Comadres Saludables: A Web-Based Promotora Training Program for Obesity Prevention in Hispanic Women

Comadres Saludables：基于网络的 Promotora 西班牙裔女性肥胖预防培训计划

• 批准号: 10010265
• 负责人: DEBRA RIOS
• 金额: $ 22.42万
• 依托单位: ISA ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-14 至 2021-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10010265
• 关键词: Adopted; Adult; Advisory Committees; Affect; Age; Age-Years; Area; Behavior; Belief; Benchmarking; Body mass index; Communities; Community Actions; Community Health Aides; Computer software; Contractor; Data; Development; Diabetes Mellitus; Diet; Dimensions; Economic Factors; Education; Educational Curriculum; Effectiveness; Ethnic Origin; Evidence based practice; Exercise; Family; Focus Groups; Goals; Health; Heart; Hispanics; Image; Intervention; Knowledge; Language; Minority Groups; Modeling; Monitor; Narration; National Heart, Lung, and Blood Institute; Not Hispanic or Latino; Obesity; Online Systems; Overweight; Participant; Persons; Phase; Physical activity; Prevention program; Process; Program Reviews; Public Health; Race; Recipe; Research; Risk; Risk Behaviors; Role playing therapy; Self Efficacy; Series; Social Interaction; Social support; South Texas; Tablets; Target Populations; Technology; Testing; Texas; Trainers Training; Training; Training Programs; Weight; Woman; Work; base; behavior change; cost; design; diet and exercise; improved outcome; indexing; mHealth; meetings; member; men; nutrition; obesity prevention; physical inactivity; preference; programs; prototype; recruit; skills; social; successful intervention; theories; tool; usability; waist circumference

ABSTRACT More than two in three (70.2%) U.S. adults are overweight or obese (Body Mass Index (BMI) of ≥ 25).1 Hispanics are 23% more likely to be obese than their White counterparts4, and obesity rates are higher in Hispanic women than Hispanic men (45% vs. 39.7, respectively).5 Obesity is driven by a variety of social, physical, and economic factors, but is mainly due to poor diet and physical inactivity.2,7 Hispanics are more likely than non-Hispanic Whites to engage in these risk behaviors10-13 Given this, most successful interventions that reduce adiposity indices (e.g. BMI, weight, waist circumference) incorporate both diet and exercise21-23 Nonetheless, most obesity research is based on a general non-Hispanic population. Culturally adapted health interventions substantially improve the outcomes in minority groups compared to generic programs26-30 including culturally tailored obesity programs for Hispanics.31 Successful obesity interventions for Hispanics have relied on promotores de salud (also known as community health workers) as key implementers.31 Promotores are effective in delivering obesity interventions 31,37,40,42, however, adequate in-person training of the promotora is necessary for effective implementation of these interventions. An in-person train-the-trainer model is a laudable means of investing in promotores and communities, however, there remains barriers to accessibility of training due to promotores availability, family commitments and associated costs.43,58-60 Our goal is to develop an effective, accessible, and scalable obesity prevention training program for promotores. We aim to develop Comadres Saludables, an interactive, web-based (and tablet compatible) promotora training for obesity prevention in Hispanic women. Comadres Saludables will : 1) combine both theory and evidence-based practices to provide promotores with the knowledge and skills required to effectively implement an obesity intervention for Hispanic women; and 2) provide promotores with interactive mHealth tools to enhance implementation with Hispanic populations. The training program will aim to increase knowledge and skills by incorporating interactive activities such as interactive quizzes, exercises, video role- playing scenarios, and tools. A booster module aimed at providing continuous support and education for promotores will also be included in the program. Lastly, interactive mHealth tools will be accessible to promotores to aid in implementation and fidelity monitoring. In Phase I, with input from focus groups and our expert consultants, ISA staff will develop and pilot test Comadres Saludables, a prototype promotora training program for obesity prevention. Community Action Corporation of South Texas (CACOST) will provide ISA with an Advisory Committee that will participate in a focus group and aid in the iterative process of developing the prototype. In addition, CACOST will help us recruit certified promotores from the area. Certified promotores will participant in both the focus groups and pilot testing of the prototype. For Phase I, the Introduction, Nutrition, and Exercise modules will be substantially developed, and the remaining modules will be partially developed with sufficient material to provide users with a sense of what the fully developed program will contain. During Phase I, we will work with our software contractor, the Redmon Group (RGI) to develop a prototype program guided by input from our expert consultants, advisory committee, and focus groups. After the completion of our prototype, our team of expert consultants will conduct a final review of the program. We will then complete the pilot testing of the prototype with the original participants from the focus groups. To move to Phase II, there must be an 80% error-free rate and no critical errors in the usability portion of pilot testing. In addition, feasibility testing mean ratings of 3.5 or higher will have to be received across the proposed prototype items and Comadres Saludables must be rated as preferable to comparable NHLBI training materials47 on 75% of the dimensions. We believe that feasibility and appeal of the program concept will be achieved by using these two rigorous criteria.

