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

项目摘要/摘要 农村地区迫切需要有效的干预措施来减少儿童肥胖症，人们越来越重视多方面的干预 以社区为基础的干预措施。基于社区的多层次干预是基于人口的方法， 让整个社区参与预防肥胖的努力，并针对多层面的因素(个人、 人际、组织、社区和政策)，限制儿童进行健康的体重行为 在社区环境中。关注社区以预防儿童肥胖症需要接触第一手资料的人 社区知识，以确保适用性、有效性和可持续性。有证据表明，多层次的 以社区为基础的干预措施促进了儿童体重的可持续、长期改善，但更多的研究 农村地区需要。此R03应用程序建议使用社区参与的策略来通知 以农村、多层次社区为基础的干预措施，以防止2-5岁儿童的不健康体重增加。这项研究 将在万斯县进行，万斯县是北卡罗来纳州一个农村、低收入、以少数族裔为主的社区， (21%)儿童肥胖水平。我们将收集形成性研究数据，以确定农村社区的核心文化价值观， 围绕儿童肥胖预防、干预机会和社区资产的需求和目标 以社区为基础的干预。形成的数据将通过以下方式收集：与50名家长的焦点小组讨论 2-5岁的儿童；对焦点小组讨论中的10名家长进行深入的一对一采访；一对一 采访了10位来自服务儿童和家庭的社区组织的领导人；以及对儿童的直接观察 小组会议由两名社区专家和一名精通以社区为基础的学术专家主持 参与性研究，我们将邀请来自农村社区的合作伙伴和我们的学术研究团队来自 UNC将农村多层次社区的设计、实施战略和评估计划概念化- 以干预为基础。这项R03研究将为NIH R21拨款申请提供信息，以初步测试干预策略 干预在生活方式、人口统计、社会生活方式上与万斯县相似的东南部其他农村社区- 环境特点，儿童健康状况较差。

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.