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心理社会协会。目的：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人的深入访谈和焦点小组，开发一种美国英语和墨西哥裔美国西班牙语的体重特异性QoL工具; 2）通过经典的心理测量和IRT分析，验证新的体重特异性工具的横截面心理测量和实际测量特性; 3）探索BMI与QoL的相关性以及已知或假设的相关性，4）评估项目和测量方法检测参与和未参与正式减肥计划的一小群青年变化的能力，以及5）制作/传播最终版本的工具。重要性：近年来，白人青年的超重状况增加了两倍，但少数民族青年，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。少数民族青年超重的不成比例的增加可能会加剧先前存在的健康结果差异，需要采取创新方法来了解他们的观点，并设计和评估有效的治疗方法，以减少健康差异。创新：应在主要受影响文化群体的充分参与下制定生活质量指标，以进行体重治疗。同时文化发展的措施，在不同的种族群体与多元文化的调查，在这项研究中将满足这一要求。方法和分析：基于定性方法的全面概念模型将推动衡量的发展。对120名超重和高危青年进行深入访谈和焦点小组，将采用基于需求的模式和对文化敏感的方法来开发工具。生成英文和西班牙文的项目，并进行认知汇报、可读性和可译性分析。将招募360名青少年（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仪器和其他问卷。因子分析和项目反应方法将用于量表开发。将检查可靠性、结构效度、小队列效应量以及与BMI的相关性。使用单变量和多变量建模来调查已知和假设的相关性，估计检测效应量为0.41或更大的差异的把握度在77-99%之间。研究者：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，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.