Improving the Reach of a CBPR Developed Obesity Program Among Disavantaged Women

描述(由申请者提供)：Take Head Lite是一个最先进的生活方式体重管理计划，遵循基于社区的参与性研究(CBPR)的原则设计。掌管Lite在六个社区健康中心运营，为超过4万名社会经济弱势的非西班牙裔黑人、西班牙裔和非西班牙裔白人成年人提供服务。在全国范围内，联邦批准的社区卫生中心每年为1400多万弱势患者提供服务。基本公共卫生原则强调，干预措施的“影响”是其“效力”和“影响范围”的产物。REACH有时被称为干预的渗透。它被定义为接受干预的目标人群的比例和特征。通过提高我们对影响少数群体和社会经济弱势群体的健康水平的因素的了解，拟议的研究将提供减少健康差距的途径。这项拟议的研究通过利用正在进行的基于社区卫生中心的Take Charge Lite体重管理计划的真实世界实验室来解决REACH问题。该项目的具体目标是确定影响1)体重管理计划处方的接收和2)体重管理计划的登记的患者、初级保健提供者和计划因素。我们的目标是中年(30-)墨西哥裔美国人、非西班牙裔黑人和非西班牙裔白人女性，他们是I级、II级或III级肥胖。我们的中年重点关注肥胖率最高的年份，这可能是慢性病和残疾预防的最好时机。我们的调查将以社会营销的原则为指导。目标1将通过对录音的患者提供者与参与提供者和患者的访问后访谈的接触进行分析来实现。目标2将通过对接受体重管理计划处方的患者进行家庭访谈来实现，这些患者要么登记、探索但没有登记，要么没有探索而没有登记。我们的数据收集将基于墨西哥裔美国人、非西班牙裔黑人和非西班牙裔白人患者的配额样本。最终，应用社会营销的原则，研究结果将被用来识别和测试可以改善弱势患者预防计划覆盖范围的变化。与公共健康相关：在美国，肥胖是一个严重的健康问题，少数民族女性的肥胖率最高。该项目将帮助确定以诊所为基础的体重管理计划可以更好地帮助少数族裔妇女管理体重的方法。

DESCRIPTION (provided by applicant): Take Charge Lite is a state-of-the-art lifestyle weight management program that was designed following the principles of community-based participatory research (CBPR). Take Charge Lite is operational in six community health centers serving over 40,000 socio-economically disadvantaged non-Hispanic black, Hispanic, and non-Hispanic white adults. Nationally, federally approved community health centers serve over 14 million disadvantaged patients annually. Basic public health principles emphasize that the "impact" of an intervention is a product of both its "efficacy" and its "reach". Reach is sometimes referred to as the penetration of the intervention. It is defined as the proportion and characteristics of the target population that is exposed to the intervention. By improving our understanding of the factors that influence reach among minority and socio-economically disadvantaged individuals, the proposed study would offer avenues to reducing health disparities. The proposed study addresses questions of reach by leveraging the real-world laboratory of the ongoing community health center- based Take Charge Lite weight management program. The specific aims of this project are to identify patient, primary care provider, and program factors that affect 1) receipt of a weight management program prescription and 2) enrollment in a weight management program. We target middle-aged (30-64) Mexican-American, non-Hispanic black, and non-Hispanic white women who are Class I, II, or III obese. Our middle-age focus captures the years with the highest obesity prevalence and may be the most opportune time for chronic illness and disability prevention. Our investigation will be guided by the principles of social marketing. Aim 1 will be accomplished through analysis of audio-recorded patient-provider encounters with post-visit interviews of participating providers and patients. Aim 2 will be accomplished by in-home patient interviews with patients who received a weight management program prescription and either enrolled, explored but did not enroll, or did not explore and did not enroll. Our data collection will be based on quota samples of Mexican-American, non-Hispanic black, and non-Hispanic white patients. Ultimately, applying the principles of social marketing, findings will be used to identify and test changes that could improve the reach of prevention programs for disadvantaged patients. PUBLIC HEALTH RELEVANCE: Obesity is a serious health issue in the U.S. and rates of obesity are highest among ethnic minority women. This project will help identify ways that clinic-based weight management programs can better assist minority women to manage their weight.