TransCommunity Approach to Pediatric Obesity Prevention and Treatment

描述（由申请人提供）：在这个发展申请（R21）中，我们建议开发和测试跨社区方法对预防墨西哥裔美国人主要人口体重增加的影响。我们将招募来自3所小学的高危和超重（BMI bb0 85百分位）三年级和四年级儿童及其父母/主要照顾者参与该项目，并接受BMI、身体成分、身体活动、饮食和与行为改变和体重相关的心理社会因素的评估（基线、6、9、12和18个月）。这三所学校的学生人口统计数据相匹配，将被随机分配到以下三种干预措施中的一种：一级-一个以学校为基础的项目，符合国家规定的营养和体育活动标准；第二级——以学校为基础的项目加上课后体育活动和营养项目；第三级——以学校和课外为基础的项目，加上以家庭为基础的体育活动和营养项目。1级计划代表了亚利桑那州学校营养和体育活动计划的最低要求，相当于医学研究中的“护理标准”。一级学校作为对照组。在“护理标准”的基础上，增加一个课后项目（第2级）和一个家庭部分（第3级），将使我们能够评估每个增加的部分（即课后项目和家庭干预）对一个典型的学校项目的贡献。此外，将1级和2级项目整合到3级项目中，可以评估家庭对这些项目的贡献。这些干预措施将结合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，跨社区方法不仅体现在干预措施的设计上，也体现在亚利桑那大学皮马县分校（通过扩大食品和营养教育计划）、桑尼赛德学区和基督教青年会之间的合作中，以减少和预防儿童肥胖。在现有计划和与广泛组织（合作推广和基督教青年会）合作的基础上，预计将促进可持续性和快速传播。

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.