EXCESS BMI GAIN DURING ELEMENTARY SCHOOL: THE ROLE OF CONTEXTUAL FACTORS

描述（由申请人提供）：儿童和青少年超重和肥胖的患病率急剧增加，低收入和一些种族/少数民族人群的风险最高。肥胖率的上升和肥胖的社会经济差异源于社会和环境因素，需要理解和修改以进行有效预防。在这个项目中，我们建议跟踪一组20，000名儿童到小学，这一时期肥胖的人口差异表现出来，研究他们的身体发育，健康行为，以及这些结果和行为与他们居住和学校社区的食物和体育活动环境的关系。我们的具体目标如下：1.描述来自不同社会经济和种族/民族群体的儿童在住宅和学校周围的食物和体育活动环境有何不同。2.描述不同社会经济和种族/民族群体的儿童在小学内的食物和体育活动环境有何不同。3.按社会经济和种族/民族群体分析食物和体育活动环境与健康行为之间的关系。4.分析食物和体育活动环境对幼儿园至5年级（某些分析为8年级）儿童体重指数（BMI）差异发展的贡献。公共卫生相关性：学校和居住环境可能会影响儿童的健康行为，但他们对体重过度增加的贡献尚不清楚。这个项目试图确定在小学期间体重过度增加的环境因素，其中包括超重的社会人口差异开始显现的年龄。在考虑拟议的干预措施和政策变化是否有希望或可能导致走上死胡同之前，这是一项必要的任务。

DESCRIPTION (provided by applicant): The prevalence of overweight and obesity among children and adolescents has been increasing dramatically with low-income and some racial/ethnic minority populations being at highest risk. Rising obesity rates and socioeconomic disparities in obesity stem from social and environmental factors that need to be understood and modified for effective prevention. In this project, we propose to follow a cohort of 20,000 children through elementary school, a period when demographic disparities in obesity manifest themselves, to study their physical development, health behaviors, and the relationship of these outcomes and behaviors to the food and physical activity environments in their residential and school neighborhoods. Our specific aims are as follows: 1. Describe how the food and physical activity environments around residences and schools differ for children from different socioeconomic and racial/ethnic groups. 2. Describe how the food and physical activity environments inside elementary schools differ for children from different socioeconomic and racial/ethnic groups. 3. Analyze the relationship between food and physical activity environments and health behaviors, by socioeconomic and racial/ethnic groups. 4. Analyze the contribution of food and physical activity environments in the development of disparities in body mass index (BMI) in children from kindergarten through 5th (and for some analyses 8th) grade. PUBLIC HEALTH RELEVANCE: School and residential environments are likely to shape children's health behaviors, but their contributions to excess weight gain are unknown. This project tries to identify environmental factors of excess weight gain during elementary school years, which includes the age where sociodemographic disparities in overweight begin to manifest themselves. This is a necessary task before considering whether proposed interventions and policy changes are promising or likely to lead down a blind alley.