COACH: Competency Based Approaches for Community Health

COACH：基于能力的社区健康方法

基本信息

批准号：
10439470
负责人：
William Heerman
金额：
$ 71.3万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-15 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10439470
关键词：
5 year old Accelerometer Address Affect Age Area Attention Behavior Behavior Therapy Behavioral Body Weight decreased Body mass index Child Child Health Child Rearing Chronic Disease Communities Community Health Competence Control Groups Cultural Sensitivity Development Diet Educational Curriculum Effectiveness Effectiveness of Interventions Enrollment Family Foundations Future Generations Goals Growth Health Health behavior Health behavior change Heterogeneity Hour Household Individual Infrastructure Intervention Latino Low income Measures Mediating Minority Minority Groups Modeling Neighborhoods Obesity Outcome Parents Participant Pattern Phase Physical activity Population Randomized Controlled Trials Readiness Reduce health disparities Schools Self Determination Sleep Structure Testing Weight adult obesity base community barrier community building community center disorder risk early childhood early-onset obesity effectiveness testing experience family support flexibility follow-up food insecurity fruits and vegetables group intervention health disparity healthy weight improved intervention effect minority children minority communities novel obesity in children obesity prevention obesity treatment personalized approach personalized intervention preventive intervention primary outcome randomized trial scale up secondary outcome sex social health determinants success telephone coaching theories therapy design treatment effect

项目摘要

PROJECT SUMMARY Despite the recognition of health disparities in obesity, behavioral interventions among low-income and minority populations have consistently met with limited success. This is partially explained by social determinants of health. Constantly changing barriers at the household and community levels impede consistent engagement in healthy behaviors. The current proposal tests a novel, culturally-tailored and multi-level intervention designed to teach families to overcome dynamic barriers as the logical next step to address obesity among low-income Latino families. It is based on the premise that by implementing a personalized multi-level intervention that simultaneously addresses healthy weight for parents and children, we will improve body mass index (BMI) among Latino parent-child pairs. COACH (COmpetency-Based Approaches to Community Health) implements a personally tailored approach, equipping families to engage in health behaviors despite dynamic barriers. COACH is a multi-level intervention targeting 1) the individual child through developmentally appropriate health behavior curriculum, 2) the family by addressing parent weight loss directly and engaging parents as agents of change for their children, and 3) the community by building capacity of Parks and Rec centers to offer parent-child programming. Using novel multi-component assessments throughout the study, the intervention identifies individual, family, and community barriers to healthy behaviors and delivers structured yet personalized intervention content in 7 domains: fruits/vegetables, snacks, sugary drinks, physical activity, sleep, media use, and parenting. Building on a successful pilot, this proposal will implement a randomized controlled trial to test the effectiveness of COACH compared to an attention-matched school-readiness control group. We will enroll 300 parent-child pairs from Latino communities in Nashville, TN. Eligible children will be 3-5 years old and have a BMI >50th percentile. Through our 10-year partnership with the Nashville Parks and Rec department, we conduct COACH in neighborhood community centers, leveraging community infrastructure to facilitate health behavior change. The primary outcome will be child BMI change at 2-year follow-up, using a growth curve analysis. Secondary outcomes will include parent BMI, and parent/child diet and physical activity. The goals of COACH are to 1) implement a novel personalized behavioral intervention, 2) test a two-generation solution to obesity, 3) address health disparities by reducing obesity among Latino families, and 4) develop a scalable and widely accessible approach to behavioral obesity interventions by delivering them in Parks and Rec centers.

项目概要尽管人们认识到肥胖带来的健康差异，但低收入和低收入人群的行为干预措施仍然存在。少数民族人口一直取得有限的成功。这部分是由社会因素解释的健康的决定因素。家庭和社区层面不断变化的障碍阻碍了一致性参与健康的行为。目前的提案测试了一种新颖的、针对文化的、多层次的旨在教导家庭克服动态障碍的干预措施，作为解决问题的下一步逻辑低收入拉丁裔家庭的肥胖问题。其前提是通过实施个性化多层次干预，同时解决父母和孩子的健康体重问题，我们将改善拉丁裔亲子对的体重指数（BMI）。 COACH（基于能力的社区健康方法）实施个性化定制方法，帮助家庭克服动态障碍，采取健康行为。 COACH是多层次的干预针对 1) 通过适合发展的健康行为课程针对个别儿童，2) 家庭直接解决父母减肥问题并让父母成为孩子变革的推动者，以及 3) 通过建设公园和娱乐中心提供亲子节目的能力来惠及社区。使用小说在整个研究过程中进行多部分评估，干预措施确定了个人、家庭和社区健康行为障碍，并提供结构化且个性化的干预内容 7 领域：水果/蔬菜、零食、含糖饮料、体力活动、睡眠、媒体使用和育儿。在成功试点的基础上，该提案将实施随机对照试验来测试 COACH 与注意力匹配的入学准备对照组相比的有效性。我们将报名300名来自田纳西州纳什维尔拉丁裔社区的亲子对。符合条件的儿童年龄为3-5岁，并且有 BMI > 50%。通过与纳什维尔公园和娱乐部门长达 10 年的合作关系，我们在邻里社区中心开展 COACH，利用社区基础设施促进健康行为改变。主要结果是使用生长曲线在 2 年随访时儿童体重指数的变化分析。次要结果包括父母体重指数、父母/孩子饮食和身体活动。的目标 COACH 将 1) 实施新颖的个性化行为干预，2) 测试两代解决方案肥胖，3) 通过减少拉丁裔家庭的肥胖来解决健康差异，以及 4) 制定可扩展的、通过在公园和娱乐中心提供广泛可行的行为肥胖干预措施。