Together We STRIDE (Strategizing Together Relevant Interventions for Diet and Exercise)

 描述(申请人提供)：华盛顿州下亚基马谷的儿童肥胖率令人震惊：34%的年轻人患有肥胖症，而该州的平均水平为23%。这些儿童中有很大一部分是西班牙裔；拉美裔占亚基马县人口的47%，占下亚基马山谷人口的67%。2013年1月，我们从国家少数民族健康和健康差距研究所(R24 MD008068；PI：L.Ko)获得规划赠款，以建设和加强下亚基马山谷儿童肥胖倡议的社区能力和基础设施。该项目始于社区，因为他们对硅谷拉美裔儿童肥胖率高表示担忧。在接下来的两年半时间里，我们利用以社区为基础的参与性研究(CBPR)1)成立了社区咨询委员会(CAB)；2)建立了指导委员会；3)进行了全面的多层次需求评估；4)开发和建立了一项试点研究；以及5)评估了我们的活动。为响应RFA MD-15-010，我们现在准备将我们初步研究中成功的干预活动实施为大规模准实验性干预试验。多层次的干预措施将包括个人、家庭、学校和社区层面的活动。活动包括向学生分发关于健康饮食和体育活动的漫画书，向家庭传授健康饮食和烹饪技能以及体育活动的跨代家庭干预，各种学校活动，向儿童传授食品行业知识，并鼓励他们在课堂上进行小范围的体育活动，以及社区活动，以培养社区是孩子们健康的地方的理念。这个项目的总体目标是继续使用CBPR方法；在这样做的过程中，我们将测试全面的、多层次的干预措施在降低儿童BMI z得分方面的有效性，这是我们的主要终点。BMI z评分将通过测量儿童在基线、12个月和24个月时的身高和体重来评估。我们将招收900名3-5年级(8-12岁)的西班牙裔儿童，他们在干预社区的四所小学和对照社区的四所小学就读。两个社区的学校将根据学生标准化考试成绩、有资格获得免费或降价午餐的学生比例以及学校规模进行匹配。次要结果包括180名西班牙裔儿童的饮食模式和体力活动加速计数据。社区对这个项目的参与是非同寻常的，我们的支持信表明了社区对这个项目的热情。

 DESCRIPTION (provided by applicant): Childhood obesity rates in the Lower Yakima Valley of Washington State are alarming: 34% of youth are obese compared to the state average of 23%. A large proportion of those children are Hispanic; Hispanics represent 47% of the population in Yakima County and 67% of the population in the Lower Yakima Valley. In January 2013, we received a planning grant from the National Institute of Minority Health and Health Disparities (R24 MD008068; PI: L. Ko) to build and enhance community capacity and infrastructure on childhood obesity initiatives in the Lower Yakima Valley. This project began with the community as they expressed concern at the high incidence of obesity among Hispanic children in the Valley. In the ensuing two and a half years, we used community-based participatory research (CBPR) to 1) form a community advisory board (CAB); 2) build a Steering Committee; 3) conduct a comprehensive multi-level needs assessment; 4) develop and institute a pilot study; and 5) evaluate our activities. In response to RFA MD-15-010, we are now prepared to implement the intervention activities that were successful in our pilot study into a large-scale quasi-experimental intervention trial. The multi-level interventions will include activities at the individual level, family level, school level, and community level. Activities incude distributing comic books to students about healthy eating and physical activity, a multi-generational level family intervention that teaches families about healthy eating and cooking skills as well as physical activity, a variety of school events to teach children about the food industry as well as encourage them to be physically activity at small intervals in the classroom, and community activities to foster the idea of the community being a healthy place for kids. The overall goal of this project is to continue to use a CBPR approach; in so doing, we will test the effectiveness of the comprehensive, multi-level intervention on reducing children's BMI z-scores, our primary endpoint. BMI z scores will be assessed by taking height and weight measures of the children at baseline, 12 months, and 24 months. We will recruit and enroll a total of 900 Hispanic children in grades 3rd to 5th (ages 8-12 years) who attend the four elementary schools in the intervention community and the four elementary schools in the comparison community. Schools in both communities will be matched based on student standardized test scores, percent of students eligible to receive free or reduced-price lunch, and school size. Secondary outcomes include dietary patterns and accelerometer data of physical activity in a subgroup of 180 Hispanic children. Community participation in this project has been extraordinary and our letters of support indicate the communities' enthusiasm for this project.