Clinical/Behavioral Approach to Overweight Latino Youth

超重拉丁裔青少年的临床/行为方法

• 批准号: 8446474
• 负责人: JOHN P. ELDER
• 金额: $ 52.07万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8446474
• 关键词: 9 year old; Acculturation; Americas; Attitude; Behavior; Behavioral; Body Weight decreased; Body mass index; Caring; Child; Child Behavior; Child health care; Childhood; Clinic; Clinic Visits; Clinical; Coercion; Communities; Consumption; Controlled Study; County; Data; Devices; Diet; Eating; Educational process of instructing; Electronics; Elements; Enrollment; Equation; Evaluation; Evidence based intervention; Family; Fasting; Feeding behaviors; Genetic Predisposition to Disease; Goals; Health; Health Educators; Health Promotion; Health behavior; Health education; High Density Lipoprotein Cholesterol; Home environment; Hypertension; Income; Instruction; Insulin; Intention; Intervention; Latino; Measurement; Measures; Mediator of activation protein; Mexican Americans; Mexico; Modeling; Newsletter; Obesity; Outcome; Outcome Study; Overweight; Parenting behavior; Parents; Participant; Patients; Philosophy; Physical activity; Poverty; Prevention; Primary Health Care; Procedures; Process; Provider; Randomized; Randomized Controlled Trials; Research Personnel; Resources; Rest; Risk Reduction; Sampling; Serum; Services; Statistical Models; Structure; Subgroup; Teaching Materials; Telephone; Time; Triglycerides; Validity and Reliability; Visit; Weight; Weight Gain; Weight maintenance regimen; Youth; arm; base; behavior change; cardiovascular disorder risk; cohort; design; efficacy testing; energy balance; experience; fasting glucose; follow-up; group intervention; improved; intervention effect; nutrition; obesity in children; parental involvement; post intervention; primary outcome; public health relevance; response; sedentary; skills; social; treatment as usual; waist circumference

DESCRIPTION (provided by applicant): Overweight and obesity is a serious problem for Mexican-American children, due in part to poverty, acculturation, genetic predisposition or other factors. Clinic-based weight control studies have shown promise, but often include convenience samples with few or no Latino children. This randomized controlled trial will test the efficacy of a culturally and linguistically appropriate, evidence-based intervention to lower Body Mass Index (BMI) or slow weight gain among 390 overweight 6-9 year old Mexican-American children randomly sampled from a large (36,192 pediatric patients) community clinic providing services to low and medium income families in a US-Mexico border community (San Ysidro, CA). Intervention and measurement design and selection are based on a "Socioecological Model for Latino Health Promotion". 69 Children and their parents will be randomly assigned to either a Special Intervention (SI) or Usual Care (UC) group. The SI group will participate in the following behavior change activities based on Prevention Plus and Structured Weight Management approaches 1 : (1) classes providing culturally-sensitive health education regarding healthy eating, increasing physical activity, decreasing sedentary behaviors, and effective parenting behaviors to model and reinforce children's health behaviors, instruction on how to modify both social and structural aspects of the home environment, and skills-building to navigate community resources; (2) group clinical visits (GCV) with a Health Educator and Mid-Level Provider (MLP); (3) family visits with primary care providers (PCP); (4) newsletters to refer families to community resources; and (5) phone calls to reinforce goal setting. The UC group will receive standard health education for childhood obesity already provided by the community clinic. The primary outcome for the study is child BMI, which along with other changes in physical outcomes, child health behaviors and parenting behaviors will be evaluated at four time-points (baseline, 6-, 12-, and 18-months). The primary hypothesis is that the SI group will demonstrate lower mean BMI than the UC group at the end of a 6 month intervention with a maximum difference occurring at 12 months, and will sustain this difference for an additional six months (18 months after baseline). Secondary aims include examining intervention effects on children's energy balance, physical activity levels, sedentary behavior and parenting strategies related to their children's health behaviors. This proposal is revised following a previous positive review. Changes in response to the review and other improvements include the addition of validity/reliability information for measures of electronic home devices, a complete dissemination plan, outcome data for preliminary studies, description of cohort retention strategies, clarification of intention to treat statistical modeling, inclusion of Structural Equation Modeling, increased effort level of co-investigators, consistent delineation of primary outcome (child BMI), sample teaching materials and description of teaching philosophy, estimates of clinic visit revenues, and procedures to reduce potential participant coercion to enroll in the study.

描述（由申请人提供）：对墨西哥裔美国儿童来说，超重和肥胖是一个严重的问题，部分原因是贫困，适应性，遗传倾向或其他因素。基于诊所的体重控制研究表明有希望，但通常包括很少或没有拉丁裔儿童的便利样本。 This randomized controlled trial will test the efficacy of a culturally and linguistically appropriate, evidence-based intervention to lower Body Mass Index (BMI) or slow weight gain among 390 overweight 6-9 year old Mexican-American children randomly sampled from a large (36,192 pediatric patients) community clinic providing services to low and medium income families in a US-Mexico border community (San Ysidro, CA).干预和测量设计和选择基于“拉丁裔健康促进的社会生态模型”。 69名儿童及其父母将被随机分配给特殊干预（SI）或通常的护理（UC）组。 SI小组将根据预防加和结构化的体重管理方法参加以下行为改变活动1：（1）课程提供有关健康饮食，增强体育锻炼，减少久坐行为的健康敏感健康教育的课程（2）与健康教育者和中级提供商（MLP）的小组临床访问（GCV）； （3）与初级保健提供者的家庭访问（PCP）； （4）通讯将家庭推荐给社区资源； （5）致电以加强目标设定。 UC组将接受社区诊所已经提供的儿童肥胖症的标准健康教育。该研究的主要结果是Child BMI，它将在四个时间点（基线，6-，12个月和18个月）评估身体结局，儿童健康行为和育儿行为的其他变化。主要假设是，在6个月的干预措施结束时，SI组将表现出比UC组低的平均BMI，并且在12个月时发生最大差异，并且将在六个月（基线后18个月）维持这种差异。次要目的包括检查对儿童能量平衡，体育锻炼水平，久坐行为和与孩子健康行为相关的育儿策略的影响。在先前的积极审查之后，对该提案进行了修订。 Changes in response to the review and other improvements include the addition of validity/reliability information for measures of electronic home devices, a complete dissemination plan, outcome data for preliminary studies, description of cohort retention strategies, clarification of intention to treat statistical modeling, inclusion of Structural Equation Modeling, increased effort level of co-investigators, consistent delineation of primary outcome (child BMI), sample teaching materials and description of teaching philosophy, estimates诊所访问收入和减少潜在参与者的胁迫的程序。