Rural Disparities in Pediatric Obesity: The iAmHealthy Intervention

项目总结/摘要 研究表明，儿童肥胖症在所有儿童中的患病率都很高，但 农村地区受到的影响尤为严重。很少有专门针对儿科的干预措施 农村儿童的肥胖治疗是造成这种健康差距的一个因素。的先前研究 我们的实验室表明，移动健康是可行的，可接受的儿童肥胖干预措施， 农村儿童，因为这种类型的干预降低了儿童体重指数z评分（BMIz），并帮助儿童和 家庭显著改变他们的健康行为。当前的应用程序扩展了这项工作，在一个新的和 创新方向，将移动医疗干预措施引入农村家庭，增加便利性， 剂量同时干预措施由团体和个人家庭两个层面组成， 基于新的研究表明这种组合非常有效。最后， 干预小组也是创新的，因为他们将由来自同一所学校的儿童组成， 个人一级的因素以及在学校一级聚集的因素可在一项干预措施中解决。的 目前的研究建议比较两种积极干预措施的有效性：iAmHealthy与对照组（a 通讯对照组）采用随机分组设计。iAmHealthy是一项为期32周的行为干预计划， 专注于营养，行为和身体活动，使父母和儿童参与治疗， mHealth技术。它将基于家庭的行为团体与个人层面的儿童和家庭支持相结合- 所有这些都通过移动医疗技术直接提供给家庭。符合入选标准的儿童和家庭 共有18所学校将被随机分配到条件，至少有8个家庭参与， 每个农村学校，共有144名儿童和144名成人参加。我们假设：iAmHealthy 干预将导致食物选择比积极控制干预显著更大的改善 (as由含糖饮料的份数、“红色食物”的份数和 水果和蔬菜）; iAmHealthy干预措施将显著改善 与对照干预相比，身体活动水平（如通过运动分钟数的变化所指示的） 中度/剧烈的身体活动）;并且，iAmHealthy干预将导致显著更大的 与对照干预相比，儿童BMIz和父母BMI的改善。Aim 2使用RE-AIM框架， 衡量iAmHealthy的有效性。iAmHealthy是一个易于扩展，广泛传播的儿科 肥胖干预选择农村儿童和家庭，如果发现是有效的;目前的研究结果 可以显著改变我们治疗高风险和服务不足的农村儿童的儿科肥胖症的方式。

Project Summary/Abstract Research indicates that pediatric obesity prevalence is high among all children, but that children from rural areas are disproportionately affected. There are very few interventions specifically targeting pediatric obesity treatment among rural children, a factor that contributes to this health disparity. Previous research from our lab indicates that mHealth is feasible and acceptable for the delivery of pediatric obesity interventions to rural children as this type of intervention lowers child Body Mass Index z score (BMIz) and helps children and families to significantly change their health behaviors. The current application extends this work in a new and innovative direction by moving the mHealth intervention into rural family homes, increasing convenience and dose simultaneously. The intervention is composed of both group and individual family level components, based upon new research that indicates this combination is highly effective. Finally, the composition of the intervention groups is also innovative as they will be composed of children from the same school, making individual level factors as well as factors clustered at the school level addressable in one intervention. The current study proposes to compare the effectiveness of two active interventions: iAmHealthy vs. control (a newsletter control group) using in cluster-randomized design. iAmHealthy is a 32 week behavioral intervention focused on nutrition, behavior and physical activity that engages parents and children in treatment using mHealth technology. It combines family based behavioral groups with individual level child and family support – all provided directly to homes via mHealth technologies. Children and families meeting inclusion criteria from a total of 18 schools will be randomly assigned by school to condition, with at least 8 families participating at each rural school, for a total of 144 child and 144 adult participants. We hypothesize that: the iAmHealthy intervention will result in significantly greater improvement in food choices than the active control intervention (as indicated by servings of sugar sweetened beverages, number of servings of “red foods,” and number of servings of fruits and vegetables); the iAmHealthy intervention will result in significantly greater improvement in levels of physical activity than the control intervention (as indicated by change in number of minutes of moderate/vigorous physical activity); and, that the iAmHealthy intervention will result in significantly greater improvement in child BMIz and parent BMI than the control intervention. Aim 2 uses the RE-AIM framework to measure the effectiveness of iAmHealthy. iAmHealthy is an easily scalable, widely disseminable pediatric obesity intervention option for rural children and families, if found to be effective; the results of the current study could significantly alter the way we treat pediatric obesity among high risk and underserved rural children.