Linking home environments and primary care: Obesity prevention for 2-5 year olds

将家庭环境与初级保健联系起来：2-5 岁儿童的肥胖预防

• 批准号: 7741822
• 负责人: NANCY E. SHERWOOD
• 金额: $ 21.24万
• 依托单位: HEALTHPARTNERS INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-22 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7741822
• 关键词: 4 year old; 5 year old; Address; Age; Awareness; Bite; Body mass index; Caring; Child; Childhood; Clinic; Computerized Medical Record; Consumption; Counseling; Data; Development; Diet; Eating; Environment; Family; Fatty acid glycerol esters; Food; Fostering; Frequencies; Gender; Goals; Growth; Health; Health Information System; Health Status; Health behavior; Home environment; Influentials; Information Systems; Injury; Institute of Medicine (U.S.); Intervention; Lead; Letters; Link; Managed Care; Mediator of activation protein; Modeling; Nursery Schools; Obesity; Overweight; Parents; Participant; Pattern; Physical activity; Pilot Projects; Play; Population; Positioning Attribute; Preschool Child; Prevention; Preventive Intervention; Primary Health Care; Process; Provider; Public Health; Randomized; Recommendation; Recruitment Activity; Reporting; Research; Resources; Risk; Risk Reduction; Role; Safety; Shapes; Smoke; Specialist; Spottings; Telephone; Testing; Treatment Efficacy; Upper arm; Weight; Weight Gain; base; early childhood; effective intervention; electronic data; environmental change; family influence; injury prevention; innovation; obesity in children; obesity prevention; obesity risk; outreach; pediatrician; prevent; primary care setting; programs; public health priorities; public health relevance; satisfaction; sweetened beverage; trend; tv watching

DESCRIPTION (provided by applicant): Linking home environments and primary care: Obesity prevention for 2-4 year olds Obesity prevention for at-risk preschool children is a public health priority. The pediatric primary care setting is a relatively untapped resource for initiating obesity prevention efforts and providing recommendations and support to families for creating home environments conducive to healthy growth. The goals of this developmental (R21) study are to develop and evaluate the feasibility and acceptability of a primary care- based, preschool obesity prevention intervention integrating pediatrician counseling and a home-based program for parents of 2-4 year old children at risk for obesity. To achieve this goal, we will identify and recruit 60 eligible parent-child dyads from families of 2-4 year old at risk children defined as having a BMI between the 85th and 95th percentile for age and gender or a BMI between the 50th and 85th percentile and at least one overweight parent. These dyads will be randomized to one of the following conditions: (a) Healthy Eating/Physical Activity Home-based Intervention including brief pediatrician counseling regarding the child's current BMI percentile status, recommendations for home environmental changes to achieve a healthy weight gain trajectory, and home safety and injury risk reduction environmental recommendations paired with a 6 month home-based program delivered via phone by a masters-level health behavior specialist to promote implementation of the obesity prevention home environmental strategies, or (b) General Health/Safety/Injury Prevention Home-based Contact Control Intervention: Families will receive the same brief counseling from their pediatrician paired with a 6 month home-based program delivered via phone by a masters-level health behavior specialist to promote implementation of the general health, safety and injury prevention home environmental strategies. Primary goals of this R21 are to assess the feasibility, acceptability, and potential efficacy of the intervention. We will estimate intervention impact on diet, activity level, hypothesized mediators of BMI change, and BMI. Our study setting is ideal given our expertise in phone-based obesity interventions and access to a pediatric primary care population and associated health information systems. If successful, this approach will be evaluated on a larger scale and provide a potential model for addressing one of the most important public health challenges of the 21st century. PUBLIC HEALTH RELEVANCE: This R21 study will develop and test the feasibility and acceptability of a primary care-based obesity prevention intervention that integrates counseling by pediatric primary care providers and a home-based program for parents of 2-4 year old children at risk for obesity. The home-based program is delivered by phone and will help parents create a healthy home environment to encourage healthy eating and activity patterns and healthy weight gain in their preschool age children.

描述（由申请人提供）： 将家庭环境与初级保健联系起来：预防 2-4 岁儿童肥胖 预防高危学龄前儿童的肥胖是一项公共卫生优先事项。儿科初级保健机构是一个相对尚未开发的资源，可用于启动肥胖预防工作，并为家庭提供建议和支持，以创造有利于健康成长的家庭环境。这项发展性 (R21) 研究的目标是开发和评估基于初级保健的学前肥胖预防干预措施的可行性和可接受性，该干预措施结合了儿科医生咨询和针对有肥胖风险的 2-4 岁儿童家长的家庭计划。为了实现这一目标，我们将从 2-4 岁高危儿童家庭中识别并招募 60 名符合条件的亲子二人组，这些儿童的年龄和性别定义为 BMI 在 85% 至 95% 之间，或 BMI 在 50% 至 85% 之间，并且至少有一名超重父母。这些二元组将被随机分配到以下条件之一：(a) 健康饮食/身体活动家庭干预，包括关于儿童当前 BMI 百分位状态的简短儿科医生咨询、为实现健康体重增加轨迹而改变家庭环境的建议、家庭安全和减少伤害风险的环境建议，以及由大师级健康行为专家通过电话提供的为期 6 个月的家庭计划，以促进肥胖预防家庭环境策略的实施， (b) 一般健康/安全/伤害预防家庭接触控制干预：家庭将接受来自儿科医生的相同简短咨询，并由大师级健康行为专家通过电话提供为期 6 个月的家庭计划，以促进实施一般健康、安全和伤害预防家庭环境策略。 R21 的主要目标是评估干预措施的可行性、可接受性和潜在功效。我们将估计干预措施对饮食、活动水平、BMI 变化的假设中介因素和 BMI 的影响。鉴于我们在基于电话的肥胖干预措施以及接触儿科初级保健人群和相关健康信息系统方面的专业知识，我们的研究环境是理想的。如果成功，这种方法将得到更大规模的评估，并为解决 21 世纪最重要的公共卫生挑战之一提供潜在模型。公共健康相关性：这项 R21 研究将开发和测试基于初级保健的肥胖预防干预措施的可行性和可接受性，该干预措施将儿科初级保健提供者的咨询和针对有肥胖风险的 2-4 岁儿童父母的家庭计划结合起来。该家庭计划通过电话提供，将帮助父母创造一个健康的家庭环境，鼓励学龄前儿童健康的饮食和活动模式以及健康的体重增加。