A Parent Intervention for Improving Physical Activity and Diet in Adolescents

青少年中肥胖率的上升已经成为一种公共健康危机，特别是对少数族裔青少年来说。已被证明对减少青少年肥胖有效的行为(即久坐行为(SB)、体力活动(PA)、饮食)会受到父母和同伴互动的影响。这位奖学金候选人进行的初步焦点小组表明，由于非裔美国人的照顾者正在从事许多积极的育儿行为，如监测，扩大这些做法以专门针对他们青少年的健康行为是有希望的。以前的研究还表明，父母除了监督孩子的同伴关系外，还可能通过监测自己孩子的行为，在塑造健康行为方面发挥作用。此外，围绕健康行为设定限制和自主性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非裔美国家庭的PA和饮食，但很少有干预措施包括青少年规则和监测方面的父母因素。此外，很少有人针对父母对这些行为周围的同伴互动进行管理。本项目的目的是测试一种针对父母变量(即规则、自主性支持、监控)的新型8周互动父母干预的可行性，以促进同伴互动，从而减少非裔美国青少年对不健康(即高脂肪、高糖)食物的SB和消费，并增加PA和水果和蔬菜(FV)的消费。70名青少年和他们的照顾者将被随机分为互动式家长干预(IPB)或一般健康教育计划(GHE)。IPB干预以社会认知理论为基础，以家长变量为目标，每周8次，旨在教导家长如何进一步完善他们的育儿策略(即规则、自主支持、监控)，以便有效地影响同伴互动与青少年自我效能和特定于SB、PA和饮食的自我概念之间的关系。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计划还将包括每周8次关于一般健康问题的小组会议。据推测，与GHE组相比，IPB组的青少年在SB和高脂肪/高糖食物的摄入量方面会有更大的下降，PA和FV的摄入量会有更大的增加。同样，假设在IPB干预中，与GHE组中的照顾者和青少年相比，在干预后，照顾者和青少年在父母变量(规则、自主支持、监控)以及特定于SB、PA和饮食的自我效能感和自我概念方面将分别表现出更大的改善。最后，本研究将探讨关键变量(如同伴支持、规则、监控和青少年自我效能感)的变化是否可能在干预后8周对IPB组青少年SB、PA、饮食变化起中介作用。

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.