Promoting fruit and veggies among pregnant Latinas: Intervention development

描述（由申请人提供）：在美国，孕妇，特别是超重或肥胖的孕妇，体重增加的趋势越来越明显，超过了医学研究所（IOM）指南的建议。此外，令人担忧的是，我们的数据显示，怀孕的低收入拉丁美洲人消费的水果和蔬菜远远少于膳食指南的建议。预防妊娠期体重过度增加的饮食干预措施一直不一致，在多种族样本中很少进行，而在拉丁美洲人中没有进行。鉴于水果和蔬菜（F&V）干预措施在降低能量密度和促进非孕妇体重减轻和体重管理方面不断取得成功，本可行性研究旨在收集数据，为设计基于社区的干预措施提供信息，通过增加超重和肥胖，孕妇，低收入拉丁美洲人的F&V消费量来促进适当的妊娠期体重增加。研究的目的是：1）确定不同的基于社区的干预措施的可接受性，以改善F&V摄入量（即社区卫生工作者模式;小组支持模式;基于诊所的社区外展模式）; 2）确定目标1中确定的可接受干预方案中的行为、自我效能、应对机制和结果的预期变化; 4）评估超重和肥胖的拉丁孕妇对各种原始和准备的F& V的可接受性和偏好;和5）计算通常的膳食能量密度（仅来自食物），并数学地确定特定水果和/或蔬菜摄入替代物改善（即降低）膳食能量密度的程度。为了实现目标1，将举行五个焦点小组（1个由Hispani Health理事会Comadrona工作人员组成，4个由孕妇超重/肥胖拉丁人组成），以确定不同社区干预措施的可接受性，以改善F&V摄入量。将对100名超重/肥胖的拉丁裔孕妇进行深入访谈，以实现目标2和3。第四个目标将通过进行两次口味测试来确定F&V偏好和准备来实现。使用24小时回忆（从进行深入访谈的100名妇女中收集）的数据进行计算机模拟将实现目标5。所有访谈和焦点小组将被录音，转录，翻译（根据需要），并使用标准的定性方法进行分析。除了告知干预措施的发展，以促进F&V消费，并随后防止妊娠期体重过度增加，研究结果还将告知卫生保健和WIC提供者有关文化F&V的做法，偏好和观点，以帮助改善营养咨询低收入超重/肥胖孕妇拉丁美洲人。 公共卫生相关性：哈特福德的大多数超重和肥胖的孕妇低收入拉丁美洲人，CT在怀孕期间获得过多的妊娠期体重，并消耗低于推荐的水果和蔬菜，清楚地表明两个循证指南，2009年医学研究所体重增加建议和2010年美国人饮食指南，没有得到满足。由于水果和蔬菜干预措施的重点是降低能量密度是最符合体重增加的损失和维护非怀孕妇女，这项可行性研究旨在收集数据，将通知设计一个以社区为基础的水果和蔬菜干预建议，以促进适当的妊娠期体重增加通过增加水果和蔬菜的消费超重和肥胖，怀孕，低收入的拉丁美洲人。这项建议是及时的，因为它将有助于确定向超重和肥胖的孕妇低收入拉丁裔传播这些相对较新的指南的最佳方法，以帮助改善这一高危人群的健康状况。

DESCRIPTION (provided by applicant): The growing trend in the U.S. is for pregnant women, especially those who are overweight or obese, to gain more weight than recommended by the Institute of Medicine (IOM) guidelines. Also, concerning are our data showing that pregnant low-income Latinas consume far less fruit and vegetables than the Dietary Guidelines recommendations. Dietary interventions to prevent excessive gestational weight gain have been inconsistent, with few conducted among multiethnic samples and none among only Latinas. Given the constant success of fruit and vegetable (F&V) interventions to decrease energy density and promote weight loss and weight management among non-pregnant women, this feasibility study aims to gather data that will inform the design of a community-based intervention promoting appropriate gestational weight gain through increased F&V consumption among overweight and obese, pregnant, low-income Latinas. The study aims are to: 1) determine the acceptability of different community-based interventions to improve F&V intake (i.e. community health worker model; group support model; clinic-based community outreach model); 2) identify expected changes in behavior, self-efficacy, coping mechanisms, and outcomes across the accepted interventions scenarios identified in aim 1; 3) identify perceived barriers and perceived benefits towards the success of a F&V intervention ; 4) assess the acceptability and preferences of a variety of raw and prepared F&Vs among overweight and obese pregnant Latinas; and 5) calculate usual dietary energy density (from food only) and mathematically determine the extent to which specific fruit and/or vegetable intake substitutions improve (i.e. decrease) dietary energy density. To fulfill aim 1, five focus groups (1 with Hispani Health Council Comadrona staff, 4 with pregnant overweight/obese Latinas) will be held to determine the acceptability of different community-based interventions to improve F&V intake. One hundred maternal in-depth interviews will be conducted with overweight/obese pregnant Latinas to fulfill aims 2 and 3. The 4th aim will be achieved by conducting two taste testings to determine F&V preferences and preparation. Computer simulations using data from 24 hour recalls (collected from the same 100 women that conducted the in-depth interview) will achieve aim 5. All interviews and focus groups will be audiotaped, transcribed, translated (as needed) and analyzed using standard qualitative methods. In addition to informing the development of an intervention to promote F&V consumption and subsequently prevent excessive gestational weight gain, study results will also inform health care and WIC providers about cultural F&V practices, preferences, and perspectives to help improve nutrition counseling among low-income overweight/obese pregnant Latinas. PUBLIC HEALTH RELEVANCE: The majority of overweight and obese pregnant low-income Latinas in Hartford, CT gain excessive gestational weight and consume lower than recommended fruits and vegetable servings during pregnancy, clearly showing that two evidence-based guidelines, the 2009 Institute of Medicine weight gain recommendations and the 2010 Dietary Guidelines for Americans, are not being met. Since fruit and vegetable interventions focusing on decreasing energy density are most consistent with weight gain loss and maintenance among non-pregnant women, this feasibility study seeks to gather data that will inform the design of a community-based fruit and vegetable intervention proposal to promote appropriate gestational weight gain through increased fruit and vegetable consumption among overweight and obese, pregnant, low-income Latinas. This proposal is timely as it will help define the best methods for dissemination of these relatively new guidelines to overweight and obese pregnant low-income Latinas to help improve health outcomes among this at-risk population.