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，已达到大流行的程度。目前的数据表明，7岁之前的体重状况与成年人的体重状况和成年人的健康问题直接相关。因此，预防和治疗儿童肥胖症可能会改善成人的健康结果。已经开发了许多干预措施来治疗儿童肥胖症，这些干预措施导致了体重状况的改善，并随着时间的推移保持了不同程度的改善。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个人中更为普遍，而可用于治疗这些农村患者的服务非常少。 目前这项研究的主要目的是使用乡村定制的行为干预方法来评估农村五年级儿童中两种儿童肥胖治疗方法(电话、埃鲁米特)的BMIz下降。十所参与的学校将被匹配，然后在学校层面随机分配给Phone或ElLumate。这项为期8个月的干预是根据之前一项研究的结果量身定做的，该研究确定了试图帮助农村地区孩子减肥的父母的独特障碍和需求。研究对象包括60名五年级儿童及其家长。其次，我们假设，与电话组相比，ElLumate组在饮食习惯(每日卡路里摄入量、每日总脂肪摄入量、每天从膳食脂肪中获得的卡路里百分比、每天含糖饮料的数量、每天垃圾食品的数量、每天外出就餐的次数)方面的积极变化将显著更大，与电话组相比，ElLumate组在体育活动习惯(Actigraph计数、每周体力活动和屏幕时间)方面的积极变化将显著更大。测量包括BMIz、24小时食物召回、自我报告的体力活动和久坐活动(SPARK)，以及活动体力活动计数，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)通过结构化访谈的关键干预组成部分，2)出席率，3)通过调查的满意度，4)成本分析。 公共卫生相关性：目前的研究解决了儿童肥胖在服务不足的人口中的关键健康问题，即农村儿童。目前的研究结果将导致确定向这些有需要的家庭提供干预服务的最合适的方法，并提供必要的信息，以导致对这些方法进行更大规模的随机对照试验。

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.