Obesity Prevention in Latino Home and Community Environ*

描述(由申请人提供)： “拉丁裔家庭和社区环境中的肥胖预防”的目的是设计、实施和评估以环境为中心的针对拉丁裔儿童及其家庭的针对体育活动和饮食行为的肥胖预防干预措施。干预不仅针对可能发生行为的微环境(即家庭环境)，还针对宏观环境(即公寓楼、学校、杂货店、公园和餐馆)。微环境干预将针对家庭和家庭规则制定的结构性方面，通过社区卫生工作者(推动者)提供，并根据家庭的需要量身定做。宏观环境干预将雇用推动者在环境(如公寓楼、学校和社区)工作，以提高意识并促进环境变化。微观和宏观环境干预及其相互作用将与无处理控制条件进行比较。我们将在南圣地亚哥县地区进行研究，该地区有29万人口，其中60%是拉丁裔。小学研究参与者将是公立小学K年级到2年级的大约900名拉丁裔儿童。还将招募儿童的初级护理人员同时参与测量和以家庭和社区为基础的干预活动。将随机选择12所学校参与研究，并随机分配到四种可能的干预条件中的一种。研究采用2×2析因设计，将社区(由小学集水区定义)随机分配到四种条件之一：仅微环境干预(“微观”)：仅宏观环境干预(“宏观”)，微环境加宏观环境干预(“微观+宏观”)，或无处理控制条件。这项研究的主要结果是K-2参与者的体重指数，在基线、12个月、24个月和36个月测量。次要结果包括对营养、活动、久坐行为和相关环境特征的观察和自我报告。调节变量将包括文化适应、社会经济地位和社区的地理信息系统措施。

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.