ADAPTING AND ASSESSING THE FEASIBILITY OF ‘HEALTHY DADS, HEALTHY KIDS’ FOR US LATINOS

调整和评估美国拉丁裔“健康的父亲、健康的孩子”的可行性

• 批准号: 9242857
• 负责人: Teresia Margareta O'Connor
• 金额: $ 21.18万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9242857
• 关键词: 11 year old; Academic achievement; Adult; Attitude; Australia; Award; Behavior; Behavior Therapy; Body Weight decreased; Body mass index; Cardiovascular Diseases; Child; Child Behavior; Child Rearing; Clinical; Clinical Trials; Cognitive; Communities; Cross-Sectional Studies; Development; Diabetes Mellitus; Diagnosis; Dietary intake; Eating; Educational Curriculum; Effectiveness; Emotional; Enrollment; Ensure; Evaluation; Evidence based program; Face; Family; Fathers; Food; Future; Goals; Health; Healthy Eating; High Prevalence; Hispanics; Interpersonal Relations; Intervention; Interview; Language; Latino; Life Style; Measures; Mediator of activation protein; Medicaid; Medical; Methods; Modeling; Modification; Mothers; National Heart, Lung, and Blood Institute; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Overweight; Parents; Physical activity; Pilot Projects; Population; Positioning Attribute; Prevalence; Prevention program; Process; Program Sustainability; Psychological reinforcement; Psychometrics; Randomized; Randomized Controlled Trials; Recruitment Activity; Research Personnel; Research Support; Risk; Sampling; Surveys; Systems Theory; Target Populations; Testing; Training; United States; Validity and Reliability; Waiting Lists; Weight; Woman; Work; authority; base; behavior change; behavior influence; clinically relevant; cognitive development; cohesion; control trial; design; evidence base; experience; health disparity; healthy lifestyle; healthy weight; improved; informant; innovation; instrument; male; men; middle childhood; novel; novel strategies; obesity in children; obesity prevention; obesity risk; prevent; programs; response; role model; satisfaction; social; social cognitive theory; social skills; treatment effect; weight loss intervention

Project Summary Latinos in the United States face health disparities for obesity and related medical conditions, such as cardiovascular disease and diabetes. Targeting families to promote healthy lifestyle behaviors has been identified as an effective strategy to prevent obesity. With the importance of familism (family cohesion) among Latino population, a family based intervention is especially desirable as an engaging strategy to promote behaviors that support a healthy weight status and decrease obesity related health disparities for Latinos. Emerging evidence supports the need to include and target fathers in family based lifestyle behavior interventions. However, to date primarily mothers have been reached by such efforts in the US. Health Dads Healthy Kids (HDHK) is an evidence based program developed in Australia, shown to have significant weight and behavior treatment effects for fathers and their children, compared to controls. The HDHK program is based on Social Cognitive Theory and Family Systems Theory and aims to promote increased physical activity and improved dietary intake. An important innovation in the program is that fathers and children attend together and are both targeted as agents of behavior change for each other (reciprocal reinforcement) and to participate in fun, family activities together. HDHK has several features that may appeal to Latino families: it is delivered in group sessions by a trained facilitator from the community (collectivism), and it promotes paternal role- modeling (enforces respeto), family cohesion, and engagement together in lifestyle behaviors (familism). How- ever, HDHK should be systematically culturally adapted for Latino families to ensure appropriate enrollment, engagement and promotion of desired health outcomes for Latino families, prior to further evaluation. We propose to convene a panel of Latino fathers and mothers from the community to serve as key informants; and an expert panel of researchers with experience in culturally adapting parenting interventions for Latinos, Latino lifestyle behaviors, and the influence of Latino fathers. The two panels will work with the study team (including the developer of HDHK) to systematically modify the HDHK program to culturally adapt it for Latino families following the Ecological Validity Model. They will also inform the selection of items from established item banks of food and physical activity parenting. The resulting scales will be tested among a sample of Latino fathers to establish validated scales of parenting for Latino fathers, which is expected to be a mediator of children's behavior change in HDHK, and will be needed in the future trial. The resulting Latino-HDHK will be tested for feasibility (as measured by retention, engagement, and satisfaction), in a pilot randomized controlled trial (n=40). The pilot study will include a thorough process evaluation, including exit interviews with participating Latino fathers and their co-parent (typically mothers). Once completed, this developmental study will position us to apply for a future R01 to assess the Latino-HDHK in a fully powered randomized controlled trial.

项目概要 美国的拉丁裔面临着肥胖和相关医疗状况的健康差异，例如 心血管疾病和糖尿病。以家庭为目标，促进健康的生活方式行为 被认为是预防肥胖的有效策略。家庭主义（家庭凝聚力）的重要性 拉丁裔人口中，以家庭为基础的干预措施尤其可取，作为一种吸引人的战略，以促进 支持拉丁裔健康体重状况并减少与肥胖相关的健康差异的行为。 新出现的证据支持需要将父亲纳入以家庭为基础的生活方式行为中并以父亲为目标 干预措施。然而，迄今为止，此类努力主要惠及美国的母亲。健康爸爸 Healthy Kids (HDHK) 是澳大利亚开发的一项基于证据的计划，被证明具有显着的权重 与对照组相比，父亲及其孩子的行为治疗效果。 HDHK计划是 基于社会认知理论和家庭系统理论，旨在促进增加身体活动 并改善饮食摄入。该计划的一个重要创新是父亲和孩子一起参加 并且都作为彼此行为改变的推动者（相互强化）并参与 一起参加有趣的家庭活动。 HDHK 有几个可能会吸引拉丁裔家庭的特点： 由来自社区的训练有素的协调员主持的小组会议（集体主义），它促进了父亲的角色- 榜样（强制尊重）、家庭凝聚力以及共同参与生活方式行为（家庭主义）。如何- HDHK 应该系统地适应拉丁裔家庭的文化，以确保适当的入学， 在进一步评估之前，参与并促进拉丁裔家庭期望的健康结果。我们 建议召集一个由社区中的拉丁裔父亲和母亲组成的小组作为关键信息提供者；和 一个由研究人员组成的专家小组，他们在针对拉丁裔的文化调整育儿干预方面拥有丰富的经验 生活方式行为以及拉丁裔父亲的影响。两个小组将与研究团队合作（包括 HDHK 的开发商）系统地修改 HDHK 计划，使其在文化上适应拉丁裔家庭 遵循生态有效性模型。他们还将告知从已建立的项目库中选择项目 食物和身体活动的养育。由此产生的量表将在拉丁裔父亲样本中进行测试 为拉丁裔父亲建立经过验证的养育量表，预计该量表将成为儿童成长的调节因素 HDHK 中的行为改变，是未来试验中需要的。由此产生的 La​​tino-HDHK 将接受测试 试点随机对照试验中的可行性（通过保留率、参与度和满意度来衡量） （n=40）。试点研究将包括彻底的过程评估，包括对参与的人员进行离职面谈 拉丁裔父亲和他们的共同父母（通常是母亲）。一旦完成，这项发展研究将定位 我们申请未来的 R01，以在一项完全有效的随机对照试验中评估 Latino-HDHK。