Social, Ethical, and Behavioral Implications (SEBI) Research on COVID-19 Testing and Vaccine Uptake among Rural Latino Migrants in Southwest Florida

项目摘要 与黑人或白人青年相比，拉美裔青年的肥胖率最高，而且 成人肥胖相关并发症的风险，包括心血管疾病。此外，居住在中国的拉丁裔青年 农村社区成人肥胖的风险和因肥胖相关慢性病而死亡的风险增加 而不是生活在其他地方的拉丁裔。我们综合了我们之前的儿童肥胖干预措施，并量身定制了我们的 循证、以理论为基础的多家庭行为干预，Adaptando Dieta y Acción Para Todos (适应)，适应文化地位、语言和民族血统或我们的目标人口--肥胖、学校 年长(8-12岁)的拉丁裔青年及其父母生活在农村地区。然而，因为父母的角色 在旨在减少拉丁裔肥胖的干预措施中，对肥胖的压力没有得到充分的解决 青少年，我们认为正念父母减轻压力的策略可能是改善的关键组成部分 儿童及其父母的饮食和身体活动(PA)行为。NIH第一阶段R34提出了一种 改进和优化最初的适应性肥胖干预方案，将正念父母纳入其中 压力减轻战略(现为ADAPT+)(第IA阶段)和实施ADAPT+的可行性评估 (阶段IB)。这种混合方法R34为第二阶段更大的R01试验奠定了基础，以确定Adapt+‘S 在改善拉丁裔家庭饮食和PA行为方面的有效性。我们的应用程序有两个主要目标。 目的1：改进适应+(适应+正念父母减压)干预。 ？我们评估了正念、父母养育、压力减轻和适应增加相结合的可接受性 健康生活方式：与我们的社区健康促进员一起开展一系列焦点小组/ 发起人和肥胖儿童(8-12岁)的父母，以获得反馈并完善每一项 我们的8个集成会话，并评估Adapt+会话的优化。 目的2：可行性和可接受性试验。一项随机试验，测试Adapt+与Enhanced的可行性 在两个农村社区进行的日常护理/EUC评估： ？研究样本的选择和招募、意愿的随机化和留存。 ？干预管理的忠诚度，干预的坚守，以及手册的进一步完善。 ？数据收集程序的可行性，包括从父母和儿童那里收集一系列措施， 随着时间的推移，我们测量的数据质量和对干预效果的敏感度--(3个月后之前)。 ？我们预计，与EUC相比，Adapt+DUAD的流失率更低，报告的流失率更高 满足感。我们还探讨了我们的饮食、PA和压力指数是否对干预敏感。 这一应用具有重要意义，因为它解决了特定高危人群中的紧急公共卫生流行病， 少数民族和地理少数群体；创新，因为它实施了独特的干预措施，以解决 目前预防肥胖的状态存在许多局限性，并采用了严谨的科学方法。

Project Summary Latino youth have the highest prevalence of obesity as compared to Black or White youth, and are at high- risk for adult obesity-related complications including cardiovascular disease. Moreover, Latino youth living in rural communities have an increased risk of adult obesity and mortality due to obesity-related chronic disease than Latinos living elsewhere. We synthesized our prior childhood obesity intervention and tailored our evidence-informed, theory-based, multi-family behavioral intervention, Adaptando Dieta y Acción Para Todos (ADAPT), to the acculturation status, language, and national origin or our target population - obese, school aged (8-12 years old) Latino youth and their parents living in rural areas. However, because the role of parent stress on obesity has not been adequately addressed in interventions aimed at reducing obesity in Latino youth, we argue that mindfulness parent stress reduction strategies may be a key component to improving eating and physical activity (PA) behaviors in both children and their parents. This NIH Stage I R34 proposes a refinement and optimization of the original ADAPT obesity intervention protocol to include mindfulness parent stress reduction strategies (now ADAPT+) (Stage IA) and feasibility assessment of ADAPT+ implementation (Stage IB). This mixed methods R34 sets the basis for a Stage 2 larger R01 trial to determine ADAPT+'s efficacy in improving Latino families' eating and PA behaviors. Two main aims guide our application. Aim 1: Refinement of ADAPT+ (ADAPT + mindfulness parent stress reduction) intervention. ? We assess acceptability of the integration of mindfulness parenting stress reduction into ADAPT to increase healthy lifestyle behaviors by: conducting a series of focus groups with our community health facilitators/ promotoras and parents of children (8-12 years old) with obesity to obtain feedback about and refine each of our 8 integrated sessions and evaluate optimization of ADAPT+ sessions. Aim 2: Feasibility and Acceptability trial. A randomized trial testing feasibility of ADAPT+ vs. Enhanced Usual Care/EUC conducted in two rural communities evaluates: ? study sample selection and recruitment, willingness to be randomized and retention. ? fidelity of intervention administration, intervention adherence, and further refinement of manuals. ? feasibility of data collection procedures, including collecting a battery of measures from parents and children, data quality and sensitivity of our measures to our intervention effects over time – (pre- post- 3 mos post). ? We anticipate that compared to EUC, ADAPT+ dyads will have a lower attrition rate and will report greater satisfaction. We also explore whether our eating, PA and stress indices are sensitive to the intervention. This application is significant, as it addresses an urgent public health epidemic among a specific at-risk, ethnic and geographical minority group; innovative, as it implements a unique intervention that addresses many limitations in the current state of obesity prevention and employs a rigorous scientific approach.