Healthy Mothers-Healthy Children: An Intervention with Hispanic Mothers and their Young Children

项目总结 超重或肥胖的西班牙裔妇女和儿童有患糖尿病前期的风险， 2型糖尿病，以及晚年的心血管疾病。到目前为止，还没有跨学科的 针对西班牙裔妇女及其4岁子女的干预措施，以改善营养和 控制母亲肥胖和体重并预防过度肥胖的体力活动行为 他们孩子的体重增加轨迹。采用随机两组、重复测量实验 设计，拟议研究的目标是调查12周营养和锻炼的效果。 西班牙裔美国人的教育、体育活动、应对技能培训和基于家庭的体育活动干预 妇女和她们4岁的孩子和6个月的持续每月接触，以帮助超重和 肥胖的西班牙裔母亲改善了肥胖、体重、健康行为(营养和体育活动)，以及 自我效能感及其4岁儿童改善肥胖和体重增加的轨迹和健康 行为(营养和体力活动)。我们将与两个联邦合格的卫生部门合作 在北卡罗来纳州的达勒姆和查塔姆招收西班牙裔妇女和她们4岁的孩子，我们 将与社区中心合作提供干预。共有294名西班牙裔女性BMI 2. 体重指数为25公斤/米的西班牙裔4岁儿童和294名体重指数为25的西班牙裔儿童将在4年内入学。 并随机分为实验组或等注意力对照组。将在时间1(0)收集数据 月[基线])至时间2(9个月[干预完成])和时间1至时间3(15个月 [6个月后，没有研究人员的联系])。收集的数据将包括肥胖症(主要 结果：母亲和儿童的腰围、三头肌和肩胛下皮褶)和体重 (主要结果：母亲的体重指数[BMI]和儿童的BMI百分位数)。次要的 结果将包括母亲的健康行为和自我效能(成人健康行为 问卷、生活方式健康促进概况II、3天24小时食品召回、7天加速计、 进食自我效能感量表和运动自我效能感量表)和儿童(7日加速计和 3天24小时食品召回)。我们还将评估实施公共卫生计划的成本 各部门。数据分析将使用一般的线性混合模型来检验假设。递减 西班牙裔女性的超重和肥胖，以及年轻人肥胖和体重增加的减缓轨迹 迫切需要拉美裔儿童来降低发病率、死亡率和未来的医疗费用。这个 从这项研究中获得的知识可能会为将这一干预扩展到其他 西班牙裔母亲和其他社区的儿童帮助母亲控制体重和 防止他们的孩子过度肥胖和体重增加。这种方法是可翻译的、真实的、 并可以在美国其他地区复制。

PROJECT SUMMARY Hispanic women and children who become overweight or obese are at risk for developing prediabetes, type 2 diabetes, and cardiovascular disease later in life. To date, there have been no interdisciplinary interventions that have targeted Hispanic women and their 4-year old children to improve nutrition and physical activity behaviors to manage adiposity and weight in mothers and prevent excessive adiposity and weight gain trajectory in their children. Using a randomized two-group, repeated measures experimental design, the goal of the proposed study is to investigate the efficacy of a 12-week nutrition and exercise education, physical activity, coping skills training, and home-based physical activity intervention in Hispanic women and their 4-year old children and 6 months of continued monthly contact to help overweight and obese Hispanic mothers improve adiposity, weight, health behaviors (nutrition and physical activity), and self-efficacy and their 4-year old children improve their adiposity and weight gain trajectory and health behaviors (nutrition and physical activity). W e will partner with two federally qualified health departments in Durham and Chatham, North Carolina to enroll Hispanic women and their 4-year old children and we will partner with community centers to deliver the intervention. A total of 294 Hispanic women with a BMI 2 >25 kg/m and 294 Hispanic 4-year old children with a BMI percentile > 25 will be enrolled over 4 years and randomized to the experimental or equal attention control group. Data will be collected at Time 1 (0 months [baseline]) to Time 2 (9 months [completion of the intervention]) and Time 1 to Time 3 (15 months [after 6 months with no contact from the study staff]). Data collected will include adiposity (primary outcomes: waist circumference, triceps and subscapular skinfolds) in mothers and children and weight (primary outcomes: body mass index [BMI] in mothers and BMI percentile in the children). Secondary outcomes will include health behaviors and self-efficacy in the mothers (Adult Health Behavior Questionnaire, Lifestyle Health Promoting Profile II, 3 day 24-Hour Food Recall, and 7 day Accelerometer, Eating Self-Efficacy Scale and Exercise Self-Efficacy Scale) and in the children (7 day Accelerometer and 3 day 24-Hour Food Recall). We will also evaluate the cost of delivering the program for public health departments. Data analysis will use general linear mixed models to test the hypotheses. Decreasing overweight and obesity in Hispanic women and slowing adiposity and weight gain trajectory in young Hispanic children is urgently needed to decrease morbidity, mortality, and future health care costs. The knowledge to be gained from this study may provide a foundation for extending this intervention to other Hispanic mothers and children in other communities to assist mothers in managing their weight and preventing excessive adiposity and weight gain in their children. This approach is translatable, real-world, and could be replicated in other areas of the United States.