A Community-Academic Partnership to Address Disparities in Obesity Among Youth

描述（由申请人提供）：正如《健康人2010》所概述的那样，消除健康差距，特别是在儿童肥胖方面，是美国的主要目标。在拟议研究的社区合作伙伴洛杉矶联合学区（LAUSD），该学区43%的中小学生肥胖或超重，拉美裔（45%）和黑人（41%）的患病率最高，而白人（29%）和亚洲/太平洋岛民（27%）。体育活动有限和饮食不良导致所有种族/族裔群体的青少年肥胖，尤其是黑人和拉丁裔。我们建议进行一项为期5年的随机对照试验，以学校为基础的肥胖预防干预，以解决LAUSD中学青少年在营养和体育活动方面的种族/民族差异。我们的目标是：(1)确定以学校为基础的社区参与性研究干预是否可以增加健康饮食、身体活动和身体健康，并减少久坐行为；(2)检查干预效果的种族和民族差异；(3)评估行为改变的理论重要相关因素（即态度、社会规范和自我效能感）是否能预测干预目标行为的变化；(4)估算干预措施的成本和效益，计算成本效益比；(5)向社区利益相关者传播干预结果，并制定广泛传播项目的计划。在NIH/NCMHD RFA-MD-05-002 （R24 MD001648; MA Schuster， PI）下进行的一项计划拨款中，我们在LAUSD的社区合作伙伴之间建立了新的关系并加强了现有的关系，主要利益相关者投资于洛杉矶县的青少年和肥胖预防，以及青少年健康促进中心的研究人员。这种伙伴关系已经成为一种强有力的、蓬勃发展的合作关系，使我们能够开发、试点测试和完善我们新的基于学校的干预措施——学生营养和运动（SNaX）。SNaX将改善学校食品环境和全校范围内针对七年级学生及其家长的多媒体推广与课后俱乐部相结合，鼓励同伴领导使用动机性访谈方式向家人和同伴推广健康饮食和体育活动。SNaX旨在通过赋予青少年权力，使其成为社区变革的倡导者，从而减少在健康饮食和体育活动方面的种族/族裔差异。

DESCRIPTION (provided by applicant): As outlined in Healthy People 2010, eliminating health disparities, especially with respect to child obesity, is a major US goal. In the LA Unified School District (LAUSD), the community partner for the proposed research, 43% of elementary and secondary school children in the district are obese or overweight, with the highest prevalence among Latinos (45%) and Blacks (41%), compared to Whites (29%) and Asians/Pacific Islanders (27%). Limited physical activity and poor diet contribute to obesity among youth from all racial/ethnic groups, especially Blacks and Latinos. We propose a 5-year randomized controlled trial of a school-based obesity prevention intervention to address racial/ethnic disparities in nutrition and physical activity among middle school youth in LAUSD. We aim to: (1) determine whether a school-based community-based participatory research intervention can increase healthy eating, physical activity, and physical fitness, and decrease sedentary behavior; (2) examine racial and ethnic differences in the effectiveness of the intervention; (3) assess whether theoretically important correlates of behavioral change (i.e., attitudes, social norms, and self-efficacy) predict changes in the behaviors targeted by the intervention; (4) estimate the costs and benefits of the intervention and calculate cost-effectiveness ratios; and (5) disseminate intervention results to community stakeholders and develop a plan for broad program dissemination. In a Planning Grant conducted under NIH/NCMHD RFA-MD-05-002 (R24 MD001648; MA Schuster, PI), we established new relationships and strengthened existing relationships among community partners at LAUSD, key stakeholders invested in youth and obesity prevention from across LA County, and researchers at the Center for Adolescent Health Promotion. This partnership has become a strong and thriving collaboration that has led to our developing, pilot testing, and refining our new school-based intervention, Students for Nutrition and exercise (SNaX). SNaX combines improvements to the school food environment and school-wide multimedia promotions for 7th graders and their parents with an after-school club in which peer leaders are encouraged to use a motivational interviewing style to promote healthy eating and physical activity to family and peers. SNaX aims to reduce racial/ethnic disparities in healthy eating and physical activity by empowering adolescents to be advocates for change within their communities.