Family-based Intervention for Preventing Obesity and Reducing Cancer Risk in Chil

以家庭为基础的预防儿童肥胖和降低癌症风险的干预措施

• 批准号: 9120338
• 负责人: Temitope O Erinosho
• 金额: $ 11.07万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-23 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9120338
• 关键词: 5 year old; Adult; Affect; Behavior; Behavior Therapy; Body mass index; Breast; Cancer Prevention Intervention; Cause of Death; Cessation of life; Characteristics; Child; Child Rearing; Childhood; Colorectal; Communication; Data; Development; Diet; Dietary intake; Educational process of instructing; Educational workshop; Effectiveness; Elderly; Equation; Family; Family history of; Foundations; Funding; Goals; Grant; Health; Healthy Eating; Home environment; Incidence; Intervention; Journals; K-Series Research Career Programs; Kidney; Life; Link; Low income; Malignant Neoplasms; Measures; Mediating; Mentorship; Methods; Modeling; North Carolina; Obesity; Obesity associated cancer; Outcome; Outcome Study; Parents; Peer Review; Personal Satisfaction; Persons; Physical activity; Play; Postmenopause; Preschool Child; Preventive Intervention; Problem Solving; Psychosocial Factor; Public Health; Randomized Controlled Trials; Regression Analysis; Research; Research Personnel; Resources; Risk; Risk Factors; Role; Sampling; Series; Shapes; Social support; Solid; Statistical Data Interpretation; Students; Surveys; Technical Expertise; Testing; Time; Underserved Population; United States; Universities; Weight; Weight Gain; Work; Writing; arm; base; cancer risk; career; design; early childhood; efficacy testing; ethnic minority population; experience; follow-up; grandparent; healthy weight; improved; indexing; innovation; intervention effect; lifetime risk; meetings; nutrition; obesity in children; obesity prevention; obesity risk; physical inactivity; post intervention; prevent; psychosocial; racial and ethnic; secondary outcome; sedentary lifestyle; self esteem; skills; therapy design; working group

DESCRIPTION (provided by applicant): My experience to date has provided a solid foundation in early childhood obesity prevention, particularly in childcare settings, that will sere as a natural launching point for expansion into cancer prevention interventions designed to reach low-income preschool children with a family history of obesity-related cancers. My long-term career goal is to become a successful, independent, externally-funded research investigator, specializing in designing and implementing family-based interventions for the prevention of obesity in childhood that can reduce the lifetime risk for obesity-related cancers, particularly among at-risk and underserved populations. My short-term goals are to: 1) develop scientific and technical skills in: mechanisms linking nutrition, physical activity, and obesity to cancer; and developing and implementing family-based behavioral interventions to prevent obesity in childhood to reduce the incidence of obesity-related cancers in later life among low-income children with a 1st or 2nd degree family history of obesity-related cancers; 2) develop skills for writing grants to become an independent investigator and compete for peer-reviewed funding; and 3) enhance my communication skills through presentations at scientific meetings, writing for peer-reviewed journals, and teaching students. To acquire these skills, I have proposed to take graduate-level courses, participate in workshops, including a research working group and seminars, and develop and pilot-test a behavioral intervention, under the mentorship of a team of accomplished senior researchers at the University of North Carolina-Chapel Hill (UNC-Chapel Hill). RESEARCH Purpose: Obesity contributes to about one-third of all cancer deaths. Having a family history of obesity-related cancers further elevates one's risk for obesity-related cancers. Interventions to prevent the onset of obesity early in life are critical for preventing/reducing the risk of obesity-related cancers in adulthood. Few interventions have focused on preventing obesity in preschool children, particularly those from low-income families, who have a family history of obesity-related cancers. The purpose of the proposed study is to develop and pilot-test a 16-week, family-based intervention that uses the life skills approach to promote healthy weight gain in low-income preschool children (3-5 years old) who have a 1st or 2nd degree family history of obesity- related cancers, to prevent/reduce their risk for obesity-related cancers in adulthood. Methods: Formative research data will be collected to develop the intervention. The intervention will be pilot-tested in a randomized controlled trial among 106 low-income families/parent-child dyads, with change in children's weight status as the primary study outcome. Secondary outcomes include change in: a) children's dietary intakes and physical activity levels; b) parental psychosocial characteristics, and parenting practices related to diet and physical activity; and c), parental dietary intakes, physical activity and weight status. Study outcomes will be assessed at baseline, 16-weeks post-intervention, and at a 2-month follow-up. Statistical Analysis: Multiple regression analyses will be conducted to assess change in child and parent outcomes, respectively, between the intervention and control arm over the16-week intervention, and at the 2-month follow-up, controlling for demographic characteristics. Structural equation modeling will be used to determine whether the effects of the intervention on children's diet and physical activity are mediated by changes in the targeted parental psychosocial variables and parenting practices related to diet and physical activity. ExpectedOutcomes/Hypothesis: At the end of the16-week intervention, children in the intervention arm will have: a) healthier weight gain; b) healthier dietary intakes, as measured by higher Healthy Eating Index-2005 (HEI-2005) scores; and c) higher levels of physical activity, compared to children in the control arm. Parents in the intervention arm will also have: a) improved psychosocial well-being; b) improved parenting practices; c) higher HEI-2005 scores; d) higher physical activity levels; and e) healthier weight gain than parents in the control arm. Study findings will provide information that will be useful in testing the efficacy of the intervenion in a larger sample of low-income families with preschool children. THE ENVIRONMENT UNC-Chapel Hill is a leading educational and research university in the United States with ample resources to support the candidate in acquiring all of the skills proposed for the career development award.

