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Improving Family Functioning in Obesity Treatment for Mexican American Women

改善墨西哥裔美国妇女肥胖治疗中的家庭功能

基本信息

批准号：
10279178
负责人：
BECKY MARQUEZ
金额：
$ 70.52万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-17 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10279178
关键词：
Acculturation Address Adherence Adoption Adult Adult Children Affect Age of Onset Age-Years Attitude Behavior Behavior Therapy Behavioral Belief Body Weight Changes Body Weight decreased Body fat Body mass index Buffers Child Code Collaborations Communication Competence Conflict (Psychology)Counseling Couples Therapy Daughter Diabetes Mellitus Diet Eating Education Effectiveness of Interventions Emotional Family Family history of Family member Glycosylated hemoglobin A Goals Health Benefit Health behavior Individual Intervention K-Series Research Career Programs Link Literature Maintenance Mediation Mental Depression Mentors Mexican Americans Modification Monitor Mothers Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Obesity Outcome Outcome Study Parent-Child Relations Parents Participant Patient Self-Report Pattern Phase Physical activity Physiological Prevalence Prevention Problem Solving Public Health Randomized Randomized Controlled Trials Recording of previous events Records Reporting Research Risk Role Structure System Techniques Testing Training Translating Treatment outcome Weight maintenance regimen Well in self Woman base behavior change cohesion commune control trial coping depressive symptoms diabetes management diabetes risk efficacy testing expectation experience follow-up improved intergenerational intervention effect lifestyle intervention member novel nutrition obesity risk obesity treatment perceived stress primary outcome psychologic secondary outcome skills skills training success treatment adherence treatment disparity waist circumference weight loss intervention weight maintenance young adult

项目摘要

SUMMARY Mexican American women are disproportionately affected by obesity and obesity-related conditions, such as type 2 diabetes. Obesity and diabetes are highly concordant in Mexican American families. Given the younger age of onset of diabetes in women with familial history, targeting mothers and their adult daughters for obesity treatment is warranted. From a family systems perspective, family-level approaches to obesity treatment can improve the adoption and maintenance of weight management behaviors. Including family members in treatment may also serve as a culturally salient intervention strategy as Mexican Americans endorse high level of familism. In contrast to traditional individual-level approaches to obesity treatment, a family-level approach grounded in familism would promote shared goals, collaborative problem solving, and communal coping when treating family members alongside each other. An important construct to consider when working with intergenerational Mexican American families is differences in acculturation, which may translate into differences in attitudes and behaviors. A wider gap in acculturation between parent and child has previously been associated with lower family functioning (e.g., poor communication, high conflict, low cohesion). However, interventions that promote bicultural competence by changing interactional patterns have been effective at improving family functioning. Hence, this study will conduct a randomized control trial testing the efficacy of a behavioral weight management intervention with brief and structured counseling on family functioning. Mexican American mothers and adult daughters (n=118 dyads) will be randomly assigned to receive standard behavioral treatment (SBT) or standard behavioral treatment plus relationship skills training (SBTR). Dyads participating in SBT or SBTR will attend 24 weekly sessions focused on nutrition and physical activity education along with behavior modification techniques. Dyads participating in SBTR will also receive experiential-based relationship skills training that draws from both general family systems concepts and behavioral family/couples therapy approaches to support familism, biculturalism, and communication competencies. The 12-month trial will consist of an intervention phase (1-6 months) and a maintenance phase (7-12 months). Assessments will be conducted at baseline and at the end of the intervention and maintenance phases. The primary outcome is weight loss. Secondary outcomes include treatment adherence (session attendance and self-monitoring records), physiological indicators of diabetes risk (hemoglobin A1c, waist circumference, and body fat percentage), health behaviors (eating and physical activity), psychological well- being (depression and perceived stress), and family functioning (subjective self-report and objective behavioral coding). Dyads in the SBTR group are expected to achieve greater improvements in primary and secondary outcomes than the STB group. Additionally, mediation by family functioning of intervention effects on primary and secondary outcomes will be examined.

总结