A Hybrid Mobile Phone Family Intervention to Prevent Childhood Obesity

项目摘要 儿童肥胖对年轻的拉丁裔儿童的影响不成比例。关注2至5岁的肥胖干预 一岁的孩子是关键，因为在这一时期过度增加体重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，中国的许多肥胖行为 成年期，就像看电视和喝含糖饮料一样，从这个年龄开始。最有效的 儿童肥胖干预是植根于行为和家庭系统理论的干预。这两个都是 理论提供了支持生活方式改变的方法，并理解了家庭是主要的 社会影响儿童发展的调解人。然而，到目前为止，大多数基于家庭的干预措施：(1) 专注于一位父母，通常是母亲；(2)错过了利用家庭主义的拉丁裔文化价值的机会 (3)包括冗长的课程，要求 每周面对面会谈，为期2至6个月。拟议研究的基本原理是解决 这些缺点是通过评估基于社区的干预的有效性来实现的，该干预措施的时间更短，而且 涉及多个家庭照顾者。干预将包括面对面和移动电话组件 侧重于年幼儿童的拉丁裔照顾者，以支持循证和适龄饮食， 在2至5岁儿童中进行媒体观看和体育锻炼，以减少种族 儿童肥胖症的差异。这项研究还将探索干预措施使公众人数成倍增长的潜力 通过降低成年照顾者的肥胖风险而有益于健康。将采用前瞻性随机研究设计。 评价以家庭为基础的儿童肥胖干预对6个月龄儿童体重指数的影响 (主要结果)和12个月(次要结果)，与通常的WIC护理组相比。这项研究 将随机抽取约260名2至5岁儿童的拉丁裔成年照顾者(每个儿童2名照顾者) 其中一半将被分配到干预组，另一半将作为对照组。所有家庭都会 从洛杉矶县的四个WIC中心招募。主要和次要成果将包括：(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 干预组与WIC常规护理组BMI的变化；(4)照顾者饮食、身体状况的变化 活动量和体重。干预前和干预后的人体测量和调查数据将在基线、1-、 基线后6个月和12个月评估干预对儿童BMI和体重相关影响的大小 实践，并探索家庭机制是否缓和了干预对儿童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.