ADAPT+: Optimizing an Intervention to Promote Healthy Behaviors in Rural, Latino Youth with Obesity and their Parents, using Mindfulness Strategies

ADAPT：利用正念策略优化干预措施，促进农村、拉丁裔肥胖青年及其父母的健康行为

• 批准号: 10302280
• 负责人: Laura S Redwine
• 金额: $ 20.61万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10302280
• 关键词: 12 year old; Acculturation; Address; Adherence; Adult; Behavior; Behavior Therapy; Behavioral; Behavioral Mechanisms; Black race; Cardiovascular Diseases; Child; Child Rearing; Chronic Disease; Cognitive; Collection; Communities; Community Health; Data; Data Collection; Diet; Eating; Eating Disorders; Education; Epidemic; Evaluation; Family; Feedback; Focus Groups; Geography; Health; High Prevalence; Immigrant; Intervention; Language; Latino; Latino Population; Link; Low income; Malignant Neoplasms; Manuals; Measures; Metabolic syndrome; Methods; Mexican; Mindfulness Training; Minority; Minority Groups; National origin; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome Measure; Overweight; Parents; Participant; Patient Self-Report; Personal Satisfaction; Physical activity; Pilot Projects; Procedures; Protocols documentation; Public Health; Randomized; Reporting; Research; Research Design; Risk; Risk Factors; Rural; Rural Community; Sampling Studies; School-Age Population; Schools; Series; Stress; Students; Target Populations; Techniques; Testing; Time; United States National Institutes of Health; Work; Youth; acceptability and feasibility; adult obesity; base; body-mind; community center; cultural competence; data quality; design; efficacy trial; evidence base; experience; feasibility testing; healthy lifestyle; high risk; improved; indexing; innovation; intervention effect; lifestyle intervention; member; mindfulness; mortality; obese person; obesity in children; obesity prevention; obesity risk; obesity treatment; offspring obesity; parental role; post intervention; programs; randomized trial; recruit; rural area; satisfaction; stress reduction; success; theories; treatment as usual; trend; uptake; willingness

Project Summary Latino youth have the highest prevalence of obesity as compared to Black or White youth, and are at high- risk for adult obesity-related complications including cardiovascular disease. Moreover, Latino youth living in rural communities have an increased risk of adult obesity and mortality due to obesity-related chronic disease than Latinos living elsewhere. We synthesized our prior childhood obesity intervention and tailored our evidence-informed, theory-based, multi-family behavioral intervention, Adaptando Dieta y Acción Para Todos (ADAPT), to the acculturation status, language, and national origin or our target population - obese, school aged (8-12 years old) Latino youth and their parents living in rural areas. However, because the role of parent stress on obesity has not been adequately addressed in interventions aimed at reducing obesity in Latino youth, we argue that mindfulness parent stress reduction strategies may be a key component to improving eating and physical activity (PA) behaviors in both children and their parents. This NIH Stage I R34 proposes a refinement and optimization of the original ADAPT obesity intervention protocol to include mindfulness parent stress reduction strategies (now ADAPT+) (Stage IA) and feasibility assessment of ADAPT+ implementation (Stage IB). This mixed methods R34 sets the basis for a Stage 2 larger R01 trial to determine ADAPT+'s efficacy in improving Latino families' eating and PA behaviors. Two main aims guide our application. Aim 1: Refinement of ADAPT+ (ADAPT + mindfulness parent stress reduction) intervention. ? We assess acceptability of the integration of mindfulness parenting stress reduction into ADAPT to increase healthy lifestyle behaviors by: conducting a series of focus groups with our community health facilitators/ promotoras and parents of children (8-12 years old) with obesity to obtain feedback about and refine each of our 8 integrated sessions and evaluate optimization of ADAPT+ sessions. Aim 2: Feasibility and Acceptability trial. A randomized trial testing feasibility of ADAPT+ vs. Enhanced Usual Care/EUC conducted in two rural communities evaluates: ? study sample selection and recruitment, willingness to be randomized and retention. ? fidelity of intervention administration, intervention adherence, and further refinement of manuals. ? feasibility of data collection procedures, including collecting a battery of measures from parents and children, data quality and sensitivity of our measures to our intervention effects over time – (pre- post- 3 mos post). ? We anticipate that compared to EUC, ADAPT+ dyads will have a lower attrition rate and will report greater satisfaction. We also explore whether our eating, PA and stress indices are sensitive to the intervention. This application is significant, as it addresses an urgent public health epidemic among a specific at-risk, ethnic and geographical minority group; innovative, as it implements a unique intervention that addresses many limitations in the current state of obesity prevention and employs a rigorous scientific approach.

项目摘要 与黑人或白色青年相比，拉丁裔青年的肥胖率最高， 成人肥胖相关并发症的风险，包括心血管疾病。此外，居住在 农村社区成人肥胖和肥胖相关慢性病死亡的风险增加 生活在其他地方的拉美人。我们综合了之前的儿童肥胖干预措施， 循证、理论为基础的多家庭行为干预 （适应），适应文化状况，语言和民族血统或我们的目标人群-肥胖，学校 年龄（8-12岁）拉丁美洲青年及其父母生活在农村地区。然而，由于父母的角色 在旨在减少拉丁美洲人肥胖的干预措施中， 青年，我们认为，正念父母减压策略可能是改善的关键组成部分， 饮食和身体活动（PA）的行为在儿童和他们的父母。NIH第一阶段R34提出了一个 完善和优化原始ADAPT肥胖干预方案，以纳入正念父母 减压战略（现为ADAPT+）（第IA阶段）和ADAPT+实施的可行性评估 （阶段IB）。该混合方法R34为第2阶段更大的R 01试验奠定了基础，以确定ADAPT+的 改善拉丁美洲家庭的饮食和PA行为的功效。两个主要目标指导我们的申请。 目的1：改进ADAPT+（ADAPT +正念父母压力减轻）干预。 ?我们评估了将正念育儿压力减轻融入ADAPT的可接受性， 健康的生活方式行为：与我们的社区健康促进者一起进行一系列焦点小组/ 促进者和肥胖儿童（8-12岁）的父母，以获得反馈，并完善每一个 我们的8个综合会议和评估ADAPT+会议的优化。 目标2：可行性和可接受性试验。一项随机试验，测试ADAPT+与增强型的可行性 在两个农村社区进行的社区保健/EUC评估： ?研究样本的选择和招募、随机化意愿和保留。 ?干预管理的保真度、干预依从性和手册的进一步完善。 ?数据收集程序的可行性，包括从父母和儿童那里收集一系列措施， 随着时间的推移，我们的措施对干预效果的数据质量和敏感性-（前-后- 3个月后）。 ?我们预计，与EUC相比，ADAPT+二联体的损耗率更低，并且报告的损耗率更高。 满意我们还探讨了我们的饮食，PA和压力指数是否对干预敏感。 这一应用具有重要意义，因为它解决了特定风险人群中的紧急公共卫生流行病， 创新，因为它实施了一项独特的干预措施， 目前的肥胖预防存在许多局限性，并采用了严格的科学方法。