A Childhood Obesity Prevention Program Designed by Families for Families

描述（由申请人提供）：这项儿童早期肥胖预防研究的重点是一个小城市中肥胖率高得不成比例的低收入和少数民族家庭。具有儿童肥胖、家庭发展、健康差异和社区参与性研究（CBPR）专业知识的跨学科研究团队将使家庭照顾者和社区组织（cbo）能够解决纽约州北部特洛伊市的肥胖问题。具体目标包括建立一个由家庭照顾者和社区卫生组织组成的社区咨询委员会（CAB）（目标1），开展混合方法社区评估，以确定家庭及其社区的优势和需求领域（目标2），利用这些信息制定和实施以家庭为中心的肥胖干预措施，并将其纳入护理系统（目标3），评估由此产生的干预措施（目标4）以及CBPR过程（目标5）。这项研究有许多创新，包括：(a)以家庭为中心的干预框架，承认家庭生活的生态现实；(b)跨专业干预框架，将家庭肥胖预防纳入现有社区方案和组织；(c)一个评估计划，该计划采用严格的主体内重复测量设计，采用非等效对照组（暴露于传统的肥胖预防）来测试以家庭为中心的干预和CBPR过程的有效性。在本研究中，通过使用CBPR方法来设计干预措施，以及传统的肥胖和肥胖相关变量的黄金标准科学措施，以及现有的赋权措施，来平衡实证严谨性和实际相关性，以评估其有效性。总体目标是建立社区预防儿童肥胖的能力，并确定使用CBPR开发的以家庭为中心的肥胖预防计划的有效性。此外，该项目将获得工具和最佳做法，以指导受健康差距挑战的低收入社区未来的CBPR儿童肥胖倡议。

DESCRIPTION (provided by applicant): This early childhood obesity prevention study focuses on low-income and often minority families in a small city who have disproportionately high obesity rates. The interdisciplinary research team with expertise in childhood obesity, family development, health disparities, and community-based participatory research (CBPR) will empower family caregivers and community-based organizations (CBOs) to address obesity in the city of Troy, NY in Upstate, NY. Specific aims include developing a Community Advisory Board (CAB) comprised of family caregivers and CBOs (aim 1), conducting a mixed-methods community assessment to identify strengths and areas of need in families and their communities (aim 2), using this information to develop and implement a family-centered obesity intervention and integrating it into systems of care (aim 3), and evaluating the resulting intervention (aim 4) as well as the CBPR process (aim 5). This study's innovations are numerous and include: (a) A family-centered intervention framework that recognizes the ecological realities of families' lives; (b) An inter-professional intervention framework in which obesity prevention with families is integrated within existing community-based programs and organizations; and (c) an evaluation plan that uses a rigorous within-subject, repeated-measures design with a non-equivalent control group (exposed to a conventional obesity prevention) to test the effectiveness of the family-centered intervention and the CBPR process. Empirical rigor and practical relevance are balanced in this study by using a CBPR approach to design the intervention and conventional gold-standard scientific measures of obesity and obesity-related variables, as well as existing measures of empowerment, to evaluate its effectiveness. The overarching goal is to build community capacity for childhood obesity prevention and determine the effectiveness of a family-centered obesity prevention program developed using CBPR. In addition, this project will derive tools and best practices to guide future CBPR childhood obesity initiatives in low-income communities challenged by health disparities. RELEVANCE (See instructions): Obesity among children has reached epidemic levels and is a top public health priority. Childhood obesity is intertwined with unhealthy diet and physical inactivity and intervening at a young age is key for establishing healthy habits. Childhood obesity is linked with diseases previously limited to adulthood (e.g., type II diabetes) and persistent obesity is a major cause of death and disability among adults.