Adapting an Intervention to Promote Healthy Eating and Prevent Weight Gain among 2-1-1 Clients through Improved Home Food Environments

 描述（由申请人提供）：通过改善家庭食品环境调整干预措施以促进健康饮食并防止2-1-1客户体重增加鉴于美国肥胖症流行的严重程度以及减肥和维持减肥的难度，首先防止体重增加是预防癌症和其他慢性病的有吸引力的公共卫生策略。目前，解决肥胖流行病的公共卫生工作重点是增加获得健康食品和体育活动的机会，以及个人行为的改变。虽然很重要，但很少有人关注家庭作为塑造体重相关行为的环境。很少有干预措施针对家庭环境预防成年人肥胖，尽管事实上，大量的时间花在家里，超过2/3的卡路里是从家里准备的食物中消耗的。我们的团队已经开发并测试了一种干预措施，通过改变家庭食物环境来防止体重增加。这项名为“健康家园/健康家庭”的干预措施成功地改变了家庭食物环境的许多特点，并减少了低收入妇女（主要是非洲裔美国妇女）的能量摄入。变化持续了12个月。我们建议通过国家2-1-1基础设施调整这种干预措施，以便最终传播。2-1-1信息和转诊系统由200多个非营利性的州和地方呼叫中心组成，在所有50个州运营，每年将1600多万呼叫者连接到地方卫生和社会服务。打电话到2-1-1的人不成比例地低收入，失业，没有保险，相对于一般人口，受教育年限较少。2-1-1在其广泛的人口覆盖面方面是独一无二的 特别容易导致体重增加和肥胖。我们的团队与美国各地的八个2-1-1系统合作，进行了一系列研究，以促进无烟家庭。我们寻求利用这一强大的合作基础设施来解决肥胖流行病。我们这项建议的具体目标是：1）与大亚特兰大联合之路2-1-1合作，采用有效的家庭食品环境干预措施，健康家园/健康家庭，以电话为基础提供服务; 2）进行一项试点研究，以测试健康之家/健康家庭干预措施在大亚特兰大联合之路中的可行性和可接受性2-1- 1呼叫者，并确定更大的疗效试验的效应量。我们的下一步将是进行有效性试验，以严格测试通过2-1-1交付的适应性干预措施。肥胖和超重会增加患多种慢性疾病的风险，包括癌症。开发一种具有广泛传播潜力的可扩展的体重增加预防干预措施，将填补我们通过肥胖预防癌症的努力中的一个显著空白。

 DESCRIPTION (provided by applicant): Adapting an Intervention to Promote Healthy Eating and Prevent Weight Gain among 2-1-1 Clients through Improved Home Food Environments Given the magnitude of the obesity epidemic in the U.S. and the difficulty of losing and then maintaining weight loss, preventing weight gain in the first place is an appealing public health strategy for prevention of cancer and other chronic diseases. Current public health efforts to address the obesity epidemic focus on increasing access to healthy foods and opportunities for physical activity, as well as individual behavior change. While clearly important, much less attention has been focused on the home as a setting that shapes weight-related behavior. Few interventions have targeted the home environment for adult obesity prevention despite the fact that a significant amount of time is spent at home and over 2/3 of calories are consumed from foods prepared in the home. Our team has developed and tested an intervention to prevent weight gain through changes in the home food environment. The intervention, called Healthy Homes/Healthy Families, succeeded in changing numerous features of the home food environment and reducing energy intake in a sample of low-income, largely African American women. Changes were sustained for 12-months. We are proposing to adapt this intervention for eventual dissemination through the national 2-1-1 infrastructure. The 2-1-1 information and referral system consists of over 200 non-profit state and local call centers operating in all 50 states and connects over 16 million callers per year to local health and social services. Callers to 2-1-1 are disproportionately low-income, unemployed, uninsured, and have fewer years of education relative to the general population. 2-1-1 is unique in its extensive reach to populations at particular risk for weight gain and obesity. Our team has partnered with eight 2-1-1 systems around the U.S. in a series of studies to promote smoke-free homes. We seek to leverage this strong collaborative infrastructure to address the obesity epidemic. Our specific aims for this proposal are to: 1) adapt an effective home food environment intervention, Healthy Homes/Healthy Families, for telephone-based delivery in collaboration with United Way of Greater Atlanta 2-1-1; 2) Conduct a pilot study to test feasibility and acceptability of the Health Homes/Healthy Families intervention among United Way of Greater Atlanta 2-1-1 callers and identify effect sizes for a larger efficacy trial. Our next step will be to conduct an efficacy tril to rigorously test the adapted intervention for delivery through 2-1-1. Obesity and excess weight increase the risk of multiple chronic diseases, including cancer. Developing a scalable weight gain prevention intervention with the potential for widespread dissemination will fill a notable ga in our efforts to prevent cancer through obesity prevention.