COACH: Competency Based Approaches for Community Health

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。家庭和社区层面不断变化的障碍阻碍了 积极参与健康的行为。目前的提案考验的是一种新颖的、量身定做的、多层次的 旨在教育家庭克服动态障碍的干预措施是合乎逻辑的下一步解决问题 低收入拉丁裔家庭中的肥胖问题。它基于这样一个前提，即通过实现个性化的 同时解决父母和孩子健康体重的多层次干预，我们将提高 拉丁裔亲子对的身体质量指数(BMI)。 Coach(基于能力的社区卫生方法)实施了一种个人定制的方法， 让家庭在遇到动态障碍的情况下从事健康行为。教练是一种多层次的干预 1)通过适合发展的健康行为课程针对个别儿童，2)家庭 通过直接解决父母减肥问题，并让父母参与到孩子的改变中来，以及3) 通过建设公园和娱乐中心的能力，为社区提供亲子节目。使用小说 多组分评估在整个研究中，干预确定了个人、家庭和 社区阻碍健康行为，并在7个月中提供结构化但个性化的干预内容 领域：水果/蔬菜、零食、含糖饮料、体育活动、睡眠、媒体使用和育儿。 在成功试点的基础上，该提案将实施随机对照试验，以测试 教练的有效性与注意力匹配的上学准备控制组进行比较。我们将招收300人 田纳西州纳什维尔拉丁裔社区的亲子对。符合条件的儿童年龄为3-5岁，并拥有 体重指数为第50个百分位数。通过我们与纳什维尔公园和娱乐部门长达10年的合作伙伴关系，我们 在社区中心进行培训，利用社区基础设施促进健康 行为改变。使用生长曲线，主要结果将是2年后儿童BMI的变化 分析。次要结果将包括父母体重指数，以及父母/孩子的饮食和体力活动。的目标 培训讲师将1)实施新的个性化行为干预，2)测试两代解决方案，以 肥胖症，3)通过减少拉丁裔家庭的肥胖症来解决健康差距，以及4)开发可扩展和 广泛使用的方法，通过在公园和娱乐中心提供行为肥胖干预。

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.