Evaluating a Novel Responder-Recommender System in a Deployment of Ecological Momentary Intervention to Effect Change in the Home Food Environment and Reduce Child Cardiometabolic Risk (C. Okitondo)

评估部署生态瞬时干预以影响家庭食物环境变化并降低儿童心脏代谢风险的新型响应者推荐系统（C. Okitondo）

• 批准号: 10629608
• 负责人: Jerica M Berge
• 金额: $ 4.65万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10629608
• 关键词: African American; Age; Atmosphere; Behavior; Body mass index; Cellular Phone; Child; Clinic; Community Health Aides; Diet; Ecological momentary assessment; Ethnic Origin; Family; Family member; Feedback; Fibrinogen; Frequencies; Health Technology; Health behavior; Healthy Eating; Hispanic; Home; Home visitation; Household; Individual; Intervention; Intervention Studies; Low income; Maintenance; Methodology; Methods; Modeling; Native Americans; Obesity; Overweight; Parents; Phase; Pilot Projects; Primary Health Care; Race; Randomized; Research; Risk; Self Efficacy; Socioeconomic Status; Stress; System; Systems Theory; Testing; Time; Weight; arm; base; behavior change; cardiometabolic risk; clinical practice; dietary; efficacy trial; family support; food environment; food quality; indexing; innovation; mHealth; novel; obesity in children; obesity risk; obesity treatment; primary outcome; recruit; secondary outcome; success; three-arm study; virtual; virtual delivery

Abstract The low to moderate success with childhood obesity interventions to date and the persistent obesity disparities across race/ethnicity and socioeconomic status indicate the need to approach childhood obesity in a new and innovative way. Building on the last three decades of research on childhood obesity, the main objective of the proposed study is to utilize state-of-the-art intervention methods including ecological momentary intervention (EMI), video feedback, and home visiting methods in partnership with primary care clinics and Community Health Workers (CHWs) to examine whether increasing the quality of family meals (i.e., dietary quality, interpersonal atmosphere) and quantity of family meals (i.e., frequency of meals) reduces childhood obesity. Numerous studies have shown significant associations between family meal frequency and child weight and weight-related behaviors (e.g., better diet quality, lower weight status). Research has also shown that the quality of family meals, including dietary quality of the food served at family meals and the interpersonal atmosphere during family meals, is associated with decreased childhood obesity risk. In addition, prior intervention research has shown that immediate feedback on health behaviors (e.g., EMI, video feedback) increases the likelihood of behavior change. Thus, the proposed individual randomized controlled efficacy trial, based on our pilot study, tests combinations of the above factors (i.e., EMI, home visiting, video feedback) across three study arms: (1) EMI; (2) EMI+Home Visiting (HV) with a Community Health Worker (CHW)+Video Feedback; and (3) EMI+HV with CHW+Video Feedback+Virtual. All arms will receive 16 weeks of EMI family meal tip messages delivered via smartphones. Arms 2 and 3 will additionally receive home visiting (eight in- home visits; eight “Try it Yourself” activities) focused on family meal quality and quantity and a family meal prep activity delivered by a CHW simultaneously with 16 weeks of EMI, as well as video feedback on family meal behavior. Arm 3 will additionally be delivered virtually. All arms will receive an 8-week maintenance phase allowing for progressively less support of families so they can increase self-efficacy and sustainability of behavior change. The intervention will be carried out for 6 months with children at risk for overweight/obesity (i.e., BMI ≥75%ile) who are ages 5-10 years (n=510), from low income and diverse households (i.e., African American, Hispanic, Native American, White). Eligible children will be recruited through primary care clinics. Drawing on Family Systems Theory, the intervention aims to change individual and family-level behaviors. Specifically, the intervention will be delivered to the family unit and primary outcomes include child weight (i.e., BMI %ile) and diet quality (i.e., Healthy Eating Index). Secondary outcomes include parent and other family member’s weight and weight-related behaviors. This study will change clinical practice by creating a new model for childhood obesity treatment in primary care using CHWs as interventionists and mobile health technology to intervene in real-time on parental stress and the home food environment to reduce obesity.

摘要 迄今为止，儿童肥胖干预的低至中等成功率和持续的肥胖差异 在种族/民族和社会经济地位之间的差异表明，需要以一种新的、 创新的方式。在过去三十年儿童肥胖研究的基础上， 拟议的研究是利用最先进的干预方法，包括生态瞬时干预 (EMI)、视频反馈以及与初级保健诊所和社区合作的家访方法 卫生工作者（CHW）检查是否提高家庭膳食的质量（即，饮食质量， 人际氛围）和家庭膳食的数量（即，饮食频率）减少儿童肥胖。 许多研究表明，家庭用餐频率和儿童体重之间存在显着联系， 与体重相关的行为（例如，更好的饮食质量，更低的体重状态）。研究还表明， 家庭膳食的质量，包括家庭膳食中提供的食物的饮食质量和人际关系， 家庭用餐时的气氛，与降低儿童肥胖风险有关。此外，事先 干预研究表明，对健康行为的即时反馈（例如，EMI、视频反馈） 增加了行为改变的可能性。因此，拟定的个体随机对照疗效试验， 基于我们的试点研究，测试上述因素的组合（即，EMI、家访、视频反馈） 三个研究组：（1）EMI;（2）EMI+社区卫生工作者（CHW）上门访视（HV）+视频 （3）EMI+HV + CHW+视频反馈+虚拟。所有武器将获得16周的EMI家庭 通过智能手机发送的用餐提示信息。第2组和第3组还将接受家访（8次， 家庭访问;八个“自己尝试”活动），重点是家庭膳食的质量和数量以及家庭膳食准备 由CHW提供的活动与16周的EMI同时进行，以及家庭用餐的视频反馈 行为第3组将另外以虚拟方式交付。所有武器将接受为期8周的维持阶段 允许逐步减少对家庭的支持，以便他们能够提高自我效能和可持续性， 行为改变干预将在超重/肥胖风险儿童中进行6个月 (i.e., BMI ≥75%ile），年龄5-10岁（n=510），来自低收入和不同家庭（即，非洲 美国人、西班牙人、美洲原住民、白色）。合格的儿童将通过初级保健诊所招募。 根据家庭系统理论，干预措施旨在改变个人和家庭层面的行为。 具体而言，干预将交付给家庭单位，主要结果包括儿童体重（即， BMI %ile）和饮食质量（即，健康饮食指数）。次要结局包括父母和其他家庭 成员的体重和体重相关的行为。这项研究将通过创造一种新的 在初级保健中使用CHW作为干预者和移动的健康的儿童肥胖症治疗模式 实时干预父母压力和家庭食物环境的技术，以减少肥胖。