Cultural adaptation and feasibility testing of a technology-based pediatric weigh management intervention for rural Latino communities

解决儿童肥胖的危险因素，如家庭环境、父母角色、超重、身体状况 在生活在农村社区的拉美裔/西班牙裔家庭中，活动和健康饮食是一种 重要的优先事项。在拉美裔/拉美裔中--美国人口增长最快的--童年 肥胖率正在上升。控制儿童肥胖增长的一个有效策略是以家庭为基础的计划 针对超重和肥胖儿童的父母。然而，支持这些干预的证据 在居住在农村社区的L/H家庭中，失踪。在这里，我们将使用文化适应和 执行科学框架，以评估提供文化上适宜的以家庭为基础的 通过自动电话系统向L/H家庭提供儿童肥胖计划 内布拉斯加州的乡村。我们将对L/H超重或肥胖家庭进行混合方法可行性试验 孩子们。在目标1中，我们将首先协作调整所有干预材料，以更好地适应农村L/H 社区概况，包括将材料翻译成西班牙语，包括与文化相关的内容和 图像，并使用健康传播战略，以解决不同水平的健康素养。然后，我们 将评估适应的干预材料和模式的文化相关性、适宜性和可用性 送货上门。在目标2中，我们将随机将参与者二元组(父母和孩子)分配给任何一个家庭 连接(n=29)或增强型标准护理组(n=29)，并确定总体研究范围， 在降低儿童体重指数z分数方面的初步有效性、计划采用、实施、 并通过地方卫生部门实现可持续发展(RE-AIM成果)。我们还将评估健康状况 部门对i-PARIHS结构(创新、背景、接受者特征)和家庭的看法 连接参与者对干预的看法(即相对优势、可观察性、可试验性、 复杂性、兼容性)。总之，这项研究将回答三个重要的问题：(1)是电话 在内布拉斯加州农村地区提供具有文化相关性、可使用并被L/H家庭接受的FBCO项目？ (2)电话传递的FBCO项目对降低L/H农村儿童的体重指数z-得分有效吗？ 内布拉斯加州？以及(3)哪些现实世界的制度和背景因素会影响 干预并可能影响其可持续地吸引L/H有意义人口的潜在能力 哪些家庭将从中受益？该项目将在当地和全球范围内产生关于 文化适宜的技术--为农村社区的L/H家庭提供家庭护理干预。

Addressing childhood obesity risk factors like home environment, parental roles, excess weight, physical activity, and healthy eating among Latinos/Hispanic (L/H) families living in rural communities is an important priority. Among Latinos/Hispanics--the fastest growing population in United States—childhood obesity is rising. An effective strategy for controlling childhood obesity growth is family-based programs targeting the parents of overweight and obese children. However, evidence supporting these interventions among L/H families living in rural communities is missing. Here we will use cultural adaptation and implementation science frameworks to evaluate the feasibility of delivering a culturally appropriate familybased childhood obesity (FBCO) program via an automated telephone system (IVR) to L/H families living in rural Nebraska. We will conduct a mixed-methods feasibility trial for L/H families with overweight or obese children. In Aim 1, we will first collaboratively adapt all intervention materials to better fit the rural L/H community profile, including translation of materials to Spanish, inclusion of culturally relevant content and images, and use of health communication strategies to address different levels of health literacy. Then, we will evaluate the cultural relevance, suitability, and usability of the adapted intervention materials and mode of delivery. In Aim 2, we will randomly assign participant dyads (parent and child) to either Family Connections (n=29) or an enhanced standard-care group (n=29) and determine overall study reach, preliminary effectiveness in reducing child BMI z- scores, potential for program adoption, implementation, and sustainability through local health departments (RE-AIM outcomes). We will also evaluate health department perceptions of i-PARIHS constructs (innovation, context, recipient characteristics), and Family Connections participants’ view of the intervention (i.e., relative advantage, observability, trialability, complexity, compatibility). In conclusion, the study will answer three important questions: (1) Is a telephone delivered FBCO program in rural Nebraska culturally relevant, usable and acceptable by L/H families? (2) Is a telephone delivered FBCO program effective at reducing BMI z-scores in L/H children living in rural Nebraska? and (3) What real-world institutional and contextual factors influence the impact of the intervention and might affect its potential ability to sustainably engage a meaningful population of L/H families who stand to benefit? This project will generate locally and globally relevant evidence on a culturally appropriate technology-delivered FBCO intervention for L/H families in rural communities.