Quality of Life of Overweight Youth: Multicultural View

描述(由申请人提供)：目标：开发一种专门针对超重青年的多元文化生活质量(QOL)工具，用于评估体重管理治疗并调查环境和心理社会联系。目标：1)通过对华盛顿西部和南加州11-18岁的非裔美国人、高加索人和墨西哥裔美国青年的深入访谈和焦点小组，开发美国英语和墨西哥裔美国人西班牙语版的特定体重的QOL量表；2)使用经典的心理测量学和IRT分析，验证新的特定体重工具的横截面心理测量学和实用测量特性；3)探索BMI与QOL和已知或假设的相关因素之间的联系，4)评估这些项目和措施的能力，以检测参与和未参与正式减肥计划的一小部分年轻人的变化，以及5)制作/传播该工具的最终版本。意义：近年来，高加索青年超重比例增加了两倍，但少数族裔青年，主要是墨西哥裔美国人和非裔美国人的超重比例增加了三倍，这一现象相形见绌。少数族裔青年超重的不成比例增加可能会加剧先前存在的健康结果差异，需要采用创新的方法来了解他们的观点，并设计和评估将缩小健康差异的有效治疗方法。创新：针对体重治疗的主要受影响文化群体应充分参与制定生活质量衡量标准。本研究中多元文化研究者在不同种族群体中的措施的同步文化发展将满足这一要求。方法和分析：以定性方法为基础的综合概念模型将推动测量的发展。对120名超重和高危青年的深入访谈和重点小组将采用以需求为基础的模式和对文化敏感的方法来开发工具。将进行英语和西班牙语项目的生成以及认知汇报、可读性和可译性分析。将招募360名青年(200 BMI 2&>95%，80 BMI 85-94%；80 BMI z 84%)的验证样本，他们将完成新的体重特定量表和其他问卷。量表的编制将使用因素分析和项目反应方法。评估的可靠性，结构效度，效应大小，在一个小队列，以及与体重指数的相关性将被检查。使用单变量和多变量建模来调查已知和假设的相关性，检测效果大小为0.41或更大的差异的能力估计在77-99%之间。研究人员：由经验丰富的结局专家、肥胖专家、内分泌学家和社区代理人组成的多元文化团队将合作招募、研究、出版和传播结果。

DESCRIPTION (provided by applicant): Goal: To develop a multicultural quality of life (QoL) instrument specific to overweight youth for use in evaluating weight-management treatments and investigating environmental and psychosocial associations. Aims: 1) To develop a weight-specific QoL instrument in US English and Mexican-American Spanish using in-depth interviews and focus groups with African-American, Caucasian, and Mexican-American youth ages 11-18 in Western Washington and Southern California; 2) To validate cross-sectional psychometric and practical measurement properties of the new weight-specific instrument using classical psychometric and IRT analyses; 3) To explore associations of BMI with QoL and known or hypothesized correlates, 4) To assess the ability of the items and measures to detect change in a small cohort of youth participating and not participating in a formal weight loss program, and 5) To produce/disseminate final version of the instrument. Significance: The two-fold increase in overweight status among Caucasian youth in recent years is only overshadowed by the three-fold increases among minority youth, primarily Mexican-Americans and African- Americans. This disproportionate increase in overweight among minority youth may exacerbate pre-existing health outcome disparities and require innovative approaches to understanding their perspectives and to design and evaluate effective treatments that will reduce health disparities. Innovation: A QoL measure should be developed with full participation of the major affected cultural groups targeted for weight treatment. Simultaneous cultural development of measures in different ethnic groups with multicultural investigators in this study will meet this requirement. Methods and Analysis: A comprehensive conceptual model grounded in qualitative methodology will drive measurement development. In-depth interviews and focus groups with 120 overweight and at-risk youth will apply a needs-based model and culturally sensitive approach to instrument development. Generation of items in English and Spanish and cognitive debriefing, readability, and translatability analyses will be conducted. A validation sample of 360 youth (200 BMI 2> 95%, 80 BMI 85-94%; 80 BMI z 84%) will be recruited who will complete the new weight-specific instrument and other questionnaires. Factor analysis and item-response methods will be used for scale development. Evaluation of reliability, construct validity, effect sizes in a small cohort, and association with BMI will be examined. Power is estimated to be between 77-99% to detect differences with an effect size of .41 or greater using univariate and multivariate modeling to investigate known and hypothesized correlates. Investigators: Multicultural team of experienced outcomes experts, obesity experts, endocrinologists, and community agents will collaborate to recruit, study, publish, and disseminate results.