Family Inclusive Childhood Obesity Treatment designed for Low Income and Hispanic Families

项目概要：该提案针对一个重要的公共卫生问题-儿童肥胖症， 来自低收入家庭的西班牙裔儿童面临的相关健康差异-干预措施是 缺乏这项随机对照试验（RCT）将测试家庭包容性体重的有效性 为低收入西班牙裔人口制定的管理计划。预防和治疗的干预措施 儿童肥胖症在历史上排除了讲西班牙语的家庭。 要测试的干预措施是通过深入的合作研究设计的， 儿童肥胖症临床医生/研究人员，安全网诊所，社区组织，以及低收入和 他们服务的大多是西班牙裔家庭健康生活方案/ La维达健康（HeLP）已被 旨在实现低收入和西班牙裔家庭的覆盖率，保留率和有效性，包括 讲西班牙语的人。HeLP结合了基于证据的核心组成部分，基于家庭的行为， 按照美国预防服务工作组推荐的有效剂量进行治疗。关键小说 HeLP的设计组件包括：1）包括整个家族。以往的干预措施侧重于 父母-孩子二人组。在HeLP中，肥胖儿童和所有2-16岁的兄弟姐妹以及成年照顾者接受 有针对性的课程组成部分。因肥胖而转诊的儿童的健康体重较轻的兄弟姐妹的目标是 预防肥胖，2）在膳食计划，购物和烹饪方面的实践家庭培训侧重于减少 3）通过与初级食品供应商的伙伴关系， 护理诊所和娱乐中心，以及4）由受过训练的，低成本的，文化和语言上和谐的 健康教育家。 本研究的目的是使用随机对照设计明确评估 治疗和预防超重和肥胖的HeLP干预与初级保健咨询 方案积极控制条件-初级保健中的肥胖推荐治疗（RTOP）。的目的 本研究的目的是：1）比较HeLP与RTOP在三个低体重年龄组中降低BMI的有效性， 收入西班牙裔肥胖儿童：2-6岁、7-12岁和13-16岁（次要指标包括： 心脏代谢实验室测试，健身，生活质量，饮食行为和食品安全）; 2）比较 通过比较2- 11岁非肥胖儿童的BMI轨迹，探讨HeLP预防肥胖的有效性 BMI高于中位数，其兄弟姐妹入组HeLP与RTOP; 3）研究HeLP的实施 RE-AIM框架内的RTOP，包括：覆盖范围、采用、实施（保真度、复制 成本和每单位BMI变化的成本）和维护。这项建议旨在填补以下方面的一个重大空白： 了解如何在低收入和西班牙裔家庭中有效治疗儿童肥胖症。

Project Summary: This proposal addresses a significant public health problem – childhood obesity and related health disparities faced by Hispanic children from low-income families – for which interventions are lacking. This Randomized Controlled Trial (RCT) will test the effectiveness of a family-inclusive weight management program developed for low-income Hispanic populations. Interventions to prevent and treat childhood obesity have historically excluded Spanish speaking families. The intervention to be tested has been designed through in-depth collaborative research involving childhood-obesity clinician/researchers, safety-net clinics, community organizations, and the low-income and mostly Hispanic families they serve. The Healthy Living Program / La Vida Saludable (HeLP) has been designed to achieve reach, retention, and effectiveness for low-income and Hispanic families, including Spanish Speakers. HeLP incorporates the core components of evidence-based family-based-behavioral- therapy at a dose the US Preventive Services Task Force has recommended to be effective. The key novel design components of HeLP include: 1) Inclusion of the entire family. Previous interventions have focused on parent-child dyads. In HeLP, children with obesity and all siblings 2-16 years and adult caregivers receive targeted curricular components. Younger healthy weight siblings of children referred for obesity are targeted for obesity prevention, 2) Hands-on family training in meal-planning, shopping, and cooking is focused on reducing food insecurity while adapting traditional cuisine, 3) Delivery close to home through a partnership of primary care clinics and recreation centers, and 4) Delivery by trained, low-cost, culturally and linguistically concordant health educators. The goal of this research is to definitively assess using a randomized controlled design the effectiveness of the HeLP intervention for treatment and prevention of overweight and obesity vs a primary care counseling protocol active control condition—Recommended Treatment of Obesity in Primary Care (RTOP). The aims of this study are to: 1) compare the effectiveness of HeLP vs. RTOP at BMI reduction in three age groups of low- income Hispanic children with obesity: 2-6, 7-12, and 13-16 years (secondary measures include: cardiometabolic lab tests, fitness, quality of life, eating behaviors, and food security); 2) To compare the effectiveness of HeLP at obesity prevention by comparing the BMI trajectory of non-obese 2-11yr old children with BMI above median whose siblings are enrolled in HeLP vs. RTOP; 3) To study implementation of HeLP and RTOP within the RE-AIM framework, including: Reach, Adoption, Implementation (fidelity, replication costs, and cost per unit BMI change), and Maintenance. This proposal seeks to fill a major gap in understanding of how childhood obesity might be effectively treated in low-income and Hispanic families.