Obesity Prevention in Head Start: The Miranos! Program

肥胖预防先行者：米拉诺斯！

• 批准号: 9354453
• 负责人: DEBORAH PARRA-MEDINA
• 金额: $ 63.16万
• 依托单位: UNIVERSITY OF TEXAS SAN ANTONIO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-20 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9354453
• 关键词: 3 year old; Accelerometer; Address; Administrator; Adolescence; Adult; Affect; Age; American; Behavior; Body mass index; Caring; Child; Child Care; Chronic Disease; Cluster randomized trial; Collaborations; Complex; Consensus; Consumption; Control Groups; Cost Effectiveness Analysis; Data Collection; Development; Diet; Dietary Fiber; Dietary intake; Economic Burden; Education; Educational Intervention; Enrollment; Environment; Epidemic; Ethnic group; Evaluation; Family; Family Practice; Fatty acid glycerol esters; Female; Food; Food Preferences; Fructose; Gender; Gold; Growth; Guidelines; Habits; Head Start Program; Health; Health behavior; Health education; Height; Home environment; Home visitation; Incidence; Intake; Interdisciplinary Study; Intervention; Latino; Literature; Low income; Methods; Motor; Motor Skills; Nutrition Policy; Obesity; Outcome; Overweight; Parents; Performance; Physical activity; Play; Policies; Preschool Child; Prevalence; Prevention; Prevention program; Prevention strategy; Process; Provider; Public Health; Randomized; Randomized Controlled Trials; Recommendation; Reporting; Research Infrastructure; Resources; Services; Sleep; South Texas; Staff Development; Strenuous Exercise; Testing; Time; Training; United States; Weight; age group; aged; arm; base; cardiometabolic risk; combat; cost; cost effectiveness; cost-effectiveness evaluation; design; early childhood; early onset; efficacy study; efficacy testing; energy balance; evidence base; follow-up; fruits and vegetables; healthy weight; intervention program; lower income families; nutrition; nutrition education; obesity in children; obesity prevention; population health; post intervention; preference; prevent; primary outcome; programs; prospective; psychosocial; racial and ethnic; secondary outcome; sedentary lifestyle; sugar; synergism; treatment group; tv watching

Abstract The prevalence of obesity remains high in American children aged 2-5 while one in three Head Start children is overweight or obese. The proposed study is designed to test the efficacy of an early childhood obesity prevention program, “Obesity Prevention in Head Start: The Míranos! Program”, which promotes healthy growth in predominantly Latino children in Head Start. The Míranos! includes center-based (policy changes, staff development, gross motor program, and nutrition education) and home-based (parent engagement/ education and home visits) interventions to address key enablers and barriers in obesity prevention in young children. In partnership with Head Start, we have demonstrated the feasibility and acceptability of the proposed interventions to influence energy-balance-related behaviors favorably in Head Start children. Using a three-arm cluster randomized design, 21 Head Start centers in equal number will be randomly assigned to one of three conditions: 1) a combined center- and home-based intervention, 2) center-based intervention only, or 3) control. The interventions will be delivered during the academic year (an 8-month period). A total of 525 3-year-old children (52% females; n=25 per center at baseline) will be enrolled in the study and followed prospectively one year post intervention. Data collection will be conducted at baseline, immediate post-intervention, and 1-year follow-up and include height, weight, physical activity (PA) and sedentary behaviors by accelerometry, parent-reports of sleep duration and TV watching time, gross motor development, dietary intakes and food and activity preferences. Information on family background, parental weight, PA- and nutrition-related practices and behaviors, PA and nutrition policy and environment at center and home, intervention program costs, and treatment fidelity will also be collected. The study has three specific aims: 1) to test the efficacy of the Míranos! intervention on healthy weight growth (primary outcome) in normal weight, overweight and obese children, 2) to test the impact of the Míranos! intervention on children's PA, sedentary behavior, sleep, and dietary behaviors (secondary outcomes), and 3) to evaluate cost- effectiveness of the Míranos! intervention. With endorsement of a large local Head Start administrator and a multi-disciplinary research team, the Míranos!, a culturally tailored obesity prevention program, is poised to provide evidence of a policy and environmental approach to prevent early onset of obesity and its cost-effectiveness in low-income Latino preschool children. By targeting multiple behaviors at different levels of influence and in multiple settings, the Míranos! holds great promise of developing long-term health habits that reduce the energy imbalance gap by targeting multiple energy-balance-related behaviors. The Míranos! can be disseminated to various organized child care settings since it is built on Head Start program and its infrastructure—a gold standard in early childhood education, as well as current PA and nutrition recommendations for preschool children.

抽象的 美国 2 至 5 岁儿童的肥胖率仍然很高，而三分之一的 Head Start 儿童 超重或肥胖。拟议的研究旨在测试早期儿童肥胖的功效 预防计划“领先一步预防肥胖：米拉诺斯！计划”，该计划促进健康 主要是拉丁裔儿童在 Head Start 中的成长。米拉诺斯！包括基于中心的（政策变化、 员工发展、大运动计划和营养教育）和家庭（家长参与/ 教育和家访）干预措施，以解决年轻人肥胖预防的关键推动因素和障碍 孩子们。我们与 Head Start 合作，证明了该计划的可行性和可接受性 提出了干预措施，以对 Head Start 儿童的能量平衡相关行为产生有利影响。 采用三臂整群随机设计，随机分配 21 个同等数量的 Head Start 中心 分配给以下三种情况之一：1) 中心和家庭相结合的干预，2) 以中心为基础的干预 仅干预，或 3) 控制。干预措施将在学年期间实施（为期 8 个月） 时期）。共有 525 名 3 岁儿童（52% 为女性；基线时每个中心 n=25）将被纳入该项目 研究并在干预后前瞻性随访一年。数据收集将在基线进行， 干预后立即进行，以及 1 年随访，包括身高、体重、体力活动 (PA) 和 通过加速度测量的久坐行为、睡眠持续时间和看电视时间的家长报告、粗大运动 发育、饮食摄入量以及食物和活动偏好。家庭背景、父母信息 体重、体能活动和营养相关的做法和行为、体能活动和营养政策及环境为中心 家庭、干预计划费用和治疗保真度也将被收集。该研究有三项具体内容 目的：1）测试Míranos的功效！对健康体重增长的干预（主要结果） 正常体重、超重和肥胖儿童，2）测试Míranos的影响！对儿童的干预 PA、久坐行为、睡眠和饮食行为（次要结果），以及 3) 评估成本- 米拉诺斯队的效率！干涉。 在当地大型启蒙管理员和多学科研究团队的认可下， Míranos! 是一项根据文化量身定制的肥胖预防计划，准备提供政策证据和 预防低收入拉丁裔早期肥胖的环境方法及其成本效益 学龄前儿童。通过针对不同影响力水平和多种环境中的多种行为， 米拉诺斯！有望养成长期健康习惯，从而减少能量不平衡差距 针对多种能量平衡相关行为。米拉诺斯！可以分发给各种有组织的 儿童保育环境，因为它是建立在启蒙计划及其基础设施之上的——早期教育的黄金标准 儿童教育，以及当前针对学龄前儿童的 PA 和营养建议。