有干预措施，以促进最佳的婴儿喂养和屏幕时间的做法，讲西班牙语的拉丁美洲父母。此外，文献中大多数预防婴儿肥胖的干预措施都是通过家长家访或专程前往干预地点进行的，由于成本和参与者的负担，这种方法在资源匮乏的环境中可能无法持续。鉴于婴儿在出生后第一年预计有7次健康儿童就诊，初级保健是一个理想的环境，可以在其中宣传父母对婴儿喂养和筛查时间的建议。这项提案的总体目标是设计、试点测试和完善一种西班牙语、文化上适当的、基于初级保健的干预措施，以预防讲西班牙语的家庭所生的拉丁裔婴儿肥胖。 妈妈们我们的总体假设是，集中教育婴儿喂养和屏幕时间避免将导致使用最佳的婴儿喂养和屏幕时间的做法之间的西班牙语拉丁美洲母亲，并导致在生命的第一年体重增加较少。在准备提交R 01申请以检验这一假设时，我们提出了在旧金山弗朗西斯科总医院（SFGH）门诊儿科诊所进行的具有以下具体目标的研究：目标1：使用信息-动机-行为技能模型设计5个小组教育模块，以促进讲西班牙语的拉丁美洲母亲的最佳婴儿喂养和屏幕时间实践;目标2：使用试点随机对照试验（RCT）来测试为期一年的干预措施，其中5个模块（目标1）提供给讲西班牙语的拉丁美洲母亲，在2周，2，4，6和12个月的健康儿童访问后（主要结果将包括使用反应性喂养方法，婴儿饮食摄入量，以及婴儿主动和被动看电视的时间;次要结果将是婴儿人体测量学）;目标3：使用定性方法评估目标2中干预措施的各个组成部分如何影响喂养和筛查时间实践。通过缔结 这个奖项，我们将有一个可扩展的和潜在的可复制的干预婴儿喂养和屏幕时间的做法，一个是语言和文化上适合讲西班牙语的拉丁裔父母，旨在减少体重增加在生命的第一年，同时促进习惯，防止肥胖的整个生命周期。艾米贝克博士，PI为这个指导的职业发展奖，是一个双语儿科医生，具有相当丰富的临床经验，照顾低收入的拉丁美洲儿童和深刻的承诺，以改善健康的结果 在这个人群中Beck博士是SFGH（一家隶属于UCSF的公立医院，为大多数拉丁裔人口提供服务）的儿科主治医生，她提供一般儿科护理，也是儿科肥胖诊所的联合主任。关于她的研究背景，Beck博士拥有公共卫生硕士学位，并在加州大学旧金山弗朗西斯科（UCSF）完成了普通儿科研究奖学金。在她的研究期间，贝克博士使用定量和定性方法来调查拉丁美洲儿童肥胖的风险因素。 她有5篇第一作者出版物，其中4篇直接告知了这一提议。她目前正在进行两项针对拉丁裔儿童的肥胖预防和治疗的试点干预研究。她的长期职业目标是成为肥胖预防领域的独立调查员，重点是改善低收入拉丁裔儿童的预防服务。为了实现这一目标，贝克博士必须加强她在生物统计学和定性方法方面的技能，并获得饮食分析和行为干预RCT方面的新技能。贝克博士成立了一个 跨学科的教师导师和顾问团队，在普通儿科学，营养学，心理学，人类学，拉丁美洲健康，儿童肥胖和健康政策方面具有专业知识。她的主要导师Michael Cabana博士是一位国际知名的卫生服务研究员，也是UCSF普通儿科主任。Cabana博士在门诊环境中设计和开展RCT方面拥有广泛的专业知识，并有良好的指导记录。除了她的指导研究计划和正在进行的教程与她 贝克博士将利用加州大学旧金山分校众多的研究培训机会。她将参加通过临床研究计划培训提供的额外课程，这些课程涵盖了她职业发展计划的特定领域。她还将参加加州大学伯克利分校公共卫生学院的饮食评估课程。最后，她将参加普通儿科部门提供的研讨会，并参加加州大学旧金山分校临床和转化科学研究所提供的K学者计划。贝克博士得到了加州大学旧金山分校儿科系和普通儿科系的全力支持。通过这个奖项的结论，贝克博士将很好地定位为一个 儿童肥胖预防研究领域的独立研究员。