Early Childhood Obesity Prevention: Building Healthier Families and Communities

描述（由申请人提供）：肥胖是当今儿童最大的健康威胁。现有的肥胖预防措施收效甚微。我们的目标是通过建立基于生态框架的多层次干预来预防幼儿肥胖的发展。这项研究是代表哈特福德儿童健康联盟提出的，该联盟有107个成员，35个团体组织，其目标是改善康涅狄格州哈特福德儿童的健康。在一项随机对照试验中，本研究的主要目的是测试在社区和社区支持下加强家访计划的初步效果，以改变母亲在婴儿营养（加糖饮料/果汁的摄入、母乳喂养和固体食物的引入）、育儿技能（建立睡眠习惯、阅读饥饿、饱腹感、看电视时间的提示）和家庭健康（改善家庭食物环境、加强体育锻炼）方面的行为。母亲们将学习核心行为技能（例如，设定目标、自我监督、解决问题和刺激控制），参与者将与相关的社区项目联系起来，以支持健康的行为改变。这项研究建立在现有的新生儿家访项目的基础上，利用光明未来家庭（BFF）中心促进健康烹饪和购物，减少含糖饮料/果汁的消费，增加身体活动，并与杂货店/街角商店的一个项目联系起来，该项目促进优质食品的选择，包括更多的新鲜水果和蔬菜。我们假设，在12个月大的时候，干预组的婴儿会喝更少的含糖饮料/果汁，会在更大的年龄摄入固体物质，会比对照组的婴儿母乳喂养的时间更长，更排外，看电视的时间更少，睡眠习惯更固定，更舒适（主要结果）。我们进一步假设，干预家庭将购买、烹饪和提供更多的水果和蔬菜，将更好地利用BFF中心和社区在食物、烹饪和运动方面的资源，并将有更多的婴儿体重/身高< 85%。这项研究的结果对长期保持健康的体重和重新建立健康的家庭具有启示意义。

DESCRIPTION (provided by applicant): Obesity is the single greatest health threat to today's children. Existing obesity prevention initiatives have had limited success. Our goal is to prevent the development of obesity in very young children by creating a multi-level intervention grounded in an ecological framework. This study is proposed on behalf of the Hartford Childhood Wellness Alliance, a 107 member, 35 group organization whose goal is to improve the health of children in Hartford, CT. In a randomized control trial, the primary aim of this stud is to test the initial efficacy of a program of enhanced home visitation with neighborhood and community support to change maternal behaviors related to infant nutrition (sweetened beverage/juice consumption, breastfeeding and introduction of solids), parenting skills (establishing routines around sleep, reading cues for hunger, satiety, TV time) and family wellness (improving the home food environment, enhancing physical activity). Mothers will be taught core behavioral skills (e.g., goal setting, self-monitoring, problem-solving and stimulus control) and participants will be linked to relevant community programs to support healthy behavior change. The study builds upon an existing home visiting program for newborns, utilizes Brighter Future Family (BFF) Centers to promote healthy cooking and shopping, to reduce sugar sweetened beverage/juice consumption and to increase physical activity, and is linked to a program in grocery/corner stores that promotes quality food choices including greater access to fresh fruits and vegetables. We hypothesize that at 12 months of age, infants in the intervention arm will drink less sugar sweetened beverages/juices, will have ingested solids at an older age, will have been breastfed longer and more exclusively than infants in the control arm and will have less TV viewing, more established sleep routines and greater soothability (primary outcomes). We further hypothesize that intervention families will purchase, cook and serve more fruits and vegetables, will demonstrate greater utilization of the BFF Centers and community resources around food, cooking and exercise and will have more infants with a weight for height <85th%. Results from this study have implications for the long-term maintenance of a healthy weight and for re-claiming the healthy family.