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

项目概要： 尽管经过数十年的研究和公众意识的不断增强，肥胖仍然影响着低收入黑人儿童 家庭不成比例。这导致肥胖、心血管疾病和其他一些疾病的差异 成年期的合并症。父母在预防肥胖和心血管疾病方面发挥着重要作用 塑造孩子早期的饮食和生活方式。然而，来自低收入的黑人父母 家庭面临许多社会经济障碍。这些社区的家长寻求切实可行的 尽管存在这些障碍，仍可以实施实用的生活方式建议。虽然医疗保健提供者在 初级保健机构通常负责提供此类建议并帮助父母实施生活方式 行为改变时，他们缺乏高效、有效、文化相关且有吸引力的工具来传达 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。作为一名独立研究员，我的长期目标是改善儿童健康结果 通过以家庭为中心的设计，致力于减少肥胖及其合并症的差异， 生物行为干预措施，激发改变的动力，促进采取可行的步骤，以及 加强低收入家庭和少数族裔家庭行为改变的维持 组。本研究的目的是开发、评估和评估可接受性、可行性和 两种利用视觉图像（图形与 说明性）加上结构化的、文化相关的、简短的行为改变咨询，以传达心血管疾病风险 来自低收入家庭、有学龄儿童（6-11 岁）的肥胖黑人父母。 具体来说，本研究的目的是：（1）通过迭代焦点小组开发两种视觉传达工具： 受肥胖影响的黑人父母和 b) 初级保健卫生保健提供者 (HCP)； (2) 确定 在模拟与黑人的临床接触过程中，每种视觉交流工具的可接受性和可行性 家长和 HCP； (3) 确定两种视觉传达工具的初步效果 父母的改变意愿、感知风险、CVD 风险知识以及短期生活方式行为改变 与标准化 CVD 风险评分相比，肥胖的影响更大。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：获得视觉发展技能 以文化相关的方式传达疾病风险的沟通工具；获得临床应用方面的专业知识 通过文化相关的简短行为改变咨询进行动机访谈；获得以下方面的能力 设计基于家庭的行为改变干预措施的随机对照试验。这项研究的结果 将确定该人群最重要的工具，并将在随机对照试验中进行测试（R01） 确定生活方式改变对父母及其孩子的影响。

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.