HomeStyles: Shaping HOME Environments and LifeSTYLE Practices to Reduce Cardiometabolic Disease Risk

研究项目1-家居风格-摘要 中国血统的人现在是美国亚裔人口中最大和增长最快的部分。美国 中国人的社会人口特征和文化与其他美国亚裔有很大的不同， 因此在健康、健康状况和疾病风险的社会决定因素上存在差异。美国华人成年人在 心脏代谢疾病、相关疾病（肥胖、2型糖尿病、高血压）风险增加， 以及促进疾病发作和发展的全身性炎症。移民到一个新的国家可以 实质上影响可促进全身炎症的肠道微生物组。 我们的试验性干预表明，富含全谷物的高纤维饮食可以减少炎症和炎症反应。 改善肥胖。此外，我们在美国农业部支持下的循证家居干预措施 在改善生活方式行为和家庭方面的可行性、可接受性和有效性 与家庭肥胖风险相关的环境。缺乏针对语言和文化的干预措施 这使得美国华人很难实施健康的生活方式行为并减少 健康风险。我们不知道有任何针对美国华人的干预措施会削弱可修改的 心脏代谢风险因素，了解生理后遗症，并弥合健康公平。 因此，本R01提案的总体目标是测试HomeStyles在改善健康方面的功效 在纽约/新泽西的美国华人中的结局。提案的目的是：A）从文化上调整家居风格干预 通过社区参与的办法。B）进行为期10周的双组随机对照试验，以测试家庭风格干预 对健康结局（饮食摄入、体力活动、自我效能、HbA1C、腰围和 BMI），假设随机分配至治疗条件的受试者在 健康结局。C）检查干预参与和肠道反应之间的关系 微生物群/全身性炎症，并测试假设，全谷物丰富的饮食采用的那些在 干预组会增加抗炎性肠道菌群，减少炎性肠道菌群，并降低 全身炎症。 该提案的目标与NIMHD的具体利益以及RFA MD-21 - 007相一致。这包括 旨在改善少数民族人群健康不平等现象并减少 多个常见的风险因素（例如，肥胖、营养不良、缺乏运动、睡眠不足、全身性 炎症），以及解决多代慢性病风险和 保护性因素。一个适应不同文化的家居风格干预措施有很大的潜力来改善我们的 了解美国和中国人群的健康差异，理解转化 机制，通过以下方式为家庭和社区干预提供信息 可持续的参与，并作为这一群体的健康干预模式。

Research Project 1 – HomeStyles – Abstract Individuals of Chinese heritage now are the largest and fastest growing segment of the US Asian population. US Chinese have sociodemographic characteristics and culture that differ substantially from other US Asians, and therefore, differ in social determinants of health, health status, and disease risk. US Chinese adults are at increased risk for cardiometabolic disease, related conditions (obesity, type 2 diabetes mellitus, hypertension), and systemic inflammation that promotes disease onset and progression. Immigration to a new country can substantially impact the gut microbiome which may promote systemic inflammation. Our pilot interventions indicate a high-fiber diet rich in whole grains reduced inflammation and improved obesity. Additionally, our USDA supported, evidence based HomeStyles intervention has demonstrated feasibility, acceptability, and efficacy in improving lifestyle behaviors and home environments associated with obesity risk in families. A lack of linguistically, culturally tailored interventions to their specific health needs makes it difficult for US Chinese to implement healthy lifestyle behaviors and reduce health risks. We are not aware of any intervention tailored for US Chinese that could attenuate modifiable cardiometabolic risk factors, understand physiological sequelae, and bridge health equity. Thus, the overall goal of this R01 proposal is to test the efficacy of HomeStyles in improving health outcomes in US Chinese in NY/NJ. Proposal aims are to: A) Culturally adapt the HomeStyles intervention through community-engaged approaches. B) Conduct a 10-week, 2-armed RCT to test HomeStyles intervention efficacy on health outcomes (dietary intake, physical activity, self-efficacy, HbA1C, waist circumference, and BMI), hypothesizing that participants randomized to the treatment condition will have greater improvements in health outcomes than control comparators. C) Examine associations between intervention participation and gut microbiota/systemic inflammation and test hypotheses that a whole-grain rich diet adopted by those in the intervention group will increase anti-inflammatory gut bacteria, reduce inflammatory gut bacteria, and lower systemic inflammation. This proposal’s aims parallel NIMHD’s specific interests, as well as RFA MD-21-007. This includes interventions, like HomeStyles, that aim to ameliorate health inequities in minority populations and reduce multiple common risk factors (e.g., obesity, poor nutrition, physical inactivity, insufficient sleep, systemic inflammation) for multiple chronic diseases as well as address multi-generational chronic disease risk and protective factors. A culturally adapted HomeStyles intervention holds great potential for improving our knowledge about health disparity in the US Chinese population, understanding translational mechanisms toward comorbidities, informing family and community-oriented interventions through sustainable engagement, and serving as a model for health interventions for this audience.