Community-based Obesity Prevention among Blacks

描述(由申请者提供)：预防黑人女性肥胖是一项主要的公共卫生优先事项。目前，近54%的成年黑人女性人口(20岁及以上)肥胖。这一群体还遭受与肥胖相关的健康后果(例如许多癌症、心血管疾病、糖尿病)的不成比例的痛苦。到目前为止，大多数公共卫生干预的注意力都集中在减肥上；很少有研究试图在黑人女性中开发肥胖预防干预措施。为了准备最终的R01提案，建议进行一项分两个阶段的研究，以帮助Bennett博士制定肥胖预防干预研究计划。在第一阶段，我们将举办一系列焦点小组，以促进干预信息的发展。然后，我们将测试信息框架和叙述的使用是否提高了参与者对干预信息的接受度。利用在焦点小组中收集的数据，我们将开发四套干预材料，采用2(健康框架与审美框架)x 2(叙事与非叙事)设计。在实验室测试中，40名成年黑人妇女将随机审查4套干预材料中的1套；将采用调查措施和定性评估方法。在第二阶段，我们将重点关注干预措施中促进体力活动的部分。我们将实施一项为期24周的实验试验，以评估计步器步数建议是否与长期坚持以计步器为基础的体力活动方案存在差异。参与者(n=226)将被随机分配到接受10,000步/d建议或自适应建议(其中参与者的步数建议以2500步/d递增，直到她达到10,000步/d阈值)。参与者将获得计步器，并将被要求使用交互式语音响应自我监控系统每周报告他们的步数。在这些电话会议期间，将提供简短的支持性反馈。评估(包括自我报告调查和人体测量)将在基线和基线后24周进行。我们的主要结果是坚持以计步器为基础的体力活动养生法。次要结果将包括体力活动和BMI的变化。

DESCRIPTION (provided by applicant): Obesity prevention among Black women is a major public health priority. At present, nearly 54% of the adult Black female population (aged 20 and older) are obese. The group also suffers disproportionately from obesity-related health consequences (e.g. many cancers, cardiovascular conditions, diabetes). To date, most public health intervention attention has been focused on weight reduction; little research has sought to develop obesity prevention interventions among Black women. In preparation for an eventual R01 proposal submission, a two-phase study is proposed to assist Dr. Bennett develop an obesity prevention intervention research program. In Phase 1, we will conduct a series of focus groups to facilitate intervention message development. We will then test whether message framing and the use of narratives enhances participant receptivity to the intervention messages. Using data gleaned in the focus groups, we will develop four sets of intervention materials, using a 2 (health frame vs aesthetic frame) x 2 (narrative vs no narrative) design. In laboratory testing, 40 adult Black women will be randomized to review 1 of the 4 sets of intervention materials; survey measures and qualitative evaluation methods will be employed. In Phase 2, we will focus attention on the physical activity promotion component of the intervention. We will implement a 24-week experimental trial to evaluate whether pedometer step count recommendations are differentially associated with long-term adherence to a pedometer-based physical activity regimen. Participants (n=226) will be randomly assigned to receive either a 10,000 steps/d recommendation or an adaptive recommendation (in which the participant's step count recommendation is increased in 2500 steps/d increments until she reaches the 10,000 steps/d threshold). Participants will be provided pedometers and will be asked to report their step counts weekly, using an interactive voice response self-monitoring system. Brief supportive feedback will be provided during these calls. Assessments (including self-report survey and anthropometric measurements) will be administered at baseline and 24-weeks post baseline. Our primary outcome is adherence to a pedometer-based physical activity regimen. Secondary outcomes will include change in physical activity and BMI.