Targeting Self-Regulation to Promote Adherence and Health Behaviors in Children

以自我调节为目标，促进儿童的依从性和健康行为

• 批准号: 9310056
• 负责人: Alison L Miller
• 金额: $ 66.93万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-18 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9310056
• 关键词: 11 year old; 4 year old; Address; Adherence; Age; Alcoholism; Appetitive Behavior; Behavior; Behavioral; Biological; Child; Childhood; Chronic; Chronic Disease; Clinic; Cognitive; Cohort Studies; Complex; Data; Development; Disease; Early Intervention; Eating Behavior; Education; Effectiveness of Interventions; Emotional; Family; Food; Future; Goals; Habits; Health; Health Promotion; Health and Behavior in Children; Health behavior; Hydrocortisone; Hyperphagia; Informal Social Control; Intervention; Lead; Life; Life Cycle Stages; Life Style; Link; Longevity; Low income; Measures; Medical; Modeling; Motivation; Obesity; Outcome; Overweight; Participant; Pathway interactions; Pattern; Pharmaceutical Preparations; Phase; Phenotype; Play; Populations at Risk; Process; Public Health; Recommendation; Recruitment Activity; Regimen; Resources; Risk; Risk Factors; Role; School-Age Population; Science; Self Assessment; Self Management; Shapes; Signal Transduction; Smoking; Stress; Substance abuse problem; Testing; Time; Validation; Weight maintenance regimen; Work; assay development; behavior change; biobehavior; clinical predictors; cohort; design; early childhood; effective intervention; emotion regulation; executive function; exercise regimen; field study; health care service utilization; improved; intervention effect; medication compliance; obesity in children; obesity risk; obesogenic; physical inactivity; preadolescence; psychologic; public health relevance; response; skills; therapy design

 DESCRIPTION (provided by applicant): Poor self-regulation (i.e., inability to harness cognitive, emotional or motivational resources to achieve goals) contributes to a number of unhealthy behaviors across the life course, including overeating, a lack of physical activity, smoking, alcoholism and substance abuse1-12 that are linked to poor long-term health. The self- regulation processes that generate the desire for such substances or that make it difficult t engage in healthy habits are theorized to begin very early in the lifespan. Targeting early self-regulation profiles that signal risk for engaging in unhealthy behaviors would allow more effective intervention. It is thus vital to identify bio- behavioral self-regulation processes thatare 1) evident early in life; 2) associated with behaviors that lead to poor health outcomes; and 3) modifiable. In response to RFA-RM-14-020, Science of Behavior Change: Assay Development and Validation for Self-Regulation Targets, we propose to assess self-regulation during pre-adolescence, a critical transition when children gain responsibility for managing their health choices and self-regulation becomes increasingly associated with health outcomes. Obesity is a complex health issue with early-emerging biological and behavioral precursors that are related to self-regulation; it is a good model for understanding a broad range of health conditions that require active self-management. Childhood obesity is also an ongoing public health crisis, with almost 25% of children overweight by age 4 years (35% by school- age).13 The goal of this proposal is to measure childhood self-regulation targets known to be associated with obesity risk and poor adherence to medical regimens and to assess whether intervening on these mechanisms can improve self-regulation. We propose to do so in a cohort of children with a high rate of obesity who have been extensively phenotyped for bio-behavioral self-regulation and obesity risk factors from early childhood. For the UH2 phase, the Aims are to, in over 250 low-income school-age children from extant ABC cohorts: Aim 1. Field-test measures to assess executive function (cool EF, hot EF, and food-specific hot EF), emotion regulation, and motivation as self-regulation targets relevant for health behavior. Aim 2. Validate measures of the above self-regulation targets against proximal constructs known to be associated with obesity and poor health outcomes (e.g., obesogenic eating behavior, blunted cortisol pattern). Aim 3. Develop and field-test interventions designed to address self-regulation targets using a Multiphase Optimization Strategy (MOST) design to detect intervention effectiveness and child or family factors (e.g., maternal education, family stress) that may moderate intervention effects. For the UH3 phase, the Aims are to, in 94 children drawn from pediatric subspecialty clinics: Aim 4. Test the hypothesis that the interventions developed in Aim 3 enhance self-regulation targets. Aim 5. Explore whether enhancing self-regulation targets predicts general and disease-specific medical regimen adherence (i.e., following weight management recommendations; taking medications).

 描述（由适用提供）：自我调节不良（即无法利用认知，情感或动机资源实现目标）有助于整个生活过程中的许多不健康行为，包括暴饮暴食，缺乏体育活动，吸烟，酒精中毒和毒品滥用1与长期健康相关，这些行为与长期健康相关。从理论上讲，自我调节的过程产生了对这种物质或使其很难养成健康习惯的渴望的过程。针对早期自我调节曲线，表明有可能从事不健康行为的风险将允许更有效的干预。因此，至关重要的是要确定1）生命早期证据的生物行为自我调节过程； 2）与导致健康结果不佳的行为相关； 3）可修改。为了响应RFA-RM-14-020，行为改变科学：分析的开发和自我调节目标的验证，我们建议评估青春期前的自我调节，当儿童承担管理健康选择和自我调节的责任时，这是一个批判性过渡，与健康欧现代越来越相关。肥胖是一个复杂的健康问题，与自我调节有关的早期生物学和行为前体出现了。这是理解需要积极自我管理的广泛健康状况的良好模型。儿童肥胖症也是一种持续的公共卫生危机，到4岁到4岁的儿童中，近25％的儿童超重。13该提案的目标是衡量衡量妇女自我调节目标已知的肥胖风险和与医疗方案的依从性不佳，并评估这些机制是否可以改善这些机制。我们建议在肥胖率高的儿童中这样做，这些儿童从幼儿期开始对生物行为的自我调节和肥胖危险因素进行广泛表型。对于UH2阶段，目的是在超过250名来自ABC延长队列的低收入学龄儿童中：AIM 1。评估执行功能的现场测试措施（Cool EF，Hot EF和食品特异性热EF），情绪调节和动机作为与健康行为相关的自我调节目标。 AIM 2。验证上述自我调节靶标，以针对已知与肥胖和健康结果不良有关的近端结构（例如，肥胖的饮食行为，皮质醇钝化）。 AIM 3。开发和现场测试干预措施，旨在使用多相优化策略（大多数）设计来解决自我调节目标，以检测可能中等干预效果的儿童或家庭因素（例如，孕产妇教育，家庭压力）。 对于UH3阶段，目的是在从儿科亚科诊所中吸引的94名儿童中：AIM 4。检验AIM 3中开发的干预措施的假设增强了自我调节靶标。目标5。探索增强自我调节目标是否预测一般和疾病特异性的医疗方案（即遵循体重管理建议；服用药物）。

项目成果

Child, Caregiver, Family, and Social-Contextual Factors to Consider when Implementing Parent-Focused Child Feeding Interventions.

• DOI: 10.1007/s13668-018-0255-9
• 发表时间: 2018-12
• 期刊: Current nutrition reports
• 影响因子: 4.9
• 作者: Miller AL;Miller SE;Clark KM
• 通讯作者: Clark KM

The Role of Parent Self-Regulation in Youth Type 1 Diabetes Management.

• DOI: 10.1007/s11892-020-01321-z
• 发表时间: 2020-07-08
• 期刊: Current diabetes reports
• 影响因子: 4.2
• 作者: Bauer KW;Hilliard ME;Albright D;Lo SL;Fredericks EM;Miller AL
• 通讯作者: Miller AL