Healthy Mothers-Healthy Children: An Intervention with Hispanic Mothers and their Young Children

项目摘要 超重或肥胖的西班牙裔妇女和儿童有患糖尿病前期的风险， 2型糖尿病和心血管疾病。到目前为止，还没有跨学科的 针对西班牙裔妇女及其4岁儿童的干预措施，以改善营养， 身体活动行为可以管理母亲的肥胖和体重并预防过度肥胖， 体重增加的轨迹。使用随机两组，重复测量实验 设计，拟议研究的目标是调查12周的营养和运动的功效 西班牙裔美国人的教育、体育活动、应对技能培训和以家庭为基础的体育活动干预 妇女及其4岁的孩子和6个月的持续每月接触，以帮助超重和 肥胖的西班牙裔母亲改善肥胖，体重，健康行为（营养和体力活动）， 自我效能和他们4岁的孩子改善他们的肥胖和体重增加轨迹和健康 行为（营养和体力活动）。我们将与两个联邦卫生部门合作 在北卡罗来纳州的达勒姆和查塔姆招募西班牙裔妇女和她们4岁的孩子， 将与社区中心合作进行干预。共有294名西班牙裔女性， 2 >25 kg/m2和294名BMI百分位数> 25的西班牙裔4岁儿童将在4年内入组 并随机分配到实验组或同等注意力的对照组。将在时间1（0）收集数据 时间点2（9个月[基线]）和时间点1至时间点3（15个月[完成干预]） [6个月后，未与研究人员联系]）。收集的数据将包括肥胖（主要 结果：母亲和儿童的腰围、三头肌和肩胛下皮褶）以及体重 （主要结果：母亲的体重指数[BMI]和儿童的BMI百分位数）。二次 结果将包括母亲的健康行为和自我效能（成人健康行为 问卷、生活方式健康促进概况II、3天24小时食物回忆和7天加速计， 饮食自我效能量表和运动自我效能量表）和儿童（7天加速度计和 3天24小时食品召回）。我们还将评估为公共卫生提供该计划的成本 部门数据分析将使用一般线性混合模型来检验假设。降低 西班牙裔女性超重和肥胖，年轻女性肥胖和体重增加轨迹减缓 西班牙裔儿童迫切需要降低发病率，死亡率和未来的医疗保健费用。的 从这项研究中获得的知识可以为将这种干预扩展到其他国家提供基础。 西班牙裔母亲和其他社区的儿童，以协助母亲管理他们的体重， 防止孩子过度肥胖和体重增加。这种方法是可翻译的，真实的， 并且可以在美国的其他地区复制。

PROJECT SUMMARY Hispanic women and children who become overweight or obese are at risk for developing prediabetes, type 2 diabetes, and cardiovascular disease later in life. To date, there have been no interdisciplinary interventions that have targeted Hispanic women and their 4-year old children to improve nutrition and physical activity behaviors to manage adiposity and weight in mothers and prevent excessive adiposity and weight gain trajectory in their children. Using a randomized two-group, repeated measures experimental design, the goal of the proposed study is to investigate the efficacy of a 12-week nutrition and exercise education, physical activity, coping skills training, and home-based physical activity intervention in Hispanic women and their 4-year old children and 6 months of continued monthly contact to help overweight and obese Hispanic mothers improve adiposity, weight, health behaviors (nutrition and physical activity), and self-efficacy and their 4-year old children improve their adiposity and weight gain trajectory and health behaviors (nutrition and physical activity). W e will partner with two federally qualified health departments in Durham and Chatham, North Carolina to enroll Hispanic women and their 4-year old children and we will partner with community centers to deliver the intervention. A total of 294 Hispanic women with a BMI 2 >25 kg/m and 294 Hispanic 4-year old children with a BMI percentile > 25 will be enrolled over 4 years and randomized to the experimental or equal attention control group. Data will be collected at Time 1 (0 months [baseline]) to Time 2 (9 months [completion of the intervention]) and Time 1 to Time 3 (15 months [after 6 months with no contact from the study staff]). Data collected will include adiposity (primary outcomes: waist circumference, triceps and subscapular skinfolds) in mothers and children and weight (primary outcomes: body mass index [BMI] in mothers and BMI percentile in the children). Secondary outcomes will include health behaviors and self-efficacy in the mothers (Adult Health Behavior Questionnaire, Lifestyle Health Promoting Profile II, 3 day 24-Hour Food Recall, and 7 day Accelerometer, Eating Self-Efficacy Scale and Exercise Self-Efficacy Scale) and in the children (7 day Accelerometer and 3 day 24-Hour Food Recall). We will also evaluate the cost of delivering the program for public health departments. Data analysis will use general linear mixed models to test the hypotheses. Decreasing overweight and obesity in Hispanic women and slowing adiposity and weight gain trajectory in young Hispanic children is urgently needed to decrease morbidity, mortality, and future health care costs. The knowledge to be gained from this study may provide a foundation for extending this intervention to other Hispanic mothers and children in other communities to assist mothers in managing their weight and preventing excessive adiposity and weight gain in their children. This approach is translatable, real-world, and could be replicated in other areas of the United States.