SANOS (SAlud y Nutricion para todOS)

SANOS（SAlud y Nutricion para todOS）

基本信息

批准号：
9899115
负责人：
Jennifer CF Leng
金额：
$ 87.13万
依托单位：
SLOAN-KETTERING INST CAN RESEARCH
依托单位国家：
美国
项目类别：
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/9899115
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 cost estimate 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 multiphase optimization strategy nutrition primary outcome programs risk sharing secondary outcome social cognitive theory theories tool treatment optimization waist circumference weight loss intervention

项目摘要

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.

项目概要 SANOS (SAlud y Nutrición para todOS)（全民健康与营养）解决了肥胖危机拉美裔是美国最大、增长最快的少数族裔和移民群体，人口达 5300 万，占美国总人口的 17%。墨西哥人是美国最大的拉美裔人口；近三分之二的拉美裔来自美国。墨西哥：肥胖及其相关的健康后果对少数群体的影响尤为严重；西班牙裔，尤其是墨西哥裔美国人，占美国墨西哥人的 78.3%，属于最高风险群体。女性和 81.9% 的美国墨西哥男性超重或肥胖，而非西班牙裔白人的这一比例为 60.9% 女性和 73.2% 的非西班牙裔白人男性肥胖是心血管疾病（和）的共同风险。虽然有很多证据表明有效的多成分生活方式干预措施可以预防癌症。非少数群体（例如糖尿病预防计划和糖尿病健康行动（展望未来）），这些计划被认为过于昂贵和繁重，无法广泛传播。有关如何针对西班牙裔移民等难以到达的社区优化此类方法的数据。减肥干预措施对于包括西班牙裔在内的少数族裔来说不太成功。迫切需要为少数群体设计优化的生活方式干预措施，特别是在无障碍环境中社区环境，减少参与者的负担和成本，但保留必要的干预成分 SANOS 是第一个使用多阶段优化策略 (MOST) 的研究。 Ventanillas de Salud（VDS；健康窗口）是一个解决这一差距的创新方法框架。墨西哥政府与 400 多个非营利组织和私营机构之间的两国合作计划机构，致力于增加获得医疗保健的机会并促进低收入者选择健康的生活方式 2016 年，VDS 购买了一辆移动货车，为车辆配备了提供领事服务的空间。服务并在纽约市有大量墨西哥人的社区进行健康检查（“VDS Mobile”） SANOS 组件是根据纽约 VDS 的试点项目开发的；建议在 VDS Mobile 上测试这些组件，以达到最边缘化的总体目标。 SANOS 将首次使用 MOST 设计一个可扩展、文化和功能的优化版本。在拟议的研究中，我们将确定针对美国墨西哥人的语言定制饮食和生活方式干预。 4 项肥胖干预措施中哪一项对体重较基线降低 5% 的贡献最大（主要摄入后 6 个月的超重或肥胖个体的结果），组成部分包括： i) 初始摄入- 个人饮食和运动咨询； ii) 每周三次饮食和运动短信； iii) 每周一次；电话支持；和 iv) 自我监测工具包括体重指数、腰围的改善。我们还将估计周长、HgbA1c、胆固醇、血压以及饮食和运动行为。干预措施的成本和增量成本效益。