Healthy Weight: Linking Child Care Centers with the Home

描述（由申请人提供）：在过去十年中，幼儿超重的患病率上升了40%以上。更具体地说，在北卡罗来纳州，10%的2-5岁儿童被认为超重。因为大多数学龄前儿童在托儿中心度过了他们一天的大部分时间，消耗了他们每天三分之二的卡路里，所以托儿中心在鼓励儿童健康营养和身体活动行为方面处于独特的地位。此外，中心可以与家长分享健康的生活方式信息，强调终身健康的重要性。随着儿童在生命早期形成营养和体育活动的生活方式，儿童护理中心和家庭之间相互加强一致的信息可以极大地促进健康行为的形成，并有可能预防儿童超重的发展。这个建议是一个儿童护理家庭干预，使用先前开发的干预（NAP SACC），旨在改变儿童护理中心的营养和体育活动环境，同时以家庭为基础，家庭组成部分（称为NAP SACC家庭），包括育儿技能培训，家访，资源材料和电话支持，以防止3-5岁儿童超重。这项干预的前半部分，NAP SACC，即儿童护理营养和身体活动自我评估，最近由该研究小组开发，试点工作的结果很有希望。我们现在建议从北卡罗来纳州的一个县招募18个托儿中心，并将其随机分为三组：其中6个中心将只接受NAP SACC干预，6个中心将接受NAP SACC和Family干预，6个中心将作为对照组，不接受正式干预。家庭干预以社会认知理论为基础，关注托儿中心和家庭环境中环境、政策和人际影响渠道之间的相互作用。这项可行性研究的主要结果是身体活动（通过加速度计测量）和饮食（水果/蔬菜、牛奶和脂肪消耗），通过从父母处获得的有效食物频率测量（Block for Kids）来测量。BMI将在干预前后进行评估。实现这一建议的目标将使这一干预措施扩大为一项全面试验，可以在广泛的儿童保育和家庭环境中使用。

DESCRIPTION (provided by applicant): The prevalence of overweight among young children has risen more than 40% over the past decade. More specifically, in North Carolina 10% of children ages 2-5 years are considered overweight. Because a majority of preschool children spend much of their day and consume up to two-thirds of their daily calories" in child care centers, centers are in a unique position to encourage and role model healthy nutrition and physical activity behaviors for children. In addition, centers can share healthy lifestyle messages, emphasizing the importance of lifelong health, with parents. With children forming nutrition and physical activity lifestyles early in life, reciprocal reinforcement of a consistent message between the child care center and the home can greatly promote the formation of healthy behaviors and potentially prevent the development of childhood overweight. This proposal is for a child care-home intervention that uses a previously developed intervention (NAP SACC) designed to change the nutrition and physical activity environments at the child care center with a simultaneous home-based, family component (to be called NAP SACC Family) that includes parenting skills training, home visits, resource material, and telephone support to prevent overweight in children aged 3-5 years. The first half of this intervention, NAP SACC, or Nutrition and Physical Activity Self-Assessment for Child Care, was recently developed by this research team and results from pilot work are promising. We now propose to recruit 18 child care centers from one county in North Carolina and randomly assign them to three groups: six of the centers will receive NAP SACC intervention only, six will receive NAP SACC and Family intervention, and six will be used as a control group and receive no formal intervention. NAP SACC and NAP SACC Family interventions are based on Social Cognitive Theory and focus on reciprocal interaction among environment, policy, and interpersonal channels of influence within the child care centers and the home environments. The primary outcomes of this feasibility study are physical activity, as measured by accelerometry, and diet (fruit/vegetable, milk, and fat consumption), as measured by a validated food frequency measure obtained from parents (Block for Kids). BMI will be assessed pre and post intervention. Accomplishing the aims of this proposal will allow the expansion of this intervention into a full-scale trial that can be used in a wide range of child care and family settings.