DISSEMINATING & IMPLEMENTING A LIFESTYLE BASED HEALTHY WEIGHT PROGRAM IN A NATIONAL ORGANIZATION

项目摘要 18-35岁的年轻成年女性体重过度增加是一个令人担忧和被忽视的趋势， 必须解决这些问题，以扭转肥胖症和慢性病的流行。在这一脆弱时期，妇女 与男性和其他生命周期相比，女性往往会增加大量的体重。我们的团队 开发了一种生活方式改变干预措施（HEALTH），可以防止体重增加，促进持续体重 损失，并减少腰围与家长作为教师（PAT），一个全国性的家访， 以社区为基础的组织，在这一人群中具有重要影响力。PAT提供亲子教育， 通过每年多达25次的免费家访，为近17万个家庭提供免费服务，直至儿童入学 幼儿园本研究将通过扩展我们以前的工作来扩展这些发现 一项随机对照试验，旨在评估健康在三个级别的传播和实施情况 （母亲，家长教育家，PAT网站），以实现广泛的影响。我们将进行务实的集群 评估健康和健康培训课程的随机对照试验（实施策略） 美国超重和肥胖母亲的体重（N= 252健康; N= 252常规护理）。 来自28个现有PAT站点（14个健康，14个常规护理）的家长教育工作者将接受健康培训 课程通过PAT国家中心，使用PAT现有的培训基础设施，作为一个持续的 教育机会。在RE-AIM指导下进行的广泛评价将决定实施结果 （可接受性、采用性、适当性、可行性、忠实性和适应性）。的 实施研究的概念框架将描述影响健康的决定因素 在三个层面进行传播和实施：母亲、家长教育者、PAT网站，以提高外部效度 （覆盖范围和维护）和人口水平的影响。这项创新研究的结果将具有重大意义。 有可能帮助扭转年轻成年妇女体重过度增加的趋势，这是一个关键的优先目标 在与肥胖症和慢性病的流行作斗争中， 全国性的

PROJECT SUMMARY Excessive weight gain among young adult women age 18-35 years is an alarming and overlooked trend that must be addressed to reverse the epidemics of obesity and chronic disease. During this vulnerable period women tend to gain disproportionally large amounts of weight compared to men and other life periods. Our team developed a lifestyle modification intervention (HEALTH) that prevented weight gain, promoted sustained weight loss, and reduced waist circumference in partnership with Parents as Teachers (PAT), a national home visiting, community based organization with significant reach in this population. PAT provides parent-child education and services free-of-charge to nearly 170,000 families through up to 25 free home visits per year until the child enters kindergarten. This study will extend these findings by extends our previous work with a pragmatic cluster randomized controlled trial to evaluate dissemination and implementation of HEALTH across three levels (mother, parent educator, PAT site) to achieve widespread impact. We will conduct a pragmatic cluster randomized controlled trial to evaluate HEALTH and the HEALTH training curriculum (implementation strategy) on weight among mothers with overweight and obesity across the US (N= 252 HEALTH; N= 252 usual care). Parent educators from 28 existing PAT sites (14 HEALTH, 14 usual care) will receive the HEALTH training curriculum through the PAT National Center, using PAT’s existing training infrastructure, as a continuing education opportunity. An extensive evaluation, guided by RE-AIM will determine implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, and adaptation) at the parent educator level. The Conceptual Framework for Implementation research will characterize determinants that influence HEALTH dissemination and implementation at three levels: mother, parent educator, PAT site to enhance external validity (reach and maintenance) and population level impact. The findings from this innovative study will have significant potential to help reverse the trend of excessive weight gain among young adult women, a critical priority target in battling the epidemics of obesity and chronic disease, by reaching women with an evidence-based intervention nation-wide.