Obesity prevention in early childhood

描述（由申请人提供）：预防儿童肥胖的需要延伸到我们最小的孩子。虽然大量的研究已经调查了肥胖的后果，但关于儿童肥胖的原因和有效的预防策略，我们仍然知之甚少。最近，有组织的儿童保育成为预防幼儿肥胖的重要环境，近四分之三的3至6岁的美国儿童接受全职或兼职儿童保育。对于Ruth Kirschstein的NRSA博士后申请，我提出了一种新的环境干预，婴儿NAP（营养和活动促进）计划，以帮助预防幼儿肥胖。在拟议的研究中，我将试点测试婴儿午睡干预，以改善儿童护理中心的营养和体育活动相关政策和实践，服务于不同群体的2岁以下儿童。这项拟议的研究是我之前的博士经历的自然发展，在我之前的博士经历中，我设计并实施了一项针对稍大儿童的肥胖预防干预，其中也包括改变儿童保育环境。作为一名营养研究人员，拟议的研究建立在我现有的技能和经验的基础上，为我的工作增加了新的维度，利用了我的赞助商和共同赞助商的专业知识，以及我博士后培训环境中的研究机会。研究目标：在一项随机对照试验设计中，在儿童保育中心进行环境干预，以促进2岁以下儿童的健康饮食和体育活动。具体目标：确定与对照条件相比，试点干预措施在多大程度上使托儿中心的政策和实践支持托儿中心内的健康饮食和体育活动。假设：与控制中心相比，参与试点干预的托儿中心在干预后对其营养和体育活动环境的自我评估方面将显示出更大的改善。次要目的：确定干预中心在自我评估工具上报告的改进程度，通过观察和记录环境和政策变化来验证。

DESCRIPTION (provided by applicant): The need to prevent childhood obesity extends down to our youngest children. While a substantial amount of research has examined consequences of obesity, much is still unknown about the causes of obesity in childhood and effective prevention strategies. Organized child care has recently emerged as an important setting for obesity prevention in young children, with nearly three quarters of US children aged three to six in full- or part-time child care. For this Ruth Kirschstein post doctoral NRSA application, I propose a novel environmental intervention, the Baby NAP (Nutrition and Activity Promotion) program, to help prevent obesity in very young children. In the proposed study, I will pilot test the Baby NAP intervention to improve nutrition- and physical activity-related policies and practices in child care centers that serve a diverse group of children up to 2 years of age. This proposed research is a natural progression from my previous doctoral experience, in which I designed and conducted an obesity prevention intervention among slightly older children that also involved altering the child care environment. The proposed study builds on my existing skills and experience as a nutrition researcher, adding new dimensions to my work that take advantage of the expertise of my Sponsor and Co-Sponsor, as well as the research opportunities in my post-doctoral training environment. Study goal: Pilot test, in a randomized controlled trial design, an environmental intervention in child care centers to promote healthy eating and physical activity among children up to 2 years of age. Specific Aim: Determine the extent to which the pilot intervention, compared with the control condition, results in child care center policies and practices that support healthy eating and physical activity within the child care center. Hypothesis: Child care centers participating in the pilot intervention, compared with control centers, will show greater post-intervention improvements in a self-assessment of their nutrition and physical activity environments. Secondary Aim: Determine the extent to which improvements reported on the self-assessment instrument by intervention centers are verified through observation and documentation of environmental and policy change.