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

肥胖及相关慢性病、2型糖尿病、非酒精性脂肪性肝病和血脂异常 在美国继续增加，拉美裔人受到的影响不成比例。这些差异在生命早期就开始了， 发生在家庭内部，由多个层面的因素驱动，包括个人(饮食、饮食行为)、社会 (文化价值、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，但很少有人以整体的方式进行研究。我们的 首要目标是了解这些多层次因素如何导致多种慢性病差异 在拉美裔人的整个生活过程中，开发和评估以家庭为基础、对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)，一个由学术、临床、政府、 以及该地区的社区利益相关者，该地区有1080万拉丁裔，占 人口。该中心由Goran博士(洛杉矶儿童医院；CHLA)和Baezconde-Garbanati领导 (大学)南加州大学)，他们在拉丁裔健康差距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，以加强和建立 协作、加速研究和推动创新，以确保中心的成功和影响力。项目1(由 Goran博士，CHLA)利用正在进行的出生队列研究早期生命营养、环境和社会 影响5岁以下慢性病风险的因素，以及这些因素如何影响对以家庭为基础的干预措施的反应 在项目2和项目3中，项目2(由加州大学圣地亚哥分校的布特尔博士领导)测试了仅由父母参与的治疗干预 拉美裔儿童的肥胖和慢性病风险。这一干预旨在解决文化问题 与拉丁裔家庭相关的，仅通过远程保健传递给父母，增加了传播潜力。项目 3(由科恩博士领导，Kaiser Permanente)检查了负担得起的食品杂货递送计划的有效性(在 费用不超过SNAP美元)，与文化上适当的饮食计划相结合，用于慢性病 在拉丁裔多代家庭中降低风险。我们将支持这些领域的协同和协作 项目，并通过中心核心建设研究型企业。方法和数据子核由Dr。 Espinoza(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，以支持数据协调和共享。调查员的发展 核心由Spruijt-Metz博士、De la Haye博士(南加州大学)和Elder博士(圣地亚哥州立大学)领导。将建立一种指导 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，同时还促进 团队科学。由Kipke博士(CHLA)和Baezconde-Garbanati博士(南加州大学)领导的社区参与核心 通过双向互动让社区参与到研究过程中，总体目标是加速 中心的调查结果对拉美裔社区的影响，以减轻整个地区的慢性病风险。

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.