The Mid-Atlantic Center for Cardiometabolic Health Equity (MACCHE) Diversity Supplement

资助的父母补助金摘要。本建议书是一个子项目的补充， 中大西洋心脏代谢健康公平中心（MACHE）（NIMHD） 5 P50 MD 017348 -02; MPI：库珀和船员），标题为“循证医学的有效性” 降低妇女和婴儿心脏代谢风险的健康指导方案 参加早期家访服务”（MPI：Bower/班尼特）。黑人和拉丁裔妇女 肥胖的患病率最高。1怀孕时肥胖的妇女 妊娠期糖尿病、高血压疾病和急性心血管事件的过度风险 与正常体重的妇女相比，在分娩和分娩期间。 2,3 生活方式干预 解决怀孕期间的肥胖问题有可能打破肥胖的循环， 黑人和拉丁裔妇女及其后代的心脏代谢疾病（CMD）。 有效性的证据，很少有生活方式干预措施已在黑人或拉丁美洲人中进行了测试 孕妇或在社区环境中实施，其中许多高风险 孕妇和产后妇女获得安全网服务。早期家访（HV）是一种 在所有50个州都发现了以证据为基础的公共卫生服务战略， 风险社区应对健康的不利社会决定因素。家庭访客提供健康 教育，促进积极的养育和早期学习，并将家庭与需要的人联系起来， 社区资源。5这是一个混合类型1的有效性-实施随机对照 一项比较H42/H4 U-HV有效性的试验， 妊娠/产后健康指导干预，纳入家访，与 对360名孕妇和产妇进行常规家访服务， 产后妇女我们将评估干预措施的执行情况， 持续融入家访。H42/H4 U-HV，专为黑人、拉丁裔、西班牙人量身定制 讲妇女和实施到早期家访计划有可能促进 健康的生活方式行为，消除肥胖，不良妊娠结局， 年轻高危黑人和拉丁裔孕妇和产后妇女中的长期CMD 和他们的孩子我们的目标是不仅要确定H42/H4 U-HV的有效性， 了解使干预措施的实施能够为可持续性提供信息的因素， 从证据转化为实践的途径，并促进更多的后续公众 健康影响6

Summary of the Funded Parent Grant. This proposal is a supplement to a sub-project of “The Mid-Atlantic Center for Cardiometabolic Health Equity (MACCHE)” (NIMHD 5P50MD017348-02; MPI: Cooper and Crews) entitled “Effectiveness of an evidence-based health coaching program for reducing cardiometabolic risk among women and infants enrolled in early home visiting services” (MPI: Bower/Bennett). Black and Latinx women have the highest prevalence of obesity.1 Women entering pregnancy with obesity have an excess risk of gestational diabetes, hypertensive disorders, and acute cardiovascular event during labor and delivery, compared to normal weight women. 2,3 Lifestyle interventions addressing obesity in pregnancy have the potential to break the cycle of obesity and cardiometabolic disease (CMD) for Black and Latinx women and their offspring.4 Despite evidence of effectiveness, few lifestyle interventions have been tested among Black or Latinx pregnant women or been implemented in community-based settings, where many high risk pregnant and postpartum women access safety-net services. Early home visiting (HV) is an evidence-based public health service strategy found in all 50 states that targets services to high- risk communities to address adverse social determinants of health. Home visitors provide health education, promote positive parenting and early learning, and link families with needed community resources.5 This is a hybrid type 1 effectiveness-implementation randomized control trial comparing the effectiveness of H42/H4U- HV, a remotely delivered evidence-based pregnancy/postpartum health coaching intervention, integrated into home visiting compared with usual home visiting services in reducing postpartum weight retention among 360 pregnant and postpartum women. We will evaluate the implementation of the intervention to enable and sustain integration into home visiting. H42/H4U-HV, which is tailored for Black, Latinx, Spanish speaking women and implemented into early home visiting programs has potential to promote healthy lifestyle behaviors and eliminate disparities in obesity, adverse pregnancy outcomes, and long-term CMD among young high-risk Black and Latinx pregnant and postpartum women and their infants. We aim to only establish the effectiveness of H42/H4U-HV but also understand the factors that enable intervention implementation to inform sustainability, further the pathway from evidence translation into practice, and facilitate greater subsequent public health impact.6