TransCommunity Approach to Pediatric Obesity Prevention and Treatment

描述(由申请人提供)：在这项发展申请(R21)中，我们建议开发和测试跨社区方法在以墨西哥裔美国人为主的人口中预防体重增加的影响。我们将从3所小学招募高危和超重(BMI&GT；85%)3年级和4年级儿童及其父母/小学照顾者参加该计划，并接受BMI、身体成分、体力活动、饮食以及与行为变化和体重相关的心理社会因素的评估(基线、6、9、12和18个月)。根据学生人口统计数据匹配的3所学校将被随机分配到以下3项干预措施中的1项：1级--符合国家规定的营养和体力活动标准的校本计划；2级--校本计划+课后体育活动和营养计划；3级--校本计划和课后计划+家庭基础体育活动和营养计划。1级计划代表了亚利桑那州学校对营养和体力活动计划的最低要求，相当于医学研究中的“护理标准”。一级学校将作为对照组。通过增加课后计划(2级)和家庭部分(3级)来建立“照顾标准”，将使我们能够评估每个增加的部分(即课后计划和家庭干预)对典型的以学校为基础的计划的贡献。此外，将1级和2级方案纳入3级方案将能够评估家庭组成部分对这些方案的贡献。这些干预措施将纳入我们研究团队开发的现有项目，并利用我们团队、学校和社区之间的现有关系。此外，跨社区的方法不仅体现在干预措施的设计上，还体现在亚利桑那大学、皮马县(通过扩大的食品和营养教育计划)、桑尼赛德学区和基督教青年会之间为减少和预防儿童肥胖而开展的合作中。建立在现有方案和与广泛的组织(合作推广和基督教青年会)合作的基础上，可望促进可持续性和迅速传播。

DESCRIPTION (provided by applicant): In this developmental application (R21), we propose to develop and test the impact of a trans-community approach to the prevention of weight-gain in a predominantly Mexican-American population. We will recruit at-risk and overweight (BMI >85th percentile) 3rd and 4th grade children, and their parents/primary caregivers, from 3 elementary schools to participate in the program and undergo assessments (baseline, 6, 9,12, and 18 months) of BMI, body composition, physical activity, diet and psychosocial factors related to behavior change and weight. The 3 schools, matched on student demographics, will be randomly assigned to 1 of the following 3 interventions: Level 1 - a school-based program that meets state mandated standards for nutrition and physical activity; Level 2 - the school-based program plus an after- school physical activity and nutrition program; and Level 3 - the school-based and after-school programs plus a family-based physical activity and nutrition program. The Level 1 program represents the minimal requirement of nutrition and physical activity programs for Arizona schools and is the equivalent of the "standard of care" in medical research. The Level 1 school will serve as the comparison group. Building on the "standard of care" by adding an after-school program (Level 2) and a family component (Level 3) will allow us to assess the contribution that each added component (i.e., after-school program and family intervention) makes to a typical school-based program. Furthermore, integrating the Level 1 and Level 2 programs into the Level 3 program will allow assessment of the contribution of the family component to these programs. The interventions will incorporate existing programs that have been developed by our research team and capitalize on existing relationships between our team, the schools and the community. Moreover, the trans-community approach is not only reflected in the design of the interventions but in the collaborations between the University of Arizona, Pima County (via the Expanded Food and Nutrition Education Program), the Sunnyside School District and the YMCA to reduce and prevent childhood obesity. Building on existing programs and collaborations with widespread organizations (Cooperative Extension and YMCA) is expected to promote sustainability and rapid dissemination.