Assessing and Preventing Obesity Among New Immigrants

描述(由申请人提供)：项目描述：移民人口由于医疗服务不足、低收入和种族/语言上的少数群体地位而面临特别高的肥胖风险，因为他们适应了他们曾经在美国居住的肥胖环境。在这些社区的积极参与下制定的预防性干预措施有可能预防或减缓体重增加。我们将使用有效性的措施，证明与马萨诸塞州萨默维尔的移民社区合作的可行性，以完善、实施、评估和传播为期两年的预防干预措施，以减缓或减少435名新移民母亲/孩子的体重增加。一旦主要试验完成，435名母婴双胞胎将被随机分为接受干预或作为对照，接受延迟干预。我们将招收来自巴西、海地和拉丁美洲国家的移民，这些群体大量来到马萨诸塞州东部，由当地社区机构提供服务。干预目标侧重于健康饮食、增加体力活动和减少久坐行为等领域的10个基于家庭的目标。具体地说，该干预措施旨在通过提供教育、技能发展和支持，通过减少或保持BMI来将成年人带入健康体重范围。在儿童中，它的设计将导致每天增加高达125千卡的能量消耗，而不是伴随着生长而增加的能量消耗和能量摄入。基于我们在这些群体中的形成性研究，干预元素将在我们社区合作伙伴的机构中以小组形式提供。针对特定移民群体的需求量身定做的课程和支持小组将利用新移民的传统健康行为，并教授影响家庭环境的具体策略。拟议的项目反映了一个多学科研究小组正在进行的工作，并建立在萨默维尔的两项成功研究倡议的基础上，一项已完成，另一项正在进行。这项以社区为基础的参与性研究的目标是从社区的兴趣和参与中发展出来的。社区合作伙伴与我们一起进行用于开发此应用程序的形成性研究，并将参与整个项目的设计、招聘、交付和研究评估。向受影响社区传播成果被认为是至关重要的，将以加强社区资源、预防性保健和对移民的教育为目的。此外，如果成功，这项试验在全国的传播可以帮助拥有大量移民人口的其他社区降低这一弱势群体中肥胖的风险。与公共健康相关：美国的新移民在适应新的肥胖环境时，体重增加和肥胖的风险很高。我们在社区合作伙伴的积极参与下开发的量身定制的干预措施，将有利于长期健康，预防心脏病、糖尿病和某些癌症，从而降低迅速增长的医疗保健成本。

DESCRIPTION (provided by applicant): Project Description: Immigrant populations, by virtue of being medically-underserved, low-income, and of race-/ethnic and linguistic minority status are at particularly high risk to become obese as they adapt to the obesogenic environment in which they reside once in the US. Preventive interventions developed with the active participation of these communities have the potential to prevent or moderate the weight gain. We will demonstrate, using measures of effectiveness, the feasibility of partnering with the immigrant community in Somerville, MA to refine, implement, evaluate, and disseminate a 2-year preventive intervention to moderate or reduce weight gain in 435 mother/child dyads of new immigrants. The 435 mother/child dyads will be randomized to either receive the intervention or to serve as controls that will receive a delayed intervention, once the main trial is completed. We will enroll immigrants from Brazil, Haiti, and Latin-American countries, groups who are coming in large numbers to eastern MA, and are served by local community agencies. Intervention targets focus on 10 family-based goals in the areas of healthy eating, increased physical activity, and the reduction of sedentary behavior. Specifically, the intervention is designed to bring adults into the healthy weight range by reducing or maintaining BMI by providing education, skill development and support. In children it will be designed to result in an increased energy expenditure of up to 125 kcals per day beyond the increases in energy expenditure and energy intake that accompany growth. Based on our formative research within these groups, intervention elements will be delivered in small groups at the agencies of our community partners. }Lifestyle coaching} sessions and support groups tailored to the specific immigrant groups' needs will capitalize on traditional healthy behaviors practiced by new immigrants and teach specific strategies that effect family environments. The proposed project reflects the ongoing work of a multidisciplinary research group and builds on two successful research initiatives in Somerville, one completed and one ongoing. The goals of this community-based participatory research study have been developed from community interest and involvement. The community partners engaged with us to conduct the formative research used to develop this application, and will be involved in the design, recruitment, delivery, and research evaluation throughout the project. Dissemination of results to the affected community was deemed critical and will be done with the intention of strengthening community resources, preventive health care and education for immigrants. Furthermore, if successful, national dissemination of this trial can assist other communities with large immigrant populations to reduce the risk of obesity in this vulnerable population. PUBLIC HEALTH RELEVANCE: New immigrants to the US are at high risk of weight gain and obesity as they adapt to their new obesogenic environment. Our tailored intervention, developed with active input of our community partners, stands to benefit long-term health, in the prevention of heart disease, diabetes, and some cancers, and thereby reduce burgeoning health care costs.