抽象的 美国成年人中有超过三分（70.2％）超重或肥胖（体重指数（BMI）≥25）。1。 西班牙裔肥胖的可能性高23％，而肥胖率更高 西班牙裔女性比西班牙裔男人（分别为45％和39.7）。5肥胖是由各种​​社会， 身体和经济因素，但主要是由于饮食不良和身体不活跃。2,7西班牙裔是更多 鉴于此，最成功的干预措施可能比非西班牙裔白人进行这些风险行为10-13 这减少了肥胖指数（例如BMI，重量，腰围）均包含饮食和运动21-23 尽管如此，大多数肥胖研究都是基于一般的非西班牙裔人群。在文化上适应健康 与通用计划相比，第二个干预措施改善了少数群体的结果26-30 包括针对西班牙裔的文化量身定制的肥胖计划。31西班牙裔肥胖干预措施 曾在晋升de Salud（也称为社区卫生工作者）中救出了主要实施者。31 促销有效地提供肥胖干预措施31,37,40,42，但是，足够的面对面培训 促销对于有效实施这些干预措施是必要的。面对面的火车训练 模型是对促销和社区进行投资的一种值得称赞的手段，但是，仍然存在障碍 由于发起人的可用性，家庭承诺和相关成本而导致的培训可及性。43,58-60我们 目标是制定有效，可访问且可扩展的肥胖预防培训计划，以促进。 我们旨在开发Comadres Saludables，这是一种互动的，基于网络的（和平板电脑）的促销活动 西班牙裔妇女预防肥胖症的培训。 Comadres Saludables将：1）结合理论和 基于证据的实践，以提供有效的知识和技能提供促销 为西班牙裔妇女实施肥胖干预； 2）为发起人提供交互式MHealth 通过西班牙裔人口增强实施的工具。培训计划将旨在增加 通过合并互动活动，例如互动测验，练习，视频角色 - 播放场景和工具。旨在为持续支持和教育提供的助推器模块 发起人也将包括在该计划中。最后，交互式MHealth工具可以访问 有助于实施和保真监控的启动者。 在第一阶段，焦点小组和我们的专家顾问的投入，ISA员工将开发和试点测试 Comadres Saludables，一种针对预防肥胖症的原型促进培训计划。社区行动 南德克萨斯州公司（CACOST）将为ISA提供一个咨询委员会，该委员会将参加 焦点小组并帮助开发原型的迭代过程。此外，Cacost将帮助我们 来自该地区的招募认证促销员。认证的发起人将参加两个焦点小组， 原型的试点测试。对于第一阶段，介绍，营养和运动模块将是 基本开发的，其余模块将以足够的材料进行部分开发 为用户提供对完全开发的程序所包含的内容的感觉。在第一阶段，我们将与 我们的软件承包商Redmon Group（RGI）开发一个原型程序，以我们的输入为指导 专家顾问，咨询委员会和焦点小组。我们的原型完成后，我们的团队 专家顾问将对该计划进行最终审查。然后，我们将完成对试点测试的 与焦点小组的原始参与者的原型。要转到第二阶段，必须有80％ 试点测试的可用性部分中无错误的率和没有关键错误。另外，可行性测试平均值 在拟议的原型项目和Comadres Saludables中，必须收到3.5或更高的评分 必须将其视为优选，以比较NHLBI培训材料47与75％的尺寸。我们相信 该程序概念的可行性和外观将通过使用这两个严格的标准来实现。