COACH: Competency Based Approaches for Community Health

COACH：基于能力的社区健康方法

• 批准号: 10657431
• 负责人: William Heerman
• 金额: $ 69.55万
• 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/10657431
• 关键词: 5 year old; Accelerometer; Address; Affect; Age; Area; Attention; Behavior; Behavior Therapy; Behavioral; Body Weight decreased; Body mass index; Child; Child Health; Child Rearing; Chronic Disease; Communities; Community Health; Competence; Control Groups; Cultural Sensitivity; Development; Diet; Education; Educational Curriculum; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Eligibility Determination; Enrollment; Family; Foundations; Future; Generations; Goals; Growth; Health; Health behavior; Health behavior change; Heterogeneity; Hour; Household; Individual; Infrastructure; Intervention; Latino; Low income; Measures; Mediating; Minority; Minority Groups; Modeling; Neighborhoods; Obesity; Outcome; Parents; Participant; Pattern; Phase; Physical activity; Population; Randomized, Controlled Trials; Readiness; Reduce health disparities; Schools; Self Determination; Sleep; Structure; Testing; Weight; adult obesity; community barrier; community building; community center; comparison control; disorder risk; early childhood; early-onset obesity; effectiveness testing; experience; family support; flexibility; follow-up; food insecurity; fruits and vegetables; group intervention; health disparity; healthy weight; improved; intervention effect; minority children; minority communities; novel; obesity in children; obesity prevention; obesity treatment; personalized approach; personalized intervention; preventive intervention; primary outcome; randomized trial; scale up; secondary outcome; sex; social health determinants; success; telephone coaching; theories; therapy design; treatment effect

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. Constantly changing barriers at the household and community levels impede consistent engagement in healthy behaviors. The current proposal tests a novel, culturally-tailored and multi-level intervention designed to teach families to overcome dynamic barriers as the logical next step to address obesity among low-income Latino families. It is based on the premise that by implementing a personalized multi-level intervention that simultaneously addresses healthy weight for parents and children, we will improve body mass index (BMI) among Latino parent-child pairs. 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 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. Building on a successful pilot, this proposal will implement a randomized controlled trial to test the effectiveness of COACH compared to an attention-matched school-readiness control group. We will enroll 300 parent-child pairs from Latino communities in Nashville, TN. Eligible children will be 3-5 years old and have a BMI >50th percentile. Through our 10-year partnership with the Nashville Parks and Rec department, we conduct COACH in neighborhood community centers, leveraging community infrastructure to facilitate health behavior change. The primary outcome will be child BMI change at 2-year follow-up, using a growth curve analysis. Secondary outcomes will include parent BMI, and parent/child diet and physical activity. The goals of COACH are to 1) implement a novel personalized behavioral intervention, 2) test a two-generation solution to obesity, 3) address health disparities by reducing obesity among Latino families, and 4) develop a scalable and widely accessible approach to behavioral obesity interventions by delivering them in Parks and Rec centers.

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。不断改变家庭和社区层面的障碍会阻碍一致的一致 参与健康行为。当前的提案测试了一种新颖的，文化的和多层次 旨在教导家庭克服动态障碍的干预措施，作为解决方案的逻辑下一步 低收入拉丁裔家庭中的肥胖症。这是基于这样的前提 多层干预措施同时解决父母和孩子的健康体重，我们将改善 拉丁裔亲子对之间的体重指数（BMI）。 教练（基于能力的社区健康方法）实施了个人量身定制的方法， 尽管动态障碍，但还是装备家庭来从事健康行为。教练是多层干预 针对1）通过发展适当的健康行为课程的单个孩子，2）家庭 通过直接解决家长体重减轻并与父母作为孩子的变革代理人，3） 社区通过建立公园和娱乐中心的能力来提供亲子节目。使用小说 在整个研究中，多组分评估，干预措施确定了个人，家庭和 健康行为的社区障碍，并在7中提供结构化但个性化的干预内容 域：水果/蔬菜，小吃，含糖饮料，体育锻炼，睡眠，媒体使用和育儿。 该提案以成功的飞行员为基础，将实施一项随机对照试验，以测试 与注意力匹配的学校准备控制小组相比，教练的有效性。我们将注册300 来自田纳西州纳什维尔的拉丁裔社区的亲子对。合格的孩子将年满3-5岁，有一个 BMI>第50个百分点。通过与纳什维尔公园和娱乐部的10年合作伙伴关系，我们 在社区社区中心进行教练，利用社区基础设施促进健康 行为改变。主要结果将是使用增长曲线在2年随访时进行的BMI变化 分析。次要结果将包括家长BMI，父母/儿童饮食和体育锻炼。目标 教练是1）实施一种新型的个性化行为干预，2）测试两代解决方案 肥胖，3）通过减少拉丁裔家庭的肥胖来解决健康差异，4） 通过在公园和娱乐中心交付行为肥胖干预措施，可以广泛获取行为肥胖。