Partnering for PA in Early Childhood: Sustainability via Active Garden Education

 描述(申请人提供)：幼儿期是生命中的一个脆弱时期，也是初级预防的关键机会。从儿童早期开始，拉丁裔社区就存在着显著的健康差距，他们在研究中的代表性不足。大多数儿童参加早期护理和教育中心(ECEC)，这使其成为促进健康习惯干预的重要环境。很少有研究系统地研究使用基于社区的参与性研究(CBPR)战略来制定符合国家健康行为指南和ECEC认证标准的实用的、但在理论上有基础的干预战略。科学与社区：杜绝肥胖改善健康(S和C；PI：Lee，U13HD063190)创建了学术和社区合作伙伴关系，将幼儿、健康饮食、体育活动机会确定为目标健康问题，并将社区花园作为干预工具，从而制定了CBPR试点项目--通过积极花园教育实现可持续发展(SAGE；PI：Lee，R21HD073685-01)。目前的项目将扩大和调整SAGE，以便在四个月内交付，使用集群随机对照试验适应的交叉设计，并在组织层面测试可持续性行动计划(SAP)。在这项研究中，我们将确定SAGE干预对3-4岁儿童健康的效果。这项研究将配对并随机选择20个来自西班牙裔或拉丁裔居民比例较高的社区的ECEC。ECEC要么接受SAGE干预，要么接受安全注意比较。然后，ECEC将跨越并接受他们没有得到的待遇，以确保所有ECEC都接受这两门课程。我们将确定在加速计量仪测量的PA和久坐行为、水果和蔬菜消费方面的改善，并探索与儿童安全注意比较中在没有饥饿的情况下进食的情况。我们将探讨对育儿实践的二次影响，促进PA和水果和蔬菜的消费，家庭水果和蔬菜的可获得性，以及改善家庭食品安全。本研究将从影响、采纳和实施三个维度探讨SAGE干预的实施过程。这项研究还将开发、实施和评估SAGE ARM中的SAP，以确定SAGE干预的可复制性和制度化(可持续性)，并探索SAGE干预的可复制性和制度化(可持续性)与后续儿童结局的关系。社区伙伴关系和SAGE社区咨询委员会的发展和成功也将使用参与度、代表性和协作性指标进行评估。这项研究将 依靠CBPR战略和既定的理论模式，将政策与实践联系起来，实施参与性和转化性的多层次干预。这项工作将测试在欧洲经委会一级执行移徙组织准则的战略，并将指导今后旨在扩大有效干预措施的努力，以便在弱势人群中广泛传播，以减少健康差距。

 DESCRIPTION (provided by applicant): Early childhood is a vulnerable time in the lifespan and a key opportunity for primary prevention. Significant health disparities exist, beginning in early childhood, in the Latino community, who are underrepresented in research. Most children attend early care and education centers (ECECs), making this an important setting for intervention for promoting healthy habits. Few studies have systematically investigated using community based participatory research (CBPR) strategies to develop practical, yet theoretically grounded, intervention strategies that comply with national health behavior guidelines and ECEC accreditation standards. Science & Community: Ending Obesity Improving Health (S&C; PI: Lee, U13HD063190) created an academic- community partnership that identified early childhood, healthy eating, physical activity opportunities as target health issues and community gardens as an intervention tool, resulting in the development of the pilot CBPR project, Sustainability via Active Garden Education (SAGE; PI: Lee, R21HD073685-01). The current project will expand and adapt SAGE for delivery over a four month period using a cluster randomized controlled trial adapted crossover design, along with testing a sustainability action plan (SAP) at the organizational level. In this study, we will determine the efficacy of the SAGE intervention on health in 3-4 year old children. This study will pair match and randomize 20 ECECs from neighborhoods with high proportions of Hispanic or Latino residents. ECEC receive either the SAGE intervention or the safety attention comparison. Then, ECEC will cross over and receive the treatment that they did not receive to ensure that all ECEC receive both curricula. We will determine improvement in accelerometry measured PA and sedentary behaviors, fruit and vegetable consumption and explore eating in the absence of hunger compared to those in a child safety attention comparison. We will explore secondary impacts on parenting practices that promote PA and fruit and vegetable consumption, home fruit and vegetable availability and improved household food security. This study will explore the process of delivery of the SAGE intervention on dimensions of reach, adoption, and implementation. This study will also develop, implement, and evaluate a SAP in the SAGE arm to determine replicability and institutionalization (sustainability) of the SAGE intervention and explore the relationship between of sustainability to child outcomes at follow up. The development and success of the community Partnership and SAGE Community Advisory Board will also be evaluated using indicators of participation, representativeness, and collaboration. This study will rely on CBPR strategies and an established theoretical model to implement an engaging and translational multilevel intervention linking policy and practice. This work will test strategies fr implementing IOM guidelines at the ECE level and will guide future efforts aimed at scaling up efficacious interventions for broad dissemination in vulnerable populations to reduce health disparities.