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.

项目摘要 尽管认识到肥胖症的健康差异，但低收入和 少数民族始终取得了有限的成功。这部分由社会解释 健康的决定因素。社区层面的障碍阻碍了对健康行为的一致参与。 拟议的辅助研究将目标社区级数据和相应的分析添加到正在进行中 低收入拉丁裔家庭的行为肥胖干预，名为Coach（R01HD100458，NICHD，PI heerman）。通过使用考虑体育锻炼环境的全面测量方法， 我们旨在表征食物环境，社会环境和历史/结构环境 这些复杂而累积的上下文风险对于我们正在进行的教练临床试验的儿童来说。 教练（基于能力的社区健康方法）实施个人量身定制的 方法是，尽管动态障碍，但仍使家庭装备家庭进行健康行为。教练是多层次 针对的干预措施1）通过发育适当的健康行为课程，单个孩子，2） 家庭通过直接处理父母的体重来解决父母作为改变的代理人的代理人 儿童，以及3）社区通过建立公园和娱乐中心的能力来提供亲子 编程。在研究的两年中，使用新型的多组分评估， 干预确定了健康行为的个人，家庭和社区障碍，并提供结构化的 但是在7个领域中的个性化干预内容：水果/蔬菜，小吃，含糖饮料，体育锻炼， 睡眠，媒体使用和育儿。 该辅助提案旨在通过添加关键社区级的上下文来增加数据收集 衡量这些变量对干预有效性的调节影响的变量。我们 提出收集与城市密度有关的数据；食物获取，可用性和质量；多个组成部分 体育锻炼环境；和与社会不平等有关的变量。我们将结合1个数据） 前瞻性进行邻里和杂货店调查以及2）本地和国家公共可用 数据集确定对社区风险的个人级别评估，然后可以将其纳入 主要试验的分析计划。除了进行每个主持人分析外 变量，我们将进行前瞻性队列分析，以评估其对儿童BMI的累积影响 时间。