A Promotora-mediated, Family-based Intervention to Prevent Obesity in Latino Pres

描述(申请人提供)：拉美裔学龄前儿童比其他种族/民族的学龄前儿童更肥胖。针对拉美裔学龄前儿童并使用文化上适当的措施和方法的以家庭为基础的肥胖干预措施很少。拉丁裔同伴健康教育者(促进者)在增加拉丁裔人口的知识和促进行为改变方面一直很有效；然而，到目前为止，还没有由促进者领导的针对拉丁裔学龄前儿童的儿童肥胖干预措施。这项拟议研究的目的是开发和评估以家庭为基础、推动者为中介的儿童肥胖干预的可行性和有效性。拟议的研究将采用混合方法顺序研究设计，分为两个主要阶段：第一阶段：对学龄前儿童的拉丁裔父母进行语言分层的焦点小组和认知访谈，以告知制定适合文化的干预和措施；第二阶段：测试干预的可行性和有效性；30名2-5岁儿童的拉丁裔父母(第一阶段)和50名亲子二人(第二阶段)将从南卡罗来纳州纽伯里和萨鲁达县由六名推动者(女性和GT；18岁，活跃在社区中)从他们自己的教堂、学校、社区和街角商店网络中招募。促进者将在南卡罗来纳大学的促进者计划培训计划完成后招聘，并将接受额外20小时的培训，使用第一阶段完成的干预课程；然后促进者将向家庭提供每周10个90分钟的干预课程。这些会议由教育、实践和行动(即目标设定)组成，包括所有希望参加的家庭成员，将教育和培训父母制定与家庭饮食、身体活动和久坐行为相关的可行目标，以创造支持性的家庭环境，促进孩子的健康体重。将在干预前后评估主要结果(即儿童身体质量指数[BMI]z分数和百分位数)和次要结果(例如，儿童饮食[食物筛选器]和体力活动[加速计]、身体和社交家庭环境[家长调查])。过程评估将使用多个数据源和混合方法评估保真度、剂量、覆盖范围、招聘和背景因素。将使用基于推广者、家长和录音的过程数据的描述性分析来确定干预的可行性和实施水平。对控制相关变量的一次和二次结果的干预影响将用SAS中的ANCOVA进行评估。这项拟议的研究具有很高的公共卫生意义，因为它将影响父母和 与体重过度增加有关的儿童。这项研究具有创新性，因为它将首次在拉丁裔学龄前儿童肥胖干预中使用促进剂 适龄儿童。如果成功，这一方法将在大规模干预中进行评估，并提供一个潜在的模式，帮助解决和预防拉丁裔家庭中的儿童肥胖问题。

DESCRIPTION (provided by applicant): Latino preschool children are more obese than preschool children in other racial/ethnic groups. Few family- based obesity interventions exist that target Latino preschool children and use culturally-appropriate measures and approaches. Latino peer health educators (promotoras) have been effective in increasing knowledge and promoting behavior change in Latino populations; however, to date, no promotora-led child obesity interventions targeting Latino preschool children exist. The purpose of the proposed research is to develop and evaluate the feasibility and effectiveness of a family-based, promotora-mediated child obesity intervention. The proposed study will employ a mixed methods sequential research design, organized into two major phases: Phase I: Conduct language-stratified focus groups and cognitive interviews with Latino parents of preschool children to inform the development of a culturally-appropriate intervention and measures; Phase II: Test the feasibility and effectiveness of the intervention; Thirty Latino parents of children aed 2-5 years (Phase I) and fifty parent-child dyads (Phase II) will be recruited from Newberry and Saluda counties, South Carolina by six promotoras (females >18 years, active in community) from their own networks of churches, schools, neighborhoods, and corner stores. Promotoras will be recruited upon completion of the Promotores Initiative training program at the University of South Carolina and will receive an additional 20 hours of training using the intervention curriculum finalized after Phase I; promotoras will then deliver the home-based intervention to families over 10, 90-minute weekly sessions. The sessions, organized into education, practice and action (i.e., goal setting) components and inclusive of all family members who desire to attend, will educate and train parents to set feasible goals related to family diet, physical activty, and sedentary behavior to create supportive home environments to promote a healthy weight in their children. Primary outcomes (i.e., child body mass index [BMI] z-score and percentile) and secondary outcomes (e.g., child diet [food screener] and physical activity [accelerometry], the physical and social home environment [parent survey]) will be assessed pre- and post-intervention. Process evaluation will assess fidelity, dose, reach, recruitment, and contextual factors using multiple data sources and mixed methods. Descriptive analyses based on process data from promotoras, parents, and audio recordings will be used to determine intervention feasibility and level of implementation. Intervention impact on primary and secondary outcomes controlling for relevant variables will be assessed with ANCOVA in SAS. The proposed research carries high public health significance because it will influence specific behaviors in parents and children that have been associated with excessive weight gain. The research is innovative because it will be the first to use promotoras in a child obesity intervention for Latino preschool age children. If successful, this approach will be evaluated in a large-scale intervention and provide a potential model to help to address and prevent child obesity in Latino families.