Quality of Life of Overweight Youth: Multicultural View

描述（由申请人提供）：目标：开发一种针对超重青少年的多元文化生活质量（QoL）工具，用于评估体重管理治疗和调查环境和社会心理关联。目的：1)通过对华盛顿州西部和南加州11-18岁的非裔美国人、高加索人和墨西哥裔美国人青年进行深入访谈和焦点小组，开发一种体重特异性的美国英语和墨西哥裔美国人西班牙语生活质量工具；2)利用经典心理测量和IRT分析验证新型体重计量仪的横截面心理测量和实际测量特性；3)探索BMI与生活质量的关系以及已知或假设的相关因素；4)评估项目和测量方法在参加和不参加正式减肥计划的青少年小队列中检测变化的能力；5)制作/传播该工具的最终版本。意义：近年来，白人青年超重状况增加了两倍，而少数民族青年（主要是墨西哥裔美国人和非洲裔美国人）的超重状况增加了三倍，这使其黯然失色。少数民族青年中超重的这种不成比例的增加可能会加剧先前存在的健康结果差异，因此需要采用创新方法来了解他们的观点，并设计和评估将减少健康差异的有效治疗方法。创新：应在体重治疗的主要受影响文化群体充分参与的情况下制定生活质量指标。本研究中多元文化研究者在不同族群中同时采取的文化发展措施将满足这一要求。方法和分析：基于定性方法论的综合概念模型将推动测量的发展。对120名超重和高危青年进行深入访谈和焦点小组讨论，将采用基于需求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、认知情况汇报、可读性和可译性分析。将招募360名青年验证样本（200 BMI 2> 95%, 80 BMI 85-94%, 80 BMI z 84%），他们将完成新的体重特定工具和其他问卷。量表的开发将采用因子分析法和项目反应法。在一个小队列中评估信度、结构效度、效应大小以及与BMI的关联将被检验。功率估计在77-99%之间，以检测效应大小的差异。使用单变量和多变量模型来调查已知和假设的相关性。研究人员：由经验丰富的结果专家、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、发表和传播结果。

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.