FAMILIES PREVENTING AND REDUCING OBESITY HEALTH DISPARITIES IN HISPANIC YOUTH

描述（由申请人提供）：儿童肥胖是我国最重要的公共卫生问题之一。与非西班牙裔白人相比，西班牙裔年轻人的风险尤其大，他们更有可能超重和肥胖，部分原因是他们运动量不足，饮食摄入质量不佳。家庭功能，特别是父母参与和家庭沟通，与许多健康行为和状况有关，包括吸毒、吸烟、性危险行为、体育活动、饮食摄入和身体质量指数（BMI）。尽管有证据表明父母的参与和父母与青少年的交流在预防肥胖方面发挥了作用，但将它们纳入预防肥胖干预措施的力度有限。因此，鉴于西班牙裔青年面临着与肥胖相关的不成比例的多重健康负担，迫切需要为他们制定以家庭为基础的肥胖预防干预措施，以体育活动和不良饮食为目标。familas Unidas是一种以家庭为基础的特定文化干预措施，可有效预防或减少一些消极的健康行为和状况，包括吸毒、酗酒、抑郁、性危险行为、行为问题、性传播疾病和酒精依赖。familas Unidas通过改善家庭功能（例如，父母参与和父母与青少年的沟通）影响了这些结果，该机制已被发现与体育活动和饮食摄入有关。初步数据还表明，家庭对身体活动有积极影响，父母参与对身体活动的干预有部分介导作用。本研究的目的是：目的1：检查familas Unidas的相对功效，扩展到针对肥胖，在超重的西班牙裔青年中增加身体活动和改善饮食摄入质量；目的2：检查家庭功能是否以及在多大程度上部分介导familas Unidas对身体活动和饮食摄入质量的影响。为了实现这些目标，这项研究将把280名西班牙裔青年随机分配到两个条件中的一个：1)家庭条件或2)社区实践控制条件。将测试三个研究假设：H1：与社区实践相比，familas Unidas将有效地增加西班牙裔青年过去七天的中度至剧烈身体活动；H2：与社区实践相比，familas Unidas将有效地改善西班牙裔青年过去七天的优质膳食摄入（定义为减少含糖饮料的摄入，减少快餐的摄入，增加新鲜水果和蔬菜的摄入）。H3：家庭对青少年过去一天中高强度体力活动和过去七天优质膳食摄入的影响将部分由家庭功能随时间的变化介导。

DESCRIPTION (provided by applicant): Childhood obesity is one of our nation's most significant public health problems. Hispanic youth are particularly at risk and are more likely to be overweight and obese than their non-Hispanic white counterparts partly because of their inadequate levels of physical activity and the poor quality of their dietary intake. Family functioning, specifically parental involvement and family communication, is related to a number of health behaviors and conditions, including drug use, tobacco use, sexual risk behaviors, physical activity, dietary intake, and body mass index (BMI). Despite the evidence that parental involvement and parent- adolescent communication have a role in obesity prevention, their incorporation into obesity prevention interventions has been limited. Thus, there is a critical need to develop family-based obesity preventive interventions for youth that target physical activity and poor diet, especially for Hispanic youth -- given the disproportionate and multiple obesity-related health burdens they face. Familias Unidas (United Families in English) is a family-based, culturally-specific intervention found to be efficacious in preventing or reducing a number negative health behaviors and conditions, including drug use, alcohol use, depression, sexual risk behaviors, conduct problems, sexually transmitted diseases, and alcohol dependence. Familias Unidas has impacted these outcomes through improvements in family functioning (e.g, parental involvement and parent-adolescent communication), the same mechanism that has been found to be related to physical activity and dietary intake. Preliminary data also indicate that Familias Unidas has positive effects on physical activity and that the effects of the intervention on physical activity are partially mediated by parental involvement. This study's aims are: AIM 1: To examine the relative efficacy of Familias Unidas, extended to target obesity, in increasing physical activity and improving the quality of dietary intake among overweight Hispanic youth and AIM 2: To examine whether and to what extent family functioning partially mediates the effects of Familias Unidas on physical activity and quality of dietary intake. To achieve these aims the proposed study will randomize 280 Hispanic youth to one of two conditions: 1) Familias Unidas or 2) a community practice control condition. Three study hypotheses will be tested: H1: Familias Unidas will be efficacious, compared to Community Practice, in increasing Hispanic youth's past seven day moderate to vigorous physical activity over time; H2: Familias Unidas will be efficacious, compared to Community Practice, in improving Hispanic youth's past seven day quality dietary intake (defined as decreases in sugar-sweetened beverages, decreases in intake of fast foods, and increases in fresh fruits and vegetables) over time; and H3: Familias Unidas' effects on youth's past day moderate to vigorous physical activity and youth's past seven day quality dietary intake will be partially mediated by changes in family functioning over time.