A Home-Based Parent-Child Intervention to Promote Children's Energy Balance

描述(申请人提供)：这项调查将开发和试行一种以家庭为基础的干预措施，以改变影响儿童饮食模式、体育活动和媒体使用行为的父母做法，从而影响儿童不健康体重增加的风险。目标1：开发一种以家庭为基础的干预措施，以修改影响儿童不健康体重增加风险的育儿做法。在项目开发期间，研究人员将采用首席调查员在先前研究中开发的以家庭为基础的预防吸烟育儿计划的成功模式，让家长和儿童参与筛选干预概念和现场测试干预原型，并利用营养和体力活动干预和评估方面的专家咨询。完整的干预将是为期六个月的一系列干预活动指南，依靠互动游戏和其他形式的体验式学习，让父母和孩子共同改变促进不健康体重增加的饮食、体育活动和媒体使用做法。目的2：进行一项小样本的初步研究，以衡量干预对父母养育行为以及对儿童的饮食、体育活动和媒体使用行为的影响。在基线阶段，将招募240对母亲和7岁的儿童。母亲将是生母、继母、养母或任何种族/民族群体的其他女性监护人；儿童将是有超重风险或接近超重风险的男孩或女孩(定义为特定性别的BMI=第80和第95个百分位数)。在母亲和儿童在现场完成基线评估后(在主要调查员RE)，参与者将被随机分配到为期6个月的治疗或延迟治疗对照条件(对照组将在后续行动后收到干预材料)。干预暴露和保真度将通过每月对治疗组父母的随机亚组进行的电话访谈来衡量。后续数据收集将重复母亲和儿童基线评估方案。回归模型将被用来检验这一假设，即接受干预的父母比对照组更有可能使用促进健康体重增加的育儿做法。回归模型还将测试治疗组的儿童是否比对照组的儿童更有可能报告推荐的饮食、体育活动和媒体使用行为。儿童肥胖已变得越来越普遍，并与多种慢性病的风险增加有关。饮食、体育活动和媒体使用行为促进能量平衡的儿童可能会体验到长期的健康益处。为了让孩子受益，父母必须拥有他们修改相关社会化过程所需的知识、基本技能和社会化工具。这项拟议的研究旨在开发一种满足这一需求的计划。

DESCRIPTION (provided by applicant): This investigation will develop and pilot test a home-based intervention to modify parenting practices that influence children's eating patterns, physical activity, and media use behaviors and thereby influence children's risk of unhealthy weight gain. Aim 1: Develop a home-based intervention to modify parenting practices that influence children's risk of unhealthy weight gain. During program development the investigators will apply a successful model of a home-based parenting program for smoking prevention developed by the Principal Investigator in prior research, they will involve parents and children in screening the intervention concepts and field testing intervention prototypes, and they will utilize expert consultation on nutrition and physical activity intervention and assessment. The complete intervention will be a six month series of intervention activity guides that rely on interactive games and other forms of experiential learning to engage parents and children jointly in modifying diet, physical activity, and media use practices that promote unhealthy weight gain. Aim 2: Conduct a small sample pilot study to measure the effects of the intervention on parenting practices and on children's dietary, physical activity, and media use behaviors. At baseline, 240 dyads of mothers and seven year old children will be recruited. Mothers will be biological mothers, step- mothers, foster mothers, or other female guardians of any racial/ethnicity group; children will be boys or girls who are at-risk or nearly-at-risk of becoming overweight (defined as sex-specific BMI-for-age = 80th and < 95th percentile). Following baseline assessments completed by mothers and children on site (at Principal InvestigatorRE), participants will be randomly assigned to a 6-month treatment or to a delayed treatment control condition (controls will receive intervention materials after follow-up). Intervention exposure and fidelity will be measured using telephone interviews conducted monthly with random subsets of treatment group parents. Follow-up data collection will repeat the baseline assessment protocol for mothers and children. Regression models will be used to test the hypothesis that parents exposed to the intervention will be significantly more likely than controls to use parenting practices that promote healthy weight gain. Regression models will also test whether children in the treatment group are significantly more likely than controls to report recommended dietary, physical activity, and media use behaviors. Pediatric obesity has become increasingly prevalent and is associated with increased risk of multiple chronic diseases. Children whose diet, physical activity, and media use behaviors promote energy balance could experience long-term health benefits. For children to benefit, parents must have the knowledge, basic skills, and socialization tools they need to modify relevant socialization processes. The proposed research aims to develop a program that will meet this need.