Promotora-based latino Family CVD risk reduction: Remaking the home environment

我们提出了一个UCLA-USC社区为基础的随机对照试验的家庭环境干预 涉及东洛杉矶的家庭，这是一个以墨西哥裔美国人为主的社区， 代谢综合征相关的心血管疾病。干预者将是经过培训的社区工作者 （promotoras）.这种多层次干预旨在降低血管僵硬度，这是生命早期的生物标志物 心血管疾病风险;对生活方式干预敏感。240个有家庭成员的家庭 最近被诊断患有糖尿病的人将被纳入研究。一半将随机分配至家庭 环境心血管疾病风险降低计划，另一半到家庭癌症早期 检测注意力控制状况。发起人将提供多达16个咨询会议， 指定的成年家庭成员没有糖尿病。会议将集中在改善家庭 通过减少看电视的机会，增加水果和蔬菜的供应， 获得精制碳水化合物，确保获得体重秤来监测体重， 运动器材生活方式改变的目标将与美国人饮食指南一致， 特别是DASH饮食和每天30分钟的适度体力活动，但适合家庭的 改变的能力。四个小组健康教育课程包括参观一间美容店 #36825;项目，参与该项目。当地农贸市场优惠券将作为奖励 每次咨询和小组健康教育会议。自我报告、饮食和心血管疾病 将在基线、6个月、12个月和24个月随访时收集生物标志物。保留是 根据研究者过去的经验，预计12个月内90%，24个月内85% 与这个人口。主要结果将是动脉硬度的两个指标。次要结局 将包括代谢综合征的共识特征和社区水平的主持人， 心血管风险，包括人口普查区快餐店的步行能力和密度， 研究参与者的居住地，预计将影响干预措施影响的可持续性。

We propose a UCLA-USC community-based randomized controlled trial of a home environment intervention involving families in East Los Angeles, a predominantly Mexican-American community at high risk of metabolic syndrome-related cardiovascular disease. The interveners will be trained community workers (promotoras). This multilevel intervention is designed to reduce vascular stiffness, an early-in-life biomarker of cardiovascular risk; one that is sensitive to lifestyle intervention. 240 families with a family member recently diagnosed with diabetes will be enrolled in the study. Half will be randomized to the Family Environment Cardiovascular Disease Risk Reduction program, the other half to the Family Cancer Early Detection attention-control condition. The promotoras will provide up to 16 counseling sessions to a designated adult family member without diabetes. The sessions will focus on improving the home environment by reducing TV viewing opportunities, increasing fruit and vegetable availability, decreasing access to refined carbohydrates, assuring access to a scale to monitor body weight and increasing access to exercise equipment Lifestyle change goals will be consistent with the Dietary Guidelines for Americans, especially the DASH diet and 30 minutes of daily moderate physical activity, but tailored to the family's capacity to change. Four group health education sessions include atour of a make-over comer store participating in Project #3 of this program project. Local farmers market coupons will be given as incentives for each counseling and group health education session. Self-report, diet and cardiovascular disease biomarkers will be collected at baseline, 6 months, 12 months and 24 months follow-up. Retention is expected to be 90% over 12 months and 85% over 24 months, based on the investigators' past experience with this population. The primary outcomes will be two measures of arterial stiffness. Secondary outcomes will include the consensus features of the metabolic syndrome and community-level moderators of cardiovascular risk, including walkability and density of fast food restaurants in the census tracts in which the study participants reside, which are expected to influence the sustainability of the intervention impact.