COACH: Competency Based Approaches for Community Health

项目摘要 尽管认识到肥胖的健康差异，但低收入和低收入人群的行为干预措施， 少数民族人口取得的成功一直有限。这部分是由社会原因造成的。 健康的决定因素。家庭和社区层面不断变化的障碍阻碍了 参与健康的行为。目前的提案测试了一种新颖的，文化定制的和多层次的 旨在教育家庭克服动态障碍的干预措施是解决这一问题的合理下一步 低收入拉丁裔家庭的肥胖问题。它是基于这样的前提，即通过实施个性化的 多层次的干预，同时解决家长和孩子的健康体重，我们将提高 拉丁裔亲子对的身体质量指数（BMI）。 COACH（基于能力的社区健康方法）实施了一种个人定制的方法， 帮助家庭克服动态障碍，采取健康行为。COACH是一种多层次的干预 目标：1）通过适合儿童发展的健康行为课程，2）家庭 通过直接解决父母减肥问题，并让父母成为孩子改变的推动者，以及3） 通过建设公园和娱乐中心的能力，提供亲子节目，使用新颖 在整个研究过程中，通过多组分评估，干预措施确定了个人、家庭和 社区健康行为的障碍，并提供结构化但个性化的干预内容， 领域：水果/蔬菜，零食，含糖饮料，体育活动，睡眠，媒体使用和养育。 在成功试点的基础上，该提案将实施一项随机对照试验， 与注意力匹配的学校准备对照组相比，COACH的有效性。我们将招收300名 来自田纳西州纳什维尔拉丁裔社区的亲子对。符合条件的儿童将是3-5岁，并有一个 BMI >第50百分位数。通过我们与纳什维尔公园和娱乐部10年的合作伙伴关系，我们 在社区中心开展COACH，利用社区基础设施促进健康 行为改变主要结果是使用生长曲线在2年随访时儿童BMI的变化 分析.次要结果将包括父母BMI，父母/孩子饮食和身体活动。的目标 教练将1）实施一种新的个性化行为干预，2）测试两代解决方案， 肥胖，3）通过减少拉丁美洲家庭的肥胖来解决健康差距，以及4）开发一个可扩展的， 通过在公园和娱乐中心提供行为肥胖干预措施，

PROJECT SUMMARY Despite the recognition of health disparities in obesity, behavioral interventions among low-income and minority populations have consistently met with limited success. This is partially explained by social determinants of health. Constantly changing barriers at the household and community levels impede consistent engagement in healthy behaviors. The current proposal tests a novel, culturally-tailored and multi-level intervention designed to teach families to overcome dynamic barriers as the logical next step to address obesity among low-income Latino families. It is based on the premise that by implementing a personalized multi-level intervention that simultaneously addresses healthy weight for parents and children, we will improve body mass index (BMI) among Latino parent-child pairs. COACH (COmpetency-Based Approaches to Community Health) implements a personally tailored approach, equipping families to engage in health behaviors despite dynamic barriers. COACH is a multi-level intervention targeting 1) the individual child through developmentally appropriate health behavior curriculum, 2) the family by addressing parent weight loss directly and engaging parents as agents of change for their children, and 3) the community by building capacity of Parks and Rec centers to offer parent-child programming. Using novel multi-component assessments throughout the study, the intervention identifies individual, family, and community barriers to healthy behaviors and delivers structured yet personalized intervention content in 7 domains: fruits/vegetables, snacks, sugary drinks, physical activity, sleep, media use, and parenting. Building on a successful pilot, this proposal will implement a randomized controlled trial to test the effectiveness of COACH compared to an attention-matched school-readiness control group. We will enroll 300 parent-child pairs from Latino communities in Nashville, TN. Eligible children will be 3-5 years old and have a BMI >50th percentile. Through our 10-year partnership with the Nashville Parks and Rec department, we conduct COACH in neighborhood community centers, leveraging community infrastructure to facilitate health behavior change. The primary outcome will be child BMI change at 2-year follow-up, using a growth curve analysis. Secondary outcomes will include parent BMI, and parent/child diet and physical activity. The goals of COACH are to 1) implement a novel personalized behavioral intervention, 2) test a two-generation solution to obesity, 3) address health disparities by reducing obesity among Latino families, and 4) develop a scalable and widely accessible approach to behavioral obesity interventions by delivering them in Parks and Rec centers.