Healthy Immigrant Families: Working Together To Move More and To Eat Well

描述(由申请人提供)：在许多衡量标准中，移民和难民抵达美国时比普通人群更健康，但他们在美国居住的时间越长，他们的心血管风险特征就越接近普通人群。这些下降在一定程度上是由于移民后成年人及其子女的体力活动减少和饮食质量下降所致。考虑到影响这些行为的复杂的社会文化力量，需要一种基于社区的参与性研究(CBPR)方法来解决这些问题。罗切斯特健康社区伙伴关系是明尼苏达州罗切斯特市的一个强有力的CBPR伙伴关系，由社区组织、卫生服务组织和在移民和难民人口中集体部署规划和成果评估方面经验丰富的学者组成。社区和学术合作伙伴共同承担了筹备这一项目的责任。具体目标是：1)为移民和难民家庭制定符合社会文化的可持续的体力活动和营养干预措施；2)评估体力活动和营养干预的效果。干预框架是一系列以家庭为基础的、针对身体活动和营养的个别化家庭辅导和教育课程，由来自每个参与的移民和难民社区(西班牙裔、索马里人、苏丹人、柬埔寨人)的训练有素的家庭健康促进员领导，并有机会开展集体活动。采用两组随机设计，160名个体(包括成年人和青少年)将被随机分配立即接受干预或在延迟一年后接受干预。在实施后两年内对成年人和青少年进行评估的主要结果将包括通过加速计量法衡量的体力活动和通过24小时饮食回忆衡量的饮食变化。次要结果将包括体重指数、身体成分、血压、腰臀比和与健康相关的生活质量的变化。需要从受影响社区有机产生的创新方法来创建和维持促进健康行为的干预措施。CBPR的使用将通过针对身体活动和营养的社会文化决定因素来加强这一计划的相关性。

DESCRIPTION (provided by applicant): Across many measures, immigrant and refugee populations arrive to the US healthier than the general population, but the longer they reside in the US, the more they approximate the cardiovascular risk profiles of the general population. These declines are mediated, in part, by less physical activity and lower dietary quality upon immigration among both adults and their children. Given the complex socio-cultural forces that influence these behaviors, a community-based participatory research (CBPR) approach is called for to address them. The Rochester Healthy Community Partnership is a robust CBPR partnership in Rochester, Minnesota consisting of community-based organizations, health service organizations, and academics who are experienced at collectively deploying programming and outcomes assessment among immigrant and refugee populations. Community and academic partners have shared the responsibility of preparing this project. The specific aims are: 1) To develop a sustainable, socio-culturally appropriate physical activity and nutrition intervention with and for immigrant and refugee families, and 2) to evaluate the efficacy of the physical activity and nutrition intervention. The intervention framework is a series of home-based, individualized family mentoring and education session for physical activity and nutrition led by trained Family Health Promoters from each of the participating immigrant and refugee communities (Hispanic, Somali, Sudanese, Cambodian) with opportunities for group activities. Using a two-group randomized design, 160 individuals (including both adults and adolescents) will be randomly assigned to receive the intervention either immediately or after a delay of one year. Primary outcomes assessed in both adults and adolescents, measured up to two years after implementation, will include physical activity as measured by accelerometry and dietary change as measured by 24 hour dietary recalls. Secondary outcomes will include changes in body mass index, body composition, blood pressure, waist-hip ratio, and health-related quality of life. Innovative approaches that arise organically from the affected communities are needed to create and sustain interventions that promote healthy behaviors. The use of CBPR will enhance the relevance of this program by targeting socio-cultural determinants of physical activity and nutrition.