Community-Based Lifestyle Promotion With Latino Women

超重/肥胖和缺乏身体活动是拉丁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。这些风险因素是可以改变的，并且可以通过侧重于促进健康饮食和增加身体活动的生活方式行为预防措施加以调整。本实验研究的总体目标是评估由promotoras提供的为期6个月的社区健康生活方式行为干预（LSBI）的效果，旨在改善超重/肥胖的中年拉丁裔妇女（主要是讲西班牙语的移民）的饮食和PA。这项研究建立在形成性研究和可行性研究的基础上，这些研究使用了社区参与性研究方法和NHLBI拉丁裔心血管疾病预防倡议中开发的材料。参与者（N=240），年龄在35-64岁之间，将被随机分配到LSBI或类似长度的控制条件（灾难准备和家庭安全计划）。文化敏感的LSBI包括2个月的小组教育（基于Su Corazón， Su Vida）和步行俱乐部，随后是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个月的随访中收集，采用临床和行为测量相结合的方法。评估的主要结果是身体质量指数（BMI）的变化。次要结果包括客观测量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。选择中介（变化阶段）和调节变量（社会支持），从行为改变的跨理论模型和社会生态模型衍生，将检查与干预和项目结果的关系。研究结果将有助于了解拉丁美洲人有效的社区心血管疾病预防，包括在临床环境之外由基层推广人员提供的生活方式干预。加深对人际和环境因素对拉丁美洲人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.