FAMILIES PREVENTING AND REDUCING OBESITY HEALTH DISPARITIES IN HISPANIC YOUTH

描述(申请人提供)：儿童肥胖是我国最严重的公共卫生问题之一。西班牙裔青年尤其危险，与非西班牙裔白人青年相比，他们更有可能超重和肥胖，部分原因是他们的体力活动水平不足，饮食摄取质量不佳。家庭功能，特别是父母的参与和家庭沟通，与许多健康行为和条件有关，包括药物使用、烟草使用、性危险行为、身体活动、饮食摄入量和体重指数(BMI)。尽管有证据表明父母的参与和父母与青少年的沟通在预防肥胖方面有作用，但将它们纳入肥胖预防干预措施却是有限的。因此，迫切需要为青年制定以家庭为基础的肥胖预防干预措施，以体育活动和不良饮食为目标，特别是针对西班牙裔青年--因为他们面临与肥胖有关的不成比例和多重的健康负担。Familas Unidas是一种以家庭为基础、针对特定文化的干预措施，可有效预防或减少一些消极的健康行为和状况，包括吸毒、酗酒、抑郁、性危险行为、行为问题、性传播疾病和酒精依赖。家庭联盟通过改善家庭功能(例如，父母参与和亲子沟通)对这些结果产生了影响，与已发现的与体力活动和饮食摄入量有关的机制相同。初步数据还表明，家庭联盟对体育活动有积极影响，干预对体育活动的影响部分是通过父母的参与来实现的。这项研究的目的是：目的1：检查针对肥胖的Familias Unidas在增加超重西班牙裔青年的体力活动和改善饮食摄取质量方面的相对功效；目的2：检查家庭功能是否以及在多大程度上部分地调节了Familias Unidas对身体活动和饮食摄取质量的影响。为了实现这些目标，拟议的研究将把280名西班牙裔青年随机分成以下两种情况之一：1)家庭联盟或2)社区实践控制条件。将检验三个研究假设：H1：与社区实践相比，家庭统一将有效地增加拉美裔青年过去七天的中等到剧烈的体力活动；H2：与社区实践相比，家庭统一将有效地改善拉美裔青年过去七天的优质膳食摄入量(定义为随着时间的推移，含糖饮料的减少、快餐的摄入量减少以及新鲜水果和蔬菜的增加)；以及H3：家庭统一将对青年过去一天的适度到剧烈的身体活动的影响，以及青年过去七天的优质膳食摄入量将部分地通过家庭功能的变化来调节。

DESCRIPTION (provided by applicant): Childhood obesity is one of our nation's most significant public health problems. Hispanic youth are particularly at risk and are more likely to be overweight and obese than their non-Hispanic white counterparts partly because of their inadequate levels of physical activity and the poor quality of their dietary intake. Family functioning, specifically parental involvement and family communication, is related to a number of health behaviors and conditions, including drug use, tobacco use, sexual risk behaviors, physical activity, dietary intake, and body mass index (BMI). Despite the evidence that parental involvement and parent- adolescent communication have a role in obesity prevention, their incorporation into obesity prevention interventions has been limited. Thus, there is a critical need to develop family-based obesity preventive interventions for youth that target physical activity and poor diet, especially for Hispanic youth -- given the disproportionate and multiple obesity-related health burdens they face. Familias Unidas (United Families in English) is a family-based, culturally-specific intervention found to be efficacious in preventing or reducing a number negative health behaviors and conditions, including drug use, alcohol use, depression, sexual risk behaviors, conduct problems, sexually transmitted diseases, and alcohol dependence. Familias Unidas has impacted these outcomes through improvements in family functioning (e.g, parental involvement and parent-adolescent communication), the same mechanism that has been found to be related to physical activity and dietary intake. Preliminary data also indicate that Familias Unidas has positive effects on physical activity and that the effects of the intervention on physical activity are partially mediated by parental involvement. This study's aims are: AIM 1: To examine the relative efficacy of Familias Unidas, extended to target obesity, in increasing physical activity and improving the quality of dietary intake among overweight Hispanic youth and AIM 2: To examine whether and to what extent family functioning partially mediates the effects of Familias Unidas on physical activity and quality of dietary intake. To achieve these aims the proposed study will randomize 280 Hispanic youth to one of two conditions: 1) Familias Unidas or 2) a community practice control condition. Three study hypotheses will be tested: H1: Familias Unidas will be efficacious, compared to Community Practice, in increasing Hispanic youth's past seven day moderate to vigorous physical activity over time; H2: Familias Unidas will be efficacious, compared to Community Practice, in improving Hispanic youth's past seven day quality dietary intake (defined as decreases in sugar-sweetened beverages, decreases in intake of fast foods, and increases in fresh fruits and vegetables) over time; and H3: Familias Unidas' effects on youth's past day moderate to vigorous physical activity and youth's past seven day quality dietary intake will be partially mediated by changes in family functioning over time.