The iâ¥Rhythm Project: Healthy sleep and behavioral rhythms for obesity prevention

项目摘要/摘要 儿童标准化BMI(BMIz)的增加在夏季期间在美国和 在国际上。证明这一点的最大规模的研究是我们为期5年的纵向研究(幼儿园-第5年 这表明，从小学早期开始，孩子们就开始了一种始终如一的模式 在学年期间BMIz有所改善，在夏季BMIz显著增加， 夏季BMIz的增加会增加5年级时超重或肥胖的风险。 睡眠时间缩短和昼夜节律紊乱显然与肥胖的发生有关。 具体地说，睡眠和饮食模式的日常行为节律的变化与 肥胖，通过随后分子生物钟的改变来调节。从历史上的 从学年到暑假代表着孩子们可能会经历一段时间的变化，在这段时间里，他们的 行为节律(即睡眠和行为节律)。人际社交节律疗法是一种 对双相情感障碍的循证治疗，已证明对预防复发有效 通过促进心境调节防止内源性昼夜节律失调 稳定的行为节律(例如，睡眠和饮食模式)。拟议研究的目标是：1)适应 IPSRT促进暑期儿童行为节律稳定，预防暑期 增加BMIZ(即i♥节拍项目)和2)进行试点研究，以审查可行性， I♥节律项目预防儿童体重指数增加的可接受性和初步疗效 夏天。将利用移动健康技术，使用熟悉和方便的 在课外时间提供资源。K99阶段将提供额外的培训，以便开发 在睡眠和昼夜节律研究和行为健康干预发展方面的专业知识 使用移动健康技术，以及解决以下问题所需的额外专业和研究开发 培训方面的差距。额外培训将促进向以发展为重点的职业的过渡 旨在解决睡眠和昼夜节律在儿童肥胖发病中的作用的行为干预。 拟议的研究解决了科学知识和实践中的几个空白：1)缺乏 针对儿童夏季体重增加的干预措施2)关于以下方面的知识存在显著差距 睡眠和昼夜节律在预防儿童肥胖和解决夏季体重问题中的作用 GAIN为解决儿童肥胖的预防问题提供了一个重要机会。这一创新的应用 代表了一种具有既定疗效的干预措施的新应用，以促进稳定的行为节律 用于治疗双相情感障碍，并承诺为预防儿童肥胖症做同样的事情。这项研究 是第一个阐述睡眠和昼夜节律在预防儿童肥胖中的作用并研究 这种干预长期预防肥胖症的初步证据。

PROJECT SUMMARY/ABSTRACT Increases in children's standardized BMI (BMIz) have been demonstrated during summer across the US and internationally. The largest study to demonstrate this was our 5-year longitudinal study (kindergarten – 5th grade) which demonstrated that beginning in early elementary school, children begin a consistent pattern of improvements in BMIz during the school year and significant increases in BMIz during summer, with summertime increases in BMIz contributing to increased risk of becoming overweight or obese by 5th grade. Shortened sleep duration and circadian rhythm disturbances have been clearly implicated in obesity onset. Specifically, shifts in the daily behavioral rhythms of sleep and meal patterns are associated with increased adiposity, mediated through subsequent alterations in the molecular circadian clock. The transition from the school year to summer vacation represents a time during which children may experience changes in their behavioral rhythms (i.e., sleep and behavioral rhythms). Interpersonal Social Rhythm Therapy (IPSRT) is an evidence based treatment for bipolar disorder that has demonstrated efficacy to prevent the reoccurrences of mood disturbances by preventing the misalignment of endogenous circadian rhythms through the promotion of stable behavioral rhythms (e.g., sleep and meal patterns). The goals of the proposed research are to 1) adapt IPSRT to promote stable behavioral rhythms in children during summer vacation for the prevention of summer increases in BMIz (i.e., the i♥rhythm project) and 2) conduct a pilot study to examine the feasibility, acceptability, and preliminary efficacy of the i♥rhythm project to prevent increases in children's BMIz during summer. mHealth technologies will be utilized in order to reach parents using a familiar and convenient resource during out of school times. The K99 phase will provide additional training in order to develop expertise in sleep and circadian rhythms research and the development of behavioral health interventions using mHealth technologies, as well as additional professional and research development needed to address gaps in training. The additional training will facilitate transition to a career focused on the development of behavioral interventions to address the role of sleep and circadian rhythms in the onset of childhood obesity. The proposed research addresses several gaps in scientific knowledge and practice: 1) there are a paucity of interventions addressing summer weight gain in children 2) there is a significant gap in knowledge regarding the role of sleep and circadian rhythms in the prevention of child obesity and 3) addressing summer weight gain provides an important opportunity to address the prevention of child obesity. This innovative application represents a novel application of an intervention with established efficacy to promote stable behavioral rhythms for treatment of bipolar disorder and promises to do the same for the prevention of child obesity. This research is the first to address the role of sleep and circadian rhythms in the prevention of child obesity and to examine the preliminary evidence of such an intervention on the long-term prevention of obesity.