A Promotora-mediated, Family-based Intervention to Prevent Obesity in Latino Pres

描述（由申请人提供）：与其他种族/民族的儿童相比，拉丁裔学龄前儿童的超重和肥胖率较高。很少有以家庭为基础的肥胖干预措施存在，重点是拉丁美洲学龄前儿童和使用文化适当的措施和方法。拉丁美洲同龄人健康教育工作者（promotoras）可以有效地增加知识，促进拉丁美洲人口的行为改变，但是，迄今为止，没有promotoras介导的儿童肥胖干预措施，针对拉丁美洲学龄前儿童存在。本研究的目的是开发和评估一种以家庭为基础的、以启动子为媒介的儿童肥胖干预措施的可行性和有效性。本研究将采用混合方法的序贯研究设计，分为两个主要阶段：第一阶段：进行形成性研究（焦点小组和认知访谈与学龄前儿童的拉丁裔父母），以告知文化适当的干预措施和措施的发展;第二阶段：测试的可行性和有效性的启动子介导的，以家庭为基础的干预，以防止肥胖在拉丁裔学龄前儿童;将从南卡罗来纳州的纽贝里县和萨卢达县招募30名2-5岁儿童的拉丁裔父母（第一阶段）和50名亲子配对（第二阶段），由来自他们自己的社交网络（例如，社区、教堂、学校、街角商店）。Promotoras将使用第一阶段开发的干预课程接受20小时的培训，然后在10周的家庭会议上向家庭提供干预。干预措施将教育和培训父母制定与家庭饮食，体育活动和久坐活动相关的可行目标，以创造支持性的家庭环境，促进儿童的健康体重。主要结果（即，儿童体重指数（BMI）z分数和百分位数）和次要结果（即，儿童腰围、饮食和身体活动、父母BMI和腰臀比、身体和社会家庭环境以及人口统计学）将在干预前后进行评估。过程评价将使用多个数据源和混合方法评估保真度、剂量、覆盖范围、招募和背景因素。根据过程评估方案中从发起人和父母收集的数据进行描述性分析，以确定干预的可行性和实施水平。将在SAS中使用ANCOVA评估干预对控制相关变量的主要和次要结局的影响。这项拟议中的研究具有很高的公共卫生意义，因为它将影响父母和儿童的特定行为，这些行为已被证明会导致体重过度增加。这项研究是创新的，因为它将是第一个在拉丁美洲学龄前儿童的儿童肥胖干预中使用promotoras。如果成功，这种方法将在一项大规模的干预研究中进行评估，并提供一个潜在的模式，以帮助解决和预防有幼儿的拉丁美洲家庭的肥胖问题。

DESCRIPTION (provided by applicant): Latino preschool children have higher rates of overweight and obesity compared with children in other racial/ethnic groups. Few family-based obesity interventions exist that focus on Latino preschool children and use culturally-appropriate measures and approaches. Latino peer health educators (promotoras) can be effective in increasing knowledge and promoting behavior change in Latino populations; however, to date, no promotora-mediated child obesity interventions targeting Latino preschool children exist. The purpose of the proposed research is to develop and evaluate the feasibility and effectiveness of a family-based, promotora-mediated child obesity intervention. The proposed study will employ a mixed methods sequential research design, organized into two major phases: Phase I: Conduct formative research (focus groups and cognitive interviews with Latino parents of preschool children) to inform the development of a culturally-appropriate intervention and measures; Phase II: Test the feasibility and effectiveness of a promotora-mediated, family-based intervention to prevent obesity in Latino preschool children; Thirty Latino parents of children aged 2-5 years (Phase I) and fifty parent-child dyads (Phase II) will be recruited from Newberry and Saluda counties, South Carolina by promotoras from within their own social networks (e.g., neighborhood, church, school, corner stores). Promotoras will receive 20 hours of training using the intervention curriculum developed in Phase I and then deliver the intervention to families over 10 weekly home sessions. The intervention will educate and train parents to set feasible goals related to family diet, physical activity, and sedentary activity to create supportive home environments to promote a healthy weight in their children. Primary outcomes (i.e., child body mass index (BMI) z-score and percentile) and secondary outcomes (i.e., child waist circumference, diet, and physical activity, parent BMI and waist-to-hip ratio, te physical and social home environment, and demographics) will be assessed pre- and post-intervention. Process evaluation will assess fidelity, dose, reach, recruitment, and contextual factors using multiple data sources and mixed methods. Descriptive analyses based on data collected from the promotoras and parents in the process evaluation protocol will be used to determine intervention feasibility and level of implementation. Intervention impact on primary and secondary outcomes controlling for relevant variables will be assessed with ANCOVA in SAS. The proposed research carries high public health significance because it will influence specific behaviors in parents and children that have been shown to contribute to excessive weight gain. The research is innovative because it will be the first to use promotoras in a child obesity intervention for Latino preschool- age children. If successful, this approach will be evaluated in a large-scale intervention study and provide a potential model to help to address and prevent obesity in Latino families with young children.