Healthy Home Offerings via the Mealtime Environment (HOME) Plus

通过用餐环境 (HOME) Plus 提供健康的家庭产品

• 批准号: 8090392
• 负责人: Jayne Allyn Fulkerson
• 金额: $ 64.94万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8090392
• 关键词: 12 year old; Address; Area; Attention; Behavior; Behavioral; Beverages; Body mass index; Calories; Child; Clinical Trials Design; Collaborations; Communities; Computers; Consumption; Eating; Environment; Family; Family member; Food; Frequencies; Gatekeeping; Goals; Health Promotion; Home environment; Influentials; Intake; Intervention; Measurement; Methods; Minnesota; Neighborhoods; Obesity; Parents; Physical activity; Pilot Projects; Play; Prevention; Prevention approach; Prevention program; Prevention strategy; Process Measure; Psychological reinforcement; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Relative (related person); Reporting; Research; Research Training; Role; School-Age Population; Services; System; Telephone; Television; Testing; Translations; Treatment Efficacy; United States National Institutes of Health; Universities; Weight; Weight Gain; Work; after-school program; arm; base; cohort; community setting; design; efficacy testing; environmental intervention; follow-up; innovation; intervention effect; intervention program; metropolitan; nutrition; obesity in children; obesity prevention; post intervention; prevent; primary outcome; programs; public health relevance; randomized trial; role model; secondary outcome; sedentary; social cognitive theory; sound; tv watching

DESCRIPTION (provided by applicant): Childhood obesity is a serious public health problem with limited effective prevention strategies to date. Although previous nutrition and physical activity environmental approaches for obesity prevention show some promise, most studies have not shown reductions in excess weight gain. Moreover, few prevention studies significantly engage parents and focus on the home environment. To prevent childhood obesity it is essential to promote healthy behaviors in the home environment because parents are influential primary role models for healthy eating and sedentary behavior, and are gatekeepers for food and beverage availability and degree of inactivity within the home. Moreover, the home setting is where most of children's calories and energy dense foods are consumed and where children engage in much of their sedentary behavior, particularly screen time (e.g., television, computer, game system). The proposed study will test the efficacy of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus program, a year-long, family-based health promotion intervention to prevent excess weight gain among 8-12 year old children. The program is based on Social Cognitive Theory and a socio-ecological framework and promotes both regular and nutritionally-sound snacks and meals in which family members eat together (i.e., family meals) and encourages reductions in sedentary behavior, particularly screen time among children in the home setting. The efficacy of the intervention will be tested in a randomized controlled trial with 160 families randomized to two conditions (intervention or attention- only control). Two cohorts of families, recruited from before- and after-school programs and community centers, will be followed for 2.5 years. The primary hypothesis is that, by the end of the 12-month intervention, target children in the intervention families, relative to children in the control families, will have significantly lower body mass index (BMI; primary outcome) after adjustment for baseline BMI values. Secondary outcomes include frequency of weekly family meals and number of healthful foods and beverages available in the home and served at family meals and snacks (as reported by parent), target children's daily intakes of healthful foods and beverages, and target children's minutes of sedentary behavior per week, particularly screen time. Child and parent measurement will occur in their homes at baseline, post-intervention (12-months post- randomization), and follow-up (9-months post-intervention) by trained research staff. The proposed study builds upon successful methods from our HOME pilot study (2006-2008; NIH R21-DK0072997) and is innovative as it actively engages entire families in experiential activities and capitalizes on the home setting. The study will provide important information on environmental and behavioral strategies that families can use at home to prevent excess weight gain. The intervention program has high translation potential and is likely to be immediately useful to families of school-age children because it will be tested in real-world community settings and sustained across the state of Minnesota by the University of Minnesota's Extension Service. PUBLIC HEALTH RELEVANCE: The goal of the proposed project is to see if an innovative family-based intervention that focuses on making healthful food changes, especially at family meals, and reducing screen time (TV, game systems) within the home can prevent children from gaining more weight than they need to as they grow. The study will provide important information on strategies that families can use at home to prevent obesity. The intervention program is likely to be immediately useful to families of school-age children because it will be tested in real-world community settings.

描述（由申请人提供）：儿童肥胖症是一个严重的公共卫生问题，迄今为止有效的预防策略有限。虽然以前的营养和身体活动环境方法预防肥胖显示出一些希望，但大多数研究并没有显示出多余体重增加的减少。此外，很少有预防研究能让父母参与，并将重点放在家庭环境上。为了预防儿童肥胖，必须在家庭环境中促进健康行为，因为父母是健康饮食和久坐行为的重要榜样，并且是家庭内食物和饮料供应以及不活动程度的守门人。此外，家庭环境是儿童消耗大部分卡路里和能量密集食物的地方，也是儿童进行大部分久坐行为的地方，特别是屏幕时间（例如，电视、计算机、游戏系统）。这项拟议的研究将通过膳食环境（HOME）Plus计划测试健康家庭办公室的功效，这是一项为期一年的以家庭为基础的健康促进干预措施，旨在防止8-12岁儿童体重过度增加。该计划以社会认知理论和社会生态框架为基础，促进家庭成员一起吃饭的定期和营养健康的零食和膳食（即，家庭用餐），并鼓励减少久坐不动的行为，特别是在家庭环境中的儿童屏幕时间。干预的有效性将在一项随机对照试验中进行测试，160个家庭随机分为两种情况（干预或仅注意控制）。两组家庭，从学前和课后计划和社区中心招募，将被跟踪2.5年。主要假设是，在12个月的干预结束时，相对于对照家庭的儿童，干预家庭的目标儿童在校正基线BMI值后将具有显著较低的体重指数（BMI;主要结局）。次要结果包括每周家庭用餐的频率和家庭中提供的健康食品和饮料的数量以及家庭用餐和零食（由父母报告），目标儿童每天摄入的健康食品和饮料，以及目标儿童每周久坐行为的分钟数，特别是屏幕时间。在基线、干预后（随机化后12个月）和随访（干预后9个月）时，由经过培训的研究人员在家中对儿童和父母进行测量。拟议的研究建立在我们的HOME试点研究（2006-2008; NIH R21-DK 0072997）的成功方法的基础上，并且具有创新性，因为它积极地使整个家庭参与体验活动并利用家庭环境。这项研究将提供有关环境和行为策略的重要信息，家庭可以在家中使用这些策略来防止体重过度增加。该干预计划具有很高的转化潜力，很可能对学龄儿童的家庭立即有用，因为它将在现实世界的社区环境中进行测试，并由明尼苏达大学推广服务部在明尼苏达州各地持续进行。 公共卫生关系：拟议项目的目标是看看一个创新的家庭为基础的干预，重点是使健康的食物变化，特别是在家庭用餐，并减少屏幕时间（电视，游戏系统）在家里可以防止儿童获得更多的体重比他们需要的成长。这项研究将提供重要的信息，家庭可以在家里使用的战略，以防止肥胖。该干预计划可能会立即对学龄儿童的家庭有用，因为它将在现实世界的社区环境中进行测试。