ACTION PAC: Adolescents Committed to Improvement of Nutrition & Physical Activity

ACTION PAC：致力于改善青少年营养

基本信息

批准号：
8719771
负责人：
Alberta Sum-Yu Kong
金额：
$ 71.56万
依托单位：
UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-12 至 2018-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8719771
关键词：
Accounting Address Adolescent Adopted Adoption Affect Age American Indians Behavior Body mass index Cardiovascular Diseases Cardiovascular system Central obesity Child Child Rearing Clinical Clinical Trials Design Commit Consumption Counseling Data Development Diet Dietary Fiber Dietary intake Dyslipidemias Eating Eating Behavior Environment Epidemic Fatty acid glycerol esters Feedback Funding Future Goals Health Health Care Visit Health Personnel Health Services Healthcare Healthy People 2020 High School Student Hispanics Home environment Homeostasis Hypertension Incidence Insulin Resistance Intake Intervention Intervention Studies Intervention Trial Left Life Life Cycle Stages Low income Measures Medical Metabolic Metabolic syndrome Methods Minority Modeling National Heart, Lung, and Blood Institute New Mexico Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Outcomes Research Overweight Parents Participant Patients Physical activity Population Prediabetes syndrome Pregnancy Prevalence Prevention Prevention program Preventive Intervention Primary Health Care Provider Randomized Randomized Controlled Trials Research Risk Schools Students Syndrome Testing Treatment Efficacy Underrepresented Minority Uninsured United States National Institutes of Health Visit Weight Weight Gain Weight maintenance regimen Work Youth base college community based participatory research comparison group efficacy testing eleventh grade experience fruits and vegetables group intervention health disparity high school improved insulin sensitivity intervention program motivational enhancement therapy ninth grade nutrition obesity in children obesity prevention prevent programs public health relevance response screening sugar sweetened beverage tenth grade treatment as usual twelfth grade young adult

项目摘要

DESCRIPTION (provided by applicant): The childhood obesity epidemic has led to the rising prevalence of cardiometabolic risks in adolescents. These risks include abdominal obesity, hypertension, dyslipidemia and pre-diabetes, the clustering of which is known as metabolic (or insulin resistance) syndrome. Longitudinal data show that children and adolescents with metabolic syndrome are more likely to develop cardiovascular disease and type-2 diabetes. This is especially worrisome for youth in New Mexico, a culturally diverse state with 44.9% Hispanics and 9.7% American Indians, because obesity disproportionately affects these populations. School-based health centers (SBHCs) offer an important venue to expand healthcare access for adolescents, who are traditionally hard-to- reach. SBHCs provide health services to all students, with a focus on the uninsured and underserved and may be the only point of intervention for low-income and minority youth. The proposed R01 study will build upon significant findings from a NIH/NHLBI funded R21 study that utilized a community-based participatory research approach to develop and pilot-test a SBHC weight management program called Adolescents Committed to Improvement of Nutrition and Physical Activity (ACTION) with two high schools. ACTION was based on the use of motivational interviewing (MI) to support adoption of healthier eating and physical activity behaviors. In this current proposal (ACTION PAC), we propose to collaborate with eight high schools that have SBHCs to evaluate the broader reach and efficacy of using MI-based approaches to prevent and treat overweight/obesity and to decrease the risk of metabolic syndrome development. Specifically, our goals are to 1) prevent the development of overweight and obesity among students with BMI <85th percentile, 2) reduce BMI z score and insulin resistance in students with BMI >=85th percentile, and 3) obtain student and parent feedback on their experience with school-based BMI screening and weight management. To test the efficacy of these MI-based approaches, we will employ a cluster randomized control trial design in which four of the eight high schools will be randomized to an intervention group and the other four high schools will be randomized to a usual care comparison group. 960 participants in the 9th and 10th grades between the ages of 14-17 years will be followed annually for two years (until their 11th and 12th grade, respectively). Analyses will be conducted in a multilevel framework to account for clustering within schools. Baseline and 2nd year comparisons within group and comparison of change between the intervention and comparison groups will be assessed. The collective impact of these research outcomes will advance the field of school-based obesity intervention studies and take a significant step towards identifying sustainable prevention and treatment approaches for adolescent obesity and metabolic syndrome through the use of SBHCs.

描述（由申请人提供）：儿童肥胖症流行导致青少年心脏代谢风险的患病率上升。这些风险包括腹部肥胖，高血压，血脂异常和糖尿病前，其聚类被称为代谢（或胰岛素抵抗）综合征。纵向数据表明，患有代谢综合征的儿童和青少年更有可能发展心血管疾病和2型糖尿病。对于新墨西哥州的年轻人来说，这尤其令人担忧，新墨西哥州是一种文化多样的国家，西班牙裔44.9％，美国印第安人9.7％，因为肥胖对这些人群的影响不成比例。以学校为基础的医疗中心（SBHC）为扩大传统上难以及的青少年提供医疗保健的重要场所。 SBHC为所有学生提供卫生服务，重点关注未保险和服务不足，可能是低收入和少数族裔青年的唯一干预点。拟议的R01研究将基于NIH/NHLBI资助的R21研究的重大发现，该研究利用基于社区的参与性研究方法来开发和试点测试SBHC体重管理计划，称为“青少年，致力于改善营养和体育锻炼（行动”）。行动基于使用动机访谈（MI）来支持采用更健康的饮食和体育锻炼行为。在当前的提案（Action PAC）中，我们建议与具有SBHC的八所高中进行合作，以评估使用基于MI的方法来预防和治疗超重/肥胖并降低代谢综合征发展的风险的更广泛的影响力和功效。具体而言，我们的目标是：1）防止BMI <85％的学生中超重和肥胖的发展，2）降低BMI> = 85％的学生的BMI Z分数和胰岛素抵抗，并且3）获得学生和父母的反馈，以基于学校的BMI筛选和体重管理。为了测试这些基于MI的方法的功效，我们将采用群集随机对照试验设计，其中八所高中中有四所将被随机分为干预组，而其他四所高中将被随机分为通常的护理比较组。 960年级和10年级的14-17岁年龄段的参与者每年将遵循两年（分别为直到11年级和12年级）。分析将在多级框架中进行，以说明学校内的聚类。将评估小组内的基线和第二年比较，并评估干预和比较组之间的变化比较。这些研究成果的集体影响将推进学校肥胖干预研究的领域，并通过使用SBHC来确定青少年肥胖和代谢综合征的可持续预防和治疗方法迈出了重要一步。