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

解决儿童肥胖的风险因素，如家庭环境，父母角色，超重，身体 生活在农村社区的拉丁裔/西班牙裔（L/H）家庭的活动和健康饮食是一个重要的因素。 重要的优先事项。在拉丁美洲人/西班牙裔-美国增长最快的人口-儿童中， 肥胖率在上升。控制儿童肥胖增长的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，支持这些干预措施的证据 在生活在农村社区的L/H家庭中，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当的 儿童肥胖症（FBCO）计划，通过自动电话系统（IVR）的L/H家庭生活在 内布拉斯加州乡村我们将为超重或肥胖的L/H家庭进行混合方法的可行性试验 孩子在目标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，纳入文化相关内容， 图像，并使用健康传播战略，以解决不同层次的健康素养。然后我们 将评估适应的干预材料和模式的文化相关性、适用性和可用性 的交付。在目标2中，我们将随机将参与者配对（父母和孩子）分配给家庭 连接（n=29）或增强标准治疗组（n=29），并确定总体研究范围， 降低儿童BMI z分数的初步有效性，项目采用的潜力，实施， 和可持续性（RE-AIM成果）。我们还将评估健康状况 部门对i-PARIHS结构的看法（创新，背景，接受者特征），以及家庭 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，本研究将回答三个重要问题：（1）电话是一种 在内布拉斯加州农村提供FBCO计划文化相关，可用和L/H家庭接受？ (2)电话传递的FBCO项目是否能有效降低生活在农村的L/H儿童的BMI z评分 内布拉斯加？以及（3）哪些现实世界的制度和背景因素影响了 干预，并可能影响其潜在的能力，可持续地从事有意义的人口L/H 哪些家庭会受益？该项目将产生关于一个问题的地方和全球相关证据， 文化上适当的技术提供FBCO干预的L/H家庭在农村社区。

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.