Etiology of Accelerated Weight Gain during Summer vs. School in Adolescents: What's UP (Undermining Prevention) with Summer 2

自20世纪90年代初以来，儿童肥胖症领域已经知道，在过去的几年里，儿童体重增加了3-5倍 他们3个月的暑假比他们整个9个月的学年都要多。有证据表明，年轻人 来自低收入家庭的人尤其容易受到夏季BMI加速上升的影响。这群人 我们在这次续订中寻求延长的研究R01是夏天的事情(破坏预防)。这是 旨在了解体重指数加速增加的最大规模和最多样化的小学儿童研究 在夏天。在本R01中，测量儿童与肥胖相关的关键健康行为(即，活动、 睡眠、看屏幕的时间、久坐的时间和饮食)在学年(4月/5月)和夏季(7月)。 《夏天怎么了》通过测量以下指标，推进了夏季BMI加速增长的领域 使用面对面设计，多年来在学校和暑假期间使用相同的孩子；2) 在每年夏天开始和结束时测量身高/体重，以检查BMI增加的变化 3)充分利用丰富的时间/日期 标记24小时加速测量数据，并将其与每天的时间日记记录相结合，记录孩子们在哪里，做什么 他们在那里的时间，他们什么时候吃什么，以及他们和谁在一起。体重指数加速增长不是一种现象 这种情况只发生在小学儿童身上。提示性的，但有限的数据表明，初中和高中- 适龄青年在夏季也表现出BMI加速增长。与小学儿童不同，重要的是 自主性和决策能力的差异出现在青春期的这些阶段。主要差距 在科学方面，很少有研究衡量中学和高中学生在学校和暑期的关键健康行为 学校青年和有限的信息存在关于社会和背景对中学和高中的影响 暑期学校的健康行为及其对体重指数变化的影响。没有收集到信息 正如本续签申请中所建议的，能够设计有效的公共卫生干预措施来解决 青少年在夏季的肥胖受到严格限制。在本R01中，我们将比较纵向变化 在学校和暑期以及从小学到高中期间的BMI z分数和健康行为方面， 确定个人、同伴、家庭/家庭、邻居和学校/社区对BMI z得分的影响，并 从小学到高中的学校和暑期的健康行为，并进行定性的探索 暑假和在校期间青少年BMI和健康行为的变化这个项目意义重大 因为它将扩展现有的队列，以确定研究不足的时间框架的影响 (夏季)在没有相关信息的发育期内体重指数加速增加 (青春期)这个项目是创新的，因为它将捕捉在校期间同一批年轻人的信息 和夏天，随着时间的推移，跟踪他们，并收集背景丰富的信息来理解和识别 为行为干预设计提供信息的可修改因素。

Since the early 1990s, the field of childhood obesity has known that children gain 3-5 times more weight during their 3-month summer vacation than they do during the entire 9-month school year. Evidence shows that youth from low-income households are especially vulnerable to accelerated BMI gain during the summer. The cohort study we seek to extend in this renewal R01 is What’s UP (Undermining Prevention) with Summer. This is the largest and most diverse study of elementary-age children designed to understand accelerated BMI gain during the summer. In this R01, children are measured on key obesity-related health behaviors (i.e., activity, sleep, screen time, time spent sedentary, and diet) during school year (April/May) and in the summer (July). What’s UP with Summer advances the field of accelerated BMI gain during the summer by 1) measuring the SAME children during school and again during summer over multiple years using a within-person design; 2) measuring height/weight at the beginning and end of each summer over time to examine changes in BMI gain during the school year and compare this to BMI gain during the summer; and 3) leveraging rich time/date stamped 24hr accelerometry data and combining this with daily time diary recordings of where children are, what times they are there, when and what they eat, and who they are with. Accelerated BMI gain is not a phenomenon that occurs only in elementary-age children. Suggestive, yet limited, data suggest that middle and high school- age youth also exhibit accelerated BMI gain during the summer. Unlike elementary-age children, important differences in autonomy and decision making occur during these formative adolescent years. The major gaps in the science are few studies measure key health behaviors during the school and summer in middle and high school youth and limited information exists about the social and setting contextual influences on middle and high school health behaviors over the summer and how they impact changes in BMI. Without information collected as proposed in this renewal application, the ability to design effective public health interventions to address obesity during the summer for adolescents is severely limited. In this R01 we will compare longitudinal changes in BMI z-scores and health behaviors during school and summer and from elementary school to high school, identify individual, peer, family/home, neighborhood, and school/community influences on BMI z-scores and health behaviors during school and summer from elementary school to high school, and qualitatively explore changes in adolescents’ BMI and health behaviors during the summer and school. This project is significant because it will extend a well-established existing cohort to identify the impact of an understudied timeframe (summer) associated with accelerated BMI gain during a developmental period for which no information exists (adolescence). This project is innovative because it will capture information on the same youth during school and summer, follow them over time, and collect contextually rich information to understand and identify modifiable factors to inform the design of behavioral interventions.