Southern California Center for Chronic Health Disparities in Latino Children and Families.

南加州拉丁裔儿童和家庭慢性健康差异中心。

• 批准号: 10437267
• 负责人: Michael Isaac Goran
• 金额: $ 505.53万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10437267
• 关键词: Address; Affect; Age; Air Pollution; Biometry; Birth; California; Cardiometabolic Disease; Chemical Exposure; Child; Chronic; Chronic Disease; Clinical; Collaborations; Communication; Communities; Complex; County; Data; Data Analyses; Development; Diet; Dyslipidemias; Eating Behavior; Economic Factors; Education; Elderly; Ensure; Environment; Evaluation; Factor Analysis; Family; Foundations; Funding; Generations; Goals; Government; Health; Health Food; Hispanics; Home; Household; Individual; Intervention; Language; Latino; Lead; Leadership; Life; Life Cycle Stages; Los Angeles; Mentors; Methods; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Parents; Pediatric Hospitals; Physical activity; Pilot Projects; Play; Policies; Population; Prevalence; Prevention; Process; Randomized Clinical Trials; Research; Research Personnel; Resources; Risk Reduction; S-nitro-N-acetylpenicillamine; Science; Support System; Technical Expertise; Testing; Underrepresented Populations; Universities; base; career; clinical efficacy; cohort; community engagement; cost; cultural values; data harmonization; data management; data sharing; design; disease disparity; disorder risk; early-life nutrition; efficacy evaluation; environmental intervention; health disparity; innovation; intergenerational; literacy; multidisciplinary; non-alcoholic fatty liver disease; nutrition; obesity treatment; programs; response; social; social determinants; social factors; success; synergism; telehealth; therapy design; transmission process; treatment program; voucher

Obesity and related chronic diseases, type 2 diabetes, non-alcoholic fatty liver disease, and dyslipidemia continue to increase in the U.S., and Latinos are disproportionally affected. These disparities begin in early life, occur within families, and are driven by multi-level factors, including individual (diet, eating behaviors), social (cultural values, economic factors), and environmental (access to healthy foods, chemical exposures such as air pollution). These factors interact to affect Latino health but are rarely studied in a holistic manner. Our overarching goal is to understand how these multi-level factors contribute to multiple chronic disease disparities in Latinos across the life course, and to develop and evaluate family-based, culturally sensitive solutions. We propose to accomplish this ambitious goal by establishing the Southern California Center for Chronic Health Disparities in Latino Families and Children (SCC-CHDLFC), a coalition of academic, clinical, government, and community stakeholders across the region that is home to 10.8 million Latinos representing 45.2% of the population. The Center is led by Drs. Goran (Children’s Hospital Los Angeles; CHLA) and Baezconde-Garbanati (Univ. of Southern California; USC), who provide complementary expertise in Latino health disparities research. The Administrative Core provides leadership, oversight, communication, and evaluation to strengthen and build collaboration, accelerate research, and drive innovation to ensure Center success and impact. Project 1 (led by Dr. Goran, CHLA) utilizes an ongoing birth-cohort to examine how early-life nutrition, environment, and social factors affect chronic disease risk by age 5y, and how these factors affect response to family-based interventions in Projects 2 and 3. Project 2 (led by Dr. Boutelle, UC San Diego) tests a parent-only intervention for treatment of obesity and chronic disease risk in Latino children. The intervention, designed to address cultural issues relevant to Latino families, is delivered by telehealth to parents only, increasing dissemination potential. Project 3 (led by Dr. Cohen, Kaiser Permanente) examines the efficacy of an affordable grocery delivery program (at a cost not exceeding SNAP dollars), in conjunction with culturally appropriate meal planning, on chronic disease risk reduction in Latino multi-generation households. We will support synergy and collaboration across these projects and build the research enterprise through Center Cores. The Methods & Data Sub-Core led by Dr. Espinoza (CHLA) will provide expertise in assessment of diet, social, environmental, and geospatial factors, and data analysis and management, to support data harmonization and sharing. The Investigator Development Core led by Drs. Spruijt-Metz and de la Haye (USC) and Elder (San Diego State Univ.) will establish a mentoring network and pilot study program to support early-stage or underrepresented researchers, while also promoting team science. The Community Engagement Core led by Drs. Kipke (CHLA) and Baezconde-Garbanati (USC) engages the community in the research process via bi-directional interaction with the overall goal to accelerate the impact of Center findings on the Latino community to mitigate chronic disease risk across the region.

肥胖及相关慢性疾病、2型糖尿病、非酒精性脂肪肝、血脂异常 在美国，这种情况持续增加，而拉丁裔受到的影响尤为严重。这些差异从早年就开始了 发生在家庭内部，并受到多层次因素的驱动，包括个人（饮食、饮食行为）、社会 （文化价值观、经济因素）和环境（获得健康食品、接触空气等化学物质） 污染）。这些因素相互作用，影响拉丁裔的健康，但很少进行整体研究。我们的 总体目标是了解这些多层次因素如何导致多种慢性病的差异 拉丁美洲人的整个生命历程，并制定和评估基于家庭的、文化敏感的解决方案。我们 建议通过建立南加州慢性健康中心来实现这一雄心勃勃的目标 拉丁裔家庭和儿童的差异 (SCC-CHDLFC)，一个学术、临床、政府、 该地区有 1080 万拉美裔人口，占总人口的 45.2% 人口。该中心由博士领导。 Goran（洛杉矶儿童医院；CHLA）和 Baezconde-Garbanati （南加州大学；南加州大学），他们在拉丁裔健康差异研究方面提供补充专业知识。 行政核心提供领导、监督、沟通和评估，以加强和建设 协作、加速研究并推动创新，以确保中心的成功和影响力。项目1（由 Goran 博士（CHLA）利用一个持续的出生队列来研究生命早期的营养、环境和社会影响如何 影响 5 岁慢性病风险的因素，以及这些因素如何影响对家庭干预措施的反应 在项目 2 和 3 中。项目 2（由加州大学圣地亚哥分校的 Boutelle 博士领导）测试了仅限家长的治疗干预措施 拉丁裔儿童的肥胖和慢性病风险。旨在解决文化问题的干预措施 与拉丁裔家庭相关的信息仅通过远程医疗提供给家长，从而增加了传播潜力。项目 3（由 Kaiser Permanente 的 Cohen 博士领导）研究了负担得起的杂货配送计划的有效性（以 费用不超过 SNAP 美元），并结合文化上适当的膳食计划，针对慢性病 减少拉丁裔多代家庭的风险。我们将支持这些领域之间的协同与合作 通过中心核心项目并建立研究企业。由博士领导的方法和数据子核心 埃斯皮诺萨 (CHLA) 将提供饮食、社会、环境和地理空间因素评估方面的专业知识，以及 数据分析和管理，支持数据协调和共享。研究者的发展 核心由博士领导。 Spruijt-Metz 和 de la Haye（南加州大学）以及 Elder（圣地亚哥州立大学）将建立一个指导 网络和试点研究计划，以支持早期或代表性不足的研究人员，同时也促进 团队科学。由博士领导的社区参与核心。 Kipke (CHLA) 和 Baezconde-Garbanati (南加州大学) 通过双向互动让社区参与研究过程，总体目标是加速 中心研究结果对拉丁裔社区的影响，以减轻整个地区的慢性病风险。