权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Addressing Obesity in Early Care and Education Settings

在早期护理和教育环境中解决肥胖问题

基本信息

批准号：
9752319
负责人：
Roshan Bastani
金额：
$ 57.34万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9752319
关键词：
Address Adolescence Adopted Adoption Adult Age Area Behavior Body mass index Caring Child Child Care Child Nutrition Childhood Cluster randomized trial Collaborations Communities County Eating Education Educational Curriculum Effectiveness Effectiveness of Interventions Ensure Environment Epidemic Evaluation Frequencies Future Health Healthy Eating Height Home environment Individual Intervention Knowledge Left Los Angeles Low income Maintenance Mediator of activation protein Modeling Nonprofit Organizations Nursery Schools Obesity Obesity Epidemic Outcome Overweight Parents Patient Self-Report Pattern Physical activity Policies Population Preschool Child Preventive Intervention Process Public Health Randomized Reporting Research Resources Sampling Schools Site System Targeted Research Waiting Lists Weight Work Workplace base early childhood effective intervention ethnic minority population evidence base experience follow-up health disparity implementation research intervention effect minority communities multi-component intervention nutrition obesity in children obesity prevention primary outcome public health relevance secondary outcome societal costs success teacher tool uptake

项目摘要

PROJECT SUMMARY Childhood obesity is a national epidemic that disproportionately burdens low income and ethnic minority communities. By preschool, nearly one-third of low income children are already overweight or obese, setting the stage for a myriad of adverse health conditions in adolescence and adulthood. Experts agree that effective, scalable, and sustainable obesity prevention efforts are urgently needed and must shift their focus to early childhood. Preschools offer a very promising environment for implementation and wide dissemination of interventions targeting large numbers of young children. However, limited rigorous implementation research targeting low income and ethnic minority preschool age children has left a major evidence gap, severely constraining the tools available to educators and policymakers to address the obesity epidemic. Individually- focused and single-component interventions have generally failed to produce long-term changes in obesity- related outcomes. Evidence increasingly supports creating entire environments (e.g., preschools) where the healthy choice is the default option. Therefore, we propose to conduct a pragmatic cluster randomized trial, based on our Healthy-By- Default framework, to evaluate the effectiveness and implementation of a multi-level, multi-component intervention that integrates healthy eating and physical activity into preschool routines. Our intervention will involve 1) establishment of organization-level policies to support healthy nutrition and physical activity, 2) integration of nutrition and physical activity into the preschool curriculum, 3) modeling of healthy behaviors by preschool teachers and staff, and 4) engagement of parents as partners in this effort. The study is a collaboration between UCLA and the Child Care Resource Center (CCRC), a large non-profit organization dedicated to ensuring that all children receive high quality, comprehensive preschool/child care experiences, particularly in low resource, diverse communities. We will randomly assign 60 preschools served by CCRC, in underserved areas of Los Angeles County, to the intervention or a usual practice, wait-list control condition. Our aims are to: 1) implement a multilevel obesity prevention intervention for preschool settings that builds on existing evidence-based approaches, stakeholder input, and our pilot research; 2) evaluate the effectiveness of the intervention on child BMI z-scores (primary outcome), and parent-reported child nutrition and physical activity (secondary outcomes); and 3) systematically assess intervention reach, adoption, implementation, adaptation and maintenance, guided by the RE-AIM Framework, which we have tailored for our specific study focus and setting. By simultaneously evaluating both effectiveness and implementation of our intervention, we will efficiently generate new knowledge vital to informing widespread dissemination. Given the staggering long-term societal costs of childhood obesity, rigorous studies to identify effective and scalable obesity prevention interventions are needed now.

项目总结