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/超重率存在很大的种族/民族差异。在种族/民族多样化的洛杉矶联合学区（LAUSD），美国第二大学区和该应用程序的社区合作伙伴，肥胖和超重的患病率（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社区参与性研究（CBPR）计划和干预补助金，将肥胖政策转化为实践。为此，我们开发、试点测试并进行了一项随机对照试验，以中学为基础的肥胖预防干预措施，学生营养和运动（SNaX）。在这个传播阶段的申请中，我们寻求资金将干预从研究过渡到实践。SNaX是一项多层次的干预措施，包括改变学校的食物环境（例如，提供切片水果和蔬菜；信息标牌；午餐时免费饮水）、同伴倡导和全校范围的多媒体推广。我们的随机对照试验结果显示，SNaX在促进健康饮食方面既有效又具有成本效益，因此符合作为一个值得推广的循证项目的标准。具体目标是使用理论驱动策略和CBPR原则：1)综合和传播有关青少年肥胖预防的信息，特别是向社区和学术利益相关者传播SNaX信息；2)提高LAUSD实施SNaX的总体组织能力和特定项目的能力，并在项目期间之后保持SNaX的交付；3)在LAUSD中学推广实施SNaX项目；4)评估SNeX的传播和实施过程，包括项目覆盖范围、招聘、有效性、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的北部地区进行传播。我们将使用一个经过验证的框架来评估和完善传播过程，该框架包括项目设施清单、对员工和学生的汇报访谈、对食堂记录和身体健康数据的分析。在传播测试之后，LAUSD计划在该地区的其他中学实施SNaX。最终，我们打算找到更广泛传播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引入社区，从而通过减少并最终消除差距，在公共卫生领域实现持久的现实变化。

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.