Adaptation of A Prevention-Treatment (ADAPT) Program: Reducing Cancer Risk for Families with Young Children

 描述（由申请人提供）：预防肥胖是预防癌症。2012年，美国癌症协会（ACS）制定了指南，推荐健康营养，定期体育活动和体重控制作为癌症预防策略。癌症预防始于童年，因为肥胖预防始于童年。针对学龄前儿童的健康生活方式干预措施具有影响终身健康的巨大潜力。最有希望的干预措施是利用父母作为孩子的伙伴来改变孩子和父母的健康生活方式。Barkin等人证明，在社区娱乐中心为幼儿（3-5岁）家庭开展的12周90分钟技能建设计划（健康家庭计划）导致儿童BMI降低0.59，p <0.001，并在计划结束一年后改变了父母和幼儿利用其建筑环境支持定期体育活动的方式。要扩大这一有效的以社区为基础、以家庭为中心的健康生活方式方案的规模，就需要对方案的采用和适应情况进行评估，以便于传播和实施。我们提出了一个试点，以适应，包装，并测试这种有效的计划，以其他公园和娱乐中心的可行性。来自全国各地的四个不同的公园和娱乐项目将参加。在第一年，我们将召开一个咨询委员会，由公园和娱乐领导人，经理，工作人员和他们所服务的幼儿家庭组成。半结构化的采访公园和娱乐的领导人，工作人员和家庭的幼儿（n=40）将提供直接的反馈，通过和适应健康的家庭计划，包括：父母学龄前儿童健康的生活方式技能建设模块，娱乐中心的领导者促进者指南，和社会媒体工具的健康行为维护。此外，还将为公园和娱乐健康家庭方案的领导人提供培训。在第二年，在健康家庭方案领导人接受培训和认证后，20个家庭/地点将参加为期12周的方案。有关出勤率，忠诚度和计划成本的数据将被收集。参与家庭将完成一项关于亲子营养、体育活动和娱乐中心使用习惯的前后调查。一个样本的参与家庭和所有的健康家庭计划的领导人将参加半结构化的采访（N =40），以确定什么工作，可以保持。公园和娱乐是一个现有的基础设施，覆盖超过2.3亿美国人。因此，通过现有的基础设施调整有效的方案，以实际传播和实施，可以改善家庭的健康生活方式，降低幼儿及其父母的癌症风险。

 DESCRIPTION (provided by applicant): Obesity prevention is cancer prevention. In 2012 the American Cancer Society (ACS) developed guidelines that recommended healthy nutrition, regular physical activity, and weight control as cancer prevention strategies. Cancer prevention begins in childhood because obesity prevention begins in childhood. Healthy lifestyle interventions targeted at children as early as preschool have enormous potential to affect lifelong health. The most promising interventions utilize parents as partners with their children t change healthy lifestyle behaviors in both the child and the parent. Barkin et al demonstrated that a 12 week 90 minute skills building program (Healthy Families Program) with families of young children (ages 3-5 years), based in community recreation centers, resulted in a reduction of child BMI of 0.59, p <0.001 and changed how parents and young children utilized their built environment to support regular physical activity one year after the program ended. Scaling up this effective community-based family centered healthy lifestyle program will require an assessment of adoption and adaptation for dissemination and implementation. We propose a pilot to adapt, package, and test feasibility for this effective program to other parks and recreation centers. Four different Parks and Recreation programs from across the country will participate. In year one, we will convene an Advisory Committee comprised of Parks and Recreation leaders, managers, staff and families with young children that they serve. Semi-structured interviews with Parks and Recreation leaders, staff and families with young children (n=40) will provide direct feedback for the adoption and adaptation of the Healthy Families Program including: parent-preschool child healthy lifestyle skills building modules, recreation center leader facilitator guides, and a social media tool for healthy behavior maintenance. Additionally, training for Parks and Recreation Healthy Family Program leaders will be developed. In year two, after Healthy Families Program leaders have been trained and certified, 20 families/site will participate in the 12 week program. Data about attendance, fidelity, and program cost will be collected. Participating families will complete a pre- and post- survey on parent-child nutrition, physical activity, and recreation center use habits. A sample of participating families and all the Healthy Families Program leaders will participate in semi-structured interviews (N =40) to identify what worked and could be maintained. Parks and Recreation is an existing infrastructure that reaches more than 230 million Americans. Therefore adapting effective programs for practical dissemination and implementation through this existing infrastructure could improve healthy lifestyles for families, reducing cancer risk potentially in both young children and their parents.