描述（由申请人提供）：迄今为止，我的经验为儿童早期肥胖预防提供了坚实的基础，特别是在儿童保育环境中，这将成为扩展到癌症预防干预措施的自然启动点，旨在接触有肥胖相关癌症家族史的低收入学龄前儿童。我的长期职业目标是成为一名成功的，独立的，外部资助的研究调查员，专门设计和实施以家庭为基础的干预措施，以预防儿童肥胖，从而降低肥胖相关癌症的终生风险，特别是在高危和服务不足的人群中。我的短期目标是：1）发展科学和技术技能：将营养，体育活动和肥胖联系起来的机制， 癌症;制定和实施以家庭为基础的行为干预措施，以预防儿童肥胖，以减少患有肥胖相关癌症的一级或二级家族史的低收入儿童在晚年患肥胖相关癌症的发病率; 2）发展撰写赠款的技能，成为独立调查员并竞争同行评审的资金;和3）通过在科学会议上演讲、为同行评审期刊撰写文章和教授学生来增强我的沟通技巧。为了获得这些技能，我建议参加研究生课程，参加研讨会，包括研究工作组和研讨会，并在北卡罗来纳大学教堂山分校（UNC-Chapel Hill）的一组资深研究人员的指导下开发和试点测试行为干预。研究目的：肥胖导致约三分之一的癌症死亡。有肥胖相关癌症的家族史会进一步增加患肥胖相关癌症的风险。预防生命早期肥胖症发作的干预措施对于预防/降低成年期肥胖相关癌症的风险至关重要。很少有干预措施专注于预防学龄前儿童的肥胖，特别是那些来自低收入家庭的儿童，他们有肥胖相关癌症的家族史。拟议研究的目的是开发和试点测试一项为期16周的基于家庭的干预措施，该干预措施使用生活技能方法促进具有肥胖相关癌症1级或2级家族史的低收入学龄前儿童（3-5岁）的健康体重增加，以预防/降低成年后肥胖相关癌症的风险。方法：收集形成性研究资料，开展干预。该干预措施将在106个低收入家庭/亲子配对中进行随机对照试验，儿童体重状况的变化作为主要研究结果。次要结果包括以下方面的变化：a）儿童的饮食摄入量和身体活动水平; B）父母的心理社会特征，以及与饮食和身体活动相关的父母行为;以及c）父母的饮食摄入量，身体活动和体重状况。研究 将在基线、干预后16周和2个月随访时评估结局。统计学分析：将进行多元回归分析，以评估干预组和对照组在16周干预期间和2个月随访时儿童和父母结局的变化，并控制人口统计学特征。结构 将使用方程模型来确定干预对儿童饮食和身体活动的影响是否通过目标父母心理社会变量和与饮食和身体活动有关的父母做法的变化来介导。预期结果/假设：在16周的干预结束时，干预组的儿童将：a）更健康的体重增加; B）更健康的饮食摄入量，通过更高的健康饮食指数-2005来衡量（HEI-2005）评分;和c）与对照组中的儿童相比，更高水平的身体活动。干预组中的父母还将具有：a）改善的心理社会健康; B）改善了父母的教养方式; c）更高的HEI-2005分数; d）更高的体力活动水平; e）比对照组的父母更健康的体重增加。环境北卡罗来纳大学教堂山分校是美国领先的教育和研究型大学，拥有充足的资源来支持候选人获得职业发展奖的所有技能。