Community Active and Healthy Families: Family-Centered Obesity Treatment for Latino Children

项目总结/摘要 有效的，面向家庭的拉丁裔儿童体重管理干预措施至关重要， 降低儿童肥胖导致的终生心血管疾病（CVD）风险。儿童肥胖是一个 成人心血管疾病的危险因素，在美国的主要死因。四分之一的美国儿童是拉丁裔，拉丁裔 在美国所有种族/民族中，儿童肥胖率最高。美国出生的拉丁裔 移民父母的孩子占美国拉丁裔儿童的一半，超重/肥胖率较高 比其他拉丁裔儿童。美国预防服务工作组建议所有肥胖者 儿童进行密集的体重管理计划，以促进行为改变，减少体重 指数（BMI）。强化课程主要是在临床环境中发现的，数量有限，而且经常 对拉丁裔移民家庭来说不切实际。减少移民家庭中拉丁裔儿童的肥胖差异 需要解决目前缺乏基于证据的肥胖治疗计划， 社会文化需求，并以可行的强度提供。拟议的研究通过以下方式解决了这一差距： 社区积极和健康家庭方案。社区AHF是一种行为理论 为5-12岁超重/肥胖儿童提供基于文化的西班牙语体重管理计划 拉丁裔儿童和他们的家人。社区-AHF改编自一组访问体重管理 在医疗保健环境中提供的计划，证明了降低拉丁美洲儿童BMI的有效性 低收入移民家庭的孩子。以前，利益攸关方参与确定适应措施， 保留关键组件，同时使用干预映射说明输送设置的变化。到 准备实施社区-AHF时，我们将使用相关的流程-实施映射。的一个关键领域 实施规划的重点将是权力和知识的公平分配， 学术团队和社区组织提供干预。第二代Hybrid Type II 将进行实施/有效性试验，以同时评估 社区-AHF降低儿童BMI的实用随机对照试验及其实施 RE-AIM（Reach，Effectiveness，Adoption，Implementation，Maintenance）框架。社区- AHF将在两个拉丁美洲移民社区实施，一个是新兴的，一个是成熟的， 与拉丁美洲移民服务社区组织建立伙伴关系。共同和独特的挑战， 在拉丁美洲移民社区的关键类型的实施将为未来的规模扩大提供信息。时发现的问题 研究将解决有关有效的实施流程和战略的知识差距 实现执行成果目标，支持和维持公平的社区伙伴关系， 我们的研究结果将加强移民家庭中拉丁裔儿童体重管理的证据基础 儿童期超重/肥胖的比例过高会增加他们一生中心血管疾病的风险。

PROJECT SUMMARY/ABSTRACT Effective, family-oriented childhood weight management interventions for Latinos are critical in order to decrease lifetime cardiovascular disease (CVD) risk that stems from childhood obesity. Childhood obesity is a risk factor for adult CVD, the leading cause of death in the US. One in four US children is Latino, and Latino children have among the highest childhood obesity rates of any US racial/ethnic group. US-born Latino children of immigrant parents comprise half of US Latino children and experience higher overweight/obesity rates than other Latino children. The US Preventive Services Task Force recommends referral of all obese children to an intensive weight management program to prompt behavior changes to decrease body mass index (BMI). Intensive programs are mainly found in clinical settings, are limited in number and are frequently impractical for Latino immigrant families. Reducing obesity disparities for Latino children in immigrant families requires addressing the current lack of evidence-based obesity treatment programs that are tailored to their sociocultural needs and delivered at a feasible intensity. The proposed research addresses this gap via the Community-Active and Healthy Families (Community-AHF) program. Community-AHF is a behavioral-theory based, culturally tailored, Spanish-language weight management program for 5-12 year old overweight/obese Latino children and their families. Community-AHF was adapted from a group visit weight management program delivered in healthcare settings that demonstrated effectiveness in reducing child BMI for Latino children in low-income immigrant families. Previously, stakeholders were engaged to identify adaptations to retain key components while accounting for the change in delivery setting using intervention mapping. To prepare to implement Community-AHF we will use a related process-implementation mapping. A key area of focus for implementation mapping will be on the equitable distribution of power and knowledge between the academic team and the community organizations delivering the intervention. Subsequently, a Hybrid Type II Implementation/Effectiveness trial will be conducted to simultaneously evaluate the effectiveness of Community-AHF at reducing child BMI using a pragmatic randomized controlled trial and its implementation using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Community- AHF will be implemented in two Latino immigrant communities, one emerging and one established, in partnership with Latino-immigrant serving community organizations. Common and distinct challenges from implementation in key typologies of Latino immigrant communities will inform future scaling. Findings from this study will address a gap in knowledge about the implementation processes and strategies that are effective in reaching implementation outcome goals and that support and sustain equitable community partnerships and our findings will strengthen the evidence-base for weight management for Latino children in immigrant families whose disproportionately high rates of childhood overweight/obesity increase their lifetime CVD risk.