A culturally-tailored narrative intervention to target disparities in obesity

描述（由申请人提供）：美国三分之一的儿童超重或肥胖，在服务不足的人群中，包括社会经济地位低（SES）和/或种族/少数民族家庭的比例更高。高糖饮料（SSB）摄入是导致儿童肥胖的能量失衡的主要因素，来自低社会经济地位和少数种族/民族背景的儿童比高社会经济地位和白色人群更有可能成为SSB的重度消费者。由于儿童摄入的大多数SSB都是在家中进行的，因此父母的合作对于减少儿童摄入SSB至关重要。基于叙述的方法，其中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、针对家庭的信息，这些信息吸引父母的情感，从而与传统的说教、教育方法相比，更有可能促进行为改变。 为了解决SSB摄入量和儿童肥胖症的健康差异，我们提出了一种针对服务不足的儿童和父母SSB摄入量的文化定制干预措施，其中青年积极参与并有权成为家庭中的关键行为改变者。青年将通过印刷，音频和电影项目设计创意，叙事为基础的材料，突出将与父母分享的SSB的关键行为信息。由于儿童在很大程度上影响父母的购买决定，我们建议，这些消息将减少父母购买SSB，并随后减少SSB在家庭环境中的可用性。干预措施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，为种族多样化和社会经济地位低的人口提供服务。干预预测试和细化将基于焦点小组输入;将通过一项研究中心匹配的随机对照试验（每个研究中心有54对父母-儿童（N=108）），评估干预的可行性、可接受性和对儿童和父母SSB摄入量和儿童体重指数（BMI）的初步疗效。 在王博士之前的试验基础上 她致力于减少市中心青少年的SSB摄入量，该奖项将为她提供开发行为干预措施和在社区环境中进行随机对照试验的培训。该提案将有助于王博士的长期目标，设计和评估以家庭为基础的肥胖预防计划，可以在社区环境中持续和传播。除了在马萨诸塞州医学院和当地男孩和女孩俱乐部的高度支持的研究环境，王博士的多学科导师团队经验丰富，并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.