Reducing obesity among public housing residents: an ecological approach

描述（由申请人提供）：肥胖的流行不成比例地影响着120万居住在公共住房中的美国家庭，其中近50%的成年人肥胖，患高血压的风险高出两倍。使用生态学框架，我们提出社区社会网络因素可能促进不健康的生活方式行为，从而导致这种差异。这项建议的总体目标是找出促进公共住房居民健康饮食、身体活动和健康体重的社会网络因素。我们关注的是社会网络——社区内人们之间的联系——因为理论工作表明，社会网络对健康行为有重要影响。然而，之前的研究没有在社会网络分析中检查生活方式行为，也没有通过社会网络干预来针对这些行为。我们将探讨三个目标：1)描述生活在马里兰州巴尔的摩市公共住房开发中的500名成年人的社会网络与肥胖/生活方式行为之间的关系；2)评估社会网络与建成环境之间是否存在相互作用，以及这种相互作用如何影响公共住房居民的生活方式行为；3)发展社会网络干预以促进生活方式行为的改变，并在马里兰州巴尔的摩的公共住房开发居民中进行试点测试。候选人的长期职业目标是通过预防和治疗肥胖和心血管疾病（CVD）来改善高危人群的健康。她在约翰霍普金斯大学完成了普通内科临床研究奖学金（GIM），并于2012年7月加入约翰霍普金斯大学GIM系，担任助理教授。她制定了职业发展计划，以提高自己在高级统计方法、社会网络分析和行为理论方面的技能。她还组建了一个核心指导团队和一个多学科咨询委员会，以支持她的研究和职业发展。她的核心指导团队由她的主要导师珍妮·克拉克博士领导，她是医学和流行病学教授，在指导和预防和治疗肥胖的临床试验方面拥有丰富的经验。该核心团队还包括具有社会网络专长的公共卫生教授Carl Latkin博士和具有社区参与性研究和减少心血管疾病风险专长的医学教授David Levine博士。在第5年，本工作的结果将导致R01申请进行随机对照试验，测试社会网络干预对促进和维持高风险公共住房人群健康生活方式行为改变的影响。

DESCRIPTION (provided by applicant): The obesity epidemic disproportionately affects the 1.2 million U.S. households living in public housing, where nearly 50% of adults are obese and have a two-fold greater risk of hypertension. Using an ecologic framework, we propose that neighborhood social network factors likely promote unhealthy lifestyle behaviors that contribute to this disparity. The overall objective of this proposal is to identify social network factors tha promote healthy diet, physical activity and healthy weight among public housing residents. We focus on the social network - the connections among people within a community - as theoretical work suggests that social networks have an important influence on health behaviors. However, no previous studies have examined lifestyle behaviors in a social network analysis or targeted these behaviors with a social network intervention. We will explore three aims: 1) To characterize the relationship between the social network and obesity / lifestyle behaviors of 500 adults living in public housing developments in Baltimore, MD; 2) To assess if an interaction between the social network and built environment exists and how such an interaction influences the lifestyle behaviors among public housing residents; and 3) To develop a social network intervention to facilitate lifestyle behavior change and pilot test it in residents of public housig developments as in Baltimore, MD. The candidate's long-term career goal is to improve the health of at-risk populations by preventing and treating obesity and cardiovascular disease (CVD). She completed a Clinical Research Fellowship in General Internal Medicine (GIM) at Johns Hopkins, and joined the GIM faculty as an Assistant Professor at Johns Hopkins in July 2012. She has laid out a career development plan to enhance her skills in advanced statistical methods, social network analysis, and behavioral theory. She has also assembled a core mentorship team along with a multidisciplinary advisory committee to support her research and career development. Her core mentorship team is headed by her primary mentor, Dr. Jeanne Clark, Professor of Medicine and Epidemiology, who has extensive experience in mentoring and clinical trials for the prevention and treatment of obesity. This core team also includes Dr. Carl Latkin, Professor of Public Health with expertise in social networks, and Dr. David Levine, Professor of Medicine with expertise in community-based participatory research and CVD risk reduction. In year 5, the results from this work will lead to an R01 application to conduct a randomized controlled trial testing the effect of the social network intervention on healthy lifestyle behavior change that promotes and sustains a healthy weight among the high-risk public housing population.