DECREASING WEIGHT GAIN IN AFRICAN-AMERICAN PREADOLESCENT

非洲裔美国女性的许多健康问题日益普遍，这与肥胖症的高发病率有关。非常令人担忧的是，非洲裔美国女性的肥胖率一直在上升，非裔美国女孩的肥胖率也有类似的模式。由于成年后很难实现减重，因此迫切需要针对儿童的预防方法。这项提案描述了一项分两个阶段的计划，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明尼苏达州圣保罗低收入社区的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力活动。随机临床试验设计将用于300名非裔美国女孩；150名将被单独随机分配到干预组，150名被分配给对照组。干预计划将在放学后进行，每周两个下午在社区中心进行，将以社会认知理论为基础，纳入以青年发展和弹性为基础的方法。通过设立社区咨询理事会，社区的参与将为研究的所有方面提供投入。干预的重点是旨在通过定期体育活动和健康饮食来模拟和传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。将通过对目标社区中的女孩、父母、社区领袖和青年工作者进行形成性评估，制定一种有效和创新的、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周的试点试验，其中25人被随机分配到干预组，25人被分配给对照组。在第二阶段，为期两年的干预将在五个社区中心进行，为期11个月，每周两次。主要观察指标为体重指数(BMI)和体脂百分比(BF)。主要假设是，在全面研究结束时，与对照组女孩相比，干预组女孩在调整基准值后，BMI和BF百分比将显著降低。次要结果包括体力活动水平、总能量摄入量、膳食脂肪摄入量百分比、儿童和父母与饮食和体力活动有关的心理社会因素、血胆固醇和血压。过程措施将评估计划的实施，包括暴露、参与、遵从性、接受性和实施的忠诚度的措施。

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.