Ad-Vance Kids: A Community-Engaged Approach to Inform a Rural, Multi-Level Community-Based Child Obesity Prevention Intervention

项目总结/摘要 非常需要有效的干预措施来减少农村地区的儿童肥胖症，并且越来越强调多方面的干预措施。 以社区为基础的干预措施。以社区为基础的多层次干预措施是以人口为基础的办法， 将整个社区暴露于肥胖预防工作中，并在多层次因素（个人， 人际关系、组织、社区和政策），这些因素限制儿童从事健康的体重行为 in community社区settings设置.以社区为重点预防儿童肥胖症需要让人们参与第一手工作， 社区知识，以确保适用性，有效性和可持续性。有证据表明，多层次 以社区为基础的干预措施促进了儿童体重的可持续的长期改善，但更多的研究表明， 农村地区需要。此R 03应用程序建议使用社区参与的策略，以告知 农村、多层次的社区干预，以防止2-5岁儿童不健康的体重增加。研究 将在万斯县，一个农村，低收入，主要是少数民族社区在北卡罗来纳州与高 (21%）儿童肥胖水平。我们将收集形成性的研究数据，以确定农村社区的核心文化价值观， 需要，以及围绕儿童肥胖预防的目标，干预的机会，以及社区资产， 社区干预。形成性数据将通过以下方式收集：与50名家长进行焦点小组讨论， 2-5岁的儿童;与焦点小组讨论中的10名家长进行深入的一对一访谈;一对一 与10名为儿童和家庭服务的社区组织的领导人进行了访谈;并直接观察了儿童 护理计划和当地的食物和体育活动环境。然后，使用charrettes，这是在人， 小组会议由两名社区专家和一名精通社区基础知识的学术专家主持。 参与式研究，我们将吸引来自农村社区的合作伙伴和我们的学术研究人员团队， * 构思农村多层次社区的设计、实施战略和评估计划， 基于干预。这项R 03研究将为NIH R21拨款申请提供信息，以进行干预策略的试点测试 可行性、有效性和潜在影响。如果成功的话，这种方法可以提供一个有用的模式， 干预其他与万斯县在生活方式、人口统计、社会 环境特征和儿童健康状况差。

PROJECT SUMMARY/ABSTRACT Effective interventions to reduce child obesity in rural areas are greatly needed and there is a growing emphasis on multi- level community-based interventions. Multi-level community-based interventions are population-based approaches that expose entire communities to obesity prevention efforts and target change at the multi-level factors (individual, interpersonal, organizational, community, and policy) that constrain children from engaging in healthy weight behaviors in community settings. Focusing on communities to prevent child obesity requires engaging persons with first-hand knowledge of the community to ensure applicability, effectiveness, and sustainability. Evidence shows that multi-level community-based interventions promote sustainable, long-term improvements in children’s weight, but more studies are needed in rural areas. This R03 application proposes to use community-engaged strategies to inform the development of a rural, multi-level community-based intervention to prevent unhealthy weight gain in children aged 2-5 years. The study will be carried out in Vance County, a rural, low-income, and largely minority community in North Carolina with high (21%) child obesity levels. We will collect formative research data to identify the rural community’s core cultural values, needs, and goals around child obesity prevention, opportunities to intervene, and community assets to leverage in a community-based intervention. The formative data will be collected via: focus group discussions with 50 parents of children aged 2-5; in-depth, one-on-one interviews with 10 parents from the focus group discussions; one-on-one interviews with 10 leaders from community organizations that serve children and families; and direct observation of child care programs and the built local food and physical activity environment. Then, using charrettes, which are in-person, group sessions facilitated by two community experts and an academic expert who are versed in community-based participatory research, we will engage partners from the rural community and our team of academic researchers from UNC to conceptualize the design, implementation strategies, and evaluation plan for the rural, multi-level community- based intervention. This R03 study will inform an NIH R21 grant application to pilot-test test the intervention strategies for feasibility, effectiveness, and potential impact. If successful, this approach could provide a useful model for intervening in other rural southeastern communities that are similar to Vance County in lifestyle, demographics, socio- environmental characteristics, and poor child health status.