Food FARMacia: Reducing Childhood Obesity in Households with Food Insecurity

Food FARMacia：减少粮食不安全家庭的儿童肥胖率

基本信息

批准号：
10681618
负责人：
Jennifer Aimee Woo Baidal
金额：
$ 32.9万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-05-15 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10681618
关键词：
Academy Acceleration Address Age American Biometry Body mass index COVID-19 pandemic Characteristics Child Childhood Clinical Clinical Nutrition Clinical Trials Communities Consumption Control Groups Data Diabetes Mellitus Diet Dietary Practices Disparity Electronic Health Record Eligibility Determination Enrollment Ethnic Origin Etiology Family Feasibility Studies Food Foundations Future Goals Growth Growth and Development function Health Healthcare Systems High Prevalence Hispanic Household Income Inequity Infant Intervention Latino Population Life Life Expectancy Measures Mediator Medicine Metabolic National Institute of Diabetes and Digestive and Kidney Diseases New York City Obesity Observational Study Outcome Parents Pediatrics Phase Pilot Projects Play Population Population Heterogeneity Preparation Prevalence Primary Care Procedures Professional Organizations Qualitative Research Race Randomized Recommendation Reduce health disparities Research Research Methodology Risk Risk Factors Role Self Direction Site Stress Structure Time United States Weight acceptability and feasibility adverse event monitoring arm attentional control clinical care dietary efficacious intervention efficacy testing experience fatty liver disease feeding food insecurity health disparity populations health information technology healthy weight improved infancy intervention effect multidisciplinary nutrition obesity in children pediatric patients population health prevent primary care visit randomized trial randomized, clinical trials recruit response routine screening satisfaction screening socioeconomic disparity sugar sweetened beverage therapy development

项目摘要

ABSTRACT Childhood obesity remains highly prevalent and originates early in life. Efficacious early life interventions to prevent childhood obesity are lacking, particularly among populations most burdened by childhood obesity. Food insecurity - defined as lack of enough food for an active, healthy life – may play key upstream roles in etiologies of obesity through establishment of unhealthy dietary patterns and stress-related metabolic perturbations. Household food insecurity during the first 24 months of life is a risk factor for later childhood obesity. Professional organizations recommend integration of household food insecurity screening into routine pediatric primary care. Yet, a critical gap exists in identification of efficacious clinical interventions to reduce food insecurity. Another gap exists in understanding relationships between food insecurity and etiologies of obesity. Food FARMacia is a clinically based mobile food pantry intervention developed to address the high prevalence of food insecurity among pediatric patients. No randomized trials of a clinically-based mobile food pantry intervention in pediatric primary care exist. To understand the role of food insecurity in etiologies of childhood obesity, efficacious interventions to reduce food insecurity are needed. To test efficacy of the Food FARMacia intervention in a randomized clinical trial (RCT), feasibility of RCT procedures must first be established. The overall goal of this study is to perform a Phase IIb pilot and feasibility RCT of the Food FARMacia clinically based mobile food pantry intervention to promote healthy weight during infancy compared to an attention control over 6 months. We will recruit 70 families (randomized n = 35 infant-parent dyads per arm) with an infant age 6 to <18 months and food insecurity identified on routine electronic health record screening at pediatric primary care visits in our multi-site urban academic health care system. We will examine feasibility and acceptability of the RCT procedures and intervention components using quantitative and qualitative research methods. We will estimate the effects of the intervention on infant weight characteristics over time to inform a full-scale trial. We will explore potential mediators of intervention effects, including household food insecurity. Our multidisciplinary team has expertise in childhood obesity, nutrition, community-engaged, and population health research; clinical trials; qualitative research; and biostatistics. Results will immediately inform a full-scale Phase III RCT to test the efficacy of the Food FARMacia intervention on preventing childhood obesity. Results of a full-scale trial will also provide new information about relationships of household food insecurity during infancy and etiologies of obesity. If successful, this research will accelerate identification of scalable, efficacious clinical interventions to transform clinical care for reduction of food insecurity and promotion of healthy infant growth.

抽象的儿童对象仍然很普遍，并且起源于生命的早期。有效的早期生活干预措施缺乏预防儿童肥胖症，尤其是在儿童肥胖症所烧伤的种群中。粮食不安全 - 定义为缺乏足够的食物来积极，健康的生活 - 可能在上游的关键角色通过建立不健康的饮食模式和与压力有关的代谢，肥胖的病因扰动。家庭粮食不安全性在生命的前24个月是童年后期的危险因素肥胖。专业组织建议将家庭粮食不安全筛查整合到常规中小儿初级保健。然而，在确定有效的临床干预措施以减少粮食不安全。在理解粮食不安全与病因之间的关系中存在另一个差距肥胖。 Food Farmacia是一种基于临床的移动食品储藏室干预措施，以解决高度小儿患者粮食不安全的患病率。没有临床基于临床的移动食品的随机试验有小儿初级保健的食品储藏室干预。了解粮食不安全感在病因中的作用需要儿童肥胖，有效的干预措施来减少粮食不安全。测试食物的便利 Farmacia干预随机临床试验（RCT），RCT程序的可行性必须首先已确立的。这项研究的总体目标是在临床上执行食物farmacia的IIB飞行员和可行性RCT 基于移动食品储藏室干预以促进婴儿期健康体重相比控制6个月。我们将用一个婴儿6至<18个月的婴儿以及在常规电子健康记录筛查中确定的粮食不安全性我们多站点的城市学术保健系统中的小儿初级保健访问。我们将检查可行性使用定量和定性的RCT程序和干预组件的可接受性研究方法。我们将估计干预对婴儿体重特征随着时间的影响的影响通知全面试用。我们将探索干预效果的潜在介体，包括家用食物不安全感。我们的多学科团队在儿童肥胖，营养，社区参与方面具有专业知识，人口健康研究；临床试验；定性研究；和生物统计学。结果将立即告知全面的第三阶段RCT，以测试食品法属干预效率预防童年的效率肥胖。全面试验的结果还将提供有关家庭食物关系的新信息婴儿期和肥胖症病因的不安全感。如果成功，这项研究将加速可扩展，有效的临床干预措施，以改变临床护理，以减少粮食不安全性和促进健康婴儿的生长。