A Hybrid Mobile Phone Family Intervention to Prevent Childhood Obesity

项目摘要 儿童肥胖对拉丁裔儿童的影响不成比例。肥胖干预措施侧重于2- 5岁 年龄是至关重要的，因为在这一时期体重过度增加会增加青少年和成年人的风险。 超重并对以后的健康问题有重要影响。此外，许多肥胖的行为， 成年，就像看电视和喝含糖饮料一样，开始于这个年龄。最有效的 儿童肥胖干预是那些植根于行为和家庭系统理论。这两 理论提供了支持生活方式改变的方法，并理解家庭是主要的 社会影响对儿童发展的中介。然而，迄今为止，大多数基于家庭的干预措施：（1） 专注于父母中的一方，通常是母亲;（2）错过了利用拉丁美洲家庭主义文化价值的机会 (i.e.家庭联系），以影响儿童肥胖的结果;（3）包括冗长的课程， 在2至6个月的时间内，每周进行一次面对面的会议。拟议研究的理由是， 通过评估以社区为基础的干预措施的有效性， 涉及多个家庭照顾者。干预将包括面对面和移动的电话组件 重点是拉丁美洲照顾幼儿，以支持基于证据和年龄适当的饮食， 在2至5岁的儿童中开展媒体观看和体育活动，以减少种族歧视。 儿童肥胖的差异。这项研究还将探讨干预措施增加公众数量的潜力。 通过降低成年看护者肥胖风险而有益健康。将采用前瞻性随机研究设计 评估以家庭为基础的儿童肥胖干预对6个月时儿童BMI的有效性 （主要结局）和12个月时（次要结局），与常规WIC护理组相比。研究 将随机分配约260名2至5岁儿童的拉丁美洲成年看护人（每名儿童2名看护人） 一半人被分配到干预组，另一半人作为对照组。所有的家庭都会 从洛杉矶县的四个WIC中心招募。主要和次要结局将包括：（1） 6个月和12个月时儿童BMI结果的变化;（2）儿童饮食，媒体观看和身体状况的变化 活动实践;（3）家庭主义是否减弱或放大了干预对儿童差异的影响 干预组和WIC常规护理组之间的BMI变化;以及（4）护理人员的饮食，身体 活动和体重。干预前和干预后的人体测量和调查数据将在基线时收集， 基线后6个月和12个月，以估计对儿童BMI和体重相关的干预效应大小。 的做法，并探讨家庭机制是否适度干预对儿童BMI的影响。

Project Summary Child obesity disproportionately impacts young Latino children. Obesity interventions focusing on 2- to 5- year-olds are critical as excessive weight gain during this period increases the risk of adolescent and adult overweight and has important implications for later health problems. Moreover, many obesogenic behaviors in adulthood, like television viewing and consumption of sugary drinks, begin at this age. The most effective childhood obesity interventions are those rooted in behavior and family systems theories. Both of these theories provide approaches to support lifestyle changes with an understanding that family is the major mediator of social influences on a child’s development. To date, however, most family-based interventions: (1) focus on one parent, typically mothers; (2) miss the opportunity to leverage the Latino cultural value of familism (i.e. family connectedness) to impact childhood obesity outcomes; and (3) include lengthy curricula requiring weekly in-person sessions over a 2- to 6-month time period. The rationale for the proposed study is to address these shortcomings by evaluating the effectiveness of a community-based intervention that is shorter and involves multiple family caregivers. The intervention will include in-person and mobile phone components focusing on Latino caregivers of young children, to support evidence-based and age appropriate dietary, media-viewing, and physical activity practices among 2- to 5-year old children, in order to decrease ethnic disparities in childhood obesity. The study will also explore the intervention’s potential to multiply the public health benefit by reducing obesity risk for adult caregivers. A prospective randomized study design will be used to evaluate the effectiveness of the family-based childhood obesity intervention on child BMI at 6- months (primary outcome) and at 12 months (secondary outcome), compared to a usual WIC care group. The study will randomize approximately 260 adult Latino caregivers of 2- to 5-year old children (2 caregivers per child) and half will be assigned to the intervention, and the other half will serve as the control group. All families will be recruited from four WIC Centers in Los Angeles County. Primary and secondary outcomes will include: (1) changes in child BMI outcomes at 6- and 12 months; (2) changes in child dietary, media-viewing, and physical activity practices; (3) whether familism attenuates or amplifies the intervention’s effect on differences in child BMI change between intervention and WIC usual care group; and (4) changes in caregiver’s dietary, physical activity, and weight. Pre- and post-intervention anthropometric and survey data will be collected at baseline, 1-, 6-, and 12-months post-baseline to estimate the intervention effect size on child BMI and weight-related practices, and explore whether familial mechanisms moderate the intervention’s effect on child BMI.