Promoting fruit and veggies among pregnant Latinas: Intervention development

描述（由申请人提供）：在美国，孕妇，尤其是那些超重或肥胖的孕妇，体重的增加超过了医学研究所（IOM）指南的建议，这是一个日益增长的趋势。同样令人担忧的是，我们的数据显示，低收入的拉丁裔孕妇食用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一直不一致，在多种族样本中很少进行，仅在拉丁裔样本中没有进行。鉴于水果和蔬菜（F&V）干预措施在降低非孕妇能量密度、促进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、孕妇和低收入拉丁裔女性的水果和蔬菜消费，促进适当的妊娠期体重增加。本研究的目的是：1)确定不同社区干预措施的可接受性，以改善F&V摄入（即社区卫生工作者模式、团体支持模式、基于诊所的社区外展模式）；2)在目标1中确定的可接受的干预方案中确定行为、自我效能、应对机制和结果的预期变化；3)确定F&V干预成功的感知障碍和感知利益；4)评估超重和肥胖的拉丁裔孕妇对各种生食和预制食品的接受度和偏好；5)计算通常的膳食能量密度（仅从食物中），并从数学上确定替代特定水果和/或蔬菜摄入提高（即降低）膳食能量密度的程度。为了实现目标1，将举行5个焦点小组（1个是西班牙卫生委员会Comadrona工作人员，4个是超重/肥胖的怀孕拉丁裔），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度访谈，以实现目标2和目标3。第四个目标将通过进行两次口味测试来确定F&V的偏好和准备。利用24小时回忆数据（从进行深度访谈的100名女性中收集）的计算机模拟将实现目标5。所有访谈和焦点小组都将被录音、转录、翻译（根据需要），并使用标准定性方法进行分析。除了为促进食品和饮料消费的干预措施的发展提供信息，并随后防止妊娠期体重过度增加，研究结果还将为卫生保健和WIC提供者提供有关文化食品和饮料实践、偏好和观点的信息，以帮助改善低收入超重/肥胖怀孕拉丁美洲人的营养咨询。

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.