Community-Based Lifestyle Promotion With Latino Women

超重/肥胖和缺乏运动是拉美裔成年人心血管疾病(CVD)和其他慢性疾病(如糖尿病)发病率和死亡率的两个重要预测因素。这些危险因素是可以改变的，也是以促进健康饮食和增加体力活动(PA)为重点的生活方式行为预防努力的服从。这项实验研究的总体目标是评估由促进者提供的为期6个月的基于社区的健康生活方式行为干预(LSBI)的效果，旨在改善超重/肥胖的中年拉丁裔女性的饮食和PA，这些女性主要是讲西班牙语的移民。这项研究的基础是利用社区参与性研究方法和材料开展的形成性和可行性研究，这些研究方法和材料是在为拉丁裔人制定的全国保健和保健协会心血管疾病预防倡议中制定的。参与者(N=240)，年龄从35岁到不等，将被随机分配到LSBI或类似的长度控制条件(备灾和家庭安全计划)。对文化敏感的LSBI包括2个月的小组教育(以Su Corazon、Su Vida为基础)和步行俱乐部，然后是4个月的个性化教学和咨询(ITC)。促进行为改变、支持健康营养和减肥以及增加PA的战略将被纳入ITC。数据将在基线、干预后(干预开始后6个月)和3个月随访时收集，使用临床和行为测量的组合。评估的主要结果是体重指数(BMI)的变化。次要结果包括对PA(加速度计读数)、血压、胆固醇、血糖、腰围和自我报告的生活方式行为的客观测量。从行为改变的跨理论模型和社会生态模型中选择的中介变量(变化阶段)和调节变量(社会支持)将与干预和计划结果相关联地进行审查。这些发现将有助于了解拉美裔人在社区有效预防心血管疾病的知识，包括在基层由推动者在临床环境之外提供生活方式干预。还将加强对人际和环境因素对拉丁裔采用健康生活方式行为的影响的了解。

Overweight/obesity and physical inactivity are two significant predictors of morbidity and mortality from cardiovascular disease (CVD) and other chronic diseases (e.g., diabetes) in Latina adults. These risk factors are modifiable and amenable to lifestyle behavior prevention efforts that focus on promoting a healthy diet and increasing physical activity (PA). The overall goal of this experimental study is to evaluate the effects of a 6-month community-based healthy lifestyle behavior intervention (LSBI) provided by promotoras, designed to improve diet and PA of overweight/obese, middle-age Latino women who are predominantly Spanish-speaking immigrants. The study builds upon formative and feasibility studies implemented using community-based participatory research methods and materials developed in a NHLBI CVD prevention initiative for Latinos. Participants (N=240), ranging in age from 35-64, will be randomly assigned to either the LSBI or a comparable length control condition (disaster preparedness and home safety program). The culturally sensitive LSBI includes 2 months of small group education (based upon Su Corazón, Su Vida) and a walking club, followed by 4 months of individualized teaching and counseling (ITC). Strategies to promote behavior change, support healthy nutrition and weight loss, and increase PA will be incorporated into the ITC. Data will be collected at baseline, post intervention (6 months after intervention initiation) and at a 3- month follow-up using a combination of clinical and behavioral measures. The primary outcome to be evaluated is change in body mass index (BMI). Secondary outcomes include objective measures of PA (accelerometer readings), blood pressure, cholesterol, blood sugar, waist circumference and self-reported lifestyle behaviors. Selected mediating (stage of change) and moderating variables (social support), derived from the transtheoretical model of behavior change and social ecological model, will be examined in relation to the intervention and program outcomes. Findings will contribute to knowledge about effective communitybased CVD prevention for Latinas involving lifestyle intervention delivered at a grassroots level by promotoras, outside of clinical settings. Understanding also will be enhanced about the influence of interpersonal and environmental factors on adoption of healthy lifestyle behaviors of Latinas.