Promoting fruit and veggies among pregnant Latinas: Intervention development

描述(由申请者提供)：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大，超过了国际医学研究所(IOM)指南的建议。同样令人担忧的是，我们的数据显示，怀孕的低收入拉丁裔人摄入的水果和蔬菜远远低于饮食指南的建议。预防妊娠体重过度增加的饮食干预措施一直不一致，很少在多种族样本中进行，只有拉丁裔样本中没有进行。鉴于水果和蔬菜(F&V)干预措施在降低非怀孕妇女的能量密度和促进减肥和体重管理方面不断取得成功，这项可行性研究旨在收集数据，为设计一项社区干预措施提供信息，以通过增加超重和肥胖、怀孕、低收入拉丁裔妇女的F&V消费来促进适当的妊娠体重增加。这项研究的目的是：1)确定不同的基于社区的干预措施以提高F&V摄入量的可接受性(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)确定在目标1中确定的接受的干预情景中行为、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未加工和准备的F&V的接受度和偏好；以及5)计算通常的膳食能量密度(仅从食物)，并从数学上确定特定水果和/或蔬菜摄入量替代改善(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个是西班牙健康委员会Comadrona工作人员，4个是怀孕超重/肥胖的拉丁裔)，以确定不同的社区干预措施对改善F&V摄入量的可接受性。将对100名超重/肥胖的拉丁裔孕妇进行100次深度访谈，以实现目标2和目标3。第四个目标将通过进行两次品尝测试来确定F&V的偏好和准备。使用24小时回忆(从同样100名进行深度采访的女性那里收集的数据)的计算机模拟将达到目标5。所有采访和焦点小组都将被录音、转录、翻译(根据需要)，并使用标准的定性方法进行分析。除了通知制定促进F&V消费并随后防止妊娠体重过度增加的干预措施外，研究结果还将向医疗保健和WIC提供者提供有关F&V文化实践、偏好和观点的信息，以帮助改善低收入超重/肥胖怀孕拉丁裔的营养咨询。

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.