MAP for Child Health: Using Social Networks to Improve child health and oral health

幼儿龋齿，沿着肥胖，是西方儿童最普遍的健康差异。 两者都与母亲的喂养行为和认知密切相关。教育和行为 最近几十年来，大多数针对个别母亲的干预措施显示出令人失望的结果， 对儿童健康和营养的影响有限。环境的社会背景特征-社区， 邻里和家庭--对儿童喂养和其他风险/保护有着深远的影响 行为。与低收入移民家庭在儿童龋齿和肥胖的高风险工作，该应用程序 将开发一个以社区为基础的社会网络干预，旨在减少口腔龋齿和肥胖， 改变儿童喂养和口腔卫生行为所处的社会环境。 MAP（“母亲行动计划”）儿童健康-是一个为期12个月的小组干预，旨在 降低南亚（SA）幼儿患幼儿龋齿和其他营养相关疾病的风险 和1-5岁的学龄前（TP）儿童。我们团队和其他人的研究发现，低收入移民SA 母亲非常容易受到社会领域的影响，这增加了儿童健康的风险。许多 在他们的社交网络中经历来自长辈的社会压力，给TP儿童喂食大量牛奶，牛奶 添加剂、糖果和精制碳水化合物-所有这些都对口腔和代谢健康产生不利影响。 因此，MAP-CH是一种通过创造新的健康环境来改变母亲社会环境的新策略， 推广社交网络。在项目的UH 3阶段，48个居住在物质密集区的母亲群体， 邻近（每群12个，总共576个）将以1：1随机分为干预组和对照组。控制将 获得健康和育儿教育材料。干预组将参加为期12个月的小组- 《母亲俱乐部》在一名熟练的同伴协调员的领导下，每个母亲俱乐部将接受一次干预， 旨在：1）建立密切的社会关系，社会支持，以及群体成员之间的群体认同感; 2） 改善与喂养有关的知识、态度和育儿技能。我们的目标是将每一位“母亲” 俱乐部”俱乐部成为一个有意义的和持久的社会网络，将支持健康的行为至少12 干预结束后的几个月。网络的形成和社会进程将在 在试验阶段和整个试验过程中，使用网络诊断框架评估社会融合情况， 网络凝聚力MAP-CH是第一个使用社交网络方法的儿童口腔健康干预。

Early Childhood Caries, along with obesity, are the most prevalent health disparities of childhood in the west. Both are closely associated with maternal feeding behaviors and cognitions. Educational and behavioral interventions—most directed at individual mothers—have shown disappointing results in recent decades, showing limited impact on child health and nutrition. Social-contextual features of the environment--community, neighborhood and household—are known to profoundly impact child feeding and other risk/protection behaviors. Working with low income immigrant families at high risk of child caries and obesity, this application will develop a neighbor-based social network intervention designed to reduce oral caries and obesity by modifying the social context in which child feeding and oral hygiene behaviors are embedded. MAP (“Mothers Action Project”) for Child Health—is a 12-month group intervention designed to decrease the risk of early childhood caries and other nutrition-related disease, among South Asian (SA) toddler and preschool (TP) children aged 1-5. Research from our team and others finds low income immigrant SA mothers to be highly vulnerable to influences from the social sphere which increase risks to child health. Many experience social pressure from elders in their social networks to feed TP children a diet heavy in milk, milk additives, sweets, and refined carbohydrates— all of which adversely impact oral and metabolic health. Accordingly, MAP-CH is a novel strategy to modify mothers’ social environment by creating new, health promoting social networks. During the UH3 Phase of the project, 48 clusters of mothers living in close physical proximity (12 per cluster, 576 total) will be randomized 1:1 into intervention and control arms. Controls will receive health and parenting education materials. The intervention group will participate in a 12-month, group- based “Mothers’ Club.” Led by a skilled peer facilitator, each mothers’ club will receive an intervention designed to: 1) build close social ties, social support, and a sense of group identity among group members; 2) improve knowledge, attitudes and parenting skills related to feeding. The goal is to transform each ‘Mothers’ Club” club into a meaningful—and lasting-- social network that will support healthy behaviors at least 12 months beyond the end of the intervention. Network formation and social processes will be monitored in the pilot phase and throughout the trial using a network diagnostics framework to assess social integration and network cohesion. MAP-CH is the first child oral health intervention using a social network approach.