Linking home environments and primary care: Obesity prevention for 2-5 year olds

描述(申请人提供)：联系家庭环境和初级保健：2-4岁儿童肥胖预防高危学龄前儿童肥胖预防是公共卫生优先事项。儿科初级保健环境是一种相对未开发的资源，可用于启动预防肥胖的努力，并为家庭创造有利于健康成长的家庭环境提供建议和支持。这项发展研究(R21)的目标是开发和评估以初级保健为基础的学龄前肥胖预防干预措施的可行性和可接受性，该干预措施结合了儿科医生咨询和为2-4岁肥胖风险儿童的父母提供的家庭计划。为了达到这一目标，我们将从2-4岁高危儿童的家庭中确定和招募60名符合条件的亲子二人组，这些儿童的定义是年龄和性别的BMI在第85至95百分位数之间，或BMI在第50至85百分位数之间，且至少有一名超重父母。这些二元组将被随机分配到以下条件之一：(A)健康饮食/体育活动家庭干预，包括关于儿童当前BMI百分位数状态的简短儿科医生咨询，为实现健康体重增加轨迹而改变家庭环境的建议，以及家庭安全和降低伤害风险的环境建议，以及由大师级别的健康行为专家通过电话提供的6个月的基于家庭的计划，以促进肥胖预防家庭环境战略的实施，或(B)一般健康/安全/伤害预防家庭接触控制干预：家庭将接受儿科医生相同的简短咨询，并通过硕士级别的健康行为专家通过电话提供为期6个月的家庭培训，以促进一般健康、安全和伤害预防家庭环境战略的实施。本R21的主要目标是评估干预措施的可行性、可接受性和潜在疗效。我们将评估干预对饮食、活动水平、假设的BMI变化中介因素和BMI的影响。考虑到我们在基于电话的肥胖干预方面的专业知识，以及获得儿科初级保健人口和相关健康信息系统的机会，我们的研究环境是理想的。如果成功，这种方法将在更大范围内进行评估，并为应对21世纪最重要的公共卫生挑战之一提供一个潜在的模式。公共卫生相关性：这项R21研究将开发和测试以初级保健为基础的肥胖预防干预措施的可行性和可接受性，该干预措施包括儿科初级保健提供者的咨询和针对2-4岁肥胖风险儿童父母的家庭计划。这个以家庭为基础的项目通过电话提供，将帮助父母创造一个健康的家庭环境，以鼓励学龄前儿童健康的饮食和活动模式以及健康的体重增加。

DESCRIPTION (provided by applicant): Linking home environments and primary care: Obesity prevention for 2-4 year olds Obesity prevention for at-risk preschool children is a public health priority. The pediatric primary care setting is a relatively untapped resource for initiating obesity prevention efforts and providing recommendations and support to families for creating home environments conducive to healthy growth. The goals of this developmental (R21) study are to develop and evaluate the feasibility and acceptability of a primary care- based, preschool obesity prevention intervention integrating pediatrician counseling and a home-based program for parents of 2-4 year old children at risk for obesity. To achieve this goal, we will identify and recruit 60 eligible parent-child dyads from families of 2-4 year old at risk children defined as having a BMI between the 85th and 95th percentile for age and gender or a BMI between the 50th and 85th percentile and at least one overweight parent. These dyads will be randomized to one of the following conditions: (a) Healthy Eating/Physical Activity Home-based Intervention including brief pediatrician counseling regarding the child's current BMI percentile status, recommendations for home environmental changes to achieve a healthy weight gain trajectory, and home safety and injury risk reduction environmental recommendations paired with a 6 month home-based program delivered via phone by a masters-level health behavior specialist to promote implementation of the obesity prevention home environmental strategies, or (b) General Health/Safety/Injury Prevention Home-based Contact Control Intervention: Families will receive the same brief counseling from their pediatrician paired with a 6 month home-based program delivered via phone by a masters-level health behavior specialist to promote implementation of the general health, safety and injury prevention home environmental strategies. Primary goals of this R21 are to assess the feasibility, acceptability, and potential efficacy of the intervention. We will estimate intervention impact on diet, activity level, hypothesized mediators of BMI change, and BMI. Our study setting is ideal given our expertise in phone-based obesity interventions and access to a pediatric primary care population and associated health information systems. If successful, this approach will be evaluated on a larger scale and provide a potential model for addressing one of the most important public health challenges of the 21st century. PUBLIC HEALTH RELEVANCE: This R21 study will develop and test the feasibility and acceptability of a primary care-based obesity prevention intervention that integrates counseling by pediatric primary care providers and a home-based program for parents of 2-4 year old children at risk for obesity. The home-based program is delivered by phone and will help parents create a healthy home environment to encourage healthy eating and activity patterns and healthy weight gain in their preschool age children.