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，种族/民族和语言上的少数民族地位，由于他们适应了他们在美国居住的致肥环境，他们变得肥胖的风险特别高。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。我们将论证，使用有效性措施，与萨默维尔移民社区合作的可行性，马萨诸塞州完善，实施，评估和传播一项为期2年的预防性干预措施，以缓和或减少435名新移民母亲/儿童的体重增加。435名母亲/孩子将被随机分配，要么接受干预，要么作为对照组，在主要试验完成后接受延迟干预。我们将招收来自巴西、海地和拉丁美洲国家的移民，这些移民将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、增加身体活动和减少久坐行为等10个以家庭为基础的目标。具体来说，干预的目的是通过提供教育、技能发展和支持来降低或维持BMI，使成年人进入健康的体重范围。在儿童中，它将被设计成导致每天增加多达125千卡的能量消耗，超过伴随生长的能量消耗和能量摄入的增加。根据我们在这些群体中的形成性研究，干预要素将在我们的社区合作伙伴的机构中以小组形式提供。生活方式辅导课程和针对特定移民群体需求的支持小组将利用新移民实践的传统健康行为，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个成功的研究计划上，一个已完成，一个正在进行。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发展而来的。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。向受影响社区传播结果被认为是至关重要的，将这样做，目的是加强社区资源、预防保健和对移民的教育。此外，如果试验成功，在全国范围内推广该试验可以帮助其他有大量移民人口的社区降低这一弱势群体的肥胖风险。公共卫生相关性：美国新移民在适应新的致肥环境时，体重增加和肥胖的风险很高。在社区合作伙伴的积极投入下，我们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.