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Project Viva - assessing the earliest influences on health and development
Matt Gillman
Project Viva is a prospective study of pregnant women and their children to study how factors that occur during pregnancy or around the time of delivery affect common childhood conditions and precursors to adult health outcomes. Between 1999 and 2002, Project Viva staff enrolled 2670 pregnant women who received prenatal care at Harvard Vanguard Medical Associates, and they continue to follow the mothers and children, the oldest of whom is now 6 years old. Thus far Project Viva has evaluated causes of preterm birth and fetal growth and a variety of childhood outcomes, including obesity, blood pressure, cognitive development, and asthma. This program has been funded by the National Institutes of Health and other sponsors. It is led by Dr. Matthew Gillman; Drs. Janet Rich-Edwards, Emily Oken, Elsie Taveras, and Ken Kleinman are DACP-based co-investigators. Twenty-four DACP faculty and staff work on Project Viva.
Click here for the Project Viva Web site,
Click here for the abstracts of selected NIH grants that support Project Viva,
and
Click here to see 10 selected Viva publications
Finding: Children who eat fried food away from home are heavier.
As part of DACP research on the epidemic of obesity that is affecting children across the country, Elsie Taveras, Matthew Gillman and others obtained dietary and other information from more than 14,000 children aged 9-14 for three years. Children who ate fried food away from home more than 4 times a week were typically heavier than children who did this less often, and they were more likely to have a diet that was less healthy in a variety of ways. Eating fried food out of the home more frequently was also associated with greater weight gain over time.
Click here to see the citation and abstract
Obesity Prevention Program - Identifying causes and finding solutions to the obesity epidemic
Matt Gillman
Since rates of overweight among both children and adults continue to climb, obesity has become a leading focus of research in the US. The Department of Ambulatory Care and Prevention (DACP) has particular expertise in this area - several DACP faculty members have studied the origins and development of obesity and conducted behavior change interventions to prevent this serious health problem in both children and adults. The HPHC Foundation recently provided support to create The Obesity Prevention Program at DACP. Through the work of its faculty members and collaborations with colleagues at local medical institutions, the Program will support research into the causes and consequences of obesity and conduct preventive interventions in clinical and community settings. DACP Associate Professor Matthew Gillman, MD, who will lead the program, is one of the leading researchers in the US in the area of prenatal and childhood origins of obesity. He leads Project Viva, a long- term study of the effects of pre- and peri-natal factors on childhood obesity and other adverse health conditions. Several other current DACP faculty members will have substantial roles in the Program, and DACP plans to recruit two new faculty members for this initiative as well. Following is an example of a DACP behavior change intervention in the clinical setting:
Click here for the Obesity Prevention Program Web site
High Five for Kids! - Intervening early to prevent obesity in young children
Elsie Taveras
At present there are few tested strategies available to pediatric clinicians to address the issue of increasing childhood obesity. DACP investigators Matthew Gillman, MD and Elsie Taveras, MD have been awarded a grant from the National Institute of Health to develop an intervention program in Harvard Vanguard Medical Associates pediatric practices to reduce the number of overweight pre-school children. The one-year intervention will have a two-year follow up period to assess long-term results and include children 2-6 years old who exceed weight recommendations for their age. The program will incorporate elements of behavior change theory and attempt to change parental behavior in order to change the child's behavior. Advanced practice clinicians will engage parents with motivational interviews, brief negotiation, goal setting, and advice about healthful dietary practices and physical activity. In addition, the program will attempt to reduce TV viewing and consumption of sugary beverages and fast food.
Center for Child Health Care Studies - Finding new ways to improve child health
Tracy Lieu
The Center for Child Health Care Studies aims to improve children's health through research that enhances decision-making by families, clinicians, and policymakers. Center investigators specialize in health services research, which evaluates how health care practices, financial and organizational processes, social factors, and personal behaviors affect health.
Areas of current research include asthma, infectious diseases, nutrition, attention deficit-hyperactivity disorder, health insurance policy, cultural diversity, and community-based health. Recently published studies include an evaluation of the projected health benefits and cost-effectiveness of a new vaccine against whooping cough in teenagers
(click here), a survey of parents' and physicians' opinions about whether ear infections should always be treated with antibiotics
(click here), and an analysis that found that children who eat more fast food are more likely to be obese (
click here). The Center receives core support from the Harvard Pilgrim Health Care Foundation. Center researchers received external grant support of more than $3.5 million in 2005 from sources including the National Institutes of Health, Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality, Robert Wood Johnson Foundation, and Health Resources and Services Administration, Maternal and Child Health Bureau. The Center includes Dr. Tracy Lieu, Director; Dr. Jonathan Finkelstein, Associate Director; and Drs. Alison Galbraith, Matthew Gillman, Don Goldmann, Grace Lee, Sharon Muret-Wagstaff, Lisa Prosser, Colin Sox, and Elsie Taveras.
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