New Ulm at HOME - (NU-HOME)

 描述（由申请人提供）：儿童肥胖是一个严重的公共卫生问题。虽然以前的环境方法预防肥胖显示出一些希望，但大多数研究并没有显示出多余的体重增加减少。此外，很少有儿童肥胖症预防研究显著参与父母或关注家庭环境，这对促进家庭健康行为至关重要。农村社区的儿童特别容易受到肥胖风险增加的影响;因此，让农村社区的家庭参与预防体重过度增加的成功计划至关重要。拟议的研究项目，新乌尔姆健康的家庭环境通过用餐时间环境（NU-HOME），是一个独特的合作领导人在农村社区和成功的学术肥胖研究人员之间。明尼苏达州新乌尔姆是一个农村社区，肥胖患病率远远超过全国水平。此外，他们准备并要求采取干预措施，以促进健康的行为改变，特别是对青年人。与我们的许多社区利益相关者团体一起，拟议研究的目的是测试NU-HOME计划的有效性，NU-HOME计划是一项为期7个月的以家庭为基础的健康促进干预措施，旨在预防新乌尔姆农村社区7-10岁儿童（n=120）体重过度增加（通过BMI z评分评估）。该干预计划以社会认知理论和社会生态框架为基础，将重点放在预防儿童肥胖的新型健康促进成分上，包括：1）促进家庭成员一起做饭和吃饭的规律膳食（即，家庭餐）; 2）促进营养良好和适当分配的零食和膳食; 3）减少久坐行为，特别是在家庭环境中的屏幕时间;以及4）通过与社区伙伴合作促进体育活动。NU-HOME研究分为四个阶段，包括学术和社区合作伙伴之间的实质性形成工作，双臂随机对照试验（RCT;干预和等待名单控制），以及两项促进可持续性的活动（对照组参与者的延迟干预交付和传播）。将采用基于社区的参与式研究（CBPR）方法来调整在城市社区试点（HOME试点：2006-2008，NIH R21-DK 0072997）并证明有效（HOME Plus：2010-2015，NIH R 01-DK 084000）的现有计划。NU-HOME计划具有很高的翻译潜力，很可能立即对农村学龄儿童家庭有用，因为它将与参与，知识渊博和有影响力的社区合作伙伴合作，在现实世界中进行测试。

 DESCRIPTION (provided by applicant): Childhood obesity is a serious public health problem. Although previous environmental approaches to obesity prevention show some promise, most studies have not shown excess weight gain reductions. Moreover, few childhood obesity prevention studies significantly engage parents or focus on the home environment, which is essential to promote healthy behaviors at home. Children in rural communities are particularly vulnerable regarding increased risk for obesity; thus, successful programs that engage families in rural communities to prevent excess weight gain are critical. The proposed research project, New Ulm-Healthy Home Environments via the Mealtime Environment (NU-HOME), is a unique collaboration between leaders in a rural community and successful academic obesity researchers. New Ulm, Minnesota is a rural community with obesity prevalence rates that far exceed national rates. Moreover, they are poised for and are requesting interventions to promote healthful behavior change, particularly for youth. In conjunction with our many community stakeholder groups, the objective of the proposed research is to test the effectiveness of the NU-HOME program, a 7-month, family-based health promotion intervention to prevent excess weight gain (assessed via BMI z-score) among 7-10 year old children (n=120) in the New Ulm rural community. The intervention program is based on Social Cognitive Theory and a socio-ecological framework and will focus on novel health promotion components to prevent childhood obesity, including: 1) promoting regular meals in which family members cook and eat together (i.e., family meals), 2) promoting nutritionally-sound and appropriately-portioned snacks and meals, 3) reducing sedentary behavior, particularly screen time in the home setting, and 4) promoting physical activity through collaboration with community partners. The NU-HOME study is designed in four stages, including substantial formative work between the academic and community partners, a two-arm randomized controlled trial (RCT; intervention and wait-list control), and two activities to facilitate sustainability (delayed intervention delivry for control group participants and dissemination). A community-based participatory research (CBPR) approach will be used to adapt an existing program that was piloted (HOME pilot: 2006-2008, NIH R21- DK0072997) and shown to be effective (HOME Plus: 2010-2015, NIH R01-DK084000) in urban communities. The NU-HOME program has high translation potential and is likely to be immediately useful to rural families of school-age children because it will be tested n a real-world setting in collaboration with engaged, knowledgeable and influential community partners.