Intervention INC: An interactive family-centered mHealth tool to reduce obesity risk in urban minority preadolescents

Intervention INC：一种以家庭为中心的互动移动医疗工具，可降低城市少数民族青少年的肥胖风险

• 批准号: 10706529
• 负责人: May May Leung
• 金额: $ 40万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10706529
• 关键词: Intervention; INC; interactive; family; centered

ABSTRACT Childhood obesity continues to be a serious public health issue in the United States (US), with disproportionate rates among low-income, minority children. Effective, yet engaging interventions need to be designed to capture the attention of children and their parents/caregivers living in a multi-media environment. Our work demonstrates the novelty, appeal, and effect of multi-modal narratives in the form of comics, which convey messages in graphics and minimal language, as a format to deliver health messages to the younger populations. Additionally, interventions delivered on web-based/mHealth platforms can be engaging and scalable to support health behavior change in families and also enhance and extend the impact of clinic visits by providing online resources that reinforce health messages delivered in-person by healthcare providers. In collaboration with our community partner, Children’s Aid (one of the oldest and largest US child welfare organizations), an AHRQ-funded R21 study supported development and pilot testing of Intervention INC, a family-centered, interactive, web-based health promotion tool focused on reducing childhood obesity risk. The tool is tailored to meet the needs and preferences of low-income, black/African-American (AA) and Latino children ages 9 to 12 and their parents/caregivers. Results of a pilot feasibility study were highly promising as not only was the tool feasible to deliver and acceptable to our child and parent populations, children receiving the comic tool demonstrated greater improvements (p<0.05) in vegetable, water, and sugar intake compared to the control group, from pre- to post-intervention. However, knowledge gaps regarding tool effectiveness and implementation in real world settings still exist. To fill these gaps, we propose a study with the following aims. In Aim 1, formative research will be conducted with healthcare practitioners/administrators and child-parent dyads to identify organizational (clinic) and family characteristics relevant to implementing such a tool in a clinic setting, while in Aim 2, the tool will be adapted (based on Aim 1 findings) and usability testing of it will be conducted. In Aim 3, a full-scale RCT will be conducted in Children’s Aid community clinics, to test the effect of the adapted and extended tool, which will comprise a 12-week comic intervention and a 6-month maintenance intervention, on child BMI z-score. In Aim 4, contextual factors at the clinic-, provider-, and family-level that influence tool implementation will be explored. We believe that this family-centered web-based tool is unique given its focus on innovative communication approaches and mHealth platform to enhance accessibility and engagement with an often hard to reach, diverse population. It also has strong

摘要 儿童肥胖仍然是美国（US）的一个严重公共卫生问题， 低收入，少数民族儿童。需要设计有效但有吸引力的干预措施， 吸引生活在多媒体环境中的儿童及其父母/照顾者的注意力。我们的工作 展示了漫画形式的多模态叙事的新奇、吸引力和效果， 信息的图形和最小的语言，作为一种格式，提供健康信息给年轻人 人口。此外，在基于网络/移动健康平台上提供的干预措施可以吸引人， 可扩展以支持家庭健康行为的改变，并增强和扩大诊所访问的影响 通过提供在线资源，加强医疗保健提供者亲自提供的健康信息。在 与我们的社区合作伙伴儿童援助（美国历史最悠久，规模最大的儿童福利机构之一）合作 AHRQ资助的R21研究支持了Intervention INC的开发和试点测试， 这是一个以家庭为中心的、互动的、基于网络的健康促进工具，重点是减少儿童肥胖风险。的 该工具是专为满足低收入、黑人/非洲裔美国人（AA）和拉丁美洲人的需求和偏好而设计的 9至12岁的儿童及其父母/照顾者。试点可行性研究的结果非常有希望， 不仅工具是可行的交付和接受我们的儿童和家长人口，儿童接受 漫画工具在蔬菜、水和糖的摄入量方面表现出更大的改善（p<0.05）， 对照组，从干预前到干预后。然而，关于工具有效性和 但是在真实的世界环境中的实现仍然存在。为了填补这些空白，我们提出了一项具有以下目标的研究。 在目标1中，将与医疗保健从业人员/管理人员和儿童-父母进行形成性研究 二元组，以确定与在诊所中实施这种工具相关的组织（诊所）和家庭特征 在目标2中，将调整工具（基于目标1的发现），并对其进行可用性测试。 进行。在目标3中，将在儿童援助社区诊所进行一项全面的随机对照试验，以测试 调整和扩展的工具，将包括12周的漫画干预和6个月的维护 干预，对儿童BMI Z评分。在目标4中，诊所、提供者和家庭层面的背景因素， 将探讨影响力工具实施问题。我们认为，这种以家庭为中心的网络工具是独一无二的 鉴于其重点是创新的沟通方法和移动健康平台，以提高可及性， 与往往难以接触到的多样化人口接触。它还具有强大的