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

研究项目1-家庭风格-摘要 中国血统的人现在是美国亚洲人口中规模最大、增长最快的部分。我们 中国人的社会人口特征和文化与其他美国亚洲人有很大不同，而且 因此，健康、健康状况和疾病风险的社会决定因素不同。美国中国成年人在 心脏代谢性疾病、相关疾病(肥胖、2型糖尿病、高血压)的风险增加， 以及促进疾病发生和发展的全身性炎症。移民到一个新国家可能会 极大地影响肠道微生物群，这可能会促进全身炎症。 我们的试点干预表明，富含全谷物的高纤维饮食可以减少炎症和 改善肥胖症。此外，我们的USDA支持的、基于证据的HomeStyles干预 证明了改善生活方式行为和家庭的可行性、可接受性和有效性 与家庭肥胖风险相关的环境。缺乏在语言和文化上量身定制的干预措施 他们的特定健康需求使美国华人难以实施健康的生活方式行为，并减少 健康风险。我们不知道有任何为美国中国人量身定做的干预措施可能会削弱可修改的 心脏代谢危险因素，了解生理后遗症，沟通健康公平。 因此，R01提案的总体目标是测试HomeStyles在改善健康方面的效果 在纽约/新泽西州的美国华人的结果。提案的目的是：a)从文化上适应家庭生活方式的干预 通过社区参与的方法。B)进行为期10周的双臂RCT，以测试HomeStyles干预 对健康结果的效果(饮食摄入量、体力活动、自我效能、糖化血红蛋白、腰围和 BMI)，假设随机进入治疗条件的参与者将在 健康结果比对照对照的结果要好。C)审查干预参与度与体检之间的关系 微生物区系/全身性炎症和测试假设，全谷物丰富的饮食被那些 干预组将增加抗炎肠道细菌，减少炎性肠道细菌，并降低 全身炎症。 这项提案的目的与NIMHD的具体利益以及RFA MD-21-007相一致。这包括 像HomeStyles这样的干预措施，旨在改善少数群体中的健康不平等，并减少 多种常见危险因素(如肥胖、营养不良、缺乏体力活动、睡眠不足、系统性 炎症)用于多种慢性病，以及应对多代慢性病风险和 保护性因素。一种适应文化的家庭生活方式干预具有改善我们的 了解美国华裔人群的健康差距，了解翻译 共病机制，向家庭和社区提供信息，通过 可持续参与，并为这些受众提供健康干预的典范。

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.