Comadres Saludables: A Web-Based Promotora Training Program for Obesity Prevention in Hispanic Women

摘要 西班牙裔肥胖的可能性比白人高23%，而且西班牙裔的肥胖率更高。 西班牙裔女性多于西班牙裔男性(分别为45%和39.7%)。据估计，77%(或1550万) 西班牙裔女性超重或肥胖。肥胖是由各种社会、身体和经济因素造成的 因素，但主要是由于饮食不良和缺乏体育活动。有鉴于此，最成功的干预措施是 减少肥胖指数(如BMI、体重、腰围)包括饮食和锻炼。成功 西班牙裔美国人的肥胖干预措施利用了文化定制，并依赖于促销活动(也 社区卫生工作者)作为提供这些干预措施的关键促进者。促销员是 有效地提供肥胖干预措施，并通过增强动机促进行为改变， 社会支持、社会互动和联系，以及自我效能感。 然而，充分的面对面的推广员培训对于有效实施这些是必要的。 干预措施。面对面培训培训师(TTT)模式是一种值得称赞的投资促销和 然而，获取服务仍然存在障碍，包括家庭承诺和相关费用。我们的 目标是开发一个有效的，可访问的，可扩展的电子健康肥胖干预TTT的推广。 Comadres Saludables将理论和基于证据的实践相结合，为促销提供 有效实施西班牙裔肥胖干预所需的自我效能感、知识和技能 女人。推广员将通过互动测验、练习和视频角色扮演来建立他们的技能集 场景。此外，Comadres Saludables将成为第一个提供促销活动的基于Web的TTT 互动移动保健工具，以加强对西班牙裔妇女的执行。具体地说，促销将具有 可以选择直接向参与者发送短信或电子邮件计划材料，并可以访问保真度 监测工具，以确保最佳实施。 在第一阶段，开发了Comadres Saludables的原型，该原型由Formative提供信息 研究对象为35名拉丁裔推广员(双语)，年龄18-。第一阶段的结果强烈 支持干预的可行性和潜在有效性，远远超过所确立的基准 在第一阶段提案中。 在第二阶段，我们将完成基于网络的Comadres Saludables培训的开发工作 促销活动。与圣安东尼奥社区卫生工作者协会合作，我们将研究 领导干部培训对提高执行有效核心自我效能感的有效性 西班牙裔肥胖干预的生活方式干预学习组成部分。参赛者将随机 分配给干预条件或控制条件的。次要措施将评估 人口统计、知识、态度、自我报告的技能掌握情况、满意度和利用率。

ABSTRACT Hispanics are 23% more likely to be obese than their White counterparts4, and obesity rates are higher in Hispanic women than Hispanic men(45% vs. 39.7, respectively). It is estimated that 77% (or 15.5 million) Hispanic women are overweight or obese. Obesity is driven by a variety of social, physical, and economic factors, but is mainly due to poor diet and physical inactivity. Given this, most successful interventions that reduce adiposity indices (e.g. BMI, weight, waist circumference) incorporate both diet and exercise. Successful obesity interventions for Hispanics utilize cultural tailoring and have relied on promotores de salud (also known as community health workers) as key facilitators in delivering these interventions. Promotores are effective in delivering obesity interventions and promoting behavior change through enhanced motivation, social support, social interaction and connectedness, and self-efficacy. However, adequate in-person promotora training is necessary for effective implementation of these interventions. An in-person train-the-trainer (TTT) model is a laudable means of investing in promotores and communities, yet, there remains barriers to access including family commitments and associated costs. Our goal is to develop an effective, accessible, and scalable eHealth obesity intervention TTT for promotores. Comadres Saludables will combine both theory and evidence-based practices to provide promotores with the self-efficacy, knowledge, and skills required to effectively implement an obesity intervention for Hispanic women. Promotores will build their skillset through interactive quizzes, exercises, and video role-playing scenarios. Additionally, Comadres Saludables will be the first web-based TTT to provide promotores with interactive mHealth tools to enhance implementation with Hispanic women. Specifically, promotores will have the option of texting or emailing program materials directly to the participant and will have access to fidelity monitoring tools to ensure optimal implementation. In Phase I, a prototype of Comadres Saludables was developed, which was informed by formative research conducted with 35 Latina promotores (bilingual) 18-64 years of age. The results of Phase I strongly support the feasibility and potential effectiveness of the intervention, far exceeding the benchmarks established in the Phase I proposal. During Phase II we will complete development of the web-based Comadres Saludables training for promotores. In partnership with San Antonio Community Health Workers Association, we will examine the effectiveness of the Comadres Saludables training to increase self-efficacy in implementing effective core lifestyle intervention learning components for obesity interventions in Hispanics. Participants will be randomly assigned to either the intervention condition or to a control condition. Secondary measures will assess demographics, knowledge, attitudes, self-reported skill mastery, satisfaction, and utilization.