Concordance between Ecological Momentary Assessment (EMA) and Video-recorded Direct Observational Measures of Family Meal Healthfulness (Admin Supplement Gap Year Khadija Mohamed)

生态瞬时评估 (EMA) 与家庭膳食健康录像直接观察措施之间的一致性（行政补充间隔年 Khadija Mohamed）

• 批准号: 10629932
• 负责人: Jerica M Berge
• 金额: $ 6.29万
• 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 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10629932
• 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; Measures; Methodology; Methods; Modeling; Native Americans; Obesity; Overweight; Parents; Phase; Pilot Projects; Primary Health Care; Race; Randomized; Research; Risk; Self Efficacy; Socioeconomic Status; Stress; Systems Theory; Testing; Time; Weight; arm; base; behavior change; clinical practice; dietary; efficacy trial; family support; food environment; food quality; indexing; innovation; mHealth; 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.

抽象的 迄今为止，儿童肥胖干预措施的成功率较低到中等，并且肥胖差异持续存在 跨种族/族裔和社会经济地位的调查表明，需要以一种新的方式来解决儿童肥胖问题。 创新的方式。以过去三十年对儿童肥胖的研究为基础，该项目的主要目标是 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)、视频反馈和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质量（即膳食质量、 人际氛围）和家庭进餐数量（即进餐频率）可以减少儿童肥胖。 大量研究表明，家庭进餐频率与儿童体重和体重之间存在显着相关性。 与体重相关的行为（例如，更好的饮食质量、较低的体重状况）。研究还表明， 家庭用餐的质量，包括家庭用餐时提供的食物的饮食质量和人际关系 家庭用餐时的氛围与儿童肥胖风险降低有关。另外，之前 干预研究表明，对健康行为的即时反馈（例如 EMI、视频反馈） 增加行为改变的可能性。 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) 跨越三个研究分支：(1) EMI； (2) EMI+社区卫生工作者(CHW)家访(HV)+视频 反馈; (3) EMI+HV 与 CHW+视频反馈+虚拟。所有手臂都将接受 16 周的 EMI 系列治疗 通过智能手机发送的用餐提示消息。第 2 组和第 3 组还将接受家访（八名 家访；八项“自己尝试”活动）重点关注家庭膳食的质量和数量以及家庭膳食的准备 由 CHW 与 16 周 EMI 同步进行的活动，以及家庭用餐的视频反馈 行为。第 3 臂也将通过虚拟方式交付。 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 行为改变。 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 美国人、西班牙裔、美洲原住民、白人）。符合条件的儿童将通过初级保健诊所招募。 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 会员的体重和与体重相关的行为。 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.