DISSEMINATING & IMPLEMENTING A LIFESTYLE BASED HEALTHY WEIGHT PROGRAM IN A NATIONAL ORGANIZATION

项目总结 18-35岁的年轻成年女性体重过度增加是一种令人震惊和被忽视的趋势 必须加以解决，以扭转肥胖症和慢性病的流行。在这个脆弱的时期，妇女 与男性和其他生命周期相比，往往会增加不成比例的大量体重。我们的团队 开发了一种改变生活方式的干预措施(健康)，防止体重增加，促进持续体重 与家长作为教师(PAT)合作，减少了体重和腰围，这是一项全国性的家访， 以社区为基础的组织，在这一人群中具有重要的影响力。PAT提供亲子教育和 向近17万个家庭提供免费服务，每年最多提供25次免费家访，直到儿童进入 幼儿园。这项研究将通过语用聚类扩展我们之前的工作来扩展这些发现 评估三个水平健康传播和实施情况的随机对照试验 (母亲、家长教育者、拍拍网站)取得广泛影响。我们将开展务实集群 评价健康和健康培训课程的随机对照试验(实施战略) 关于美国超重和肥胖母亲的体重(N=252健康；N=252常规护理)。 来自28个现有PAT站点(14个健康站点，14个常规护理站点)的家长教育人员将接受健康培训 课程通过PAT国家中心，使用PAT现有的培训基础设施作为继续 教育机会。由RE-AIM指导的广泛评估将决定执行结果 (可接受性、认可性、适当性、可行性、忠诚度和适应性)。这个 实施研究的概念框架将确定影响健康的决定因素 在母亲、家长教育者、拍拍网站三个层面进行传播和实施，以增强外部效度 (覆盖和维护)和人口水平的影响。这项创新研究的发现将具有重要的意义 有可能帮助扭转年轻成年女性体重过度增加的趋势，这是一个关键的优先目标 在与肥胖和慢性病的流行作斗争中，通过循证干预接触到妇女 全国范围内。

PROJECT SUMMARY Excessive weight gain among young adult women age 18-35 years is an alarming and overlooked trend that must be addressed to reverse the epidemics of obesity and chronic disease. During this vulnerable period women tend to gain disproportionally large amounts of weight compared to men and other life periods. Our team developed a lifestyle modification intervention (HEALTH) that prevented weight gain, promoted sustained weight loss, and reduced waist circumference in partnership with Parents as Teachers (PAT), a national home visiting, community based organization with significant reach in this population. PAT provides parent-child education and services free-of-charge to nearly 170,000 families through up to 25 free home visits per year until the child enters kindergarten. This study will extend these findings by extends our previous work with a pragmatic cluster randomized controlled trial to evaluate dissemination and implementation of HEALTH across three levels (mother, parent educator, PAT site) to achieve widespread impact. We will conduct a pragmatic cluster randomized controlled trial to evaluate HEALTH and the HEALTH training curriculum (implementation strategy) on weight among mothers with overweight and obesity across the US (N= 252 HEALTH; N= 252 usual care). Parent educators from 28 existing PAT sites (14 HEALTH, 14 usual care) will receive the HEALTH training curriculum through the PAT National Center, using PAT’s existing training infrastructure, as a continuing education opportunity. An extensive evaluation, guided by RE-AIM will determine implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, and adaptation) at the parent educator level. The Conceptual Framework for Implementation research will characterize determinants that influence HEALTH dissemination and implementation at three levels: mother, parent educator, PAT site to enhance external validity (reach and maintenance) and population level impact. The findings from this innovative study will have significant potential to help reverse the trend of excessive weight gain among young adult women, a critical priority target in battling the epidemics of obesity and chronic disease, by reaching women with an evidence-based intervention nation-wide.