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A Multi-Level Intervention to Promote Healthy Beverage Intake through Childcare

通过儿童保育促进健康饮料摄入的多层次干预

基本信息

批准号：
10627934
负责人：
Anisha Indravadan Patel
金额：
$ 61.3万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-24 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10627934
关键词：
5 year old Adult Affect Age Beverages Body mass index California Calories Caregivers Child Child Care Cluster randomized trial Consumption Counseling Development Early Intervention Education Energy Intake Environment Family Food Future Goals Health Height Home Hour Intake Intervention Juice Latino Liquid substance Low income Magic Measurement Measures Mediating Mediator Metabolic Modeling Motivation Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Overweight Parents Persons Pilot Projects Policies Prevention Prevention strategy Public Health Randomized, Controlled Trials Research Risk Schools Science Self Administration Self Efficacy Source Surveys Treatment Efficacy Water consumption Weight aged behavior change cardiometabolism care providers comorbidity dietary early childhood efficacy testing expectation food environment improved intervention effect non-alcoholic fatty liver disease nutrition obesity in children obesity prevention post intervention prevent primary outcome secondary outcome social social cognitive theory sugar sweetened beverage wasting

项目摘要

PROJECT SUMMARY There is little debate that sugar-sweetened beverages (SSBs; drinks with added sugar) lack nutrition, are a major source of added sugar and calories, and promote obesity and poor cardiometabolic health, especially when consumed during early childhood. Nearly half of children aged 2-5 drink SSBs on a daily basis, with heavier consumption in low-income Latino children. After decades of research, it is clear that there is no single “magic bullet” for solving obesity. What we need are bundled interventions that combine incremental changes that transform food environments with targeted behavior changes that steer people towards those healthy options. Childcare centers, which serve 12.5 million children per year, provide an efficient way to intervene early by engaging childcare providers and parents to make resonant, mutually reinforcing changes in both the home and childcare environment. Interventions that promote water consumption in place of SSBs have shown promise for preventing childhood obesity in schoolchildren. Yet, no studies have examined whether interventions to promote intake of water instead of SSBs in childcare could prevent childhood obesity at an even earlier stage of development. The proposed cluster-randomized controlled trial will test the efficacy of an intervention called Healthy Drinks, Healthy Futures (Bebidas Saludables, Futuros Saludables) that is culturally adapted for Latino children and families. Following the Social-Ecological Model and Social Learning Theory, the intervention supports complementary changes in the childcare and home food environments that promote water consumption while reducing SSB availability. This is combined with education for childcare providers and children, and a one-on-one brief motivational counseling intervention with parents to reduce SSB intake and encourage water consumption in the home. Fourteen childcare centers serving low-income, predominately Latino children (n=420) will participate in this trial. The primary outcome is child BMI z-score (BMI standard deviation score). Key secondary outcomes are intake of water and beverage calories at centers and at home. Outcomes will be captured using anthropometrics (weight, height), plate waste measurements (water and caloric intake at centers), and Automated Self-Administered 24-hour dietary recalls (water and caloric intake at home) at baseline, 6, and 12 months post-intervention. Surveys of childcare providers and parents will allow us to explore possible mediators of the intervention effect. We hypothesize that the childcare-based healthy beverage intervention will increase intake of water and reduce beverage calories consumed at both childcare and at home. BMI z-score will also improve among children in intervention centers vs. control centers. If shown to be effective, the Healthy Drinks, Healthy Futures intervention will offer a strategy for intervening early to prevent obesity for millions of low-income children attending childcare centers. Findings from this study will contribute to the science of multilevel obesity prevention, and inform the implementation of state, federal, and local policies to promote healthy beverage intake in childcare centers.

项目总结