COACH: Competency Based Approaches for Community Health

COACH：基于能力的社区健康方法

• 批准号: 10655736
• 负责人: William Heerman
• 金额: $ 23.2万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655736
• 关键词: 6 year old; Address; Age; Ancillary Study; Behavior; Behavior Therapy; Behavioral; Body Weight decreased; Body mass index; Child; Child Health; Child Rearing; Clinical Trials; Cohort Analysis; Communities; Community Health; Competence; Complex; Crime; Data; Data Collection; Data Set; Data Sources; Development; Diet; Educational Curriculum; Effectiveness; Effectiveness of Interventions; Enrollment; Environment; Ethnic Origin; Family; Food; Food Access; Funding; Future; Goals; Green space; Growth; Health behavior; Health behavior change; Heterogeneity; Hour; Income; Individual; Inequality; Intervention; Latino; Low income; Measurement; Measures; Minority; Minority Groups; Modeling; National Institute of Child Health and Human Development; Neighborhoods; Obesity; Parents; Participant; Persons; Phase; Physical activity; Population; Prospective cohort; Race; Readiness; Reduce health disparities; Research; Resources; Risk; Schools; Sleep; Social Environment; Source; Specific qualifier value; Sports; Structure; Surveys; Testing; Time; Work; base; built environment; community barrier; community building; community center; community-level factor; density; early childhood; experience; follow-up; food environment; food quality; fruits and vegetables; health disparity; improved; interest; novel; obesity in children; obesity treatment; personalized approach; personalized intervention; personalized medicine; primary outcome; prospective; recruit; secondary outcome; social; social determinants; social health determinants; social inequality; success; telephone coaching; walkability

PROJECT SUMMARY Despite the recognition of health disparities in obesity, behavioral interventions among low-income and minority populations have consistently met with limited success. This is partially explained by social determinants of health. Barriers at the community level impede consistent engagement in healthy behaviors. The proposed ancillary study adds objective community-level data and corresponding analyses to an ongoing behavioral obesity intervention for low-income Latino families, entitled COACH (R01HD100458 from NICHD, PI Heerman). By using a comprehensive measurement approach that considers the physical activity environment, the food environment, the social environment, and the historical/structural environment, we aim to characterize these complex and cumulative contextual risks for children enrolling in our ongoing COACH clinical trial. COACH (COmpetency-Based Approaches to Community Health) implements a personally tailored approach, equipping families to engage in health behaviors despite dynamic barriers. COACH is a multi-level intervention targeting 1) the individual child through developmentally appropriate health behavior curriculum, 2) the family by addressing parent weight loss directly and engaging parents as agents of change for their children, and 3) the community by building capacity of Parks and Rec centers to offer parent-child programming. Using novel multi-component assessments throughout the two years of the study, the intervention identifies individual, family, and community barriers to healthy behaviors and delivers structured yet personalized intervention content in 7 domains: fruits/vegetables, snacks, sugary drinks, physical activity, sleep, media use, and parenting. This ancillary proposal seeks to augment the data collection by adding key community-level contextual variables to measure the moderating impact of those variables on the effectiveness of the intervention. We propose collecting data related to urban density; food access, availability, and quality; multiple components of the physical activity environment; and variables related to social inequality. We will combine data from 1) prospectively conducting neighborhood and grocery store surveys and 2) local and national publicly available datasets to identify individual-level assessments of community-risk that can then be incorporated into the analysis plan for the main trial. In addition to conducting individual moderator analyses for each of the variables, we will conduct a prospective cohort analysis to evaluate their cumulative impact on child BMI over time.

项目总结 尽管认识到肥胖方面的健康差异，但低收入和低收入人群的行为干预 少数族裔人口始终取得有限的成功。这在一定程度上是由社会因素造成的 健康的决定因素。社区层面的障碍阻碍了人们对健康行为的持续参与。 拟议的辅助研究将客观的社区数据和相应分析添加到正在进行的 针对低收入拉丁裔家庭的行为肥胖干预，名为COACH(来自NICHD的R01HD100458，PI 希尔曼)。通过使用考虑身体活动环境的综合测量方法， 食物环境、社会环境和历史/结构环境，我们的目标是描述 对于参加我们正在进行的Coach临床试验的儿童来说，这些复杂和累积的背景风险。 COACH(基于能力的社区卫生方法)实施个人定制的 方法，使家庭在克服动态障碍的情况下从事健康行为。教练是一个多层次的 干预措施：1)通过适合儿童发展的健康行为课程，针对个别儿童；2) 通过直接解决父母减肥问题并让父母参与到改变他们的家庭中来 儿童，以及3)通过建设公园和娱乐中心的能力来为亲子提供 编程。在研究的两年中，使用了新颖的多组成部分评估， 干预措施确定个人、家庭和社区对健康行为的障碍，并提供有组织的 然而，个性化干预内容涉及7个领域：水果/蔬菜、零食、含糖饮料、体力活动、 睡眠、媒体使用和育儿。 这项辅助性建议旨在通过增加关键的社区级背景信息来增强数据收集 衡量这些变量对干预效果的缓和影响的变量。我们 建议收集与城市密度、食物获取、可获得性和质量有关的数据； 体育活动环境；以及与社会不平等有关的变量。我们将合并来自1)的数据 前瞻性地进行社区和杂货店调查，以及2)地方和全国公开提供 数据集，以确定个人级别的社区风险评估，然后可以将这些评估合并到 主审分析方案。除了对每个项目进行单独的主持人分析 ，我们将进行前瞻性队列分析，以评估它们对儿童BMI的累积影响。 时间到了。