Guided Imagery Intervention for Obese Latino Adolescents

描述(由申请人提供)：总体目标：这项研究的总体目标是开发和测试一种基于理论的引导性成像生活方式干预措施，以减少超重拉美裔青少年中2型糖尿病和心血管疾病的危险因素。总体假设：在减少2型糖尿病和心血管疾病的危险因素，以及增加促进健康的饮食和体育活动行为方面，引导意象生活方式干预将比单纯的营养教育更有效。具体目标和方法：具体目标1：开发一个基于压力减轻和行为意义理论的指导性意象干预方案，用于超重的拉丁裔青少年。具体目标2：进行一项随机对照试验，以测试在超重的拉丁裔青少年营养教育计划中增加引导性意象干预计划的直接和中介效果。主要结果将包括胰岛素敏感性、心理社会测量以及饮食和体力活动行为。理由：肥胖和2型糖尿病在超重青年中的患病率正在上升，特别是在少数民族中。有2型糖尿病家族史的超重拉丁裔青少年中，28%有糖耐量受损(IGT)，30%有代谢综合征。迫切需要开发创新和有效的生活方式干预措施，以减少这一高危人群的胰岛素抵抗和超重。研究设计与方法：采用焦点小组定性方法，将制定一项12周的引导性成像干预计划，该计划在文化和发育上适合超重的拉丁裔青少年。这种干预措施随后将在随机对照试验中进行测试。结果评估将包括生理指标(胰岛素敏感性、身体成分、皮质醇分泌)、心理社会指标(感受到的压力、情绪性进食、进食和体力活动的意义)以及行为指标(饮食摄入量和体力活动)。健康暗示：引导图像通过减少慢性压力和改变不健康的饮食和体育活动行为，特别有望减少超重青少年的慢性病风险因素。这可能是在易感青年中预防2型糖尿病和心血管疾病的有效手段，从而减少与这些疾病相关的痛苦和成本。

DESCRIPTION (provided by applicant): Overall Objective: The overall aim of this study is to develop and test a theory-based guided imagery lifestyle intervention to reduce risk factors for type 2 diabetes and cardiovascular disease in overweight Latino adolescents. Overall Hypothesis: Guided imagery lifestyle intervention will be more effective than nutrition education alone in decreasing risk factors for type 2 diabetes and cardiovascular disease, and in increasing health-promoting dietary and physical activity behaviors. Specific Aims and Approach: Specific Aim 1: To develop a guided imagery intervention program based on stress reduction and on the Theory of Meanings of Behavior for use with overweight Latino adolescents. Specific Aim 2: To conduct a randomized and controlled trial to test the direct and mediated effects of adding a guided imagery intervention program to a nutrition education program in overweight Latino adolescents. Major outcomes will include insulin sensitivity, psychosocial measures, and dietary and physical activity behaviors. Rationale: Prevalence of obesity and type 2 diabetes is increasing in overweight youth, especially in ethnic minorities. 28% of overweight Latino adolescents with a family history of type 2 diabetes have impaired glucose tolerance (IGT), and 30% have the metabolic syndrome. There is a critical need to develop innovative and effective lifestyle interventions to reduce insulin resistance and overweight in this population at risk. Research Design & Methods: Using focus group qualitative methods, a 12-week guided imagery intervention program will be developed that is culturally and developmentally appropriate for overweight Latino adolescents. This intervention will then be tested in a randomized, controlled trial. Outcome assessments will include physiologic measures (insulin sensitivity, body composition, cortisol secretion), psychosocial measures (perceived stress, emotional eating, meanings of eating and physical activity), and behavioral measures (dietary intake and physical activity). Health implications: Guided imagery holds particular promise to reduce chronic disease risk factors in overweight adolescents by reducing chronic stress and transforming unhealthful dietary and physical activity behaviors. This could be an effective means of preventing both type 2 diabetes and cardiovascular disease in susceptible youth, thereby reducing both the suffering and costs associated with these diseases.