Community-Based Lifestyle Promotion With Latino Women

超重/肥胖和缺乏身体活动是心血管疾病（CVD）和其他慢性疾病（例如，糖尿病（Latina adults）这些风险因素是可以改变的，并且适合于生活方式行为预防工作，重点是促进健康饮食和增加体力活动（PA）。这项实验研究的总体目标是评估为期6个月的社区健康生活方式行为干预（LSBI）的效果，该干预由promotoras提供，旨在改善超重/肥胖的中年拉丁美洲妇女的饮食和PA，这些妇女主要是讲西班牙语的移民。该研究建立在形成性和可行性研究的基础上，采用基于社区的参与性研究方法和材料，在NHLBI针对拉丁美洲人的CVD预防倡议中开发。参与者（N=240），年龄从35-64岁不等，将被随机分配到LSBI或类似的长度控制条件（备灾和家庭安全计划）。对文化敏感的LSBI包括2个月的小组教育（基于Su Corazón，Su维达）和步行俱乐部，然后是4个月的个性化教学和咨询（ITC）。促进行为改变、支持健康营养和减肥以及增加PA的战略将纳入ITC。将在基线、干预后（干预开始后6个月）和3个月随访时使用临床和行为测量组合收集数据。评价的主要结局是体重指数（BMI）的变化。次要结果包括PA（加速计读数）、血压、胆固醇、血糖、腰围和自我报告的生活方式行为的客观测量。选定的中介（阶段的变化）和调节变量（社会支持），来自行为改变和社会生态模型的跨理论模型，将检查有关的干预和计划的结果。调查结果将有助于知识有效的社区为基础的CVD预防拉丁美洲人参与生活方式干预提供在基层由promotoras，临床环境之外。还将加强对人际和环境因素对拉丁美洲人采取健康生活方式行为的影响的了解。

Overweight/obesity and physical inactivity are two significant predictors of morbidity and mortality from cardiovascular disease (CVD) and other chronic diseases (e.g., diabetes) in Latina adults. These risk factors are modifiable and amenable to lifestyle behavior prevention efforts that focus on promoting a healthy diet and increasing physical activity (PA). The overall goal of this experimental study is to evaluate the effects of a 6-month community-based healthy lifestyle behavior intervention (LSBI) provided by promotoras, designed to improve diet and PA of overweight/obese, middle-age Latino women who are predominantly Spanish-speaking immigrants. The study builds upon formative and feasibility studies implemented using community-based participatory research methods and materials developed in a NHLBI CVD prevention initiative for Latinos. Participants (N=240), ranging in age from 35-64, will be randomly assigned to either the LSBI or a comparable length control condition (disaster preparedness and home safety program). The culturally sensitive LSBI includes 2 months of small group education (based upon Su Corazón, Su Vida) and a walking club, followed by 4 months of individualized teaching and counseling (ITC). Strategies to promote behavior change, support healthy nutrition and weight loss, and increase PA will be incorporated into the ITC. Data will be collected at baseline, post intervention (6 months after intervention initiation) and at a 3- month follow-up using a combination of clinical and behavioral measures. The primary outcome to be evaluated is change in body mass index (BMI). Secondary outcomes include objective measures of PA (accelerometer readings), blood pressure, cholesterol, blood sugar, waist circumference and self-reported lifestyle behaviors. Selected mediating (stage of change) and moderating variables (social support), derived from the transtheoretical model of behavior change and social ecological model, will be examined in relation to the intervention and program outcomes. Findings will contribute to knowledge about effective communitybased CVD prevention for Latinas involving lifestyle intervention delivered at a grassroots level by promotoras, outside of clinical settings. Understanding also will be enhanced about the influence of interpersonal and environmental factors on adoption of healthy lifestyle behaviors of Latinas.