Strong Families Start at Home/Familias Fuertes Comienzan en Casa: A novel Video and Motivational Interviewing Intervention to improve diet quality of low-income, ethnically diverse children

强大的家庭从家庭开始/Familias Fuertes Comienzan en Casa：新颖的视频和动机访谈干预措施，旨在改善低收入、种族多样化儿童的饮食质量

• 批准号: 10585437
• 负责人: ALISON TOVAR
• 金额: $ 55.85万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-08 至 2028-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585437
• 关键词: 5 year old; Address; Adolescence; Adult; Attention; Behavior; Beverages; Body mass index; COVID-19; Cardiometabolic Disease; Cardiovascular Diseases; Carotenoids; Cessation of life; Child; Child Rearing; Clip; Communities; Community Health Aides; Cues; Dermal; Desire for food; Diet; Dietary Fiber; Dietary intake; Dose; Eating; Enrollment; Equipment and supply inventories; Exposure to; Family; Feedback; Food; Food Access; Health; Health Food; Healthy Eating; High Prevalence; Home; Home visitation; Hour; Intervention; Knowledge; Latinx; Latinx population; Learning; Life; Low income; Measurement; Measures; Mediator; Morbidity - disease rate; Motivation; Nursery Schools; Obesity; Outcome Measure; Parents; Participant; Population Heterogeneity; Preparation; Preschool Child; Primary Prevention; Printing; Public Health; Randomized, Controlled Trials; Reduce health disparities; Research; Resources; Risk Factors; Satiation; School-Age Population; Self Efficacy; Shapes; Signal Transduction; Strategic Planning; System; Telephone; Testing; Text Messaging; Time; Training; Unhealthy Diet; United States National Institutes of Health; Work; acceptability and feasibility; comparison group; contextual factors; cooking; cost; dietary; disorder prevention; efficacy evaluation; efficacy testing; energy balance; ethnic diversity; experience; feasibility testing; feasibility trial; feeding; food environment; food quality; food resource; food security; fruits and vegetables; group intervention; improved; indexing; intervention delivery; intervention effect; motivational enhancement therapy; novel; pilot test; precision nutrition; preventive intervention; primary outcome; public health relevance; screening; secondary outcome; social determinants; social health determinants; trait; trial design

The diets of US children are suboptimal and effective primary prevention interventions are urgently needed to shape dietary behaviors early in life, especially among Latinx families, who experience higher prevalence of obesity and cardiovascular disease. The community energy balance framework suggests the need to intervene at multiple levels, while addressing cultural and contextual factors, to effectively impact diet quality for disease prevention including: 1) Child level, including appetitive traits (satiety responsiveness (sensitivity to internal satiety signals), food responsiveness (sensitivity to external food cues), and food fussiness; 2) Parent level including the food parenting practices they use to feed children; 3) Home level including the availability and accessibility of food, and; 4) Broader context including social determinants, food security/access to healthy foods. While there have been several interventions aimed at improving the diet quality of young children, few have targeted more than one of these levels and almost none are tailored to a child’s appetitive traits, culturally appropriate, and convenient for busy, working Latinx families. Further, most have only focused on what parents should not be doing, rather than supporting what they should be doing. This proposal will build on our recently completed R34 pilot feasibility trial (R34HL140229-01A1) to test the efficacy of a novel home-based intervention with 257 Latinx families of preschool children. The proposed 6-month intervention will include: 1) Three home visits by a community health worker (CHW) trained in brief motivational interviewing that include in-home cooking demonstrations to prepare a meal involving the child; using a family meal-time video to provide feedback on food parenting; 2) Screening for social-determinants of health and connecting families to federal/state/local resources; 3)Text-messages (2x/wk); 4) Tailored materials/messages; and 5) Three CHW phone calls to reinforce food parenting, food resource management and healthy eating. Specific Aims are to: Improve quality of the dietary intakes of 2–5-year-old children (Aim 1); Improve food parenting practices (Aim 2); and Improve the home availability of healthy foods (Aim 3). Exploratory aims will assess: the relationship between outcome measures and intervention dose; the relationship between outcome measures and potential mediators and moderators and the intervention’s effect on child BMI. This study fills an important research gap by targeting the home food environment with positive food parenting while acknowledging a child’s appetitive traits. It also meets the NIH call for needed research to reduce health disparities among Latinx populations and has the potential for high public health impact.

美国儿童的饮食不理想，有效的一级预防干预措施 迫切需要在生命早期塑造饮食行为，特别是在拉丁裔家庭中， 肥胖和心血管疾病的患病率更高。社区电力 平衡框架表明，需要在多个层面进行干预，同时解决文化问题， 和环境因素，以有效地影响饮食质量，预防疾病，包括：1）儿童 水平，包括食欲性状（饱腹感反应性（对内部饱腹感信号的敏感性）， 食物反应性（对外界食物线索的敏感性）和食物敏感性; 2）父母水平 包括他们用来喂养孩子的食物养育方法; 3）家庭层面，包括 4）更广泛的背景，包括社会决定因素、粮食 安全/获得健康食品。虽然有几项干预措施， 改善幼儿的饮食质量，很少有针对性的超过一个这些水平 而且几乎没有一种是针对儿童的食欲特点，适合文化，方便 适合忙碌、工作的拉丁裔家庭。此外，大多数人只关注父母不应该做的事情。 做，而不是支持他们应该做的事情。这项建议将建立在我们的 最近完成的R34试点可行性试验（R34 HL 140229 - 01 A1），以测试一种新的 对257个拉丁裔学龄前儿童家庭进行家庭干预。拟议的6个月 干预措施将包括：1）由一名社区卫生工作者（CHW）进行三次家访， 简短的激励性面试，包括在家烹饪示范，以准备一顿饭 让孩子参与进来;使用家庭用餐时间视频提供关于食物养育的反馈; 2） 筛查健康的社会决定因素，并将家庭与联邦/州/地方政府联系起来 资源; 3）文本信息（每周2次）; 4）定制材料/信息; 5）三个CHW 电话，以加强食物养育，食物资源管理和健康饮食。 具体目标是：提高2-5岁儿童的饮食质量（目标1）; 改善食物养育做法（目标2）;改善健康食品的家庭供应 (Aim（3）第三章。探索性目标将评估：结果指标与 干预剂量;结局指标与潜在介质之间的关系， 调节者和干预对儿童BMI的影响。这项研究填补了一个重要的研究空白 通过以积极的食物养育为目标的家庭食物环境，同时承认 孩子的胃口。它也满足了美国国立卫生研究院的呼吁，需要进行研究，以减少健康 拉丁裔人口之间的差异，并有可能对公共卫生产生重大影响。