A Parent Intervention for Improving Physical Activity and Diet in Adolescents

描述（由申请人提供）：青少年肥胖症的日益普遍已成为一种公共卫生危机，特别是对少数民族青少年。已被证明有效减少肥胖的行为（即，青少年的久坐行为（SB）、身体活动（PA）、饮食）受到父母和同伴互动的影响。由奖学金候选人进行的初步焦点小组表明，由于非洲裔美国人照顾者正在从事许多积极的育儿行为，如监测，扩大这些做法，专门针对他们的青少年的健康行为是有希望的。以前的研究也表明，父母可能通过监控自己孩子的行为以及孩子的同伴关系来塑造健康行为。此外，围绕健康行为设定限制和自主权之间的平衡可能基于青少年和父母在决策过程中合作的一系列互动。虽然干预措施，试图改善PA和饮食在非洲裔美国人的家庭，很少有包括父母组件周围的规则和监测青少年。此外，很少有针对性的父母管理的同伴互动围绕这些行为。本项目的目的是测试一种新的8周互动式父母干预的可行性，该干预针对父母变量（即，规则、自治支持、监视）以促进对等体交互，这减少了SB和不健康的消费（即，高脂肪，高糖）食物和增加PA和水果和蔬菜（FV）的消费在非洲裔美国青少年。70名青少年和他们的照顾者将被随机分配到一个互动的基于父母的干预（IPB）或一般健康教育计划（GHE）。IPB干预是基于社会认知理论，将通过8个每周一次的课程针对父母变量，旨在教父母如何进一步完善他们的养育策略（即，规则，自主支持，监测），以有效地影响同伴互动和青少年自我效能感和自我概念之间的关系，具体到SB，PA和饮食。干预的基本要素包括：规则、自主支持、监控、同伴支持、青少年自我效能感和自我概念。GHE计划还将包括8个关于一般健康问题的每周小组会议。据推测，与GHE组相比，IPB组的青少年将表现出SB和高脂肪/高糖食物消费的更大减少，以及PA和FV消费的更大增加。同样，据推测，照顾者和青少年将表现出更大的改善父母变量（规则，自主权的支持，监测）和自我效能和自我概念的具体SB，PA和饮食在IPB干预相比，照顾者和青少年在GHE组在干预后，分别。最后，本研究将探讨关键变量（例如，同伴支持、规则、监控和青少年自我效能感）可能介导干预对IPB组青少年SB、PA、饮食在干预后8周的变化的影响。 公共卫生相关性：这项研究的公共卫生意义是通过减少负面健康行为（即，久坐行为，高脂肪/高糖食物的消费）和增加的积极健康行为（即，体育活动、水果和蔬菜的消费），通过测试创新的互动式家长干预的可行性。

DESCRIPTION (provided by applicant): The increasing prevalence of obesity in youth has become a public health crisis, especially for minority adolescents. Behaviors that have been shown to be effective in reducing obesity (i.e., sedentary behavior (SB), physical activity (PA), diet) in youth are influenced by their parents and peer interactions. Preliminary focus groups conducted by the fellowship candidate suggest that because African American caregivers are engaging in many positive parenting behaviors such as monitoring, expanding these practices to specifically target their adolescent's health behaviors is promising. Previous studies also indicate that parents may play a role in shaping health behaviors by monitoring their own child's behavior in addition to their child's peer relationships. Furthermore, the balance between setting limits and autonomy around health behaviors may be based on a set of interactions in which adolescents and parents collaborate in the decision-making process. While interventions that have sought to improve PA and diet in African American families, few have included parent components around rules and monitoring in adolescents. Furthermore, few have targeted parental management of peer interactions around these behaviors. The purpose of this project is to test the feasibility of a novel 8-week interactive parent intervention that targets parent variables (i.e., rules, autonomy support, monitoring) to facilitate peer interactions which decrease SB and consumption of unhealthy (i.e., high fat, high sugar) foods and increase PA and fruit and vegetable (FV) consumption in African American adolescents. Seventy adolescents and their caregivers will be randomized to either an interactive parent-based intervention (IPB) or a general health education program (GHE). The IPB intervention is based on Social Cognitive Theory and will target parent variables through 8 weekly sessions designed to teach parents how to further refine their parenting strategies (i.e., rules, autonomy support, monitoring) in order to effectively impact the relationship between peer interactions and adolescent self-efficacy and self-concept specific to SB, PA, and diet. The essential elements of the intervention include: rules, autonomy support, monitoring, peer support, adolescent self-efficacy and self-concept. The GHE program will also include 8 weekly group sessions on general health issues. It is hypothesized that adolescents in the IPB group will demonstrate greater reductions in SB and consumption of high-fat/high sugar foods and greater increases PA and FV consumption compared to those in the GHE group. Similarly, it is hypothesized that caregivers and adolescents will demonstrate greater improvements in parent variables (rules, autonomy support, monitoring) and self-efficacy and self-concept specific to SB, PA, and diet in the IPB intervention compared with caregivers and adolescents in the GHE group at post-intervention, respectively. Finally, this study will explore whether changes in key variables (e.g., peer support, rules, monitoring, and adolescent self-efficacy) may mediate the effect of the intervention on changes in adolescent SB, PA, diet in the IPB group at 8-weeks post-intervention. PUBLIC HEALTH RELEVANCE: The public health implications of this study are to prevent obesity in African American adolescents and their families by decreasing negative health behaviors (i.e., sedentary behavior, consumption of high-fat/high-sugar foods) and increasing positive health behaviors (i.e., physical activity, consumption of fruits and vegetables) through testing the feasibility of an innovative interactive parent intervention.