My weight-their weight: eHealth intervention for managing obesity in child care settings

我的体重-他们的体重：在儿童保育环境中管理肥胖的电子健康干预

• 批准号: 10364383
• 负责人: Erik A Willis
• 金额: $ 68.95万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10364383
• 关键词: 5 year old; Address; Adopted; Behavior; Body mass index; Caring; Child; Child Care; Cluster randomized trial; Data; Diet; Dietary intake; Eating; Educational Models; Effectiveness; Enrollment; Environment; Evaluation; Habits; Health; Health Personnel; Health Promotion; Health and Behavior in Children; Health behavior; Healthy Eating; High Prevalence; Intervention; Knowledge; Modeling; Obesity; Obesity Epidemic; Organizational Change; Outcome; Outcome Measure; Physical activity; Play; Policies; Prevention program; Process; Provider; Public Health; Randomized; Randomized Controlled Trials; Reach Effectiveness Adoption Implementation and Maintenance; Research; Specific qualifier value; Testing; Weight; Weight maintenance regimen; arm; base; behavior change; care providers; dietary; eHealth; early childhood; evidence base; healthy lifestyle; healthy weight; improved; interest; meetings; nutrition; obesity in children; obesity management; obesity prevention; obesity risk; programs; provider behavior; randomized trial; recruit; secondary analysis; weight loss intervention

ABSTRACT Child care centers ─ and their providers ─ are critical partners in public health efforts to address today’s obesity epidemic. Diet and physical activity (PA) habits are formed early, influencing immediate and long-term obesity risk, and both centers and providers play key roles in forming children’s weight-related habits. Yet, the standard paradigm of child care-based obesity prevention initiatives primarily target only center directors to change organizational-level policies and practices; failing to recognize the needs of the child care providers. These providers suffer disproportionally high prevalence of obesity and research has shown that providers’ own poor eating and PA behaviors reduce their confidence and ability to model and promote healthy lifestyle behaviors to the children in their care. However, information regarding the effectiveness of improving provider health behaviors or whether such improvements elicit meaningful change in the child care environment and the children in their care is limited. Leveraging our team’s expertise with implementing evidence-based behavior change and weight loss interventions, the proposed study will integrate an evidence-based weight management intervention for child care providers into Go NAPSACC’s existing childhood obesity prevention program (Go NAPSACC+). Go NAPSACC+ program will be assessed using a clustered randomized controlled trial to evaluate if improving child care providers’ health behaviors elicit meaningful change in dietary and PA behaviors in 2-5-year-old children in their care and the child care environment. We will recruit 84 centers, including 168 providers, and 672 2–5-year-old children to participate in the evaluation. Centers will be randomly assigned to 1) standard “Go NAPSACC” or 2) “Go NAPSACC+” (with a provider weight management component). Outcome measures will assess impact on dietary intake and PA behaviors of 2-5-year-old children at 6 months (primary aim) and 12 months. Secondarily we will compare the impact of the intervention on centers’ implementation of healthy weight practices and the effect on provider-level weight, diet quality and/or PA at 6 and 12-months. Extensive process analysis, guided by the RE-AIM framework, will document the fidelity of the interventions, challenges and barriers to effective implementation, and use of program specified activities. If successful, findings will provide a highly implementable, scalable, and sustainable strategy that would enhance the standard paradigm of early childhood obesity prevention initiatives.

抽象的 儿童保育中心及其提供者 - 是公共卫生努力解决当今肥胖症的关键伙伴 流行性。饮食和体育锻炼（PA）习惯是早期形成的，影响了直接和长期肥胖症 风险，中心和提供商在形成儿童体重相关的习惯方面都起着关键作用。但是，标准 基于儿童保育的肥胖预防计划的范式仅主要目标中心董事 组织级政策和实践；未能认识到托儿提供者的需求。这些 提供者的肥胖症患病率过高，研究表明，提供者的穷人 饮食和PA行为降低了他们的信心和能力来建模和促进健康的生活方式行为 孩子们照顾的。但是，有关改善提供商健康有效性的信息 行为或这种改善是否引起托儿环境和孩子的有意义的变化 在他们的护理中是有限的。利用我们团队的专业知识来实施基于证据的行为改变和 减肥干预措施，拟议的研究将整合基于证据的体重管理干预措施 对于儿童保育提供者，进入NAPSACC现有的童年肥胖预防计划（GO NAPSACC+）。 GO NAPSACC+程序将使用聚类的随机对照试验进行评估，以评估是否改善 儿童保育提供者的健康行为在2-5岁的饮食和PA行为中引起有意义的变化 孩子们和儿童保育环境中的孩子。我们将招募84个中心，包括168个提供商和672个中心 2-5岁的孩子参加评估。中心将随机分配给1）标准“ G​​O NAPSACC”或2）“ GO NAPSACC+”（提供提供者的体重管理组件）。结果度量将 评估6个月时2-5岁儿童对饮食摄入和PA行为的影响（主要目的）和12 月份。次要我们将比较干预对中心实施健康体重的影响 在6个月和12个月时，实践以及对提供商级别的体重，饮食质量和/或PA的影响。广泛的过程 在Re-Aim框架的指导下，分析将记录干预措施，挑战和障碍的保真度 有效实施和使用计划指定的活动。如果成功，发现将提供高度 可实施，可扩展和可持续的战略将增强幼儿的标准范式 预防肥胖计划。