脆弱な家庭における小児肥満予防のための多要素早期介入の評価 (Bambú)

対照群は介入を受けません。 対照群に割り当てられた家族は、通常のケアを受けます。

研究期間中、他のトレーニングや支援サービスへのアクセスについて、家族や一次医療センターに制限は設けませんが、この情報は潜在的な交絡因子として監視されます。

介入群に割り当てられた一次医療センターは、研究終了前に対照群の他のセンターに介入内容を共有しないよう求められます。

This arm will include all primary care centers assigned to the intervention group.

All participants (parents) within these centers will receive the Bambú intervention.

They will participate in a 9-session group-based face-to-face intervention. Sessions will last 2 hours. The first 5 sessions will be delivered weekly and the following 4 sessions will be delivered monthly. They will be delivered at primary care centers in Catalonia, Andalusia, the Balearic Islands and Castile and León. They will be led by two professionals, either healthcare professionals working at the primary care center (who will be previously trained) or by members of the research team.

The following main topics will be covered in the program: (1) nutrition; (2) physical activity and interactive play; (3) emotion regulation; (4) positive parenting; (5) child sleep; and (6) community support networks.

Approximately 38 groups will be conducted, and each of them will include around 7 families.

Bambúプログラムは、6か月から3.11歳の子供を持つ親を対象とした対面式の9セッションのグループベースの介入プログラムで、少なくとも一方の親が過体重または肥満であることを条件としています。 各セッションは2時間です。 最初の5セッションは毎週実施され、残りの4セッションは毎月実施されます。 セッションは2人の訓練を受けた共同リーダーによって進行されます（トレーニングには2回のオンラインセッションと、すべての介入資料が含まれる仮想プラットフォームへのアクセスが含まれます）。

プログラムは6つの主要トピックをカバーしています：(1) 栄養：食事習慣と食事推奨事項；(2) 身体活動とインタラクティブな遊び；(3) 感情調整スキルとテクニック；(4) ポジティブな子育て；(5) 子供の睡眠；(6) コミュニティサポートネットワーク。

介入は構造化されており、ビデオ視覚化とインタラクティブな活動を含みます。

このプログラムは以前、過体重または肥満の脆弱な家族のニーズと好みに合わせて設計することを目指し、家族と医療専門家によって共同で設計されました。

The Feeding Practices and Structure Questionnaire is a self-administered questionnaire that measures parental feeding practices, specifically maternal responsiveness to children's hunger/satiety signals facilitated by routine and structure in feeding.

Age- and feeding-stage-appropriate versions of the questionnaire will be administered: (a) the specific FPSQ-28 version for children aged ≥2 years; and (b) the FPSQ version for children aged <2 years, either the FPSQ milk-feeding version (for caregivers predominantly feeding their child with milk) or the FPSQ (semi-)solids version (for caregivers predominantly feeding their child with solid food.

Each subscale is scored separately (range 1-5). No overall total score is calculated. Higher scores indicate greater endorsement of the feeding practice represented by the subscale.

The Movement Behavior Questionnaire is a self-administered questionnaire that measures physical activity, screen time and sleep in infants, toddlers and preschoolers.

The two age-specific versions of the questionnaire will be used: the MBQ-Baby (MBQ-B) for infants who have not yet reached the walking milestone, and the MBQ-Child (MBQ-C) for children who are able to walk. The closed-ended versions of the MBQ will be used.

The questionnaire does not produce a total score. It assesses individual movement behaviours (e.g., tummy time, physical activity, screen time, restrained time, sleep duration). Interpretation depends on the behaviour measured and its alignment with age-specific movement guidelines.

Parents' eating patterns will be measured with the self-administered Dutch Eating Behavior Questionnaire.

The questionnaire comprises three subscales (Restrained Eating, Emotional Eating, and External Eating), each scored separately by averaging item responses (range 1-5). No overall total score is calculated. Higher scores indicate greater endorsement of the eating behaviour measured by each subscale; the interpretation of whether this represents a more or less desirable outcome depends on the subscale.

Selected items (applicable to the whole children's age range included in the study) from the Brief Infant Sleep Questionnaire (BISQ) will be used to measure child sleep.

The complete BISQ will not be administered because the original questionnaire is not appropriate for the full age range of the study population. Sleep parameters derived from selected BISQ items will be analyzed individually. No total sleep score will be calculated; therefore, there is no overall minimum or maximum score. The direction of interpretation depends on the specific sleep parameter assessed (e.g., longer sleep duration is generally considered favorable, whereas more frequent night awakenings or longer nocturnal wakefulness may indicate poorer sleep).

Parents' acceptability and satisfaction with the program will be assessed with a Final Participant Satisfaction Questionnaire. Data will be collected after the last session of the intervention.

Higher scores indicate greater acceptability and satisfaction with the intervention.