Location: Office of The Area Director
Project Number: 6001-51000-003-000-D
Project Type: In-House Appropriated
Start Date: May 1, 2014
End Date: Apr 30, 2019
Objective:
1. Determine the effects of a diet and activity enhanced Maternal, Infant, and Early Childhood Home Visiting program on weight and health related outcomes in mothers and their infants.
2. Determine associations between dietary patterns (identified using variant statistical and epidemiologic approaches) and health indicators in children using the most recent NHANES datasets.
Approach:
1. The Delta Healthy Sprouts Project is an 18-month, randomized, controlled comparative effectiveness trial. Participants are randomly assigned to 1 of 2 treatment arms (75 participants per arm) – Parents as Teachers (PaT) or Parents as Teachers Enhanced (PaTE). All participants receive monthly PaT lessons and materials. Only participants in the experimental arm receive PaTE supplemental nutrition and physical activity lessons and materials. The control arm utilizes the PaT curriculum which is a nationally recognized, evidence based MIECHV program that includes one-on-one home visits, monthly group meetings, developmental screenings, and resource networks for families. Through these activities, PaT seeks to increase parental knowledge of child development, improve parenting practices, provide early detection of developmental delays, prevent child abuse, and increase school readiness. PaTE, delivered to experimental participants, builds on PaT by adding culturally tailored, maternal weight management and early childhood obesity prevention components. These components include healthy weight gain during pregnancy, nutrition and physical activity in the gestational and postnatal periods, breastfeeding, appropriate introduction of solid foods, and parental modeling of positive nutrition and physical activity behaviors. The interventions are delivered in the home to women beginning early in their second trimester of pregnancy by community based, trained Parent Educators.
2. Dietary patterns will be determined for 2-18 year old U.S. children using the 2 most recent cycles of NHANES datasets with available dietary data. Analyses will be conducted separately by gender, age group (2-5, 6-11, and 12-18 years), race/ethnicity, and poverty income ratio (PIR) given sufficient sample sizes. The first dietary pattern identification method is based upon existing recommended dietary guidelines and current knowledge. The Health Eating Index-2010 (HEI-2010) ranks individuals in terms of compliance with the 2010 Dietary Guidelines for Americans. Total HEI-2010 scores range from 0-100 and are computed by summing scores for 12 components including: total fruit; whole fruit; total vegetables, greens and beans; whole grains; dairy; total protein foods; seafood and plant proteins; fatty acids; refined grains; sodium; and empty calories. For the first 9 components, higher intakes result in higher scores (healthier diet). For the last 3 components, lower intakes (more beneficial) result in higher scores. Latent class analysis (LCA), the second dietary pattern identification method, derives empirical dietary patterns based on current study data. Similar to cluster analysis, LCA partitions data into groups so that observations (children) within a group are as similar as possible to each other (foods consumed) and as dissimilar as possible to the observations in other groups. Differing from cluster analysis, LCA does not absolutely assign observations to groups, but assigns a probability of group membership. Associations between identified dietary pattern scores, excess adiposity, physical activity, and sedentary behavior will be determined.
