Turn Up the HEAT - Healthy Eating and Activity Time in Summer Day Camps

描述（由申请人提供）：夏令营（SDCs）代表了在学年期间针对儿童的健康和保健工作的扩展的潜在环境。 SDCs每年为超过1430万青少年（<12岁）提供服务，是学年之外最大的有组织环境，儿童可以在那里进行健康饮食（即，水果[F]、蔬菜[V]、水[W]的每日消耗量）和体力活动（PA）。2011年，美国国家课外活动协会发布了儿童肥胖政策，称为健康饮食和身体活动（HEPA）标准，呼吁SDC确保注册的儿童每天摄入一份FV和W，并进行60分钟的中度至剧烈PA（MVPA）。从我们广泛的试点工作中，我们确定了SDC需要支持的两个领域，以满足HEPA标准。首先，大多数SDC不提供膳食或零食;相反，父母决定每天为孩子打包什么类型的食物作为午餐和零食。为了解决这个问题，我们开发了一种创新的HE干预这种设置-健康午餐盒挑战（HLC）-接地行为选择理论。HLC是一个低成本的每周激励计划，奖励积分给孩子们包装健康的零食/午餐（即，F，V，W）。其次，我们开发了创新的PA干预方法（5 M和让我们玩），以解决项目领导和工作人员促进PA所需的基本技能。这些重点是让我们玩的原则，删除线和消除，减少团队规模，让无关的工作人员/孩子参与活动，并有效地利用空间，设备和规则。我们的长期目标是增加符合HEPA标准的SDC数量。目的是评估旨在提高儿童PA水平和改善儿童携带和消费的食品/饮料质量的多组分干预措施的有效性。HEPA干预采用培训师培训模式，由SDC领导培训其员工，以提供干预并将其融入日常实践。我们将使用20个SDC的4年随机对照试验评估HEPA干预。本研究的一个重要特征是在取消研究支持后评价干预措施的维持情况（例如，培训、助推器）以及与实施有关的费用。目标1.评估HEPA干预措施对以下方面的影响：1A：符合PA标准的儿童比例（即，e60 min MVPA/d）参加夏令营时; 2A：符合HE标准的食物比例（例如，增加水果、蔬菜、水）;以及3A：从夏季开始到结束，儿童的年龄性别特定BMI百分位数的变化。目标2：评估HEPA干预措施的成本效益;目标3。评估夏令营中HEPA干预措施的维持情况。这项拟议的研究意义重大，因为SDC有可能接触到数百万儿童。这项研究是创新的，因为没有研究已经进行了这一重要的设置和时间框架（暑假）。

DESCRIPTION (provided by applicant): Summer day camps (SDCs) represent a potential setting for the extension of health and wellness efforts targeting children during the school year. SDCs serve more than 14.3 million youth (<12yrs) annually and are the single largest organized setting, outside of the school year, where children can engage in healthy eating (i.e., consumption of fruits [F], vegetables [V], water [W] daily) and physical activity (PA). In 2011, th National Afterschool Association released childhood obesity policies referred to as the Healthy Eating and Physical Activity (HEPA) Standards, that call upon SDCs to ensure the children enrolled consume a serving of FV and W daily and engage in 60 minutes of moderate-to-vigorous PA (MVPA). From our extensive pilot work, we identified two areas SDCs' require support to meet the HEPA Standards. First, the majority of SDCs do not provide meals or snacks; rather, parents decide what types of foods are packed daily for their child to eat for lunch and snacks. To address this, we developed an innovative HE intervention for this setting - the Healthy Lunchbox Challenge (HLC) - grounded in Behavioral Choice Theory. The HLC is a low-cost weekly incentive program that awards points to children for packing healthy items for snacks/lunch (i.e., F, V, W). Second, we developed our innovative PA intervention approach (5 Ms and LET US Play) to address fundamental skills program leaders and staff require to facilitate PA. These focus on the LET US Play principles of removing lines and elimination, reducing team sizes, getting uninvolved staff/kids involved in activities, and using space, equipment, and rules effectively. Our long-term goal is to increase the number of SDCs that meet the HEPA Standards. The objective is to evaluate the effectiveness of a multi-component intervention designed to increase children's PA levels and improve the quality of foods/beverages children bring and consume in SDCs. The HEPA intervention uses a train-the-trainer model with SDC leaders to train their staff to deliver and integrate the intervention into routine practice. We will evaluate the HEPA intervention using a 4-year randomized controlled trial with 20 SDCs. An important feature of the study will be the evaluation of maintenance of the intervention after the removal of research support (e.g., training, boosters) during the final year as well as costs associated with implementation. Aim 1. Evaluate the impact of the HEPA interventions on: 1A: The proportion of children meeting the PA Standard (i.e., e60min MVPA/d) while attending summer day camp; 2A: The proportion of foods meeting the HE Standards (e.g., increase fruit, vegetable, water) children and staff bring and consume at the summer day camp; and 3A: Changes in children's age-sex specific BMI percentile from the start to end of summer. Aim 2: Evaluate the cost-effectiveness of the HEPA intervention; and Aim 3. Evaluate the maintenance of the HEPA intervention in summer day camps. The proposed study is significant because SDCs have the potential to reach millions of children. This research is innovative because no research has been conducted on this important setting and timeframe (summer vacation).