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

我们提出了一项以加州大学洛杉矶分校-南加州大学社区为基础的家庭环境干预随机对照试验 涉及东洛杉矶的家庭，一个以墨西哥裔美国人为主的社区，有很高的 代谢综合征相关的心血管疾病。干预者将是训练有素的社区工作者。 (发起人)。这种多水平的干预旨在减少血管僵硬，这是一种早期生命的生物标志物 心血管风险；对生活方式干预敏感的人。240个有一名家庭成员的家庭 最近被诊断出患有糖尿病的患者将被纳入这项研究。一半将随机分配给家庭 环境心脑血管疾病风险降低计划，另一半到家族性癌症早期 检测注意控制状态。推广者将提供多达16次咨询会议给 指定的无糖尿病的成年家庭成员。会议的重点将是改善家庭环境 通过减少看电视的机会，增加水果和蔬菜的供应，减少 获得精制碳水化合物，确保获得监测体重的秤，并增加获得 运动器材改变生活方式的目标将与美国人的饮食指南保持一致， 特别是DASH节食和每天30分钟的适度体力活动，但为家庭量身定做 改变的能力。四个团体健康教育课程包括一家改头换面的商店 参与本计划项目的项目#3。将给予当地农贸市场优惠券作为奖励 每一次咨询和小组健康教育课程。自我报告、饮食与心血管疾病 在基线、6个月、12个月和24个月随访时收集生物标志物。保留率是 根据调查人员过去的经验，预计12个月内90%，24个月内85% 有这么多人。主要结果将是动脉僵硬的两个指标。次要结果 将包括新陈代谢综合征的共识特征和社区层面的调节剂 心血管风险，包括人口普查地区快餐店的步行能力和密度 研究参与者居住，预计这将影响干预影响的可持续性。

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.