The Development and Evaluation of Visual Communication Tools to Convey Parental and Intergenerational Cardiovascular Disease Risk and Evoke Lifestyle Behavior Change in Low-income Black Families

项目总结： 尽管经过了几十年的研究和公众意识的不断提高，肥胖仍然影响着来自低收入家庭的黑人儿童 不成比例的家庭。这导致了肥胖、心血管疾病和其他几种疾病的差异 成年后的共病。父母在肥胖和心血管疾病预防中发挥着重要作用 在孩子生命早期塑造他们的饮食和生活方式行为。然而，来自低收入家庭的黑人父母 家庭面临许多社会经济障碍。来自这些社区的父母寻求有形的和 实用的生活方式建议，尽管存在这些障碍，但仍然可以实施。而医疗保健服务提供者在 初级保健机构的任务通常是提供这种建议，并授权父母实施生活方式 行为改变，他们缺乏高效、有效、与文化相关和引人入胜的工具来传达 肥胖和心血管疾病的代际风险，并促进所有人生活方式行为的改变 家庭成员。作为一名独立研究人员，我的长期目标是改善儿童健康状况 他的职业生涯致力于通过设计以家庭为中心来减少肥胖症及其共病的差异， 生物行为干预，激发改变的动力，促进进展到可操作的步骤，以及 加强维持低收入家庭和少数民族家庭的行为改变 组。本研究的目标是开发、评估和评估可接受性、可行性和 利用视觉图像的两种视觉交流工具的初步效果(图形与 说明性)与结构化的、与文化相关的、简短的行为改变咨询相结合，以传达 患有肥胖症的黑人父母，他们有一个学龄儿童(6-11岁)，来自低收入家庭。 具体地说，本研究的目的是：(1)通过迭代焦点小组开发两种视觉交流工具， 受肥胖影响的黑人父母和b)初级保健保健提供者；(2)确定 在与布莱克的模拟临床会面中每种视觉交流工具的可接受性和可行性 以及(3)确定两种视觉沟通工具对儿童的初步效果 父母的改变意向、感知风险、心血管疾病风险知识和短期生活方式行为改变 将受影响的肥胖与标准化的心血管疾病风险评分进行比较。我的职业发展计划包括 三个重点领域的指导、正式课程和研讨会：获得视觉发展的技能 沟通工具，以文化相关的方式传达疾病风险；获得临床应用方面的专业知识 通过与文化相关的短暂行为改变咨询来进行激励性访谈；在 在基于家庭的行为改变干预中设计随机对照试验。这项研究的结果 将确定该人群最显著的工具，该工具将在随机对照试验中进行测试(R01) 以确定对父母及其子女生活方式改变的影响。

PROJECT SUMMARY: Despite decades of research and growing public awareness, obesity affects Black children from low-income households disproportionately. This leads to disparities in obesity, cardiovascular disease, and several other co-morbidities in adulthood. Parents play an important role in obesity and cardiovascular disease prevention by shaping their child’s dietary and lifestyle behaviors early in life. However, Black parents from low-income households face numerous socioeconomic barriers. Parents from these communities seek tangible and practical lifestyle advice that can be implemented despite these barriers. While health care providers in the primary care setting are often tasked with providing this advice and empowering parents to implement lifestyle behavior change, they lack efficient, effective, culturally relevant, and engaging tools that can convey the intergenerational risk of obesity and cardiovascular disease and facilitate changes in lifestyle behaviors for all members of the family. My long term goal as an independent researcher is to improve child health outcomes through a career focused on reducing disparities in obesity and its comorbidities by designing family-centered, bio-behavioral interventions that evoke motivation to change, facilitate progression to actionable steps, and augment the maintenance of behavior change in families from low-income households and minority racial groups. The objective of this study is to develop, assess, and evaluate the acceptability, feasibility, and preliminary efficacy of two visual communication tools, that make use of a visual image (graphical versus illustrative) coupled with structured, culturally relevant, brief behavior change counseling, to convey CVD risk in Black parents with obesity who have a school-age child (6-11 years) and are from a low-income household. Specifically, this study aims to: (1) develop two visual communication tools via iterative focus groups with a) Black parents affected by obesity and b) primary care health care providers (HCPs); (2) determine the acceptability and feasibility of each visual communication tool during a simulated clinical encounter with Black parents and HCPs; and (3) determine the preliminary efficacy of the two visual communication tools on intention to change, perceived risk, knowledge of CVD risk, and short-term lifestyle behavior change in parents affected obesity compared to a standardized CVD risk score. My career development plan includes mentorship, formal coursework, and seminars in three focus areas: acquire skills in the development of visual communication tools to convey disease risk in a culturally relevant way; gain expertise in the clinical application of Motivational Interviewing through culturally relevant brief behavior change counseling; obtain competence in designing randomized controlled trials in family-based behavior change interventions. Results from this study will determine the most salient tool for this population which will be tested in a randomized controlled trial (R01) to determine the effect on lifestyle change in parents and their children.