EFFICACY TRIAL OF A PROGRAM FOR WEIGHT LOSS FOR HISPANIC FATHERS AND INCREASED PHYSICAL ACTIVITY FOR THEIR CHILDREN: HEALTHY DADS, HEALTHY KIDS

西班牙裔父亲减肥和孩子增加体力活动计划的功效试验：健康的父亲，健康的孩子

• 批准号: 10304420
• 负责人: Teresia Margareta O'Connor
• 金额: $ 73.66万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10304420
• 关键词: 11 year old; Acculturation; Age; Australia; Award; Behavior; Behavior Therapy; Behavioral; Biological; Blood Pressure; Body Weight decreased; Body mass index; Cardiovascular Diseases; Cause of Death; Child; Child Health; Child Rearing; Childhood; Clinic; Clinical; Cognitive; Communities; Control Groups; Diabetes Mellitus; Diagnosis; Dietary intake; Dimensions; Eating; Eating Behavior; Enrollment; Evaluation; Evidence based program; Face; Family; Fathers; Food; Future; Goals; Guidelines; Health Insurance; Healthy Eating; Hispanics; Intervention; Language; Life Style; Literature; Mediating; Medicaid; Medical; Metaphor; Methods; Modeling; Modification; Mothers; National Heart, Lung, and Blood Institute; Not Hispanic or Latino; Obesity; Outcome; Overweight; Participant; Persons; Physical activity; Population; Prevalence; Prevention program; Process; Psychological reinforcement; Randomized; Randomized Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Risk; Risk Factors; Sampling; Strenuous Exercise; Systems Theory; Testing; Texas; Time; United States; Waiting Lists; Weight; Weight maintenance regimen; Woman; Youth; base; behavior change; cardiovascular disorder risk; clinically relevant; cohesion; community setting; dissemination trial; efficacy study; efficacy trial; evidence base; experience; feasibility testing; feasibility trial; follow-up; health disparity; health plan; healthy lifestyle; healthy weight; improved; innovation; male; member; men; middle childhood; novel; novel strategies; obesity in children; obesity prevention; optimal treatments; primary outcome; programs; psychosocial; recruit; satisfaction; secondary outcome; sedentary; social; social cognitive theory; standard of care; treatment effect; weight loss program

Project Summary Hispanics in the United States face health disparities for obesity and related medical conditions, such as cardiovascular disease and diabetes. Targeting families to promote healthy lifestyle behaviors has been identified as an effective strategy to prevent obesity. With the importance of familism (family cohesion) among the Hispanic population, a family based intervention is especially desirable as an engaging strategy to promote behaviors that support a healthy weight status and decrease obesity related health disparities for Hispanics. Emerging evidence supports the need to include and target fathers in family based lifestyle behavior interventions. However, to date mothers have almost exclusively been reached by such efforts in the US. Healthy Dads Healthy Kids (HDHK) is an evidence based program developed in Australia, shown to have significant weight and behavior treatment effects for fathers and their children, compared to controls. The HDHK program is based on Social Cognitive Theory and Family Systems Theory and aims to promote increased physical activity and improved dietary intake for fathers and their children. An important innovation in the program is that fathers and children attend together and are both targeted as agents of behavior change for each other (reciprocal reinforcement) and to participate in fun, family activities together. HDHK was culturally adapted for Hispanic families following the Ecological Validity Model by this research team, with input from a community Hispanic family panel, expert committee and the developer of the HDHK program. The resulting Papás Saludables, Niños Saludables (PSNS) program was tested for feasibility in a waitlist controlled RCT among 36 Hispanic families, whose child was a Texas Children’s Health Plan member. The findings support testing the culturally adapted program in a family randomized group trial with a standard of care comparison/ control for efficacy. The proposed efficacy trial is powered to detect a clinically meaningful change in father’s weight and children’s physical activity. The study will also assess other behavioral (dietary intake, sedentary time, screen media use, and parenting practices), psychosocial (familism, acculturation, and co-parenting alliance) and biological (non-HDL, HgbA1C, BP) outcomes. Partnership with the YMCA of Greater Houston offers a venue for where to deliver the program, and partnership with Texas Children’s Health Plan provides access to over 80,000 Hispanic children between the ages from 5-11 from which to recruit. The RE-AIM framework will inform a detailed process evaluation to assess barriers and facilitators to implementing PSNS with our community partners in the future. This novel lifestyle program can provide a paradigm shift for how obesity prevention for Hispanic children should be conceptualized, by directly engaging Hispanic fathers, which has not been done to date.

项目概要 美国的西班牙裔人因肥胖和相关医疗状况而面临健康差异，例如 以家庭为目标促进健康的生活方式行为已成为心血管疾病和糖尿病的目标。 由于家庭主义（家庭凝聚力）的重要性，被认为是预防肥胖的有效策略。 对于西班牙裔人口来说，以家庭为基础的干预措施尤其可取，作为促进 支持健康体重状态并减少西班牙裔肥胖相关健康差异的行为。 新出现的证据支持需要将父亲纳入以家庭为基础的生活方式行为中并以父亲为目标 然而，迄今为止，此类努力几乎完全惠及美国的母亲。 健康爸爸健康孩子 (HDHK) 是澳大利亚开发的一项基于证据的计划，事实证明 与对照组相比，父亲及其孩子的体重和行为治疗效果显着。 HDHK课程以社会认知理论和家庭系统理论为基础，旨在促进 增加父亲及其孩子的体力活动和改善饮食摄入量是一项重要的创新。 该计划是父亲和孩子一起参加，并成为行为改变的推动者 彼此（相互强化）并一起参加有趣的家庭活动在文化上是HDHK的。 根据该研究团队的生态有效性模型，根据来自 社区西班牙裔家庭小组、专家委员会和 HDHK 项目的开发商。 Papás Saludables, Niños Saludables (PSNS) 计划在候补名单控制的 RCT 中进行了可行性测试 在 36 个西班牙裔家庭中，他们的孩子是德克萨斯州儿童健康计划的成员，调查结果支持了这一点。 在家庭随机分组试验中通过护理标准比较来测试文化适应计划/ 拟议的疗效试验旨​​在检测父亲的临床意义的变化。 该研究还将评估其他行为（饮食摄入、久坐）。 时间、屏幕媒体使用和养育方式）、社会心理（家庭主义、文化适应和共同养育） 与大休斯顿 YMCA 合作）和生物学（非 HDL、HgbA1C、BP）结果。 提供了实施该计划的场所，并且与德克萨斯儿童健康计划的合作提供了 RE-AIM 招募超过 80,000 名 5 至 11 岁的西班牙裔儿童。 框架将为详细的流程评估提供信息，以评估实施 PSNS 的障碍和促进因素 未来与我们的社区合作伙伴一起，这个新颖的生活方式计划可以提供范式转变。 西班牙裔儿童的肥胖预防应该通过直接让西班牙裔父亲参与来概念化，这 迄今为止尚未完成。