SANOS (SAlud y Nutricion para todOS)

SANOS（SAlud y Nutricion para todOS）

• 批准号: 9768541
• 负责人: Jennifer CF Leng
• 金额: $ 88.26万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9768541
• 关键词: Address; Affect; Area; Attitude; Behavior; Behavioral; Belief; Blood Pressure; Body Weight decreased; Cardiovascular Diseases; Cholesterol; Church; Communities; Consumption; Counseling; Data; Diabetes Mellitus; Diabetes prevention; Dietary Intervention; Effectiveness of Interventions; Expectancy; Government; Health; Health Benefit; Hispanics; Immigrant; Individual; Institution; Intake; Intervention; Knowledge; Latino; Lead; Linguistics; Link; Location; Low income; Malignant Neoplasms; Mediation; Mediator of activation protein; Memorial Sloan-Kettering Cancer Center; Methodology; Mexican; Mexican Americans; Mexico; Minority; Monitor; Neighborhoods; New York; New York City; Not Hispanic or Latino; Obesity; Outcome; Outcome Study; Overweight; Participant; Persons; Population; Privatization; Randomized; Randomized Controlled Trials; Research; Resources; Risk Factors; Schools; Self Efficacy; Services; Site; Telephone; Testing; Text Messaging; Time; Weight; Woman; base; cancer health disparity; cancer risk; cardiovascular disorder risk; community setting; cost; design; diabetes prevention program; diet and exercise; ethnic minority population; health care availability; health disparity; healthy lifestyle; high risk population; incremental cost-effectiveness; innovation; lifestyle intervention; men; metropolitan; nutrition; primary outcome; programs; risk sharing; secondary outcome; social cognitive theory; theories; tool; treatment optimization; waist circumference; weight loss intervention

Project Summary SANOS (SAlud y Nutrición para todOS) (Health and Nutrition for All) addresses the obesity crisis among Hispanics, the largest, fastest growing U.S. minority and immigrant group at 53 million, 17% of the total U.S. population. Mexicans are the largest U.S. Hispanic population; nearly two-thirds of Hispanics originate from Mexico. Obesity and its associated health consequences disproportionately affect minority populations; Hispanics, and particularly Mexican Americans, are among the highest risk groups. 78.3% of U.S. Mexican women and 81.9% of U.S. Mexican men are overweight or obese, compared to 60.9% of non-Hispanic White women and 73.2% of non-Hispanic White men. Obesity is a shared risk for both cardiovascular disease (and its risk factors) and cancer. While there is much evidence on effective multicomponent lifestyle interventions in non-minority populations (e.g. Diabetes Prevention Program and Action for Health in Diabetes (Look AHEAD)), these programs are considered too expensive and burdensome to be widely disseminated. There is a paucity of data on how to optimize such approaches for hard-to-reach communities such as Hispanic immigrants. Most weight-loss interventions have been less successful with ethnic minorities, including Hispanics. There is a pressing need to design optimized lifestyle interventions for minority populations, particularly in accessible community settings, that reduce participant burden and costs but retain essential intervention components for meaningful weight loss. SANOS is the first study to use the Multiphase Optimization Strategy (MOST), an innovative methodological framework, to address this gap. Ventanillas de Salud (VDS; Health Windows) is a bi-national collaborative program between the Mexican government and over 400 non-profit and private agencies, working to increase access to health care and promote healthy lifestyle choices among low-income U.S. Latinos. In 2016, the VDS purchased a mobile van, outfitting the vehicle with space to provide consular services and to conduct health screenings (“VDS Mobile”) in NYC neighborhoods with large Mexican populations. SANOS components were developed from a pilot program at the NY VDS; in this application we propose testing these components at VDS Mobile to reach the most marginalized. The overall objective of SANOS is to use MOST to design, for the first time, an optimized version of a scalable, culturally and linguistically tailored diet and lifestyle intervention for U.S. Mexicans. In the proposed research we will identify which of 4 obesity intervention components contribute most to decreasing weight by 5% from baseline (primary outcome) among overweight or obese individuals at 6 months post-intake. Components include: i) Initial in- person individual diet and exercise counseling; ii) Thrice weekly diet and exercise text messages; iii) Weekly telephone support; and iv) Self-monitoring tools. Secondary outcomes include improvements in BMI, waist circumference, HgbA1c, cholesterol, blood pressure, and diet and exercise behavior. We will also estimate the cost and incremental cost-effectiveness of the intervention components.

项目摘要 Sanos（Salud yNutriciónParatodos）（所有人的健康与营养）解决了肥胖危机 西班牙裔是美国最大，增长最快的美国少数民族和移民群体的5300万，占美国总数的17％ 人口。墨西哥人是美国最大的西班牙裔人口。近三分之二的西班牙裔来自 墨西哥。肥胖及其相关的健康后果不成比例地影响少数群体； 西班牙裔，尤其是墨西哥裔美国人，是风险最高的群体之一。美国墨西哥的78.3％ 妇女和81.9％的美国墨西哥男性超重或肥胖，而非西班牙裔白人为60.9％ 妇女和73.2％的非西班牙裔白人男性。肥胖是患心血管疾病的共同风险（和 它的危险因素）和癌症。虽然有很多证据表明有效的多组分生活方式干预 非少数人群（例如，糖尿病的糖尿病预防计划和糖尿病健康行动（前面））， 这些程序被认为太昂贵且朴实，无法广泛传播。很少 有关如何为诸如西班牙裔移民等难以触及的社区优化这种方法的数据。最多 减肥干预措施在包括西班牙裔在内的少数民族中取得了不太成功。有一个 迫切需要为少数族裔设计优化的生活方式干预措施，尤其是在可访问中 社区环境，减少参与者的燃烧和成本，但保留了基本干预组件 有意义的减肥。 SANOS是第一项使用多相优化策略（大多数）的研究， 创新的方法论框架，以解决这一差距。 Ventanillas de Salud（VDS； Health Windows）是一个 墨西哥政府与400多个非营利组织和私人的双国合作计划 机构，努力增加获得医疗保健的机会并促进低收入的健康生活方式选择 美国拉丁裔。 2016年，VDS购买了一辆移动面包车，戴上带有空间的车辆以提供领事 服务并在纽约市与大墨西哥的纽约市社区进行健康放映（“ VDS Mobile”） 人群。 Sanos组件是由纽约VDS的试点计划开发的；在此应用中，我们 在VDS移动设备上测试这些组件以达到最边缘化的建议。总体目标 Sanos首次使用大多数用于设计的可伸缩版，文化和 美国墨西哥人的语言量身定制饮食和生活方式干预。在拟议的研究中，我们将确定 4种肥胖干预组件中的哪个贡献最大的贡献是从基线降低5％（主要 结果）在感染后6个月的超重或肥胖个体中。组件包括：i）初始in- 个人饮食和运动咨询； ii）每周三次饮食和锻炼短信； iii）每周 电话支持；和iv）自我监控工具。次要结果包括改善BMI，腰部 周长，HGBA1C，胆固醇，血压以及饮食和运动行为。我们还将估计 干预组件的成本和成本效益。