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

描述（由申请人提供）：超过三分之一的美国青少年肥胖或超重，肥胖/超重率存在较大的种族/民族差异。在种族/民族多样化的洛杉矶联合学区（LAUSD），美国第二大学区和本申请的社区合作伙伴，肥胖和超重患病率（46%）高于全国平均水平，黑人和拉丁裔学生的患病率最高。我们与LUUSD合作，通过NlMHD的R24社区参与式研究（CBPR）规划和干预赠款将肥胖政策转化为实践，为此我们开发，试点测试，并对我们的中学肥胖预防干预措施进行随机对照试验，学生营养和运动（SNaX）。在这个传播阶段的应用程序，我们寻求资金，从研究到实践的干预过渡。SNaX是一种多层次的干预措施，包括改变学校食品环境（例如，切片水果和蔬菜产品;信息标牌;午餐时间免费水），同伴宣传，以及全校范围的多媒体推广。我们的随机对照试验结果表明，SNaX在增加健康饮食和成本效益方面都是有效的，因此符合标准，作为一个值得推广的循证计划。具体目标是使用理论驱动的战略和CBPR原则：1）综合和传播有关青少年肥胖预防的一般信息，特别是向社区和学术利益相关者传播SNaX; 2）提高LAUSD实施SNaX的一般组织和特定方案的能力，并在项目期后保持SNaX的交付; 3）在LAUSD中学传播和实施SNaX计划; 4）评估SNeX传播和实施过程，包括计划范围，招聘，效率，采用，保留，实施保真度和维护等领域。我们计划使用一个迭代的过程，在这个过程中，我们首先在LAUSD的北部地区启动传播。我们将使用一个经过验证的框架，包括程序设施清单，与员工和学生的述职访谈，以及自助餐厅记录和身体健康数据的分析，评估和完善传播过程。在传播测试之后，LAUSD计划在该地区其他地区的中学实施SNax。最终，我们打算找到更广泛地传播SNax的方法，利用从LAUSD传播过程中吸取的经验教训，指导进入其他学区。我们的目标是将肥胖预防从研究领域带到社区，从而通过减少和最终消除差距来实现公共卫生的持久现实变化。

DESCRIPTION (provided by applicant): Over one-third of US adolescents are obese or overweight, and large racial/ethnic disparities exist in obesity/ overweight rates. In the racially/ethnically diverse Los Angeles Unified School District (LAUSD), the second largest US school district and the community partner for this application, obesity and overweight prevalence (46%) is higher than the national average, und Black and Latino students have the highest prevalence. We have partnered with LUUSD to translate obesity policy into practice through NlMHD's R24 community-based participatory research (CBPR) Planning and Intervention Grants, for which we developed, pilot tested, and conducted a randomized controlled trial of our middle-school-based obesity prevention intervention, Students for Nutrition and exercise (SNaX). In this Dissemination Phase application, we seek funds to transition the intervention from research to practice. SNaX is a multi-level intervention that includes changes to the school food environment (e.g., sliced fruit and vegetable offerings; informational signage; free water at lunchtime), peer advocacy, and school-wide multimedia promotion. Our RCT results showed that SNaX is both effective at increasing healthy eating and cost-effective, and thus meets criteria as an evidence-based program worthy of dissemination. The specific aims are to use a theory-driven strategy and CBPR principles: 1) to synthesize and disseminate information about adolescent obesity prevention in general and SNaX in particular to community and academic stakeholders; 2) to enhance the general organizational and program- specific capacity of LAUSD to implement SNaX and maintain delivery of SNaX beyond the project period; 3) to disseminate and implement the SNaX program in LAUSD middle schools; and 4) to evaluate the SNeX dissemination and implementation process, including the domains of program reach, recruitment, efficacy, adoption, retention, implementation fidelity, and maintenance. We plan to use an iterative process, in which we initially launch dissemination in LAUSD's North region. We will evaluate and refine the dissemination process using a validated framework that includes program facility checklists, debriefing interviews with staff and students, and analyses of cafeteria records and physical fitness data. After the dissemination test, LAUSD plans to implement SNaX in middle schools across the rest of the district. Ultimately, we intend to find ways to disseminate SNaX more broadly, using lessons learned from the LAUSD dissemination process to guide entry into other school districts. Our goal is to bring obesity prevention out of the research realm and into communities, and thereby achieve enduring real-world changes in public health through the reduction and eventual elimination of disparities.