ADAPTING AND ASSESSING THE FEASIBILITY OF ‘HEALTHY DADS, HEALTHY KIDS’ FOR US LATINOS

项目摘要 在美国的拉美裔面临着肥胖和相关医疗条件的健康差距，例如 心血管疾病和糖尿病。以家庭为目标促进健康的生活方式一直是 被确定为预防肥胖的有效策略。随着家庭主义(家庭凝聚力)在 在拉美裔人口中，以家庭为基础的干预尤其可取，因为这是促进 支持拉美裔健康体重状况并减少与肥胖相关的健康差距的行为。 新出现的证据支持有必要将父亲纳入基于家庭的生活方式行为中并将其作为目标 干预措施。然而，到目前为止，在美国，主要是通过这种努力接触到了母亲。健康爸爸 健康儿童(HDHK)是澳大利亚开发的一项以证据为基础的计划，显示出显著的体重 与对照组相比，父亲和他们的孩子的行为治疗效果。HDHK计划是 基于社会认知理论和家庭系统理论，旨在促进更多的体育活动 以及改善饮食摄入量。该项目的一项重要创新是父亲和孩子一起参加 两者都被作为彼此行为改变的目标(互惠强化)并参与其中 在娱乐、家庭活动中聚在一起。HDHK有几个可能吸引拉丁裔家庭的功能：它是在 由来自社区的训练有素的促进者进行小组会议(集体主义)，它促进了父亲的角色- 模范(强制执行)，家庭凝聚力，以及共同参与生活方式行为(家族主义)。怎么- HDHK应该系统地适应拉丁裔家庭的文化，以确保适当的入学， 在进一步评估之前，参与和促进拉丁裔家庭预期的健康结果。我们 提议召集一个由社区拉丁裔父母组成的小组，作为关键的告密者；以及 一个由研究人员组成的专家小组，他们在文化上适应拉丁裔、拉丁裔的育儿干预措施方面有经验 生活方式行为，以及拉丁裔父亲的影响。这两个小组将与研究小组合作(包括 HDHK的开发商)系统地修改HDHK计划，使其在文化上适应拉丁裔家庭 遵循生态效度模型。他们还将通知从已建立的题库中选择题项 食物和体力活动的育儿。得出的量表将在拉丁裔父亲的样本中进行测试，以 为拉丁裔父亲建立有效的父母教养量表，预计这将成为孩子们 HDHK的行为改变，并将在未来的试验中需要。由此产生的拉丁裔-HDHK将进行测试 在试点随机对照试验中的可行性(通过保留、参与和满意度来衡量) (n=40)。试点研究将包括彻底的流程评估，包括与参与者的离职面谈 拉丁裔父亲及其共同父母(通常是母亲)。一旦完成，这项发展研究将定位 美国将申请未来的R01，以在完全有效的随机对照试验中评估拉丁裔-HDHK。

Project Summary Latinos in the United States face health disparities for obesity and related medical conditions, such as cardiovascular disease and diabetes. Targeting families to promote healthy lifestyle behaviors has been identified as an effective strategy to prevent obesity. With the importance of familism (family cohesion) among Latino population, a family based intervention is especially desirable as an engaging strategy to promote behaviors that support a healthy weight status and decrease obesity related health disparities for Latinos. Emerging evidence supports the need to include and target fathers in family based lifestyle behavior interventions. However, to date primarily mothers have been reached by such efforts in the US. Health Dads Healthy Kids (HDHK) is an evidence based program developed in Australia, shown to have significant weight and behavior treatment effects for fathers and their children, compared to controls. The HDHK program is based on Social Cognitive Theory and Family Systems Theory and aims to promote increased physical activity and improved dietary intake. An important innovation in the program is that fathers and children attend together and are both targeted as agents of behavior change for each other (reciprocal reinforcement) and to participate in fun, family activities together. HDHK has several features that may appeal to Latino families: it is delivered in group sessions by a trained facilitator from the community (collectivism), and it promotes paternal role- modeling (enforces respeto), family cohesion, and engagement together in lifestyle behaviors (familism). How- ever, HDHK should be systematically culturally adapted for Latino families to ensure appropriate enrollment, engagement and promotion of desired health outcomes for Latino families, prior to further evaluation. We propose to convene a panel of Latino fathers and mothers from the community to serve as key informants; and an expert panel of researchers with experience in culturally adapting parenting interventions for Latinos, Latino lifestyle behaviors, and the influence of Latino fathers. The two panels will work with the study team (including the developer of HDHK) to systematically modify the HDHK program to culturally adapt it for Latino families following the Ecological Validity Model. They will also inform the selection of items from established item banks of food and physical activity parenting. The resulting scales will be tested among a sample of Latino fathers to establish validated scales of parenting for Latino fathers, which is expected to be a mediator of children's behavior change in HDHK, and will be needed in the future trial. The resulting Latino-HDHK will be tested for feasibility (as measured by retention, engagement, and satisfaction), in a pilot randomized controlled trial (n=40). The pilot study will include a thorough process evaluation, including exit interviews with participating Latino fathers and their co-parent (typically mothers). Once completed, this developmental study will position us to apply for a future R01 to assess the Latino-HDHK in a fully powered randomized controlled trial.