DECREASING WEIGHT GAIN IN AFRICAN-AMERICAN PREADOLESCENT

非裔美国妇女许多健康问题的日益普遍与肥胖的高流行率有关。值得关注的是，非裔美国妇女的肥胖患病率一直在上升，非裔美国女孩也有类似的趋势。由于在成年期很难实现减肥，因此迫切需要针对儿童的预防措施。该提案描述了一项两阶段计划，旨在制定和评估一项以社区为基础的干预措施，以促进生活在明尼阿波利斯和圣保罗双城低收入社区的8-10岁有风险或超重的非裔美国女孩的健康饮食习惯和增加体育活动。一项随机临床试验设计将用于300名非裔美国女孩；150人将被随机分为干预组和对照组。干预计划将在放学后进行，每周两个下午在社区中心进行，并将以社会认知理论为基础，结合青少年发展和弹性为基础的方法。通过成立社区谘询委员会，社区参与将为研究的各个方面提供投入。干预的重点是旨在通过定期体育活动和健康饮食来示范和教授预防肥胖的技能的活动，以及旨在加强和支持这些行为的家庭组成部分。将通过与目标社区的女孩、家长、社区领导人和青年工作者进行形成性评估，制定一项有效和创新的适合文化的干预措施。在第一阶段，将对50名女孩进行为期12周的试点测试；25人随机分到干预组，25人分到对照组。在第二阶段，为期两年的干预将在五个社区中心进行，每周两次，持续11个月。主要的结果测量将是身体质量指数（BMI）和身体脂肪百分比（BF百分比）。主要假设是，在全面研究结束时，干预组的女孩在基线值调整后，相对于对照组的女孩，BMI和BF百分比会显著降低。次要结局包括身体活动水平、总能量摄入、膳食脂肪摄入百分比、儿童和父母与饮食和身体活动相关的社会心理因素、血液胆固醇和血压。过程度量将评估规划执行，包括执行的暴露、参与、遵从、接受和忠实度度量。

The increased prevalence of many of the health problems of African American women has been linked to the high prevalence of obesity. Of great concern, the prevalence of obesity has been increasing among African American women with a similar pattern in African American girls. Since weight reduction weight is difficult to achieve in adulthood, there is an urgent need for prevention approaches geared towards children. This proposal describes a two-phase plan to develop and evaluate a community-based intervention that promotes healthy dietary practices and increased physical activity among at risk or overweight 8-10 year-old African American girls living in low- income neighborhoods in the Twin Cities of Minneapolis and St Paul, Minnesota. A randomized clinical trial design will be used with 300 African American girls; 150 will be individually randomized to the intervention group and 150 to the control group. The intervention program will take place after school, two afternoons a week in neighborhood community centers and will be based on social cognitive theory, incorporating a youth development, resiliency-based approach. Community involvement through the establishment of a Community Advisory Council will provide input into all aspects of the study. The intervention focuses on activities designed to model and teach skills to prevent obesity through regular physical activity and healthy eating and a family component designed to reinforce and support these behaviors. An effective and innovative culturally- appropriate intervention will be developed through formative assessment with girls, parents, community leaders and youth workers in the targeted communities. In Phase I, a 12-week pilot-test will be conducted with 50 girls; 25 randomized to the intervention and 25 to the control group. In Phase II, the two-year intervention will be conducted in five community centers, twice a week for 11 months. Main outcome measures will be body mass index (BMI) and percent body fat (percent BF). The major hypothesis is that at the end of the full-scale study, girls in the intervention group, relative to girls in the control group, will have significantly lower BMI and percent BF after adjustment for baseline values. Secondary outcomes include physical activity level, total energy intake, percent intake from dietary fat, child and parent psychosocial factors related to diet and physical activity, blood cholesterol and blood pressure. Process measures will assess program implementation including measures of exposure, participation, compliance, receptivity, and fidelity of implementation.