PREVENTING CHILDHOOD OBESITY: ADDRESSING THE FAMILY ENVIRONMENTAL FACTORS

描述(申请人提供)：拉美裔在超重或肥胖的2-5岁儿童中所占比例不成比例，这表明预防肥胖的努力必须更早开始。解决拉美人在婴儿期和幼儿期的健康体重发育问题，对目前和未来的肥胖症流行及其相关后果，如糖尿病，具有重要影响。多个复杂的子系统，如家庭系统，会影响与儿童肥胖相关的行为。然而，很少有儿童肥胖干预措施全面解决家庭环境因素。NIDDK职业发展奖的总体目标是确定幼儿营养、体育活动和媒体观看行为的特定文化家庭层面的决定因素，并利用这些知识开发、试点测试和检验家庭干预措施的初步结果、可接受性、可行性和可持续性，以减少儿童早期肥胖。实现这一目标的具体目标是：(1)确定和比较影响6至24个月大拉丁裔儿童营养、体育活动和媒体观看做法的母亲、父亲和祖父母的知识、态度和信念；(2)设计和评估试点干预措施的初步结果，以建立适合年龄和指南建议的营养、体育活动和媒体观看做法的家庭集体主义；以及(3)评估这种创新的家庭干预的可行性、可接受性和可持续性。在目标1中，将开展焦点小组，以确定和检查特定照顾者的知识、态度、信念和塑造幼儿营养、体育活动和媒体观看模式的家庭动态的异同。在目标2中，来自AIM的结果将用于设计、中试测试和评估初步结果(例如。儿童饮用含糖饮料、儿童缺乏体力活动等)，这项为期8周的文化适宜性家庭干预的重点是通过干预和对照小组设计，建立家庭对幼儿健康行为的共识。在目标3中，这种干预的可行性、可接受性和可持续性将通过汇报会议和照顾者调查进行评估。拟议的研究将提供关键数据，以制定R01提案，在更大的随机对照试验中评估文化定制干预的有效性。这些研究将产生创新的方法和新的知识，以响应NIDDK改善所有个人体重结果的使命及其优先事项，以解决以家庭为基础的干预措施，以防止高危人群中的幼儿体重过度增加。加州大学洛杉矶分校的资源和机构支持、才华横溢的多学科指导团队以及拟议的职业发展活动，将使候选人能够实现她的长期目标，即成为一名以社区为基础的干预措施以减少儿童肥胖症种族/民族差异的独立调查员和全国公认的专家。

DESCRIPTION (provided by applicant): Latinos are disproportionately represented among overweight or obese 2 to 5 year old children suggesting efforts to prevent obesity must begin earlier. Addressing healthy weight development in Latinos during infancy and early childhood has critical implications for the present and future obesity epidemic and its related consequences like diabetes. Multiple and complex subsystems, such as family systems, influence behaviors associated with childhood obesity. Few childhood obesity interventions, however, comprehensively address family environmental factors. The overall objective of this NIDDK Career Development Award is to identify the culturally-specific family-level determinants of young children's nutritional, physical activity, and media-viewing behaviors and use this knowledge to develop, pilot test, and examine the preliminary outcomes, acceptability, feasibility, and sustainability of a family intervention to reduce early childhood obesity. The specific aims to meet this objective are to: (1) identify and compare the knowledge, attitudes, and beliefs of mothers, fathers, and grandparents that shape nutritional, physical activity, and media-viewing practices of Latino children 6- to 24-months of age; (2) design and evaluate preliminary outcomes of a pilot intervention to build family collectivism in age-appropriate and guideline-recommended nutritional, physical activity, and media-viewing practices; and (3) evaluate the feasibility, acceptability, and sustainability of this innovative family intervention.In Aim 1, focus groups will be conducted to identify and examine similarities and differences in specific caregiver knowledge, attitudes, beliefs, and the family dynamics that shape young children's nutritional, physical activity, and media-viewing patterns. In Aim 2, findings from Aim will be used to design, pilot test, and evaluate the preliminary outcomes (ex. child consumption of sweetened beverages, child physical inactivity, etc) of a culturally appropriate 8-week family intervention focusing on building family consensus on healthy behaviors for young children by using an intervention and comparison group design. In Aim 3, the feasibility, acceptability, and sustainability of this intervention will be evaluated via debriefing sessions and caregiver surveys The proposed studies will provide the critical data to develop an R01 proposal to evaluate the effectiveness of a culturally tailored intervention in a larger randomized controlled trial. These studies will produce innovative approaches and new knowledge that is responsive to NIDDK's mission to improve weight outcomes of all individuals and its priorities to address family-based interventions to prevent excess weight gain in young children within high-risk populations. The resources and institutional support at UCLA, talented multi-disciplinary mentorship team, and proposed career development activities, will allow the candidate to achieve her long-term goal of becoming an independent investigator and nationally recognized expert on community-based interventions to reduce racial/ethnic disparities in childhood obesity.