Project 2 Behavioral

项目 2 行为

• 批准号: 10588266
• 负责人: Ann Marie Cheney
• 金额: $ 34.7万
• 依托单位: UNIVERSITY OF CALIFORNIA RIVERSIDE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-08 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588266
• 关键词: 2 year old; Address; Adult; Affect; Age; Age Months; American; Attitude; Behavioral; Cardiovascular Diseases; Caregivers; Child; Child Behavior; Childhood; Communities; Data; Development; Diabetes Mellitus; Diet Habits; Disparity; Distal; Eating Behavior; Enrollment; Face; Family; Fostering; Future; Goals; Growth; Habits; Head Start Program; Health; Health Disparities Research; Healthcare Systems; Healthy Eating; Hispanic; Infant; Infant Care; Intervention; Interview; Knowledge; Latino; Latino Population; Length; Life; Longitudinal Studies; Longitudinal Surveys; Low income; Malignant Neoplasms; Modeling; Morbid Obesity; Mothers; Obesity; Outcome; Parenting Education; Parents; Perception; Physical environment; Politics; Population; Preschool Child; Prevalence; Prevention; Prevention program; Productivity; Public Health; Randomized, Controlled Trials; Research; Risk; Role; Social Environment; Testing; Toddler; Translating; Translations; Trust; United States; United States National Institutes of Health; Variant; Weight; aged; cardiovascular risk factor; cohort; comorbidity; comparison intervention; critical period; early childhood; ethnic disparity; ethnic minority; feeding; grandparent; high body mass index; improved; infancy; infant adiposity; infant nutrition; infant outcome; intervention refinement; lower income families; maternal outcome; nutrition; nutrition education; obesity in children; obesity prevention; obesity risk; parental role; pilot test; programs; racial disparity; social; socioeconomic disparity; stem

PROJECT SUMMARY The prevalence of obesity in early life remains unacceptably high, especially among low-income children, most of whom are ethnic minorities. Marked ethnic disparities are evident by two years of age, which suggests that existing interventions are not adequate. Early prevention is critical, especially for low-income children. For example, among Latino children high body mass index during infancy renders them three times more likely than other children to be obese by age 6. The disparity observed at this young age presents a window of opportunity to intervene early through existing nutrition programs that foster healthful eating habits, which track into childhood and continue into adulthood. Yet, few prevention programs intervene during infancy, and those that do, do not incorporate feeding styles and practices into nutrition education, do not account for the involvement of caregivers other than parents in infant feeding, and/or 3) start too late. The proposed research addresses these gaps by moving beyond healthy eating to better understand and promote healthy feeding. Using a community-based participatory approach, the proposed research aims to 1): conduct a longitudinal study to characterize the caregiver context of infant feeding in low-income families and 2) develop and pilot test an enhanced intervention compared to EHS' existing nutrition education program. For Aim 1, we will create a cohort of 300 mother-infant dyads who will participate in a longitudinal survey to examine the relation of infant feeding styles and practices to infant growth and obesity. A subsample of 36 mothers and 36 trusted other caregivers, identified by the mothers, will participate in longitudinal qualitative interviews (feeding data debriefings and dyadic interviews) to examine mothers' translation of nutrition education to practice in the context of multiple caregivers. Building on Aim 1, for Aim 2, we will engage EHS-enrolled mothers and other caregivers and EHS staff to develop and refine an enhanced intervention that will include new components on infant feeding styles and practices and the role of other caregivers in infant feeding. We will pilot test the enhanced intervention to produce information on its feasibility, acceptability and preliminary efficacy in promoting healthy feeding. Future research will involve an NIH R01 to test in a randomized controlled trial the effects of the enhanced nutrition education program, relative to those of the existing EHS nutrition education alone, on both mother and infant outcomes, specifically, the proximal outcomes of nutrition and feeding styles and practices and the distal outcomes of infant growth and obesity. This project, which focuses on an-at-risk child population, has great potential to address our nation's growing crisis of childhood obesity, which can dramatically improve the health of millions of Latino children, their families, and their future children.

项目概要 生命早期肥胖的患病率仍然高得令人无法接受，特别是在低收入儿童中，大多数 其中有少数民族。明显的种族差异在两岁时就很明显，这表明 现有的干预措施还不够。早期预防至关重要，特别是对于低收入儿童。为了 例如，在拉丁裔儿童中，婴儿期体重指数高使他们的可能性增加三倍 到 6 岁时，他们比其他儿童更容易肥胖。在这个年纪观察到的差异提供了一个窗口 有机会通过现有的营养计划进行早期干预，以培养健康的饮食习惯，这些计划跟踪 进入童年并持续到成年。然而，很少有预防计划在婴儿期进行干预，而且那些 这样做，没有将喂养方式和做法纳入营养教育，没有考虑到 父母以外的照顾者参与婴儿喂养，和/或 3) 开始得太晚。拟议的研究 通过超越健康饮食，更好地理解和促进健康喂养来解决这些差距。 使用基于社区的参与方法，拟议的研究旨在 1)：进行纵向研究 研究描述低收入家庭婴儿喂养的护理人员背景，2) 开发和试点测试 与 EHS 现有的营养教育计划相比，这是一项增强的干预措施。对于目标 1，我们将创建一个 由 300 名母婴二人组成的队列，他们将参加一项纵向调查，以检查婴儿的关系 喂养方式和做法对婴儿生长和肥胖的影响。由 36 名母亲和 36 名信任的其他人组成的子样本 由母亲确定的照顾者将参加纵向定性访谈（喂养数据 情况汇报和双向访谈）以检查母亲将营养教育转化为实践的情况 多个照顾者的背景。在目标 1 的基础上，对于目标 2，我们将让参加 EHS 的母亲和其他人参与进来 护理人员和 EHS 工作人员制定和完善强化干预措施，其中包括以下方面的新组成部分： 婴儿喂养方式和做法以及其他护理人员在婴儿喂养中的作用。我们将进行试点测试 加强干预，以提供有关其可行性、可接受性和初步效果的信息 促进健康喂养。未来的研究将涉及 NIH R01 在随机对照试验中测试 强化营养教育计划相对于现有 EHS 营养教育的效果 单独而言，对母亲和婴儿的结果，特别是营养和喂养方式的近期结果 婴儿生长和肥胖的实践和远端结果。该项目重点关注高危人群 儿童人口，具有解决我国日益严重的儿童肥胖危机的巨大潜力，这可以 极大地改善了数百万拉丁裔儿童、他们的家庭以及他们未来孩子的健康。