Improving feeding practices for child diet and weight in low income families

描述（由申请人提供）：改善低收入家庭儿童饮食和饮食的喂养方法本研究的长期目标是制定和测试父母喂养策略，用于R01应用，以减少儿童肥胖和改善低收入群体的饮食质量。具体目标是：目标1)定义影响低收入家庭3-5岁儿童体重状况和饮食摄入的父母喂养控制做法的结构；目的2)检验和估计一个解释父母喂养方式如何影响儿童饮食质量和体重状况的模型；目标3)开发和试点测试一种基于视频的互动教育干预，以改善父母的喂养方式，优化儿童的体重和食物摄入量。这些目标的实现反映了NIH的使命，即通过传播健康信息，提供减少儿童肥胖和改善饮食质量的手段，应用生命系统行为的知识来延长健康生命和减轻疾病负担。这项横断面研究将针对来自密歇根州大兰辛市26个Head Start站点的约400名3-5岁的母子二人组，分两个阶段进行。第一阶段将使用横断面设计来开发一种工具，以调查三种父母喂养方式与儿童营养密集和能量密集食物的摄入量之间的关系，以及控制母亲体重状况和儿童久坐活动的儿童体重状况（n=330）。对于仪器，验证性分析，Cronbach's alpha和重测信度将被使用。此外，将进行结构方程建模来检验变量之间的关系。第二阶段将使用第一阶段的工具和框架的结构来开发和试点测试基于视频的交互式教育干预措施，以改善父母的喂养方式、儿童饮食质量和儿童体重状况。目标是为交互式DVD制作六个短视频片段，其中包含菜单选择选项，并使用它来教育非指令和食品环境类型的控制，激发小组讨论。交互式视频干预将进行试点测试，并使用形成性评估和结果评估进行评估。结果评估将包括使用第一阶段开发的工具中的看护者喂养行为结构，以及在前后测试中儿童的食物摄入量和体重状况。

DESCRIPTION (provided by applicant): Improving feeding practices for child diet and eight in low income families The long-term objective of this study is to develop and test parental feeding strategies for an R01 application to reduce childhood obesity and improve diet quality among low-income groups. The specific aims are to: Aim 1) Define constructs of parental feeding control practices that influence weight status and dietary intake of 3-5 yr children from low-income families; Aim 2) Test and estimate a model that explains how parental feeding practices affect the diet quality and weight status the children; and Aim 3) Develop and pilot test an video- based interactive educational intervention to improve parents' feeding practices to optimize the child's weight and food intake. Achievement of these aims reflect the NIH's mission to apply knowledge of behavior of living systems to extend healthy life and reduce the burden of illness by providing a means to reduce child obesity and improve diet quality via dissemination of information in health. This cross sectional study will target about 400 mother-child dyads, children ages 3-5 yr, from 26 Head Start sites in greater Lansing, Michigan and be conducted in 2 phases. Phase 1 will use a cross-sectional design to develop an instrument to investigate relationships among the three types of parental feeding practices and the child's intake of nutrient-dense and energy-dense foods and child weight status controlling for maternal weight status and the child's sedentary activity (n=330). For the instrument, confirmatory analysis, Cronbach's alpha and test-retest reliability will be used. Furthermore, structural equation modeling will be conducted to test the relationships among the variables. Phase 2 will use the constructs from the instrument and framework in Phase 1 to develop and pilot test a video-based, interactive educational intervention to improve parental feeding practices, child diet quality and child weight status. The goal is to produce six short length video segments for an interactive DVD with menu selection options and use it educate about non-directive and food environmental types of control, stimulating small group discussion. The interactive video intervention will be pilot tested and evaluated using formative and outcome evaluation. Outcome evaluation will include use of the caregiver feeding behavior constructs from the instrument developed in the Phase 1 and the child's food intake and weight status in a pre- post test. PUBLIC HEALTH RELEVANCE: Developing and testing a model about how parental feeding control practices affect the diet and weight status of 3-5 year old children from low income families is important to address the child obesity epidemic. Community applications of the model will be as an interactive educational video to be used in Head start parent meetings and other sites to help parents improve their feeding practices for good child diet quality and weight status. Achieving the study objectives should extend healthy life and reduce the cost of illness by distribution of health information in a meaningful way to parents from families with low income.