COMMUNITY STEPS TO MINORITY YOUTH FITNESS

目标：通过改善城市中学生的饮食和增加他们的生活方式体力活动，降低他们晚年患肥胖相关疾病的风险。具体目标：从一所随机选择的城市中学招募125名主要是非裔美国人和拉丁裔男孩和女孩（6 - 7年级），并将他们纳入一个文化量身定制的，以社区为基础的生活方式改变计划，旨在通过预防胰岛素抵抗综合征来预防肥胖；将他们的经历与随机选择的一所比较学校的125名男女学生进行对比。2. 实施一项全面的、自我效能增强的、一学期的生活方式改变计划，通过减少胰岛素抵抗综合征的风险因素来降低肥胖的风险。该计划将在持续增加日常“生活方式”体育活动（例如，有趣的散步、建筑之旅、徒步旅行等）的背景下，提倡多吃蔬菜、全水果、全谷物和低热量密度食物。这个长达一个学期的项目包括每周30分钟的散步和在各种社区场所举行的简短讨论会，讨论更好的饮食选择和增加生活方式的体育活动的挑战和好处。训练有素的同伴榜样，精选的父母和成人辅导员将提供合理的建议，让孩子吃得更好，更频繁地进行愉快的体育活动。在资源有限的情况下，该项目将尝试多层次，包括家长、教师、教练、餐饮服务人员、同龄人以及研究参与者。3. 在4个月以上的随访（学期结束）、12个月和18个月的随访中评估项目的有效性。主要结局是血清HbA1c和BMI；次要结果是血清总胆固醇，1英里跑步，饮食自我报告，身体活动自我报告。中介变量是自我报告行为和态度。4. 编写并分发一本资源手册，其中包括那些被观察到对这类人群最有效的行为改变策略。

Goal: Reduce contemporary markers of later-in-life risk of obesity-related disease in urban, middle school children by improving their diet and increasing their lifestyle physical activity. Specific Aims. 1. Recruit 125 mostly African American and Latino girls and boys (6th - 7th grades) from a randomly- selected urban middle school and enroll them in a culturally- tailored, community-based lifestyle change program designed to prevent obesity by preventing the insulin resistance syndrome; contrast their experience with 125 matched girls and boys attending a randomly-selected comparison school. 2. Implement a comprehensive, self-efficacy-enhancing, semester-long lifestyle change program to reduce risk of obesity by reducing risk factors comprising the insulin resistance syndrome. The program will promote eating more servings of vegetables, whole fruits, whole grains and more servings of reduced calorie density foods in the context of sustained increases in daily "lifestyle" physical activity (e.g., fun walks, architectural tours, hiking, etc.). The semester-long program includes weekly 30-minute walks and brief discussion sessions in a variety of community venues about the challenges and benefits of better eating choices and increased lifestyle physical activity. Trained peer role models, selected parents and adult facilitators will provide sound advice for eating better and doing more frequent, enjoyable physical activity. Within resource constraints, the program will attempt to be multi-level, involving parents, teachers, coaches, food service staff, peers as well as study participants. 3. Evaluate program effectiveness at 4+ months follow-up (end of the semester), 12 and 18 months follow-up. Primary outcomes are serum HbA1c and BMI; secondary outcomes are serum total cholesterol, 1-mile run, dietary self-report, physical activity self-report. Mediating variables are self-report behaviors and attitudes. 4. Compile and distribute a resource book that includes those behavior change strategies that were observed to work best with this population.