Adaptation of A Prevention-Treatment (ADAPT) Program: Reducing Cancer Risk for Families with Young Children

 说明(申请人提供)：预防肥胖就是预防癌症。2012年，美国癌症协会(ACS)制定了指南，建议将健康营养、定期体育锻炼和控制体重作为癌症预防策略。预防癌症从儿童开始，因为肥胖预防从儿童开始。早在学龄前就以儿童为目标的健康生活方式干预措施具有巨大的潜力，可以影响终身健康。最有希望的干预措施是利用父母作为孩子的合作伙伴，改变孩子和父母的健康生活方式。Barkin等人证明，一项以社区娱乐中心为基础的为期12周的90分钟技能培养计划(健康家庭计划)，以社区娱乐中心为基础，导致儿童体重指数下降0.59p；0.001，并在计划结束一年后改变了父母和儿童利用建筑环境支持常规体育活动的方式。扩大这一有效的、以社区为基础、以家庭为中心的健康生活方式计划将需要对采用和适应进行评估，以便传播和实施。我们建议进行一项试点，以适应、打包并测试这一有效计划在其他公园和娱乐中心的可行性。来自全国各地的四个不同的公园和娱乐项目将参加。在第一年，我们将召集一个咨询委员会，成员包括公园和康乐事务负责人、管理人员、工作人员和他们所服务的有年幼子女的家庭。对公园和康乐负责人、工作人员和有幼儿的家庭(n=40)的半结构化访谈将为健康家庭计划的采用和调整提供直接反馈，包括：家长-学龄前儿童健康生活方式技能培养模块，娱乐中心负责人辅导员指南，以及用于保持健康行为的社交媒体工具。此外，还将为公园和康乐健康家庭计划负责人开展培训。在第二年，在健康家庭计划负责人经过培训和认证后，20个家庭/站点将参加12周的计划。将收集有关出席率、保真度和项目成本的数据。参与家庭将完成一项关于亲子营养、体力活动和娱乐中心使用习惯的前后调查。参与的家庭和所有健康家庭计划负责人的样本将参加半结构化访谈(N=40)，以确定哪些有效，哪些可以维持。公园和娱乐是一个现有的基础设施，覆盖了超过2.3亿美国人。因此，通过现有的基础设施调整有效的方案，以便实际传播和实施，可以改善家庭的健康生活方式，降低幼儿及其父母患癌症的潜在风险。

 DESCRIPTION (provided by applicant): Obesity prevention is cancer prevention. In 2012 the American Cancer Society (ACS) developed guidelines that recommended healthy nutrition, regular physical activity, and weight control as cancer prevention strategies. Cancer prevention begins in childhood because obesity prevention begins in childhood. Healthy lifestyle interventions targeted at children as early as preschool have enormous potential to affect lifelong health. The most promising interventions utilize parents as partners with their children t change healthy lifestyle behaviors in both the child and the parent. Barkin et al demonstrated that a 12 week 90 minute skills building program (Healthy Families Program) with families of young children (ages 3-5 years), based in community recreation centers, resulted in a reduction of child BMI of 0.59, p <0.001 and changed how parents and young children utilized their built environment to support regular physical activity one year after the program ended. Scaling up this effective community-based family centered healthy lifestyle program will require an assessment of adoption and adaptation for dissemination and implementation. We propose a pilot to adapt, package, and test feasibility for this effective program to other parks and recreation centers. Four different Parks and Recreation programs from across the country will participate. In year one, we will convene an Advisory Committee comprised of Parks and Recreation leaders, managers, staff and families with young children that they serve. Semi-structured interviews with Parks and Recreation leaders, staff and families with young children (n=40) will provide direct feedback for the adoption and adaptation of the Healthy Families Program including: parent-preschool child healthy lifestyle skills building modules, recreation center leader facilitator guides, and a social media tool for healthy behavior maintenance. Additionally, training for Parks and Recreation Healthy Family Program leaders will be developed. In year two, after Healthy Families Program leaders have been trained and certified, 20 families/site will participate in the 12 week program. Data about attendance, fidelity, and program cost will be collected. Participating families will complete a pre- and post- survey on parent-child nutrition, physical activity, and recreation center use habits. A sample of participating families and all the Healthy Families Program leaders will participate in semi-structured interviews (N =40) to identify what worked and could be maintained. Parks and Recreation is an existing infrastructure that reaches more than 230 million Americans. Therefore adapting effective programs for practical dissemination and implementation through this existing infrastructure could improve healthy lifestyles for families, reducing cancer risk potentially in both young children and their parents.