Reducing Health Disparities through an Adaptive Healthy Eating Program for Underserved Infants in a Home Visiting Program

通过家访计划中针对服务不足的婴儿的适应性健康饮食计划来减少健康差异

• 批准号: 10362571
• 负责人: Cathleen Stough
• 金额: $ 20.07万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-02 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10362571
• 关键词: Address; Affect; Aftercare; Age-Months; Behavior; Behavioral; Body mass index; Caregivers; Child; Child Nutrition; Communities; Complex; Control Groups; Development; Diet; Diet Habits; Eating; Eating Behavior; Enrollment; Family; Feedback; Feeding behaviors; Goals; Habits; Health; Health behavior; Healthy Eating; High Prevalence; Home; Home visitation; Income; Individual; Infant; Interview; Knowledge; Leadership; Length; Life; Longevity; Low income; Measurement; Mental Health; Metabolic; Methodology; Methods; Monitor; Morbidity - disease rate; Nutritional; Nutritional Requirements; Obesity; Outcome; Pathway interactions; Phase; Physiological; Population; Populations at Risk; Prevention; Prevention program; Problem Solving; Process; Professional counselor; Program Effectiveness; Questionnaires; Randomized Controlled Trials; Readiness; Recommendation; Recording of previous events; Reduce health disparities; Resources; Risk; Risk Factors; Secondary to; Services; Standardization; Testing; Time; Trauma; Underserved Population; Weight; Work; Youth; base; community involvement; cost efficient; design; dietary; early childhood; eating in absence of hunger; emotional eating; ethnic minority; evidence base; experience; feeding; food insecurity; health disparity; healthy lifestyle; improved; infancy; infant adiposity; meetings; member; mortality; nutrition; obesity development; obesity in children; obesity prevention; obesity risk; peer; preference; programs; racial and ethnic; racial minority; rapid growth; rehearsal; satisfaction; standard care; treatment group; underserved minority

Project Abstract Poor dietary habits and obesity-risk begin early in infancy. Infants from underserved and minority backgrounds experience disparate rates of poor nutritional outcomes and subsequent health disparities related to obesity. Each infant and their family experiences a unique set of risk factors and barriers to healthy eating. However, obesity prevention programs that are culturally and contextually relevant for underserved families and adapted based on the needs of individual families are lacking. The current study will develop an obesity prevention program, Healthy Eating for My Infant (HEMI), using a community-engaged approach involving community members in development and delivery of the program. HEMI targets healthy infant feeding through six monthly sessions with infants 3-8 months old. The program will be delivered as a supplement to an already existing evidence-based home visiting program, Every Child Succeeds (ECS), serving families with primarily low income and ethnic/racial minority backgrounds. Treatments modules include: 1) two standardized sessions focused on child nutrition recommendations, responsive feeding, and child mealtime behaviors, 2) two tailored sessions selected from a list of modules based on individual family need and preference, and 3) two sessions with a peer counselor who has valuable lived-experience expertise and personal firsthand knowledge regarding everyday life in their community that can be of benefit to families. Through a group level assessment (GLA), community stakeholders (e.g., ECS leadership, community partners, home visitors, and families) will identify themes regarding ECS caregivers’ needs, resources, and barriers related to healthy infant eating and feeding, including the influence of trauma history. These themes will be used in an action planning session with community members to develop a plan for HEMI content that is relevant and helpful for families. While the specific content of adaptive modules will be determined based on the GLA and action planning phase, treatment modules could address topics such as the influence of maternal mental health and past trauma history on feeding behaviors, emotional eating and eating in the absence of hunger, addressing child nutrition and feeding in the context of many other life demands, preparing time and cost-efficient home meals, and engaging other caregivers to promote healthy eating. A pilot randomized control trial of HEMI will be completed with 15 treatment and 15 control families enrolled in the ECS program. This trial will examine the feasibility of implementation and gather family and peer counselor feedback on treatment satisfaction and relevance. Effectiveness of the program for reducing rates of Body Mass Index > 85th percentile and improving child diet (assessed via interview-administered 24-hr dietary recalls) at post-treatment will also be examined. Development of an adaptive and effective obesity prevention program meeting the needs of underserved infants is critical for addressing health disparities in infant eating and obesity.

项目摘要 饮食习惯和肥胖风险不良。来自服务不足和少数族裔背景的婴儿 经历不良营养结果和随后与肥胖有关的健康差异的差异。 每个婴儿及其家人都有一系列独特的风险因素和健康饮食的障碍。然而， 预防肥胖计划在文化和上下文上与服务不足的家庭相关并适应 基于单个家庭的需求。当前的研究将开发预防肥胖 计划，使用涉及社区的社区参与方法对我的婴儿（Hemi）健康饮食（Hemi） 该计划开发和交付的成员。 Hemi靶向健康的婴儿喂养六个月 3-8个月大的婴儿会议。该计划将作为已经存在的已存在的补充 循证家庭访问计划，每个孩子都成功（EC），为主要低位家庭服务 收入和种族/种族少数民族背景。处理模块包括：1）两个标准化会话 专注于儿童营养建议，反应迅速的喂养和儿童进餐时间行为，2）量身定制 从基于单个家庭需求和偏好的模块列表中选择的会议，以及3）两次会议 与拥有宝贵的经验专业知识和个人第一手知识的同伴辅导员 关于社区中每天的生活可能对家庭有益的生活。通过小组评估 （GLA），社区利益相关者（例如ECS领导力，社区合作伙伴，家庭访客和家庭）将 确定有关EC的护理人员的需求，资源和障碍的主题，与健康的婴儿饮食和 进食，包括创伤历史的影响。这些主题将在采取行动计划会议中使用 社区成员制定针对家庭的Hemi内容计划，这对家庭有帮助。而 自适应模块的特定内容将根据GLA和行动计划阶段确定， 治疗模块可以解决诸如孕产妇心理健康和过去创伤之类的主题 关于喂养行为，情绪饮食和饮食的历史，在没有饥饿的情况下，解决儿童营养 并在许多其他生活需求，准备时间和成本效益的家庭餐以及 吸引其他护理人员促进健康饮食。 Hemi的试验随机控制试验将完成 ECS计划中有15个治疗和15个对照家庭。该试验将检查 实施并收集家庭和同伴辅导员对治疗满意度和相关性的反馈。 该计划可降低体重指数> 85％和改善儿童饮食的有效性 （通过访谈的24小时饮食召回来评估）治疗后也将进行检查。 制定适应性肥胖计划的自适应和有效的肥胖计划满足服务不足的需求 婴儿对于解决婴儿饮食和肥胖症的健康差异至关重要。