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) 大多数美国成年人没有达到国家体力活动(PA)和饮食推荐标准，拉丁裔 与非拉丁裔白人相比，他们不太可能满足这些建议。缺乏体力活动，不良饮食，以及 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，而且 在美国的社会环境中，导致可预防的发病率和死亡率的重要因素广泛存在 虽然公认对这些行为有重要影响，但大多数行为改变计划给予的帮助有限 注意行为发生的社会背景。拟议研究的目标是评估 为期6个月的以社区为基础的家庭对偶干预在促进参与和治疗方面的有效性 在居住在三个以拉丁裔为主的社区的拉丁裔成年人中维持PA和健康饮食 德克萨斯州休斯顿。二人组将被随机分配到社区卫生工作者(CHW)领导的干预行动中 致敬，“Si Cuenta！-熟悉”(TSSC-Family)或专注于健康家庭的接触控制条件。 TSSC-Family将在六个月的时间内向DYAD成员提供六次家访 拉丁裔家庭二人组持续健康行为改变的行为技能和社会支持。这个 健康之家联系控制也将包括由CHW每月向DYAD成员提供六次访问。 研究参与者将包括552名目前不符合PA或营养建议的拉丁裔成年人 招募和登记为家庭成员二元组(n=276个二元组)。这种方法从经验上扩展了-- 基于动机行为改变的干预，由调查团队的一名成员在 与社区合作伙伴的合作已显示出对积极PA有效的初步证据 拉丁裔个体的饮食行为发生了变化。参与者将在基线、6个月和12个月进行评估 在基线后几个月评估中期和长期效果。主要结果包括分钟数 每周适度和剧烈的PA，以及水果和蔬菜，含糖饮料， 和全麦食品。体重减轻是次要结果。自我效能感、变化阶段、社会支持和 社会控制也将被视为PA和营养变化的潜在中介。建议数 研究的创新之处在于它使用了一种新的干预方法，除了强调二元社会过程外，还 标准的行为改变策略。干预措施明确针对以家庭为基础的社交网络，以促进 支持健康行为改变的社会环境，使用社区卫生服务促进居家外展和 与这些未被充分研究的人群进行沟通。这项研究有望产生关于以下方面的批判性见解 在规模最大、速度最快的拉丁裔中，增加PA和健康饮食的有效方法 美国日益增长的少数群体。

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.