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

描述（由申请人提供）：拉丁裔学龄前儿童比其他种族/民族的学龄前儿童更肥胖。很少有以家庭为基础的肥胖干预措施针对拉丁美洲学龄前儿童，并使用文化适当的措施和方法。拉丁美洲同伴健康教育工作者（promotoras）一直有效地增加知识和促进拉丁美洲人口的行为改变;然而，迄今为止，没有promotoras主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。拟议的研究将采用混合方法序贯研究设计，分为两个主要阶段：第一阶段：对学龄前儿童的拉丁裔父母进行语言分层焦点小组和认知访谈，为制定文化适当的干预措施和措施提供信息;第二阶段：测试干预措施的可行性和有效性; 30名拉丁裔父母的孩子aed 2-5岁（第一阶段）和50个亲子配对（第二阶段）将从南卡罗来纳州的纽贝里和萨卢达县招募6名推广员（女性>18岁，活跃于社区）从他们自己的教堂，学校，社区和街角商店网络。Promotoras将在南卡罗来纳州大学完成Promotores倡议培训计划后招募，并将使用第一阶段后确定的干预课程接受额外20小时的培训; Promotoras将在每周10次90分钟的会议上向家庭提供家庭干预。会议分为教育、实践和行动三部分（即，目标设定）的组成部分，并包括所有家庭成员谁愿意参加，将教育和培训家长制定可行的目标有关的家庭饮食，体育活动，和久坐不动的行为，创造支持性的家庭环境，以促进健康的体重在他们的孩子。主要结果（即，儿童体重指数[BMI] z评分和百分位数）和次要结局（例如，将在干预前后评估儿童饮食[食物筛选]和身体活动[加速度计]、身体和社会家庭环境[家长调查]。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。描述性分析的基础上，从promotoras，父母和录音的过程数据将被用来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，因为它将影响父母的特定行为， 与体重过度增加有关的儿童。这项研究是创新的，因为它将是第一个在拉丁裔学龄前儿童肥胖干预中使用promotoras 年龄的孩子。如果成功，这种方法将在大规模干预中进行评估，并提供一个潜在的模式，以帮助解决和预防拉丁美洲家庭的儿童肥胖。

DESCRIPTION (provided by applicant): Latino preschool children are more obese than preschool children in other racial/ethnic groups. Few family- based obesity interventions exist that target Latino preschool children and use culturally-appropriate measures and approaches. Latino peer health educators (promotoras) have been effective in increasing knowledge and promoting behavior change in Latino populations; however, to date, no promotora-led 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 language-stratified 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 the intervention; Thirty Latino parents of children aed 2-5 years (Phase I) and fifty parent-child dyads (Phase II) will be recruited from Newberry and Saluda counties, South Carolina by six promotoras (females >18 years, active in community) from their own networks of churches, schools, neighborhoods, and corner stores. Promotoras will be recruited upon completion of the Promotores Initiative training program at the University of South Carolina and will receive an additional 20 hours of training using the intervention curriculum finalized after Phase I; promotoras will then deliver the home-based intervention to families over 10, 90-minute weekly sessions. The sessions, organized into education, practice and action (i.e., goal setting) components and inclusive of all family members who desire to attend, will educate and train parents to set feasible goals related to family diet, physical activty, and sedentary behavior 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 (e.g., child diet [food screener] and physical activity [accelerometry], the physical and social home environment [parent survey]) 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 process data from promotoras, parents, and audio recordings 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 associated with 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 and provide a potential model to help to address and prevent child obesity in Latino families.