Reducing Sugared Fruit Drinks in Alaska Native Children

减少阿拉斯加原住民儿童的含糖水果饮料

基本信息

批准号：
9507145
负责人：
Donald Leslie Chi
金额：
$ 65.79万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-01 至 2019-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9507145
关键词：
Address Adopted Age Alaska Alaska Native American Heart Association American Indians Behavior Behavioral Behavioral trial Beverages Biological Markers Caregivers Cessation of life Child Childhood Chronic Communication Communities Community Health Aides Consumption Country Data Dental Dental Care Dental caries Development Drops Eating Elements Energy Intake Enhancers Ensure Epidemic Etiology Evidence based program Exercise Face Family Focus Groups Food Fruit Goals Health Health Food Health Promotion Health education Healthy People 2020 Home environment Hospitalization Hour Human Resources Improve Access Industry Infant Intake Interdisciplinary Study Intervention Interview Knowledge Lead Learning Life Low Income Population Manuals Manuscripts Measures Milk Misinformation Modeling Morbidity - disease rate National Institute of Dental and Craniofacial Research Native Americans Oral Oral health Outcome Outcome Measure Output Persons Population Quality of life Recruitment Activity Reporting Research Resources Sampling Schools Self Efficacy Social support Structure Testing Time Tooth Extraction Toothache Training Translating Update Visit Water Water consumption Weight Work Yukon Kuskokwim Yukon-Kuskokwim Delta Yup&apos ik active method arm base behavior change caregiver education community planning drinking water early childhood education access effective intervention experience health inequalities healthy lifestyle improved indigenous community member middle childhood nutrition post intervention primary outcome program dissemination programs response rural Alaska secondary outcome social cognitive theory sugar sweet taste perception systematic review tool

项目摘要

PROJECT SUMMARY/ABSTRACT Yup’ik children in Alaska’s YK Delta consume 50 teaspoons of added sugar each day, 16 times the American Heart Association’s recommended maximum. Most of this added sugar is from sugared fruit drinks (mostly Tang and Kool-Aid) consumed at home. Consequently, Yup’ik children experience tooth decay rates that are 16 times the U.S. average and suffer from oral health inequalities compared to children from better off communities. We propose a 2-arm quasi-experimental behavioral trial in 3 rural Alaska Native communities to test the hypothesis that Community Health Worker-led health education and self-efficacy training for caregivers will decrease child added sugar intake. The Specific Aims are to: (1) Refine and finalize the health promotion intervention; (2) Implement the intervention and determine outcomes; and (3) Identify intervention improvement strategies and disseminate findings. Beverage substitution interventions involving health education and access to alternatives are effective, but improvements are not typically sustained long-term. The reason for this drop off is that the interventions lack specific efforts to boost self-efficacy, a critical omission according to Bandura’s Social Cognitive Theory. This application builds on previous research and will test these concepts in Alaska Native communities. In the proposed study, 3 communities will be assigned to 1 of 2 arms based on the order in which the community is ready. 101 families with children ages 0-10 years in 2 Yup’ik communities will be recruited to test the 6-month culturally-adapted, 5-session intervention consisting of interactive health education and self-efficacy training delivered in-person by an indigenous Community Health Worker. 41 families in a third Yup’ik community will be recruited to a comparison condition in which health education with the same culturally-adapted content will be delivered by mail. Health education will address tooth decay etiology and misinformation about sugared fruit drinks, and promote sugar-free water enhancers. Self-efficacy training will empower caregivers to initiate and sustain behavior change over time. Local stores in all 3 communities will stock sugar-free fruit drinks (Tang and Kool-Aid drops, also called water enhancers by industry) as a tool to help shift children from sugared fruit drinks. The primary outcomes at the child level are sugared fruit drink intake (caregiver-reported 24-hour recalls) and added sugar intake (through a validated, non-invasive biomarker) measured at baseline and at 1, 3, 6, and 12 months. Secondary outcomes include % total energy intake from added sugar and caregiver self-efficacy to provide alternatives. This work has the support of the Yukon Kuskokwim Health Corporation which will maintain and disseminate the program if it works and can address a critical problem facing over 15,000 Alaska Native children in the YK Delta and millions more if adopted throughout Alaska and American Indian country in the Lower 48. Moreover, it can be adapted to meet the needs of other populations with similar problems.

项目摘要/摘要 Yup’ik的孩子在阿拉斯加的YK Delta中每天消耗50茶匙糖，是美国人的16倍心脏协会的建议最大。大多数添加的糖来自加糖的果实（主要是唐和库德·艾菲（Tang and Kool-Aid）在家中消耗。因此，Yup’ik的孩子经历了蛀牙率与从Better Off的儿童相比社区。我们建议在阿拉斯加3个乡村的2臂实验性行为试验检验以社区卫生工作者领导的健康教育和自我效能培训的假设护理人员将减少儿童添加的糖摄入量。具体目的是：（1）完善和最终确定健康促进干预；（2）实施干预并确定结果；（3）确定干预改进策略并传播发现。涉及健康的饮料替代干预措施教育和获得替代方案是有效的，但改进通常不会长期持续。造成这种情况的原因是，干预措施缺乏提高自我效能的特定努力，这是一个关键根据班杜拉（Bandura）的社会认知理论的遗漏。该应用在先前的研究基础上建立将在阿拉斯加土著社区中测试这些概念。在拟议的研究中，将分配3个社区根据社区准备就绪的顺序，2个武器中的1个。 101个儿童0-10岁的家庭将在2个Yup’ik社区中招募，以测试6个月的文化适应，5节的干预措施由互动健康教育和自我效能感培训组成社区卫生工作者。第三个Yup’ik社区中的41个家庭将被招募到比较条件其中将通过邮件提供具有相同文化化内容的健康教育。健康教育将解决有关加糖果酒的蛀牙病因和错误信息，并促进无糖水增强剂。自我效能训练将使护理人员能够随着时间的流逝启动和维持行为的变化。所有3个社区的当地商店都将库存无糖的果实饮料（Tang和Kool-Aid Drops，也称为水通过行业增强剂）是一种工具，可以帮助儿童脱离糖果饮料。主要结果儿童级别是加糖果酒摄入量（护理人员报告的24小时召回）和添加糖摄入量（通过在基线和1、3、6和12个月时测量的经过验证的非侵入性生物标志物）。次要结果包括添加的糖和照料者自我效能感的总能量摄入量的百分比。这项工作得到了育空Kuskokwim健康公司的支持，该公司将维持和传播该计划是否有效，可以解决YK中15,000多名阿拉斯加本地儿童面临的关键问题三角洲和数百万，如果在较低的48岁的阿拉斯加和美洲印第安国家中采用了更多。此外，它可以适应以满足其他人群的需求。