EFFICACY TRIAL OF A PROGRAM FOR WEIGHT LOSS FOR HISPANIC FATHERS AND INCREASED PHYSICAL ACTIVITY FOR THEIR CHILDREN: HEALTHY DADS, HEALTHY KIDS

项目摘要 美国的西班牙裔面临肥胖和相关医疗状况的健康差异，例如 心血管疾病和糖尿病。以家庭为目标，促进健康的生活方式， 被认为是预防肥胖的有效策略。家庭凝聚力（Family Cohesion） 西班牙裔人口，特别需要以家庭为基础的干预措施，作为促进 支持健康的体重状况和减少西班牙裔肥胖相关的健康差异的行为。 新出现的证据支持需要包括和目标的父亲在家庭为基础的生活方式行为 干预措施。然而，到目前为止，在美国，这种努力几乎完全针对母亲。 健康的爸爸健康的孩子（HDHK）是一个基于证据的计划在澳大利亚开发，显示有 显着的体重和行为治疗效果的父亲和他们的孩子相比，控制。的 HDHK计划以社会认知理论和家庭系统理论为基础，旨在促进 增加体育活动，改善父亲及其子女的饮食摄入。的重要创新 该计划是父亲和孩子一起参加，并作为行为改变的代理人， 互相帮助（相互加强），一起参加有趣的家庭活动。香港人权会在文化上 适应西班牙裔家庭以下的生态有效性模型，由这个研究小组，从一个输入 社区西班牙裔家庭小组，专家委员会和HDHK计划的开发者。所得 在一项等待名单控制的RCT中，对Papás Saludables，Niños Saludables（PSNS）计划的可行性进行了测试 在36个西班牙裔家庭中，他们的孩子是德克萨斯州儿童健康计划的成员。这些发现支持 在一项家庭随机分组试验中测试文化适应计划，并进行标准护理比较/ 控制功效。拟议的疗效试验有能力检测父亲的临床有意义的变化， 体重和儿童的身体活动。这项研究还将评估其他行为（饮食摄入，久坐 时间、屏幕媒体使用和育儿实践）、社会心理（家庭主义、文化适应和共同育儿 联盟）和生物学（非HDL，HgbA 1C，BP）结果。大休斯敦基督教青年会（YMCA of Greater Houston） 提供了一个场所，在哪里提供该计划，并与得克萨斯州儿童健康计划的伙伴关系提供 有超过80，000名年龄在5-11岁之间的西班牙裔儿童可以从中招募。RE-AIM 框架将为详细的过程评估提供信息，以评估实施PSNS的障碍和促进因素 我们的社区合作伙伴在未来。这个新颖的生活方式计划可以提供一个范式转变， 西班牙裔儿童的肥胖预防应该概念化，通过直接参与西班牙裔父亲， 迄今为止还没有这样做。

Project Summary Hispanics in the United States face health disparities for obesity and related medical conditions, such as cardiovascular disease and diabetes. Targeting families to promote healthy lifestyle behaviors has been identified as an effective strategy to prevent obesity. With the importance of familism (family cohesion) among the Hispanic population, a family based intervention is especially desirable as an engaging strategy to promote behaviors that support a healthy weight status and decrease obesity related health disparities for Hispanics. Emerging evidence supports the need to include and target fathers in family based lifestyle behavior interventions. However, to date mothers have almost exclusively been reached by such efforts in the US. Healthy Dads Healthy Kids (HDHK) is an evidence based program developed in Australia, shown to have significant weight and behavior treatment effects for fathers and their children, compared to controls. The HDHK program is based on Social Cognitive Theory and Family Systems Theory and aims to promote increased physical activity and improved dietary intake for fathers and their children. An important innovation in the program is that fathers and children attend together and are both targeted as agents of behavior change for each other (reciprocal reinforcement) and to participate in fun, family activities together. HDHK was culturally adapted for Hispanic families following the Ecological Validity Model by this research team, with input from a community Hispanic family panel, expert committee and the developer of the HDHK program. The resulting Papás Saludables, Niños Saludables (PSNS) program was tested for feasibility in a waitlist controlled RCT among 36 Hispanic families, whose child was a Texas Children’s Health Plan member. The findings support testing the culturally adapted program in a family randomized group trial with a standard of care comparison/ control for efficacy. The proposed efficacy trial is powered to detect a clinically meaningful change in father’s weight and children’s physical activity. The study will also assess other behavioral (dietary intake, sedentary time, screen media use, and parenting practices), psychosocial (familism, acculturation, and co-parenting alliance) and biological (non-HDL, HgbA1C, BP) outcomes. Partnership with the YMCA of Greater Houston offers a venue for where to deliver the program, and partnership with Texas Children’s Health Plan provides access to over 80,000 Hispanic children between the ages from 5-11 from which to recruit. The RE-AIM framework will inform a detailed process evaluation to assess barriers and facilitators to implementing PSNS with our community partners in the future. This novel lifestyle program can provide a paradigm shift for how obesity prevention for Hispanic children should be conceptualized, by directly engaging Hispanic fathers, which has not been done to date.