Health Outcomes in Preschool: INnovations for Obesity Prevention (HOP-IN)

项目总结/摘要 儿童肥胖是一个严重的公共卫生威胁，也是加速心脏代谢健康的主要危险因素 童年和成年的条件。此外，儿童期肥胖对学业有负面影响。 这一成就预测了终生健康结果，并具有巨大的经济影响。日托设置 已被确定为儿童早期肥胖干预的高影响目标。平均而言，75% 在美国，学龄前儿童每周花35个小时在日托中心， 为儿童提供健康膳食的能力，增加体育活动的机会，并促进充分的 睡眠-所有这些都有助于防止肥胖。虽然学前教育机构提供定期的身体锻炼机会， 然而，由于儿童活动量大，日托中心的大多数儿童不符合现行准则。2014年，只有12%的日托中心 华盛顿州达到了体育活动的目标，只有22%的户外时间。因为那些 更多的时间在户外比那些花更多时间在室内的人更活跃， 户外和游戏课程可能有助于增加体育活动。关于这个主题的唯一发表的研究 研究发现，在户外幼儿园的瑞典儿童不太可能超重，睡眠时间也比他们的孩子长。 室内幼儿园的同龄人。然而，这项研究是横断面的，招募了一个小样本，没有检查 学术成就或成本影响，并在具有不同医疗保健和 教育系统比美国。对于这个K 01应用，我们提出了一个前瞻性的观察 一项利用自然实验评估户外学前教育模式对健康影响的研究 成果和学术成就。我们将与位于华盛顿西雅图的幼儿园Tiny Trees合作， 一个完全户外的，以游戏为基础的课程。我们将招募100名3-5岁的儿童参加Tiny Trees， 来自Tiny Trees候补名单的儿童目前正在传统的室内幼儿园上学。我们将收集 身体活动、睡眠、身体质量指数和学习成绩的客观和主观指标， 3年学习期间的课程。我们还将进行成本效益分析，以评估微型树 长期可持续发展的户外学前教育模式。我们的具体目标是：1）与人比较 Tiny Trees登记者（干预）和候补儿童之间的健康和学业结果变化 （对照），2）估计Tiny Trees户外学前教育模式的短期和长期成本效益，以及3） 完成一个严格的指导职业发展计划，将主要研究者进行 在预防儿童肥胖的干预措施方面进行了开创性的研究， 干预措施，为政策提供信息，并作为独立调查员开始成功的职业生涯。这项建议 通过优先考虑新的流行病学研究，与国家心肺血液研究所的议程保持一致 预防儿童肥胖，这是心血管疾病的一个关键风险因素，并将产生急需的成本- 福利数据，以检查肥胖预防的能力和户外学前教育模式的可持续性。

PROJECT SUMMARY/ABSTRACT Childhood obesity is a critical public health threat, and a major risk factor for accelerating cardiometabolic health conditions in childhood and adulthood. In addition, obesity in childhood negatively impacts academic achievement, which predicts lifetime health outcomes and has dramatic economic implications. Daycare settings have been identified as a high impact target for early childhood obesity intervention. On average, 75% of preschool-aged children in the United States spend 35 hours per week in daycare, and childcare settings have the ability to offer children healthy meals, increase opportunities for physical activity, and promote adequate sleep – all of which help to prevent obesity. Although preschool settings offer regular opportunities for physical activity, most children in daycare do not meet current guidelines. In 2014, only 12% of daycare centers in Washington State met goals for physical activity, and only 22% for outdoor time. Because children who spend more time outdoors are more physically active than those who spend more time indoors, preschools with outdoor- and play-based curricula may help to increase physical activity. The only published study on this topic found that Swedish children in outdoor preschools were less likely to be overweight and slept longer than their peers in indoor preschools. However, the study was cross-sectional, recruited a small sample, did not examine academic achievement or cost implications, and was conducted in a country with different healthcare and educational systems than the United States. For this K01 application, we propose a prospective observational study that leverages a natural experiment to evaluate the impact of an outdoor preschool model on health outcomes and academic achievement. We will partner with Tiny Trees, a preschool in Seattle, Washington, with an entirely outdoor, play-based curriculum. We will recruit 100 children ages 3-5 who attend Tiny Trees, and 100 children from the Tiny Trees waitlist who are currently attending a traditional indoor preschool. We will collect objective and subjective measures of physical activity, sleep, body mass index, and academic performance over the course of the 3-year study period. We will also perform a cost-benefit analysis to evaluate the Tiny Trees outdoor preschool model for longer-term sustainability. Our Specific Aims are to: 1) compare within-person change in health and academic outcomes between Tiny Trees enrollees (intervention) and waitlisted children (control), 2) estimate the short- and long-term cost-benefit of the Tiny Trees outdoor preschool model, and 3) complete a rigorous mentored career development plan that will position the Principal Investigator to conduct groundbreaking research in interventions to prevent childhood obesity, establish cost-benefit estimates of interventions to inform policy, and launch a successful career as an independent investigator. This proposal aligns with the National Heart, Lung, and Blood Institute agenda by prioritizing novel epidemiological research to prevent childhood obesity, a critical risk factor for cardiovascular disease, and will yield much-needed cost- benefit data to examine the capacity for obesity prevention and sustainability of an outdoor preschool model.