Father-Focused Nutrition and Parenting Program to Help Prevent Childhood Obesity in Preschool Age Children

 描述(由申请人提供)：大约四分之一的2-5岁儿童超重或肥胖，其中非裔美国人、西班牙裔和低收入儿童超重或肥胖的比例较高。低收入儿童及其家庭肥胖的某些风险因素包括：比高收入儿童消费更多的方便食品，摄入更多的含糖饮料，以及总蔬菜、深绿色和橙色蔬菜、豆类和全谷物的饮食质量得分较低。在考虑低收入家庭预防肥胖的潜在新干预目标时，父亲们花在孩子身上的时间比过去更多，也越来越多地参与到孩子的生活中。与母亲类似，父亲也表达了对孩子挑食的困难和失望，并报告说，他们使用了不受欢迎的喂养方式，如贿赂，让孩子吃东西。此外，由于父亲的体重可能比母亲的体重更能预测孩子的体重，如果只涉及母亲，而不确定父亲的独特影响，儿童肥胖干预可能不会成功。因此，拟议研究的具体目标是进行一项试点可行性试验， 对低收入的父亲/孩子二人组进行研究，为未来的随机对照试验(RCT)提供信息，包括：a)测试招募/保留方法、干预提供、评估方法和措施的可行性；b)比较DAD干预和等待名单对照干预，以计算结果的影响大小，包括与食物有关的育儿做法、用餐时间行为和做法，以及父亲/孩子的营养和体力活动行为。其他目的将探索DAD干预对父亲/孩子饮食质量和BMI/BMI z分数的有效性，以及结果衡量标准和潜在中介变量之间的关系。父子二人组(n=60)将参加8节(2小时/节)干预(DAD)，包括营养和家长教育，并在节间推广技术。二人一组将被随机分配给父亲或等待名单对照组，每组10人。评估将在前、后和1个月后进行，包括同居母亲的数据子集，以评估对结局的缓和影响。建议的干预措施将评估和探索低收入父亲对他们的学龄前儿童肥胖行为和肥胖风险的独特影响。将营养和父母教育结合起来，同时针对儿童肥胖预防的新人群--低收入父亲，这一创新将为未来的随机对照试验和美国将实施的计划提供证据，特别是针对参与联邦资助的营养的高危家庭 援助计划。

 DESCRIPTION (provided by applicant): Approximately one quarter of children between the ages of 2 and 5 years are overweight or obese with higher rates among African American, Hispanic and low-income children. Certain risk factors for obesity in low- income children and their families include consumption of more convenience food than their higher income counterparts, higher intake of sugar sweetened beverages and lower diet quality scores for total vegetables, dark green and orange vegetables, legumes, and whole grains. When considering potential novel intervention targets for obesity prevention in low-income families, fathers are spending more time with their children than they have in the past and becoming much more involved in their children's lives. Similar to mothers, fathers have expressed difficulty and frustration with children being picky eaters, and report using undesirable feeding practices, such as bribing, to get their children to eat. Furthermore, because a father's weight may be a stronger predictor of a child's weight than a mother's weight, childhood obesity interventions may be unsuccessful if they only involve mothers and do not determine the unique influences of fathers. Therefore, the specific aims of the proposed research are to conduct a pilot feasibility trial with low-income father/child dyads to inform a future randomized controlled trial (RCT) including: a) Testing feasibility of recruitment/retention methods, intervention delivery, evaluation methods and measures; b) Comparing the DAD intervention with a wait-list control intervention to calculate effect sizes for outcomes including food- related parenting practices, mealtime behaviors and practices, and father/child nutrition and physical activity behaviors. Additional aims will explore the effectiveness of the DAD intervention on father/child diet quality and BMI/BMI z-score and the relationship between outcome measures and potential mediating variables. Father and child dyads (n=60) will enroll in an 8 session (2 hours/session) intervention (DAD) including nutrition and parent education with between-session technology enhancement outreach. Dyads will be randomly assigned within groups of 10 to DAD or a wait-list control group. Assessments will be conducted at pre, post and 1 month post including a subset of data from cohabiting mothers to assess moderating influences on outcomes. The proposed intervention will evaluate and explore the unique influences that low-income fathers have on their preschool age children's obesogenic behaviors and obesity risk. The innovation of combining nutrition and parent education while targeting a novel population, low income fathers, for childhood obesity prevention will provide evidence for future RCTs and programs to be implemented in the US especially for high risk families participating in federally funded nutrition assistance programs.