Puerto Rican Obesity Intervention for Men

摘要 超重和肥胖是影响拉美裔男性的最普遍和最紧迫的健康问题， 拉美裔男性的超重率和肥胖率分别为42%和37%。在这组人中， 波多黎各(PR)男性的风险尤其高。在拉美裔社区健康研究/拉丁裔研究中， 公关男性肥胖率最高(40.9%)22，公关男性肥胖率较高 2型糖尿病(16.2%)和高胆固醇血症(48.2%)22.因此，迫切需要解决 波多黎各男性的肥胖相关行为，如饮食和缺乏体育活动。此外，发展 针对波多黎各饮食、体力活动和久坐行为的文化定制肥胖干预措施 Ricans有潜力满足关键的公共卫生需求，并为定制和 将未来的干预措施传播到其他文化。这项研究得到了拉美裔/拉丁裔的积极支持 卫生社区咨询委员会，波多黎各文化中心，波多黎各议程，其他 以波多黎各人为中心的拉丁裔组织和个人，拉什-蒙特利尔银行健康公平研究所， 以及美国国立卫生研究院资助的芝加哥大学拉什转化医学研究所。尽管远程医疗已经 在难以接触到的人群中增加减肥干预的覆盖面26、27，很少有人关注 关于男性或少数族裔8。此外，还没有公布的远程健康减肥干预措施侧重于 健康饮食、身体活动和久坐行为，特别针对波多黎各男性 肥胖的高风险。因此，我们建议进行一项概念验证研究，以确定远程医疗干预是否， 针对不同文化适应程度的波多黎各男性量身定做的，是可行和可接受的，如果可以的话 达到临床上有意义的减肥效果。电话推销健康饮食、体育锻炼和久坐不动 行为干预“(TeleSalud HE-PA/SB)将包括为期4个月的每周两次的增加课程 健康饮食和身体活动，减少久坐行为，然后进行为期4个月的维护 健康饮食、体力活动和久坐行为干预。这种干预将被比作 “TeleSalud General Health”干预，包括为期4个月的每周两次关于General的远程保健课程 健康问题，然后进行为期4个月的一般健康干预。我们将审查可行性、可接受性和 饮食的中间过程措施(能量摄入量，饱和脂肪、水果和蔬菜的卡路里百分比 通过整体食物频率问卷摄入量)；体力活动/久坐行为(代谢 相当于任务(MET)-每周和分钟的中等到剧烈的身体活动[MVPA]通过 国际体力活动问卷和加速度计辅助的MVPA分钟数)；以及 认知理论概念(自我效能、结果期望、对饮食和锻炼的社会支持) 指导干预。最终目的是根据文化适应程度的差异来检查趋势。

Abstract Overweight and obesity are among the most prevalent and pressing health issues affecting Latino men, with rates of overweight and obesity among Latino men being 42% and 37%, respectively22. Within this group, Puerto Rican (PR) men are at especially high risk. In the Hispanic Community Health Study/ Study of Latinos, the highest rates of obesity were observed among PR men (40.9%)22, and PR men had a high prevalence of type 2 diabetes (16.2%) and hypercholesterolemia (48.2%)22. Thus, there is an urgent need to address obesity-related behaviors- such as diet and physical inactivity- in Puerto Rican men. Moreover, developing culturally tailored obesity interventions that target diet, physical activity and sedentary behavior in Puerto Ricans has the potential to address a critical public health need and provides a foundation for tailoring and disseminating future interventions to other cultures. This study has the active support of the Hispanic/Latino Health Community Advisory Board, the Puerto Rican Cultural Center, The Puerto Rican Agenda, additional Puerto Rican-centered and Latino organizations and individuals, the RUSH-BMO Institute for Health Equity, and the NIH-funded University of Chicago- Rush Institute for Translational Medicine. Although telehealth has been used to increase reach in weight loss interventions with hard-to-reach populations26, 27, few have focused on men or ethnic minorities8. Moreover, there are no published telehealth weight loss interventions focusing on healthy eating, physical activity, and sedentary behaviors, specifically targeting Puerto Rican men who are at high risk for obesity. We therefore propose a proof-of-concept study to determine if a telehealth intervention, tailored to target Puerto Rican men of varying levels of acculturation, is feasible and acceptable, and if it can achieve clinically meaningful weight loss. The “TeleSalud Healthy Eating, Physical Activity, and Sedentary Behavior Intervention” (TeleSalud HE-PA/SB) will consist of 4 months of twice-weekly classes on increasing healthy eating and physical activity and decreasing sedentary behavior, followed by a 4-month maintenance healthy eating, physical activity, and sedentary behavior intervention. This intervention will be compared to the “TeleSalud General Health” intervention, consisting of 4 months of twice weekly telehealth classes on general health issues, followed by a 4-month general health intervention. We will examine feasibility, acceptability, and intermediate process measures for diet (energy intake, percent calories from saturated fat, fruit & vegetable intake via the Block Food Frequency Questionnaire); physical activity/ sedentary behavior (metabolic equivalent of task (MET)-minutes/week and minutes of moderate to vigorous physical activity [MVPA] via the International Physical Activity Questionnaire and accelerometer-assisted minutes of MVPA); and social cognitive theory concepts (self-efficacy, outcome expectations, social support for eating & exercise) which are guiding the intervention. The final aim is to examine trends based on differences in level of acculturation.