Tu Salud Si Cuenta! Reaching Latino family dyads to increase physical activity and healthy eating

摘要（摘自母基金，1R01HL128705 - 01，1R56HL128705 - 01） 美国的大多数成年人未能达到国家体育活动（PA）和饮食建议，拉丁美洲人 比非拉丁裔白人更不可能达到这些建议。缺乏运动，饮食不佳， 肥胖是心血管疾病、某些癌症、糖尿病和中风的主要危险因素， 在美国，可预防的发病率和死亡率的重要贡献者。 被认为对这些行为有重要影响，但大多数行为改变计划给予有限的 注意行为发生的社会背景。拟议研究的目标是评估 为期6个月的基于社区的家庭二元干预在促进参与和 在居住在三个主要拉丁裔社区的拉丁裔成年人中维持PA和健康饮食 在德克萨斯州的休斯顿。二人组将被随机分配到一个社区卫生工作者（CHW）领导的干预，"涂 你好啊! - 熟悉"（TSSC-家庭）或接触控制条件集中在健康的家庭。 TSSC-家庭将包括在六个月内向二元组成员提供的六次家访， 行为技能和社会支持的持续健康的行为改变之间的拉丁美洲家庭的二人组。的 健康家居接触控制亦包括由社区卫生工作者每月六次探访两组成员。 研究参与者将包括552名目前不符合PA或营养建议的拉丁美洲成年人 招募并登记为家庭成员二联体（n = 276二联体）。这种方法扩展了经验- 基于动机的行为改变干预开发的调查小组的成员， 与社区合作伙伴的合作已显示出积极PA有效性的初步证据 和饮食行为的改变。参与者将在基线、6个月和12个月时接受评估。 基线后3个月，以评估中期和长期影响。主要成果包括： 每周适度和剧烈的PA，以及水果和蔬菜，含糖饮料， 和全谷物。体重减轻是次要结局。自我效能、变化阶段、社会支持和 社会控制也将作为PA和营养变化的潜在媒介进行研究。拟议 研究是创新的，它使用了一种新的干预措施，强调二元社会过程， 标准行为改变策略。干预措施明确针对以家庭为基础的社交网络， 支持健康行为改变的社会环境，利用社区卫生工作者促进以家庭为基础的外展， 对这一未被充分研究的人群进行沟通。这项研究预计将产生关键的洞察力， 在拉丁美洲人中增加PA和健康饮食的有效方法， 在美国，少数民族群体不断壮大。

Abstract(extracted from the parent grant, 1R01HL128705-01, 1R56HL128705-01) Most adults in the U.S. fail to meet national physical activity (PA) and dietary recommendations, and Latinos are less likely to meet these recommendations than non-Latino Whites. Physical inactivity, a poor diet, and obesity are major risk factors for cardiovascular disease, certain cancers, diabetes, and stroke and are important contributors to preventable morbidity and mortality in the U.S. Social environments are widely recognized to have an important impact on these behaviors, yet most behavior change programs give limited attention to the social contexts in which behaviors occur. The goal of the proposed research is to evaluate the efficacy of a 6-month, community-based family dyad intervention in promoting engagement in and maintenance of PA and healthy eating among Latino adults residing in three predominantly Latino communities in Houston, TX. Dyads will be randomly assigned to a community health worker (CHW)-led intervention, “Tu Salud, ¡Si Cuenta! – Familiar” (TSSC-Family) or to a contact control condition focused on healthy homes. TSSC-Family will consist of six home visits delivered to dyad members over a six-month period to build behavioral skills and social support for sustained healthy behavior change among Latino family dyads. The healthy homes contact control will also consist of six monthly visits delivered to dyad members by a CHW. Study participants will include 552 Latino adults not currently meeting PA or nutrition recommendations recruited and enrolled as family member dyads (n=276 dyads). This approach expands on an empirically- based motivational behavior change intervention developed by a member of the investigative team in collaboration with community partners that has shown preliminary evidence of effectiveness for positive PA and dietary behavior change in Latino individuals. Participants will be assessed at baseline, 6 months, and 12 months after baseline to evaluate both intermediate and long-term effects. Primary outcomes include minutes per week of moderate and vigorous PA, and servings of fruits and vegetables, sugar-sweetened beverages, and whole grains. Weight loss is a secondary outcome. Self-efficacy, stage of change, social support, and social control will also be examined as potential mediators of changes in PA and nutrition. The proposed research is innovative in its use of a novel intervention that emphasizes dyadic social processes in addition to standard behavior change strategies. The intervention explicitly targets family-based social networks to foster social environments supportive of healthy behavior change using CHWs to facilitate home-based outreach and communication to this understudied population. This research is expected to yield critical insight regarding effective approaches for increasing PA and healthy eating among Latinos, the largest and among the fastest growing minority groups in the U.S.