Tu Salud Si Cuenta! Reaching Latino family dyads to increase physical activity and healthy eating

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• 批准号: 9174743
• 负责人: Larkin Strong
• 金额: $ 67.26万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9174743
• 关键词: Accounting; Address; Adoption; Adult; Advocate; Affect; Attention; Behavior; Behavioral; Body Weight decreased; Cardiovascular Diseases; Cessation of life; Chronic Disease; Collaborations; Communication; Communities; Community Health; Counseling; Diabetes Mellitus; Diet; Dietary Fiber; Dietary Intervention; Educational Curriculum; Effectiveness; Enrollment; Ethnic group; Family; Family member; Fostering; Goals; Health; Health behavior; Health behavior change; Healthy Eating; High Prevalence; Hispanics; Home environment; Home visitation; House Call; Individual; Instruction; Intervention; Knowledge; Latino; Life; Life Style; Long-Term Effects; Maintenance; Malignant Neoplasms; Mediating; Mediator of activation protein; Minority Groups; Morbidity - disease rate; Motivation; Obesity; Outcome; Overweight; Participant; Physical activity; Population; Positioning Attribute; Process; Randomized; Recommendation; Recruitment Activity; Research; Research Personnel; Resources; Risk Factors; Role; Safety; Self Efficacy; Social Controls; Social Environment; Social Interaction; Social Network; Social support; Staging; Strenuous Exercise; Stroke; Testing; United States; Visit; Work; base; behavior change; community building; disorder risk; evidence base; fruits and vegetables; hazard; health disparity; improved; innovation; insight; meetings; member; mortality; novel; nutrition; outreach; peer; physical inactivity; primary outcome; programs; secondary outcome; skills; social; sugar; sweetened beverage; vigorous intensity

ABSTRACT Most adults in the U.S. fail to meet national physical activity (PA) and dietary recommendations, and Latinos are less likely to meet these recommendations than non-Latino Whites. Physical inactivity, a poor diet, and obesity are major risk factors for cardiovascular disease, certain cancers, diabetes, and stroke and are important contributors to preventable morbidity and mortality in the U.S. Social environments are widely recognized to have an important impact on these behaviors, yet most behavior change programs give limited attention to the social contexts in which behaviors occur. The goal of the proposed research is to evaluate the efficacy of a 6-month, community-based family dyad intervention in promoting engagement in and maintenance of PA and healthy eating among Latino adults residing in three predominantly Latino communities in Houston, TX. Dyads will be randomly assigned to a community health worker (CHW)-led intervention, “Tu Salud, ¡Si Cuenta! – Familiar” (TSSC-Family) or to a contact control condition focused on healthy homes. TSSC-Family will consist of six home visits delivered to dyad members over a six-month period to build behavioral skills and social support for sustained healthy behavior change among Latino family dyads. The healthy homes contact control will also consist of six monthly visits delivered to dyad members by a CHW. Study participants will include 552 Latino adults not currently meeting PA or nutrition recommendations recruited and enrolled as family member dyads (n=276 dyads). This approach expands on an empirically- based motivational behavior change intervention developed by a member of the investigative team in collaboration with community partners that has shown preliminary evidence of effectiveness for positive PA and dietary behavior change in Latino individuals. Participants will be assessed at baseline, 6 months, and 12 months after baseline to evaluate both intermediate and long-term effects. Primary outcomes include minutes per week of moderate and vigorous PA, and servings of fruits and vegetables, sugar-sweetened beverages, and whole grains. Weight loss is a secondary outcome. Self-efficacy, stage of change, social support, and social control will also be examined as potential mediators of changes in PA and nutrition. The proposed research is innovative in its use of a novel intervention that emphasizes dyadic social processes in addition to standard behavior change strategies. The intervention explicitly targets family-based social networks to foster social environments supportive of healthy behavior change using CHWs to facilitate home-based outreach and communication to this understudied population. This research is expected to yield critical insight regarding effective approaches for increasing PA and healthy eating among Latinos, the largest and among the fastest growing minority groups in the U.S.

抽象的 美国大多数成年人未能达到国家体育活动 (PA) 和饮食建议，拉丁裔美国人 与非拉丁裔白人相比，他们不太可能满足这些建议。缺乏身体活动、不良饮食习惯以及 肥胖是心血管疾病、某些癌症、糖尿病和中风的主要危险因素， 造成美国可预防发病率和死亡率的重要因素 社会环境广泛 公认对这些行为有重要影响，但大多数行为改变计划给予的影响有限 关注行为发生的社会背景。拟议研究的目标是评估 为期 6 个月、以社区为基础的家庭二元干预在促进参与和参与方面的效果 居住在三个以拉丁裔为主的社区的拉丁裔成年人的 PA 维护和健康饮食 在德克萨斯州休斯顿。双人组将被随机分配到社区卫生工作者 (CHW) 主导的干预措施“Tu 万岁，Si Cuenta！ – 熟悉”（TSSC-家庭）或关注健康家庭的接触控制条件。 TSSC-Family 将在六个月内对二人成员进行六次家访，以建立 拉丁裔家庭二人组中持续健康行为改变的行为技能和社会支持。这 健康之家接触控制还包括社区卫生工作者每月对二人成员进行六个月的拜访。 研究参与者将包括 552 名目前未达到 PA 或营养建议的拉丁裔成年人 作为家庭成员二人组招募和登记（n = 276 双人组）。这种方法扩展了经验- 由调查小组成员开发的基于动机的行为改变干预措施 与社区合作伙伴的合作已显示出积极 PA 有效性的初步证据 拉丁裔个体的饮食行为变化。参与者将在基线、6 个月和 12 个月时接受评估 基线后几个月评估中期和长期影响。主要结果包括分钟数 每周适度和剧烈的 PA，以及水果和蔬菜、含糖饮料、 和全谷物。减肥是次要结果。自我效能、变革阶段、社会支持和 社会控制也将被视为 PA 和营养变化的潜在调节因素。拟议的 研究的创新之处在于它使用了一种新颖的干预措施，除了强调二元社会过程之外，还强调了二元社会过程。 标准行为改变策略。该干预措施明确针对以家庭为基础的社交网络，以促进 支持健康行为改变的社会环境，利用社区卫生工作者促进家庭外展和 与这些未被研究的人群进行沟通。这项研究预计将产生关于以下方面的重要见解： 增加拉丁美洲人的 PA 和健康饮食的有效方法，是最大和最快的拉丁美洲人之一 美国少数族裔群体不断壮大