Obesity Prevention in Latino Home and Community Environ*

描述（由申请人提供）： “肥胖预防拉丁美洲家庭和社区环境”的目的是设计，实施和评估以环境为中心的肥胖预防干预拉丁美洲儿童及其家庭针对体育活动和饮食行为。干预将不仅针对行为可能发生的微环境（即家庭环境），而且针对宏观环境（即，公寓大楼、学校、杂货店、公园和餐馆。微观环境干预将针对家庭的结构方面和家庭规则的制定，通过社区卫生工作者（promotoras）提供，并针对家庭的需要。宏观环境干预将使用启动子在环境中工作（例如，公寓大楼，学校和社区），以提高认识和促进环境变化。微观和宏观的环境干预，以及它们之间的相互作用，将进行比较，与无处理控制条件。我们将进行研究的南圣地亚哥县地区有29万人口，其中60%是拉丁美洲人。主要研究参与者将是大约900名在公立小学K至2年级就读的拉丁裔儿童。还将招募儿童的初级保健人员同时参与测量和家庭及社区干预活动。将随机选择12所学校参与研究，并随机分配到四个可能的干预条件之一。拟议的研究是一个2x2析因设计，邻里（定义为小学集水区）被随机分配到四个条件之一：微观环境干预（“微观”），宏观环境干预（“宏观”），微观环境加宏观环境干预（“微观+宏观”），或无处理控制条件。该研究的主要结果是K-2参与者的体重指数，在基线，12，24和36个月时测量。次要结果包括营养、活动和久坐行为以及相关环境特征的观察和自我报告。调节变量将包括社区的文化适应、社会经济地位和地理信息系统措施。

DESCRIPTION (provided by applicant): The purpose of "Obesity Prevention in Latino Home and Community Environments" is to design, implement, and evaluate an environmentally-centered obesity prevention intervention for Latino children and their families targeting physical activity and dietary behaviors. The intervention will target not only the microenvironment in which the behaviors are likely to occur (i.e. the home environment), but also macro-environments (i.e., apartment complex, schools, grocery stores, parks, and restaurants.) The microenvironmental intervention will target structural aspects of the home and household rule setting delivered via community health workers (promotoras) and tailored to the needs of the family. The macroenvironmental intervention will employ promotoras to work in the environment (e.g., apartment complex, schools, and neighborhoods) to increase awareness and promote environmental change. The micro and macro environmental interventions, and their interaction, will be compared with a no-treatment control condition. The South San Diego County region where we will conduct our study has a population of 290,000, 60% of whom are Latinos. Primary study participants will be approximately 900 Latino children enrolled in grades K through 2 in public elementary schools. The child's primary care giver will also be recruited for concurrent participation in measurement and home- and community-based intervention activities. Twelve schools will be randomly selected to participate in the study, and randomly assigned to one of the four possible intervention conditions. The proposed study is a 2x2 factorial design, with neighborhoods (defined by primary school catchment areas) being randomly assigned to one of four conditions: microenvironmental intervention only ("micro"): macroenvironmental intervention only ("macro"), microenvironmental plus macroenvironmental intervention ("micro + macro"), or a no-treatment control condition. The study's primary outcome is Body Mass Index of the K-2 participants, measured at baseline, 12, 24, and 36 months. Secondary outcomes include observations and self report of nutritional, activity and sedentary behavior and related environmental characteristics. Moderator variables will include acculturation, socioeconomic status and GIS measures in the community.