PILI 'Ohana Project: Partnerships to Overcome Obesity Disparities in Hawai'i

描述(申请人提供)：肥胖和超重在美国是公认的公共健康问题，在种族/少数民族人口中超重的程度更大。对于夏威夷原住民(NHS)和太平洋人(PPS)来说，估计有70%到80%的成年人超重或肥胖。在NHS和PPS中，与肥胖相关的差异，如糖尿病和心脏病(CVD)，也在增加。为了解决肥胖和相关的差异，成立了一个以社区为基础的参与性研究(CBPR)伙伴关系，名为改善生活方式干预伙伴关系(PILI)Ohana计划(PILI意味着关系，Ohana意味着家庭)。PILI‘OHANA计划(POP)由5个社区组织和夏威夷大学(UH)约翰·A·伯恩斯医学院(JABSOM)的原住民健康系(DNHH)组成。在国家少数民族健康和健康差距中心(NCMHD)提供的为期3年的CBPR规划拨款下，民研计划成功地建立了旨在夏威夷肥胖相关差距的社区-学术合作伙伴关系，并在NHS和PPS实施了一项试点干预措施，以解决减肥维持问题(Pili‘Ohana干预措施)，这是本申请的初步数据。因此，这项拨款申请是为民研计划进行为期5年的干预研究：1)就国民健康保险制度和保健计划的减肥维持情况进行更明确的研究；及2)确定民研计划的社区与学术合作伙伴关系，以促进共同学习和平等的环境。具体目标如下：1)确定PILI‘OHANA(以家庭+社区为重点)干预措施的哪些方面被试点干预的前参与者和社区同行教育者认为有效。2)测试Pili‘Ohana干预的面对面或DVD交付方法在改善NHS和PPS对照组的减肥维持方面是否有效。3)确定支持共同学习和平等环境的PILI‘OHANA方案的优势。目标1将采用焦点小组方法，从试点干预的参与者和干预的社区同行教育者那里收集信息。目标2将通过三臂(两个干预组和一个对照组)随机对照试验(RCT)进行。目标3将使用以观察技术为特色的人种学方法来解决。

DESCRIPTION (provided by applicant): Obesity and overweight are well recognized public health concerns in the US and the magnitude of excess weight is greater among racial/ethnic minority populations. For Native Hawaiians (NHs) and Pacific Peoples (PPs) 70 to 80% of adults are estimated to be overweight or obese. Obesity-related disparities such as diabetes and heart disease (CVD) are also increasing among NHs and PPs. To address obesity and related disparities, a community-based participatory research (CBPR) partnership was formed entitled, the Partnership for Improving Lifestyle Interventions (PILI) 'Ohana Program (Pili meaning relationship and 'Ohana meaning family). The PILI 'Ohana Program (POP) consists of 5 community organizations and the Department of Native Hawaiian Health (DNHH) at the John A. Burns School of Medicine (JABSOM) of the University of Hawai'i (UH). With a 3-year CBPR planning grant from the National Center on Minority Health and Health Disparities (NCMHD), the POP was successful at establishing this community-academic partnership aimed at obesity-related disparities in Hawai'i and in implementing a pilot intervention to address weight loss maintenance (the PILI 'Ohana Intervention) in NHs and PPs, which serves as preliminary data for this application. Thus, this grant application is a 5-year intervention study for the POP 1) to conduct a more definitive study of weight loss maintenance in NHs and PPs and 2) to identify the aspects of the POP's community-academic partnership that fosters a co-learning and co-equal environment. The specific aims are as follow: 1) To identify the aspects of the PILI 'Ohana (family + community focused) Intervention deemed effective by former participants and community-peer educators of the pilot intervention. 2) To test whether a face-to-face or DVD delivery method of the PILI 'Ohana intervention is effective in improving weight loss maintenance versus a control group in NHs and PPs. 3) To identify the strengths of the PILI 'Ohana Program that supports a co-learning and co-equal environment. Aim 1 will be addressed using a focus group methodology to gather information from participants of the pilot intervention and the community-peer educators of the intervention. Aim 2 will be addressed via a 3-arm (2 intervention arms and a control group) randomized control trial (RCT). Aim 3 will be addressed using an ethnographic approach featuring observational techniques.