Understanding the Rise of Obesity among Immigrants: A Pilot Study

了解移民肥胖率的上升：一项试点研究

• 批准号: 7739414
• 负责人: Gilbert Gee
• 金额: $ 20.33万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-13 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7739414
• 关键词: Acculturation; Adopted; Age; American; Area; Behavior; Biological Monitoring; Body mass index; Cellular Phone; Characteristics; Clinical Research; Country; Data; Data Collection; Development; Devices; Diabetes Mellitus; Diet; Eating; Education; Employment; Enrollment; Environment; Fatty acid glycerol esters; Feasibility Studies; Filipino; Food; Gender; General Population; Glucocorticoids; Goals; Health; Immigrant; Incentives; Individual; International; Intervention; Language; Legal; Life; Life Style; Location; Malignant neoplasm of prostate; Measurement; Measures; Methods; Native-Born; Natural experiment; Nature; Nomads; Nurses; Nursing Assessment; Obesity; Parents; Participant; Patient Self-Report; Pattern; Persons; Philippines; Physical activity; Pilot Projects; Population; Positioning Attribute; Prevention program; Primary Prevention; Process; Production; Public Health; Questionnaires; Reading; Research; Research Personnel; Research Project Grants; Sampling; Satiation; Social Network; Stress; Sum; System; Technology; Testing; United States; Weight; Weight Gain; base; cohort; comparison group; design; digital; ethnic discrimination; experience; follow-up; increased appetite; innovation; insight; migration; novel; obesity risk; public health relevance; response; stressor; trend; waist circumference

DESCRIPTION (provided by applicant): The goal of this R21 application, in response to PA-06-256 (Exploratory/Developmental Clinical Research Grants in Obesity), is to evaluate the feasibility of conducting a longitudinal, transnational study of obesity among immigrants. Although immigrants have lower rates of obesity than the native-born, these rates converge the longer immigrants reside in the U.S. This convergence suggests that weight gain is occurring faster among immigrants. Weight gain among immigrants likely results from changes in diet, physical activity and stress. However, most prior studies of weight gain among immigrants were cross-sectional, lacked an international comparison group, and did not contain pre-migration information. Thus, studies may have been confounded by secular trends arising from the globalization of "American" foods and lifestyles. This proposed pilot study examines a natural experiment, with migration itself as the "treatment." The pilot aims to: (1) demonstrate the feasibility of enrolling three cohorts of migrants; (2) collect baseline information of dietary and physical activity patterns; (3) follow three cohorts over one year, assess strategies to minimize loss-to-followup, and evaluate retention rates. The three cohorts consists of: (1) migrants, followed from the Philippines to the U.S.; (2) non-migrants, matched on age, gender and education to the migrants, and followed within the Philippines; (3) non-migrants comprised of individuals who wish to migrate, but do not yet have the necessary clearances. Three waves of data will be collected over one year, with initial measurements taken in the Philippines. This data consists of readings from accelerometers, anthropomorphic assessments, self-reported measures, and novel information from cell phones. The cell phones will be equipped with global positioning systems (GPS) technology to track participants' locations and with cameras to allow photographs of the foods participants eat and their self- measurements of weight and waist circumference. A subsample of participants will have nurse-administered assessments across all waves. In sum, the proposed pilot study provides a unique examination of how weight gain may actually occur among immigrants to the U.S. Compared to most studies that examine immigrants after arrival in the U.S., major innovations of this study include the assessment of pre-migration experiences, a comparison group of non-immigrants in the parent country, and the use of cell phone technology to validate self-reported measures. Ultimately, this research may provide insights into the nature of weight gain among immigrants and potential avenues for intervention. PUBLIC HEALTH RELEVANCE: Rising rates of obesity in the United States and worldwide are a significant public health concern because of the many health problems associated with obesity. Immigrants are among the fastest segments of the U.S. population and further, may be gaining weight at faster rates than the general population. The identification of factors that contribute to weight gain among immigrants may provide key information for the development of primary prevention programs.

描述（由申请人提供）：为了响应PA-06-256（肥胖症探索性/发展性临床研究资助），本R21申请的目标是评估在移民中进行肥胖症纵向跨国研究的可行性。尽管移民的肥胖率低于本土出生的人，但随着移民在美国居住的时间越长，这些肥胖率趋于一致。这种趋同表明，移民的体重增加速度更快。移民的体重增加可能是饮食、身体活动和压力变化的结果。然而，先前大多数关于移民体重增加的研究都是横断面的，缺乏国际比较组，并且不包含移民前的信息。因此，研究可能会被“美国”食品和生活方式全球化所产生的长期趋势所混淆。这项拟议的试点研究考察了一个自然实验，将移民本身作为“治疗”。该试点旨在：(1)证明招收三组移民的可行性；(2)收集饮食和身体活动模式的基线信息；(3)在一年的时间里跟踪三个队列，评估最小化随访损失的策略，并评估保留率。这三个群体包括：(1)移民，从菲律宾到美国；(2)非移民，在年龄、性别和教育程度上与移民相匹配，并在菲律宾境内跟进；(3)非移民，包括希望移民但尚未获得必要许可的个人。将在一年内收集三波数据，初步测量在菲律宾进行。这些数据包括来自加速度计的读数、拟人化评估、自我报告的测量和来自手机的新信息。这些手机将配备全球定位系统（GPS）技术来追踪参与者的位置，并配有摄像头，可以拍摄参与者所吃的食物，以及他们自己测量的体重和腰围。参与者的子样本将在所有波浪中进行护士管理的评估。总而言之，拟议的试点研究提供了一种独特的方法来研究美国移民中体重增加的实际情况。与大多数研究移民抵达美国后的情况相比，本研究的主要创新包括对移民前经历的评估，母国非移民的比较组，以及使用手机技术来验证自我报告的措施。最终，这项研究可能为了解移民体重增加的本质和潜在的干预途径提供见解。公共卫生相关性：在美国和世界范围内，肥胖率的上升是一个重要的公共卫生问题，因为许多健康问题与肥胖有关。移民是美国人口中增长最快的群体之一，而且他们的体重增长速度可能比普通人群更快。确定导致移民体重增加的因素可能为初级预防项目的发展提供关键信息。