SANOS (SAlud y Nutricion para todOS)

SANOS（SAlud y Nutricion para todOS）

• 批准号: 10376041
• 负责人: Jennifer CF Leng
• 金额: $ 85.59万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10376041
• 关键词: Address; Affect; Area; Attitude; Behavior; Behavioral; Belief; Blood Pressure; Body Weight decreased; Body mass index; Cardiovascular Diseases; Cholesterol; Church; Communities; Consumption; Counseling; Data; Diabetes Mellitus; Diabetes prevention; Dietary Intervention; Effectiveness of Interventions; Expectancy; Government; Health; Health Benefit; Hispanic; Hispanic Populations; Immigrant; Individual; Institution; Intake; Intervention; Knowledge; Latino; Latino Population; Lead; Linguistics; Link; Location; Low income; Malignant Neoplasms; Mediation; Mediator of activation protein; Memorial Sloan-Kettering Cancer Center; Methodology; Mexican; Mexican Americans; Mexico; Minority; Minority Groups; Monitor; Neighborhoods; New York; New York City; Not Hispanic or Latino; Obesity; Outcome; Outcome Study; Overweight; Participant; Persons; Population; Privatization; Randomized; Randomized Controlled Trials; Research; Resources; Risk Factors; Schools; Self Efficacy; Services; Site; Telephone; Testing; Text Messaging; Time; Weight; Woman; base; cancer health disparity; cancer risk; cardiovascular disorder risk; community setting; cost; cost estimate; design; diabetes prevention program; diet and exercise; efficacy outcomes; ethnic minority; health care availability; health disparity; healthy lifestyle; high risk population; incremental cost-effectiveness; innovation; lifestyle intervention; men; metropolitan; multiphase optimization strategy; nutrition; obese person; obesity treatment; primary outcome; programs; risk sharing; secondary outcome; social cognitive theory; theories; tool; treatment optimization; waist circumference; weight loss intervention

Project Summary SANOS (SAlud y Nutrición para todOS) (Health and Nutrition for All) addresses the obesity crisis among Hispanics, the largest, fastest growing U.S. minority and immigrant group at 53 million, 17% of the total U.S. population. Mexicans are the largest U.S. Hispanic population; nearly two-thirds of Hispanics originate from Mexico. Obesity and its associated health consequences disproportionately affect minority populations; Hispanics, and particularly Mexican Americans, are among the highest risk groups. 78.3% of U.S. Mexican women and 81.9% of U.S. Mexican men are overweight or obese, compared to 60.9% of non-Hispanic White women and 73.2% of non-Hispanic White men. Obesity is a shared risk for both cardiovascular disease (and its risk factors) and cancer. While there is much evidence on effective multicomponent lifestyle interventions in non-minority populations (e.g. Diabetes Prevention Program and Action for Health in Diabetes (Look AHEAD)), these programs are considered too expensive and burdensome to be widely disseminated. There is a paucity of data on how to optimize such approaches for hard-to-reach communities such as Hispanic immigrants. Most weight-loss interventions have been less successful with ethnic minorities, including Hispanics. There is a pressing need to design optimized lifestyle interventions for minority populations, particularly in accessible community settings, that reduce participant burden and costs but retain essential intervention components for meaningful weight loss. SANOS is the first study to use the Multiphase Optimization Strategy (MOST), an innovative methodological framework, to address this gap. Ventanillas de Salud (VDS; Health Windows) is a bi-national collaborative program between the Mexican government and over 400 non-profit and private agencies, working to increase access to health care and promote healthy lifestyle choices among low-income U.S. Latinos. In 2016, the VDS purchased a mobile van, outfitting the vehicle with space to provide consular services and to conduct health screenings (“VDS Mobile”) in NYC neighborhoods with large Mexican populations. SANOS components were developed from a pilot program at the NY VDS; in this application we propose testing these components at VDS Mobile to reach the most marginalized. The overall objective of SANOS is to use MOST to design, for the first time, an optimized version of a scalable, culturally and linguistically tailored diet and lifestyle intervention for U.S. Mexicans. In the proposed research we will identify which of 4 obesity intervention components contribute most to decreasing weight by 5% from baseline (primary outcome) among overweight or obese individuals at 6 months post-intake. Components include: i) Initial in- person individual diet and exercise counseling; ii) Thrice weekly diet and exercise text messages; iii) Weekly telephone support; and iv) Self-monitoring tools. Secondary outcomes include improvements in BMI, waist circumference, HgbA1c, cholesterol, blood pressure, and diet and exercise behavior. We will also estimate the cost and incremental cost-effectiveness of the intervention components.

项目摘要 Sanos(Salud y Nucición Para Todos)(全民健康和营养)解决了以下人群的肥胖危机 拉美裔是美国最大、增长最快的少数民族和移民群体，有5300万人，占美国人口总数的17%。 人口。墨西哥人是美国最大的拉美裔人口；近三分之二的拉美裔美国人来自 墨西哥。肥胖及其相关的健康后果对少数群体的影响不成比例； 拉美裔，特别是墨西哥裔美国人，是风险最高的群体之一。78.3%的美国墨西哥人 美国墨西哥女性和81.9%的男性超重或肥胖，而非西班牙裔白人的这一比例为60.9% 女性和73.2%的非西班牙裔白人男性。肥胖是心血管疾病的共同风险(和 其风险因素)和癌症。虽然有很多证据表明有效的多成分生活方式干预在 非少数群体(如糖尿病预防规划和糖尿病健康行动(展望未来))， 这些节目被认为过于昂贵和繁重，无法广泛传播。有一种稀缺 关于如何为拉美裔移民等难以到达的社区优化这种方法的数据。多数 在包括西班牙裔在内的少数族裔中，减肥干预并不那么成功。有一个 迫切需要为少数群体设计优化的生活方式干预措施，特别是在无障碍地区 社区环境，减少参与者负担和成本，但保留必要的干预组件 有意义的减肥。SANOS是第一个使用多阶段优化策略(MOST)的研究， 创新的方法框架，以解决这一差距。Ventanillas de Salud(VDS；Health Windows)是 墨西哥政府与400多个非营利性和私人组织之间的双边合作项目 机构，努力增加获得医疗保健的机会，并在低收入者中促进健康的生活方式选择 美国拉丁裔。2016年，VDS购买了一辆流动面包车，为车辆配备了空间，以提供领事 服务并在纽约市有大量墨西哥人的社区进行健康筛查(VDS Mobile) 人口。SANOS组件是从NY VDS的一个试点计划中开发的；在此应用程序中，我们 建议在VDS Mobile测试这些组件，以接触到最边缘化的人群。总的目标是 Sanos将首次使用MOST来设计可扩展、文化和 为美国墨西哥人量身定做的饮食和生活方式干预。在拟议的研究中，我们将确定 以下4项肥胖干预措施中，哪一项对体重较基线降低5%的贡献最大(主要 结果)超重或肥胖者在摄入后6个月。组件包括：i)首字母in- 个人饮食和运动咨询；二)每周三次饮食和运动短信；三)每周一次 电话支持；以及四)自我监测工具。次要结果包括BMI、腰围的改善 周长、糖化血红蛋白、胆固醇、血压、饮食和锻炼行为。我们还将估计 干预措施组成部分的成本和增量成本效益。