"Sib-Works"

描述（由申请人提供）：儿童肥胖被认为是青少年面临的最严重的健康问题之一。人们普遍认为，父母作为食物的看门人和孩子的主要榜样，在塑造孩子的饮食行为方面发挥着重要作用。不幸的是，很少有纵向数据可以同时检查父母喂养习惯和儿童饮食行为的演变。Net-Works赠款是nichd资助的一项研究，该研究将在一项多环境干预试验（例如，初级保健、育儿班、n-家庭访问者）的背景下，跟踪父母的喂养做法和儿童的饮食行为，目标是预防2至4岁的低收入和种族不同的儿童（n=500）的肥胖。目前的研究方案Sib- Works是对Net-Works研究的辅助，有两个主要目的。sibb - works的主要目的是检查父母的喂养行为对兄弟姐妹的饮食行为的反应，并确定兄弟姐妹的饮食行为和父母的喂养行为之间的互惠过程。例如：(1)兄弟姐妹的饮食行为有多相似（或不同）？(2)如果兄弟姐妹的饮食行为或体重指数z-score （BMIz）不同，父母会采用什么喂养方法？(3)父母的喂养行为是根据孩子个体的饮食行为量身定制的，还是使用与哥哥姐姐已经形成的喂养行为？(4)父母对儿童饮食行为差异的反应如何影响家庭饮食环境和家庭饮食模式？(5)父母喂养方式、兄弟姐妹饮食行为和兄弟姐妹bmi之间的时间关系是什么？之前的研究没有调查过同一家庭中多个孩子的饮食行为。因此，目前的研究提供了一个独特的机会来扩展与肥胖风险发展相关的家庭动态知识。NET-Works的第二个目的是检验NET-Works对兄弟姐妹的干预溢出效应。虽然一些以家庭为基础的研究表明干预对指数参与者的家庭成员有溢出效应，但尚未确定对儿童肥胖干预的溢出效应。兄弟姐妹工作的主要目的将通过在父母研究中增加一些措施来回答，包括：父母与兄弟姐妹一起喂养的做法（例如，鼓励多吃或少吃），兄弟姐妹的饮食行为（例如，对食物的兴趣）和家庭饮食模式（例如，家庭聚餐）。兄弟姐妹（壁橱年龄较大的兄弟姐妹；n=317）的数据收集将在12个月、24个月和36个月时与父母研究同时进行。sibb - works将允许对家庭食物环境中父母和多个孩子之间的动态更复杂的互动模型进行评估，以便确定关键的可修改变量和过程，这些变量和过程可以作为家庭干预措施的目标，以预防儿童肥胖。此外，确定干预措施是否有可能影响没有直接参与干预的兄弟姐妹，将告知是否需要针对家庭中的不同儿童量身定制方案，或者是否普遍干预措施足够，从而降低成本。

DESCRIPTION (provided by applicant): Childhood obesity is considered one of the most serious health problems facing youth. It is generally agreed that parents, as the gatekeepers to food and primary role models for children play an important role in shaping child eating behaviors. Unfortunately, little longitudinal data are available that examine simultaneously the evolution of parental feeding practices and child eating behaviors. The Net-Works grant is an NICHD-funded study that will follow parent feeding practices and child eating behaviors over time in the context of a multi- setting intervention trial (e.g., primary care, parenting classes, n-home visitors) targeting obesity prevention in low income and ethnically diverse children (n=500) ages two to four years. The present research proposal, Sib- Works, is ancillary to the Net-Works study and has two main aims. The primary aim of Sib-Works is to examine parent feeding practices in response to sibling dyads' eating behaviors and to identify reciprocal processes between sibling dyads' eating behaviors and parent feeding behaviors. For example, (1) How similar (or different) are eating behaviors of sibling dyads?; (2) What feeding practices do parents use if sibling dyads differ in their eating behaviors or Body Mass Index z-score (BMIz)?; (3) Do parents' tailor feeding behaviors to individual children's eating behaviors, or do they use feeding behaviors that have been established with older siblings?; (4) How does parent response to differences between children's eating behaviors affect the family food environment and family eating patterns? (5) What is the temporal relationship between parent feeding practices, sibling dyad's eating behaviors and sibling dyad's BMIz? Prior research has not examined the eating behaviors of more than one child in the same home. Thus, the current study offers a unique opportunity to expand knowledge of family dynamics related to obesity risk development. The secondary aim of Sib-Works is to examine intervention spillover effects of the NET-Works intervention on siblings. While some family-based studies have shown intervention spillover effects for family members of index participants, spillover effects have not been identified for childhood obesity interventions specifically. The Sib-Works main aims will be answered by adding measures to the parent study including: parent feeding practices (e.g., encouragement to eat more or less) with a sibling, sibling eating behaviors (e.g., interest in food), and family eating patterns (e.g., family meals). Sibling (closet-aged older sibling; n=317) data collection will coincide with the parent study at 12-, 24-, and 36-months. Sib-Works will allow for the evaluation of a more complex interactive model of the dynamics between parents and multiple children within the home food environment in order to identify key modifiable variables and processes that could be targeted in family-based interventions to prevent childhood obesity. Additionally, identifying whether interventions have the potential to impact siblings not directly participating in an intervention will inform whether programs need to be tailored to different children within the home, or whether universal interventions are adequate, thus reducing costs.