Reducing Childhood Obesity Using Ecological Momentary Intervention (EMI) and Video Feedback atFamily Meals

使用生态瞬时干预 (EMI) 和家庭用餐时的视频反馈减少儿童肥胖

• 批准号: 10814597
• 负责人: Jerica M Berge
• 金额: $ 6.12万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10814597
• 关键词: Adult; African American; Age; Atmosphere; Behavior; Body mass index; Cellular Phone; Child; Communities; Community Health Aides; Coping Skills; Cost Analysis; Data Collection; Diet; Dietary intake; Disparity; Ecological momentary assessment; Education; Eligibility Determination; Environment; Ethnic Origin; Evidence based intervention; Family; Family member; Feedback; Frequencies; Health Technology; Health behavior; Healthy Eating; High Prevalence; Hispanic; Home; Home visitation; Household; Income; Individual; Intervention; Intervention Studies; Longitudinal Studies; Low income; Maintenance; Measures; Methodology; Methods; Minority; Modeling; Native Americans; Obesity; Outcome; Overweight; Parents; Participant; Pattern; Phase; Pilot Projects; Primary Care; Procedures; Protocols documentation; Race; Randomized; Readiness; Research; Risk; Self Efficacy; Siblings; Socioeconomic Status; Stress; Systems Theory; Testing; Time; Visit; Weight; arm; behavior change; clinical practice; cost effective; cost effectiveness; dietary; effectiveness trial; family support; feeding; food environment; food quality; implementation intervention; indexing; innovation; intervention effect; mHealth; meetings; obesity in children; obesity risk; obesity treatment; post intervention; primary care clinic; primary care setting; primary outcome; recruit; secondary outcome; sex; success; three-arm study; video visit

Abstract The low to moderate success with childhood obesity interventions to date and the persistent obesity disparities across race/ethnicity and socioeconomic status indicate the need to approach childhood obesity in a new and innovative way. Building on the last three decades of research on childhood obesity, the main objective of the proposed study is to utilize state-of-the-art intervention methods including ecological momentary intervention (EMI), video feedback, and home visiting methods in partnership with primary care clinics and Community Health Workers (CHWs) to examine whether increasing the quality of family meals (i.e., dietary quality, interpersonal atmosphere) and quantity of family meals (i.e., frequency of meals) reduces childhood obesity. Numerous studies have shown significant associations between family meal frequency and child weight and weight-related behaviors (e.g., better diet quality, lower weight status). Research has also shown that the quality of family meals, including dietary quality of the food served at family meals and the interpersonal atmosphere during family meals, is associated with decreased childhood obesity risk. In addition, prior intervention research has shown that immediate feedback on health behaviors (e.g., EMI, video feedback) increases the likelihood of behavior change. Thus, the proposed individual randomized controlled effectiveness trial, based on our pilot study, tests combinations of the above factors (i.e., EMI, home visiting, video feedback) across three study arms: (1) EMI; (2) EMI+Home Visiting (HV); and (3) EMI+HV+Video Feedback. All arms will receive 16 weeks of EMI family meal tip messages delivered via smartphones. Arms 2 and 3 will additionally receive home visiting (eight in-home visits; eight “Try it Yourself” activities) focused on family meal quality and quantity and a family meal prep activity delivered by a CHW simultaneously with the 16 weeks of EMI. Arm 3 will additionally receive eight weeks of video feedback focused on family meal behavior(s)/patterns delivered by a CHW during the eight in-home visits. All arms will receive an 8-week maintenance phase allowing for progressively less support of families so they can increase self-efficacy and sustainability of behavior change. The intervention will be carried out for 6 months with children with overweight/obesity (i.e., BMI ≥85%ile) who are ages 5-8 years (n=510), from low income and diverse households (i.e., African American, Hispanic, Native American, White), and their families. Eligible children will be recruited through primary care clinics. Drawing on Family Systems Theory, the intervention aims to change individual and family-level behaviors. Specifically, the intervention will be delivered to the family unit and primary outcomes will include child weight (i.e., BMI %ile) and diet quality (i.e., Healthy Eating Index). Secondary outcomes will include parent and other family member’s weight and weight-related behaviors. This study will change clinical practice by creating a new model for childhood obesity treatment in primary care using CHWs as interventionists and mobile health technology to intervene in real-time on parental stress and the home food environment to reduce childhood obesity.

