A Randomized Controlled Trial to Enhance Nutrition and Activity Among Rural Child

描述（由申请人提供）： 儿童肥胖症是一个日益严重的公共卫生问题，已达到流行病的程度。目前的数据表明，7岁之前的体重状况与成人体重状况和成人健康问题直接相关。因此，预防和治疗儿童期肥胖可能会改善成年后的健康状况。已经开发了许多干预措施来治疗儿童肥胖症，这些干预措施导致体重状况改善，并随着时间的推移保持不同程度的改善。然而，这些研究的参与者通常来自大城市或郊区。研究表明，成人和儿童肥胖症实际上在农村人群中更为普遍，而且治疗这些农村患者的服务很少。 本研究的主要目的是评估两种儿童肥胖治疗方法（电话，Elluminate）在农村五年级儿童中使用农村定制的行为干预来降低BMIz。十所参与的学校将被配对，然后在学校一级随机分配到电话或Elluminate。这项为期8个月的干预措施是根据以前的研究结果进行的，这些研究确定了农村地区父母试图帮助孩子减肥的独特障碍和需求。受试者将包括60名五年级儿童和他们的父母。其次，我们假设Elluminate组在饮食习惯方面会有更大的积极变化（每日卡路里摄入量、每日总脂肪摄入量、每日来自膳食脂肪的卡路里百分比、每天含糖饮料的数量、每天垃圾食品的数量、每天离家吃饭的数量）与电话组相比时，与电话组相比，Elluminate组在身体活动习惯（活动记录仪计数、每周身体活动和屏幕时间）方面的积极变化显著更大。测量包括BMIz、24小时食物回忆、自我报告的身体和久坐活动（SPARK）以及ActiGraph身体活动计数，并将在基线和8个月干预后完成。我们还建议对几个项目进行定性评估，包括1）通过结构化访谈进行的关键干预组件，2）出勤率，3）通过调查进行的满意度，以及4）成本分析。 公共卫生相关性：目前的研究解决了儿童肥胖的关键健康问题，在服务不足的人群，农村儿童。目前的研究结果将导致确定最合适的方法来提供干预服务，这些家庭的需要，并提供必要的信息，导致这些方法的一个更大的随机对照试验。

DESCRIPTION (provided by applicant): Obesity in childhood is a growing public health concern reaching pandemic proportions. Current data indicate that weight status by age 7 is directly related to adult weight status and adult health concerns. Thus, preventing and treating obesity in childhood may lead to improved adult health outcome. Many interventions have been developed to treat childhood obesity and these interventions have led to improved weight status with varying degrees of maintenance of improvements over time. However, participants in these studies have generally been from large urban or suburban areas. Research indicates that adult and pediatric obesity is actually more prevalent among rural individuals, and that there are very few services available to treat these rural patients. The primary aim of the current study is to estimate the decrease in BMIz for two pediatric obesity treatment methodologies (phone, Elluminate) among rural 5th grade children using a rurally tailored behavioral intervention. Ten participating schools will be matched and then randomized at the school level to either phone or Elluminate. The 8-month intervention was tailored to the findings of previous research identifying the unique barriers and needs of parents trying to help their children lose weight in rural areas. Subjects will include 60 5th grade children and their parents. Secondarily, we hypothesize that the Elluminate group will have a significantly greater positive change in eating habits (daily calorie intake, total daily fat intake, daily percentage of calories from dietary fat, number of sugar sweetened beverages per day, number of junk food items per day, number of meals eaten away from home per day) when compared to the phone group, and that the Elluminate group will have a significantly greater positive change in physical activity habits (Actigraph counts, weekly physical activity and screen time) when compared to the phone group. Measures include BMIz, 24 hour food recall, self-reported physical and sedentary activity (SPARK), and ActiGraph Physical Activity counts and will be completed at baseline and after the 8 month intervention. We also propose to assess several items qualitatively including 1) key intervention components via structured interviews, 2) attendance rates, 3) satisfaction via surveys, and 4) cost analysis. PUBLIC HEALTH RELEVANCE: The current study addresses the key health issue of pediatric obesity among an underserved population, rural children. The findings of the current study will lead to identification the most appropriate methodology to deliver intervention services to these families in need, and provide the necessary information to lead to a larger randomized controlled trial of these methodologies.