Testing a Multilevel, Multicomponent, Multigenerational Dietary Intervention to Improve Southeast Asian Children's Diets

测试多层次、多成分、多代饮食干预措施以改善东南亚儿童的饮食

• 批准号: 10584609
• 负责人: Kim M. Gans
• 金额: $ 27.24万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-07 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10584609
• 关键词: Address; Adult; Adult Children; Affect; Age; Asian; Behavior; Behavioral; Body Weight decreased; Body mass index; Cambodian; Carotenoids; Child; Child Health; Child Nutrition; Chronic; Chronic Disease; Clinical; Clinical Trials; Communities; Community Health Aides; Community Healthcare; County; Dermal; Diet; Dietary Intervention; Dietary Practices; Disease; Disparity; Disparity population; Dose; Education; Emotions; Ethnic Population; Exhibits; Family; Fatty acid glycerol esters; Feasibility Studies; Feedback; Food; Food Access; Frequencies; Funding; Future; Gestational Diabetes; Glycosylated hemoglobin A; Goals; Guilt; Health Food; Healthy Eating; Height; Home; Individual; Insulin Resistance; Intervention; Intervention Studies; Measures; Methods; Mission; Modeling; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Parents; Participant; Philosophy; Pilot Projects; Poverty; Prevalence; Publishing; Race; Randomized; Reducing diet; Refugees; Research; Rhode Island; Risk; Risk Factors; Scientific Advances and Accomplishments; Structure; Subgroup; Telephone; Testing; Text Messaging; Training; Trauma; Treatment Efficacy; Unhealthy Diet; Vietnamese; Weight Gain; Woman; Work; acceptability and feasibility; arm; attentional control; behavior change; community based participatory research; community clinic; community intervention; community partnership; design; dietary; early onset; effective intervention; efficacious intervention; energy balance; ethnic disparity; ethnic minority; ethnic minority population; experience; feasibility testing; feasibility trial; financial incentive; food environment; good diet; grandparent; health disparity; health disparity populations; high risk; implementation fidelity; implementation framework; implementation intervention; improved; indexing; innovation; intergenerational; intervention refinement; motivational enhancement therapy; multi-component intervention; nutrition education; prevent; primary outcome; process evaluation; racial minority; racial population; recruit; secondary outcome; social; social cognitive theory; southeast Asian; stem; sugar; transmission process; treatment arm; waist circumference

Background. Poor diet quality is a significant and critical problem for Southeast Asian (SEA) children whose families came to the US as refugees [e.g., Hmong, Cambodian, Laotian, Vietnamese]. SEA children are disproportionately burdened by higher rates of obesity and increased risk of other diet-related chronic diseases like type 2 diabetes relative to other Asian subgroups, Whites and “Other” races. Although dietary interventions have been shown to prevent/delay onset of diet-related chronic diseases, to our knowledge, there are no dietary interventions developed specifically for SEA children. Thus, there is an urgent need for dietary interventions that leverage state-of-the-art methods to address existing health disparities affecting SEA children and to advance scientific understanding of gaps in intervention research. Overview of Proposal. This proposal reflects our eight year (ongoing) academic-community research partnership with the Center for SEA in Rhode Island, formative work with SEA families, and our extensive experience conducting successful dietary interventions with underserved health disparity groups. The current study is a pilot feasibility study that tests an innovative multilevel, multicomponent, multigenerational dietary intervention to improve diet quality among SEA children. Conceptual Model. The Community Energy Balance and Family-Centered Action Model of Intervention Layout and Implementation frameworks provide the intervention rationale and structure. These frameworks propose that for disparity ethnic minority groups like SEA, multilevel, multicomponent, intergenerational interventions are the most effective intervention approach for changing and sustaining individual-level behavior change. Social cognitive theory and popular education philosophy inform the intervention content. Overview of Research Plan. 75 SEA families with children ages 6 to 11 years will be recruited from Providence County, Rhode Island. Adult-child pairs will be randomized to: (1) financial incentive only arm that will receive weekly $15 financial incentive coupons to subsidize purchase of healthy foods at a local SEA grocery store; or (2) financial incentive plus twice-monthly, family-based group nutrition education at the Center for SEA led by SEA community health workers; three motivational interviewing (MI) calls by trained community health workers; dietary norms messaging for adults (via weekly text messages) and for children (via Infographics at nutrition education sessions); and weekly $15 financial incentive coupons to subsidize purchase of healthy foods at SEA grocery stores; or (3) an Academic Engagement attention control arm that will follow the structure of the financial incentive plus nutrition education, MI and text messages and infographics arm. The primary outcomes are study feasibility and clinically meaningful improvement in child’s diet quality (measured by healthy eating index). Secondary outcomes are clinically meaningful changes in children’s body mass (~ 2kg weight loss or no weight gain), HbA1c (0.5%) and parent’s diet quality, HbA1c and the home food environment. These study findings will be used to inform a future, larger clinical trial.

背景。饮食质量差是东南亚（SEA）儿童面临的一个重要而关键的问题