Community-based Obesity Prevention among Blacks

描述（由申请人提供）：预防黑人妇女肥胖是一项重要的公共卫生优先事项。目前，近54%的成年黑人女性人口（20岁及以上）肥胖。这一群体还不成比例地遭受与肥胖相关的健康后果（例如，许多癌症、心血管疾病、糖尿病）。迄今为止，大多数公共卫生干预措施的注意力都集中在减肥上；很少有研究试图在黑人女性中开发预防肥胖的干预措施。在准备提交最终的R01提案时，建议进行一项两阶段的研究，以协助Bennett博士制定肥胖预防干预研究计划。在第一阶段，我们会进行一系列的焦点小组讨论，以促进干预讯息的发展。然后，我们将测试信息框架和叙述的使用是否增强了参与者对干预信息的接受度。使用焦点小组收集的数据，我们将开发四套干预材料，使用2（健康框架vs美学框架）x 2（叙事vs无叙事）设计。在实验室测试中，40名成年黑人女性将被随机分配到4套干预材料中的1套；将采用调查手段和定性评价方法。在第二阶段，我们将重点关注干预措施中促进身体活动的部分。我们将实施一项为期24周的实验试验，以评估计步器步数建议是否与长期坚持计步器为基础的身体活动方案存在差异。参与者（n=226）将被随机分配接受10,000步/天的建议或适应性建议（其中参与者的步数建议以2500步/天的增量增加，直到她达到10,000步/天的阈值）。参与者将获得计步器，并被要求使用交互式语音应答自我监控系统每周报告他们的步数。简短的支持性反馈将在这些电话期间提供。评估（包括自我报告调查和人体测量测量）将在基线和基线后24周进行。我们的主要结果是坚持以计步器为基础的身体活动方案。次要结果包括身体活动和身体质量指数的变化。

DESCRIPTION (provided by applicant): Obesity prevention among Black women is a major public health priority. At present, nearly 54% of the adult Black female population (aged 20 and older) are obese. The group also suffers disproportionately from obesity-related health consequences (e.g. many cancers, cardiovascular conditions, diabetes). To date, most public health intervention attention has been focused on weight reduction; little research has sought to develop obesity prevention interventions among Black women. In preparation for an eventual R01 proposal submission, a two-phase study is proposed to assist Dr. Bennett develop an obesity prevention intervention research program. In Phase 1, we will conduct a series of focus groups to facilitate intervention message development. We will then test whether message framing and the use of narratives enhances participant receptivity to the intervention messages. Using data gleaned in the focus groups, we will develop four sets of intervention materials, using a 2 (health frame vs aesthetic frame) x 2 (narrative vs no narrative) design. In laboratory testing, 40 adult Black women will be randomized to review 1 of the 4 sets of intervention materials; survey measures and qualitative evaluation methods will be employed. In Phase 2, we will focus attention on the physical activity promotion component of the intervention. We will implement a 24-week experimental trial to evaluate whether pedometer step count recommendations are differentially associated with long-term adherence to a pedometer-based physical activity regimen. Participants (n=226) will be randomly assigned to receive either a 10,000 steps/d recommendation or an adaptive recommendation (in which the participant's step count recommendation is increased in 2500 steps/d increments until she reaches the 10,000 steps/d threshold). Participants will be provided pedometers and will be asked to report their step counts weekly, using an interactive voice response self-monitoring system. Brief supportive feedback will be provided during these calls. Assessments (including self-report survey and anthropometric measurements) will be administered at baseline and 24-weeks post baseline. Our primary outcome is adherence to a pedometer-based physical activity regimen. Secondary outcomes will include change in physical activity and BMI.