A culturally-tailored narrative intervention to target disparities in obesity

描述(申请人提供)：美国三分之一的儿童超重或肥胖，在服务不足的人群中，超重或肥胖的比例高得不成比例，包括低社会经济地位(SES)和/或种族/少数民族家庭。高含糖饮料(SSB)摄入量是导致儿童肥胖的能量失衡的主要原因，来自低SES和少数族裔/民族背景的儿童比SES和白人高的儿童更有可能大量消费SSB。由于儿童消费的大多数SSB是在家中发生的，父母的合作对于减少儿童SSB的摄入量至关重要。基于叙事的方法，即关键的健康信息是由儿童在故事的背景下创建和呈现的，可以用来开发文化定制的、特定于家庭的信息，吸引父母的情绪，从而与传统的说教、教育方法相比，促进行为改变的可能性更大。为了解决SSB摄入量方面的健康差距以及儿童肥胖问题，我们建议针对服务不足的儿童和父母摄取SSB的儿童和父母进行文化定制的干预，让年轻人积极参与并授权成为其家庭中关键的行为改变因素。青年将通过印刷、音频和电影项目设计基于叙事的创造性材料，突出SSB上的关键行为信息，并将与他们的父母分享。由于子女在很大程度上影响了父母的购买决定，我们认为这些信息将减少父母对SSB的购买，从而降低家庭环境中SSB的可用性。干预将通过美国男孩和女孩俱乐部提供，这是一个以青年为基础的社区环境，服务于种族多样化和以低社会经济地位为主的人口。干预前的测试和改进将基于焦点小组的输入；干预的可行性、可接受性和对儿童及其父母的SSB摄入量和儿童的体重指数(BMI)的初步效果将通过现场匹配的随机对照试验进行评估，每个地点有54对亲子(N=108)。建立在王博士之前的试验基础上 在减少市中心青年SSB摄入量的工作中，这个奖项将为她提供制定行为干预措施和在社区环境中进行随机对照试验的培训。这项提案将有助于王博士的长期目标，即设计和评估以家庭为基础的肥胖预防计划，这些计划可以在社区环境中持续和传播。除了麻省大学医学院和当地男孩和女孩俱乐部高度支持的研究环境外，王博士的多学科导师团队经验丰富，致力于为她提供所需的支持，以实现拟议的培训和研究目标。

DESCRIPTION (provided by applicant): One-third of children in the U.S. are overweight or obese, with disproportionately higher rates among underserved populations, including low socio-economic status (SES) and/or racial/ethnic minority households. High sugar-sweetened beverage (SSB) intake is a major contributor to the energy imbalance leading to childhood obesity, with children from low SES and minority racial/ethnic backgrounds more likely to be heavy consumers of SSBs than higher SES and White populations. As the majority of SSBs consumed by children take place at home, parental collaboration is critical to reduce children's SSB intake. Narrative-based approaches, in which key health messages are created and presented within the context of a story by children, can be used to develop culturally-tailored, family-specific messages that appeal to parents' emotions and thus facilitate greater likelihood of behavior change compared to traditional didactic, educational approaches. To address health disparities in SSB intake as well as childhood obesity, we propose a culturally-tailored intervention targeting underserved children and parents' SSB intake in which youth are actively engaged and empowered to be key behavior change agents within their families. Youth will design creative, narrative-based materials through print, audio, and film projects, highlighting key behavioral messages on SSBs that will be shared with their parents. As children heavily influence parental purchasing decisions, we proposed that these messages will reduce parental purchase of SSBs and subsequently decrease SSB availability in the home environment. The intervention will be delivered through the Boys and Girls Clubs of America, a youth-based community setting that serves an ethnically diverse and predominantly low SES population. Intervention pre- testing and refinement will be based on focus group input; intervention feasibility, acceptability, and preliminary efficacy on children and parents' SSB intake and children's body mass index (BMI) will be assessed through a site-matched, randomized controlled trial with 54 parent-child pairs (N=108) per site. Building upon Dr. Wang's prior pilot work on reducing SSB intake among inner-city youth, this award will provide her with training in developing behavioral interventions and conducting randomized controlled trials in community settings. The proposal will contribute to Dr. Wang's long-term goal of designing and evaluating family-based obesity prevention programs that can be sustained and disseminated in community settings. In addition to the highly supportive research environment at the University of Massachusetts Medical School and the local Boys and Girls Clubs, Dr. Wang's multidisciplinary team of mentors is highly experienced and committed to provide her with the support needed to achieve the proposed training and research goals.