COACH: Competency Based Approaches for Community Health

COACH：基于能力的社区健康方法

• 批准号: 10655736
• 负责人: William Heerman
• 金额: $ 23.2万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655736
• 关键词: 6 year old; Address; Age; Ancillary Study; Behavior; Behavior Therapy; Behavioral; Body Weight decreased; Body mass index; Child; Child Health; Child Rearing; Clinical Trials; Cohort Analysis; Communities; Community Health; Competence; Complex; Crime; Data; Data Collection; Data Set; Data Sources; Development; Diet; Educational Curriculum; Effectiveness; Effectiveness of Interventions; Enrollment; Environment; Ethnic Origin; Family; Food; Food Access; Funding; Future; Goals; Green space; Growth; Health behavior; Health behavior change; Heterogeneity; Hour; Income; Individual; Inequality; Intervention; Latino; Low income; Measurement; Measures; Minority; Minority Groups; Modeling; National Institute of Child Health and Human Development; Neighborhoods; Obesity; Parents; Participant; Persons; Phase; Physical activity; Population; Prospective cohort; Race; Readiness; Reduce health disparities; Research; Resources; Risk; Schools; Sleep; Social Environment; Source; Specific qualifier value; Sports; Structure; Surveys; Testing; Time; Work; base; built environment; community barrier; community building; community center; community-level factor; density; early childhood; experience; follow-up; food environment; food quality; fruits and vegetables; health disparity; improved; interest; novel; obesity in children; obesity treatment; personalized approach; personalized intervention; personalized medicine; primary outcome; prospective; recruit; secondary outcome; social; social determinants; social health determinants; social inequality; success; telephone coaching; walkability

PROJECT SUMMARY Despite the recognition of health disparities in obesity, behavioral interventions among low-income and minority populations have consistently met with limited success. This is partially explained by social determinants of health. Barriers at the community level impede consistent engagement in healthy behaviors. The proposed ancillary study adds objective community-level data and corresponding analyses to an ongoing behavioral obesity intervention for low-income Latino families, entitled COACH (R01HD100458 from NICHD, PI Heerman). By using a comprehensive measurement approach that considers the physical activity environment, the food environment, the social environment, and the historical/structural environment, we aim to characterize these complex and cumulative contextual risks for children enrolling in our ongoing COACH clinical trial. COACH (COmpetency-Based Approaches to Community Health) implements a personally tailored approach, equipping families to engage in health behaviors despite dynamic barriers. COACH is a multi-level intervention targeting 1) the individual child through developmentally appropriate health behavior curriculum, 2) the family by addressing parent weight loss directly and engaging parents as agents of change for their children, and 3) the community by building capacity of Parks and Rec centers to offer parent-child programming. Using novel multi-component assessments throughout the two years of the study, the intervention identifies individual, family, and community barriers to healthy behaviors and delivers structured yet personalized intervention content in 7 domains: fruits/vegetables, snacks, sugary drinks, physical activity, sleep, media use, and parenting. This ancillary proposal seeks to augment the data collection by adding key community-level contextual variables to measure the moderating impact of those variables on the effectiveness of the intervention. We propose collecting data related to urban density; food access, availability, and quality; multiple components of the physical activity environment; and variables related to social inequality. We will combine data from 1) prospectively conducting neighborhood and grocery store surveys and 2) local and national publicly available datasets to identify individual-level assessments of community-risk that can then be incorporated into the analysis plan for the main trial. In addition to conducting individual moderator analyses for each of the variables, we will conduct a prospective cohort analysis to evaluate their cumulative impact on child BMI over time.

项目概要 尽管人们认识到肥胖带来的健康差异，但低收入和低收入人群的行为干预措施仍然存在。 少数民族人口一直取得有限的成功。这部分是由社会因素解释的 健康的决定因素。社区层面的障碍阻碍了健康行为的持续参与。 拟议的辅助研究在正在进行的研究中添加了客观的社区级数据和相应的分析 针对低收入拉丁裔家庭的行为肥胖干预，题为 COACH（R01HD100458 来自 NICHD，PI 赫尔曼）。通过使用考虑身体活动环境的综合测量方法， 食物环境、社会环境和历史/结构环境，我们旨在表征 对于参加我们正在进行的 COACH 临床试验的儿童来说，这些复杂且累积的背景风险。 COACH（基于能力的社区健康方法）实施了个人定制的 方法，使家庭能够克服动态障碍，采取健康行为。 COACH是一个多层次的 干预措施针对 1) 通过适合发育的健康行为课程针对个别儿童，2) 直接解决父母减肥问题并让父母成为家庭变革的推动者 儿童，以及 3) 社区，建设公园和娱乐中心的能力，为亲子提供服务 编程。在整个研究的两年中，使用新颖的多成分评估， 干预识别个人、家庭和社区健康行为的障碍，并提供结构化的 7个领域的个性化干预内容：水果/蔬菜、零食、含糖饮料、体力活动、 睡眠、媒体使用和养育子女。 该辅助提案旨在通过添加关键的社区级上下文来扩大数据收集 变量来衡量这些变量对干预有效性的调节影响。我们 建议收集与城市密度相关的数据；食物的获取、供应和质量；的多个组成部分 身体活动环境；以及与社会不平等相关的变量。我们将合并来自 1) 的数据 前瞻性地进行社区和杂货店调查，2) 地方和国家公开调查 数据集来识别个人层面的社区风险评估，然后将其纳入 主要试验的分析计划。除了对每个人进行单独的主持人分析之外 变量，我们将进行前瞻性队列分析，以评估它们对儿童 BMI 的累积影响 时间。