Project 2 Behavioral

项目 2 行为

• 批准号: 10360626
• 负责人: Ann Marie Cheney
• 金额: $ 38.74万
• 依托单位: UNIVERSITY OF CALIFORNIA RIVERSIDE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-08 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10360626
• 关键词: 2 year old; Address; Adult; Affect; Age; Age-Months; American; Americas; Attitude; Behavioral; Cardiovascular Diseases; Caregivers; Child; Child Behavior; Childhood; Communities; Data; Development; Diabetes Mellitus; Diet Habits; Distal; Eating Behavior; Enrollment; Face; Family; Fostering; Future; Goals; Growth; Habits; Head Start Program; Health; Health Disparities Research; Healthcare Systems; Healthy Eating; Hispanic; Infant; Infant Care; Intervention; Interview; Knowledge; Latino; Latino Population; Length; Life; Longitudinal Studies; Longitudinal Surveys; Low income; Malignant Neoplasms; Modeling; Morbid Obesity; Mothers; Obesity; Outcome; Parenting Education; Parents; Perception; Physical environment; Politics; Population; Preschool Child; Prevalence; Prevention; Prevention program; Productivity; Public Health; Randomized Controlled Trials; Research; Risk; Role; Social Environment; Testing; Time; Toddler; Translating; Translations; Trust; United States; United States National Institutes of Health; Variant; Weight; aged; base; cardiovascular risk factor; cohort; comorbidity; comparison intervention; critical period; early childhood; ethnic disparity; ethnic minority; feeding; grandparent; high body mass index; improved; infancy; infant adiposity; infant nutrition; infant outcome; lower income families; nutrition; nutrition education; obesity in children; obesity prevention; obesity risk; parental role; pilot test; programs; racial and ethnic disparities; social; socioeconomic disparity; stem

PROJECT SUMMARY The prevalence of obesity in early life remains unacceptably high, especially among low-income children, most of whom are ethnic minorities. Marked ethnic disparities are evident by two years of age, which suggests that existing interventions are not adequate. Early prevention is critical, especially for low-income children. For example, among Latino children high body mass index during infancy renders them three times more likely than other children to be obese by age 6. The disparity observed at this young age presents a window of opportunity to intervene early through existing nutrition programs that foster healthful eating habits, which track into childhood and continue into adulthood. Yet, few prevention programs intervene during infancy, and those that do, do not incorporate feeding styles and practices into nutrition education, do not account for the involvement of caregivers other than parents in infant feeding, and/or 3) start too late. The proposed research addresses these gaps by moving beyond healthy eating to better understand and promote healthy feeding. Using a community-based participatory approach, the proposed research aims to 1): conduct a longitudinal study to characterize the caregiver context of infant feeding in low-income families and 2) develop and pilot test an enhanced intervention compared to EHS' existing nutrition education program. For Aim 1, we will create a cohort of 300 mother-infant dyads who will participate in a longitudinal survey to examine the relation of infant feeding styles and practices to infant growth and obesity. A subsample of 36 mothers and 36 trusted other caregivers, identified by the mothers, will participate in longitudinal qualitative interviews (feeding data debriefings and dyadic interviews) to examine mothers' translation of nutrition education to practice in the context of multiple caregivers. Building on Aim 1, for Aim 2, we will engage EHS-enrolled mothers and other caregivers and EHS staff to develop and refine an enhanced intervention that will include new components on infant feeding styles and practices and the role of other caregivers in infant feeding. We will pilot test the enhanced intervention to produce information on its feasibility, acceptability and preliminary efficacy in promoting healthy feeding. Future research will involve an NIH R01 to test in a randomized controlled trial the effects of the enhanced nutrition education program, relative to those of the existing EHS nutrition education alone, on both mother and infant outcomes, specifically, the proximal outcomes of nutrition and feeding styles and practices and the distal outcomes of infant growth and obesity. This project, which focuses on an-at-risk child population, has great potential to address our nation's growing crisis of childhood obesity, which can dramatically improve the health of millions of Latino children, their families, and their future children.

项目摘要 儿童早期肥胖的发生率仍然高得令人无法接受，特别是在低收入家庭的儿童中， 其中包括少数民族。到两岁时，明显的种族差异就很明显，这表明， 现有的干预措施是不够的。早期预防至关重要，特别是对低收入儿童。为 例如，在拉丁美洲儿童中，婴儿期的高体重指数使他们的可能性增加了三倍。 比其他儿童在6岁时肥胖。在这个年轻的年龄观察到的差异， 有机会通过现有的营养计划进行早期干预，培养健康的饮食习惯， 一直延续到成年。然而，很少有预防计划在婴儿期进行干预， 没有将喂养方式和做法纳入营养教育， 父母以外的照顾者参与婴儿喂养，和/或3）开始得太晚。拟议研究 通过超越健康饮食，更好地理解和促进健康喂养，解决这些差距。 采用基于社区的参与式方法，拟议的研究旨在：1）进行纵向研究， 研究低收入家庭婴儿喂养的照顾者背景，2）开发和试点测试 与EHS现有的营养教育计划相比，加强了干预。对于目标1，我们将创建一个 300对母婴配对队列将参与一项纵向调查，以检查婴儿的关系 喂养方式和实践对婴儿生长和肥胖的影响。36名母亲和36名信任的其他人的子样本 由母亲确定的照顾者将参加纵向定性访谈（喂养数据 询问和二元访谈），以检查母亲将营养教育转化为实践的情况， 多个照顾者的背景。在目标1的基础上，对于目标2，我们将让参加环境卫生服务的母亲和其他 护理人员和EHS工作人员制定和完善强化干预措施，包括以下新内容： 婴儿喂养方式和做法以及其他照顾者在婴儿喂养中的作用。我们将试点测试 加强干预，以提供关于其可行性、可接受性和初步功效的信息， 促进健康饮食。未来的研究将涉及NIH R 01，在随机对照试验中测试 与现有EHS营养教育相比，加强营养教育计划的效果 单独，对母亲和婴儿的结果，特别是，营养和喂养方式的近端结果 和实践以及婴儿生长和肥胖的远端结果。这个项目的重点是 儿童人口，有很大的潜力来解决我们国家日益严重的儿童肥胖危机，这可以 极大地改善了数百万拉丁裔儿童、他们的家庭和他们未来孩子的健康。