DECREASING WEIGHT GAIN IN AFRICAN-AMERICAN PREADOLESCENT

非裔美国妇女许多健康问题的流行率增加与肥胖症的高流行率有关。 令人极为关切的是，非裔美国妇女的肥胖患病率一直在增加，非裔美国女孩的肥胖患病率也在增加。 由于体重减轻很难在成年期实现，因此迫切需要针对儿童的预防方法。 该提案描述了一个两阶段计划，以制定和评估基于社区的干预措施，促进健康的饮食习惯和增加生活在明尼阿波利斯和圣保罗双子城低收入社区的8-10岁非洲裔美国女孩的身体活动。 将对300名非裔美国女孩进行随机临床试验设计; 150名将被单独随机分配到干预组，150名分配到对照组。 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，结合青年发展，以服从为基础的方法。 通过设立社区咨询理事会使社区参与，将为研究的各个方面提供投入。 干预措施的重点是旨在通过定期体育活动和健康饮食以及旨在加强和支持这些行为的家庭组成部分来模拟和教授预防肥胖的技能的活动。将通过对目标社区的女孩、家长、社区领导人和青年工作者进行形成性评估，制定有效和创新的文化上适当的干预措施。 在第一阶段，将对50名女孩进行为期12周的试点测试; 25名随机分配到干预组，25名随机分配到对照组。 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，为期11个月。 主要的结果指标是体重指数（BMI）和体脂百分比（BF百分比）。 主要假设是，在全面研究结束时，干预组的女孩，相对于对照组的女孩，在调整基线值后，BMI和BF百分比显著降低。 次要结果包括身体活动水平、总能量摄入、膳食脂肪摄入百分比、与饮食和身体活动相关的儿童和父母心理社会因素、血胆固醇和血压。过程测量将评估计划的实施，包括暴露、参与、遵守、接受性和实施的忠诚度的测量。

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.