EFFICACY TRIAL OF A PROGRAM FOR WEIGHT LOSS FOR HISPANIC FATHERS AND INCREASED PHYSICAL ACTIVITY FOR THEIR CHILDREN: HEALTHY DADS, HEALTHY KIDS

项目摘要 美国的拉美裔美国人在肥胖和相关医疗条件方面面临健康差距，例如 心血管疾病和糖尿病。以家庭为目标促进健康的生活方式一直是 被确定为预防肥胖的有效策略。随着家庭主义(家庭凝聚力)在 在西班牙裔人口中，以家庭为基础的干预尤其可取，作为一种促进 支持西班牙裔健康体重状态并减少与肥胖相关的健康差距的行为。 新出现的证据支持有必要将父亲纳入基于家庭的生活方式行为中并将其作为目标 干预措施。然而，到目前为止，在美国，几乎只有母亲通过这样的努力获得了帮助。 健康爸爸健康儿童(HDHK)是澳大利亚开发的一个基于证据的计划，显示出 与对照组相比，父亲和他们的孩子的体重和行为治疗效果显著。这个 HDHK计划以社会认知理论和家庭系统理论为基础，旨在促进 增加体力活动，改善父亲及其子女的膳食摄入量。一项重要的创新 该计划是父亲和孩子一起参加的，他们都是行为改变的目标 互相(相互加强)并一起参加有趣、合家的活动。HDHK在文化上 该研究小组遵循生态有效性模型对西班牙裔家庭进行了调整，输入来自 社区西班牙裔家庭小组、专家委员会和HDHK计划的开发者。由此产生的 PapáS Saludables，Niños Saludables(PSNS)计划在等待名单控制的随机对照试验中进行可行性测试 在36个西班牙裔家庭中，他们的孩子是德克萨斯州儿童健康计划的成员。调查结果支持 在一项家庭随机分组试验中测试文化适应计划，并进行标准护理比较/ 控制药效。这项拟议的疗效试验旨在检测父亲的临床上有意义的变化 体重和儿童的体力活动。该研究还将评估其他行为(饮食摄入、久坐不动 时间、屏幕媒体使用和育儿实践)、社会心理(家庭主义、文化适应和共同育儿 联盟)和生物学(非高密度脂蛋白、HgbA1C、BP)结果。与大休斯顿基督教青年会的合作伙伴关系 提供了一个在哪里提供项目的场所，与德克萨斯州儿童健康计划的合作伙伴关系提供了 接触80,000多名年龄在5-11岁之间的西班牙裔儿童，从他们那里招募新兵。RE-AIM 框架将提供详细的流程评估，以评估实施PSN的障碍和促进者 与我们的社区合作伙伴在未来。这种新颖的生活方式计划可以提供一种范式转变， 西班牙裔儿童的肥胖预防应该是概念化的，通过直接接触拉美裔父亲，这 到目前为止还没有做过。

Project Summary Hispanics in the United States face health disparities for obesity and related medical conditions, such as cardiovascular disease and diabetes. Targeting families to promote healthy lifestyle behaviors has been identified as an effective strategy to prevent obesity. With the importance of familism (family cohesion) among the Hispanic population, a family based intervention is especially desirable as an engaging strategy to promote behaviors that support a healthy weight status and decrease obesity related health disparities for Hispanics. Emerging evidence supports the need to include and target fathers in family based lifestyle behavior interventions. However, to date mothers have almost exclusively been reached by such efforts in the US. Healthy Dads Healthy Kids (HDHK) is an evidence based program developed in Australia, shown to have significant weight and behavior treatment effects for fathers and their children, compared to controls. The HDHK program is based on Social Cognitive Theory and Family Systems Theory and aims to promote increased physical activity and improved dietary intake for fathers and their children. An important innovation in the program is that fathers and children attend together and are both targeted as agents of behavior change for each other (reciprocal reinforcement) and to participate in fun, family activities together. HDHK was culturally adapted for Hispanic families following the Ecological Validity Model by this research team, with input from a community Hispanic family panel, expert committee and the developer of the HDHK program. The resulting Papás Saludables, Niños Saludables (PSNS) program was tested for feasibility in a waitlist controlled RCT among 36 Hispanic families, whose child was a Texas Children’s Health Plan member. The findings support testing the culturally adapted program in a family randomized group trial with a standard of care comparison/ control for efficacy. The proposed efficacy trial is powered to detect a clinically meaningful change in father’s weight and children’s physical activity. The study will also assess other behavioral (dietary intake, sedentary time, screen media use, and parenting practices), psychosocial (familism, acculturation, and co-parenting alliance) and biological (non-HDL, HgbA1C, BP) outcomes. Partnership with the YMCA of Greater Houston offers a venue for where to deliver the program, and partnership with Texas Children’s Health Plan provides access to over 80,000 Hispanic children between the ages from 5-11 from which to recruit. The RE-AIM framework will inform a detailed process evaluation to assess barriers and facilitators to implementing PSNS with our community partners in the future. This novel lifestyle program can provide a paradigm shift for how obesity prevention for Hispanic children should be conceptualized, by directly engaging Hispanic fathers, which has not been done to date.