TRANSLATING A WEIGHT LOSS INTERVENTION THROUGH A NATIONAL HOME VISITING PROGRAM

通过全国上门拜访计划转化减肥干预措施

• 批准号: 8291227
• 负责人: Debra Haire-Joshu
• 金额: $ 63.92万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8291227
• 关键词: Address; Adult; Age; Am 80; Behavior; Behavioral; Body Weight decreased; Child; Child Behavior; Clinical; Control Groups; Data; Decision Making; Development; Diabetes Mellitus; Diastolic blood pressure; Eating; Educational process of instructing; Elements; Energy Intake; Enrollment; Evaluation; Evidence based practice; Family; Funding; Future Generations; Group Homes; Group Meetings; Habits; Health; Health Benefit; Home environment; Home visitation; House Call; Information Services; Institutionalization; Intervention; Knowledge; Life; Life Style; Maintenance; Measures; Methods; Mothers; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Overweight; Parents; Participant; Population; Poverty; Preschool Child; Prevention; Program Evaluation; Provider; Quality of life; Randomized; Research; Risk Factors; Services; Site; Telephone; Testing; Time; Training; Translating; Translational Research; Translations; Walking; Weight; Woman; base; cohort; control trial; cost; design; diabetes control; diabetes prevention program; early onset; evidence base; feeding; health disparity; improved; innovation; intergenerational; lifestyle intervention; obesity risk; prevent; programs; teacher; treatment as usual; uptake; waist circumference; weight loss intervention; young mother

DESCRIPTION (provided by applicant): Background. Obese women are 80 times more likely to develop Type 2 diabetes than those who maintain a lean weight. Intergenerational obesity is common, with maternal obesity a strong risk factor for the development of overweight in young children. The Diabetes Prevention Program (DPP) identified strategies for achieving weight loss through lifestyle change, but translation to real world settings remains challenging. Aims. This study will test Healthy Eating & Active Living Taught at Home (HEALTH), which adapts and integrates the DPP lifestyle intervention within Parents As Teachers (PAT), a national home visiting program. HEALTH will be delivered by parent educators to obese mothers of overweight/obese preschoolers through 36 home visits, 24 group meetings, and 18 booster telephone calls. Our primary hypothesis is that participants in HEALTH will achieve a 7% weight loss at 12 months and maintain a 5% weight loss at 24 months, which will be at least two-fold greater than that achieved in the usual care control group. Secondary aims will determine whether improvements in 'mother to child' behaviors of HEALTH participants will explain all or part of changes in the weight trajectory of the participant's overweight/obese preschool child. An extensive program evaluation will address elements of external validity. Methods and Evaluation. A two group randomized nested cohort design with data collected at baseline, 12, and 24 months, will evaluate weight, clinical, and behavioral outcomes of participants randomized to either control sites (N=8 sites; 128 participants) receiving the standard PAT program or intervention sites (N=8 sites; 128 participants) receiving HEALTH. Evaluation will include elements of reach and representativeness, implementation and adaptation, decision making outcomes, maintenance and institutionalization, and cost. Innovation. This proposal will overcome translational barriers and optimize the fit between evidence-based practice and the practice context. HEALTH has the potential for dissemination across all 50 states to 2200 PAT sites and 9600 educators reaching approximately 58,000 obese mothers and children.

描述（由申请人提供）：背景。肥胖女性患2型糖尿病的可能性是那些保持瘦体重的糖尿病的可能性的80倍。代际肥胖很常见，孕产妇肥胖是幼儿超重的强大危险因素。糖尿病预防计划（DPP）确定了通过改变生活方式来实现体重减轻的策略，但转化为现实世界环境仍然具有挑战性。目标。这项研究将测试健康的饮食和积极生活在家中教授的生活（健康），该生活适应并整合了父母在父母中的DPP生活方式干预措施（PAT），这是一项国家家庭访问计划。父母教育工作者将通过36次家庭访问，24个小组会议和18个助推器电话，将健康教育者提供给超重/肥胖学龄前儿童的肥胖母亲。我们的主要假设是，健康的参与者将在12个月时实现7％的体重减轻，并在24个月时保持5％的体重减轻，这将比通常的护理对照组中至少要大2倍。次要目标将确定卫生参与者的“母亲到子女”行为的改善是否会解释参与者超重/肥胖学龄前儿童体重轨迹的全部或部分变化。广泛的计划评估将解决外部有效性的要素。方法和评估。两组随机嵌套队列设计，其在基线，12个月和24个月时收集的数据将评估随机分配到接受标准PAT计划或干预地点的对照地点（n = 8个站点）随机分配给参与者的体重，临床和行为结果（n = 8 = 8个地点； 128名参与者）接受健康。评估将包括覆盖范围和代表性，实施和适应性的要素，决策结果，维护和制度化以及成本。创新。该建议将克服翻译障碍，并优化循证实践与实践背景之间的拟合度。健康有可能在所有50个州到2200个PAT网站和9600名教育工作者的传播潜力，达到了约58,000个肥胖的母亲和儿童。