抽象的 迄今为止，儿童肥胖干预措施以及持续的肥胖分布的低至中等成功 跨越种族/种族和社会经济地位，表明需要在新的和 创新的方式。建立在过去三十年的童年对象研究的基础上，这是 拟议的研究是利用最新的干预方法，包括生态时刻干预 （EMI），视频反馈和家庭访问方法与初级保健诊所和社区合作 卫生工作者（CHW）检查是否提高家庭餐质量（即饮食质量， 人际气氛）和家庭餐数量（即餐的频率）减少了儿童的对象。 大量研究表明，家庭用餐频率和儿童体重与 与体重相关的行为（例如，饮食质量更好，体重降低）。研究还表明 家庭餐的质量，包括家庭餐食食品的饮食质量和人际关系 家庭用餐期间的气氛与儿童对象的风险降低有关。另外，先验 干预研究表明，有关健康行为的立即反馈（例如，EMI，视频反馈） 增加行为改变的可能性。这是拟议的个体随机控制有效性 根据我们的试点研究，试验测试了上述因素的组合（即EMI，家庭访问，视频反馈） 在三个研究臂上：（1）EMI； （2）EMI+家庭访问（HV）； （3）EMI+HV+视频反馈。所有的武器都会 通过智能手机接收16周的EMI家庭进餐小费消息。武器2和3还将 接受家庭访问（八次在家访问；八次“自己尝试”活动），重点是家庭用餐质量和 只需使用16周的EMI，CHW提供的数量和家庭进餐准备活动。手臂3 还将收到八个星期的视频反馈，重点是家庭膳食行为/模式 在八次内部访问期间通过一堂CHW。所有武器都将获得一个为期8周的维护阶段 逐渐减少对家庭的支持，因此他们可以增加行为改变的自我有效和可持续性。 干预措施将与患有超重/肥胖症的儿童（即BMI≥85％ILE）进行6个月 来自低收入家庭和潜水家庭（即非裔美国人，西班牙裔，本地人）的5-8岁（n = 510） 美国，怀特）及其家人。合格的儿童将通过初级保健诊所招募。吸引 家庭系统理论，干预旨在改变个人和家庭水平的行为。具体来说， 干预将交付给家庭部门，主要结果将包括儿童体重（即BMI％ILE） 和饮食质量（即健康饮食指数）。次要结果将包括父母和其他家庭成员的 体重和体重相关的行为。这项研究将通过创建一个新模型来改变临床实践 使用CHW作为干预主义者和移动卫生技术的儿童肥胖症治疗 实时干预父母的压力和家庭食品环境，以减少儿童对象。

项目成果

A Three-Arm Randomized Controlled Trial Using Ecological Momentary Intervention, Community Health Workers, and Video Feedback at Family Meals to Improve Child Cardiovascular Health: The Family Matters Study Design.

使用生态瞬时干预、社区卫生工作者和家庭用餐视频反馈来改善儿童心血管健康的三组随机对照试验：家庭事务研究设计。

• DOI: 10.21203/rs.3.rs-2662682/v1
• 发表时间: 2023
• 期刊: Research square
• 作者: Berge,JericaM;Trofholz,AmandaC;Aqeel,Marah;Norderud,Kristin;Tate,Allan;Fertig,AngelaR;Loth,Katie;Mendenhall,Tai;Neumark-Sztainer,Dianne
• 通讯作者: Neumark-Sztainer,Dianne