Healthy Hearts/ Corazones Saludables: Partnership to promote cardiovascular health in Hispanic and non-Hispanic mothers and children in US home visiting programs

Healthy Hearts/Corazones Saludables：在美国家访计划中合作促进西班牙裔和非西班牙裔母亲和儿童的心血管健康

• 批准号: 10618401
• 负责人: Stephanie Hart Parade
• 金额: $ 74.34万
• 依托单位: CALIFORNIA POLY STATE U SAN LUIS OBISPO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-05 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10618401
• 关键词: Accounting; Adherence; Affect; Ancillary Study; Behavior; Blood Pressure; Body Weight; Body Weight decreased; Body mass index; Breast Feeding; California; Cardiovascular Diseases; Cause of Death; Cessation of life; Child; Cholesterol; Development; Diabetes Mellitus; Diet; Early Intervention; Family; Female; Funding; Future; Glucose; Goals; Health Personnel; Health behavior; Heart; Hispanic; Home; Home environment; Home visitation; Hybrids; Hypertension; Infant; Intervention; Life; Link; Low income; Maternal and Child Health; Measures; Mediator; Modeling; Mothers; Not Hispanic or Latino; Obesity; Overweight; Phase; Positioning Attribute; Postpartum Period; Pregnancy; Pregnancy Complications; Prevalence; Protocols documentation; Quality of life; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Research Design; Research Personnel; Resources; Rhode Island; Risk; Risk Factors; Series; Site; Sleep; Social support; Target Populations; Telephone; Testing; Time; Triglycerides; Unhealthy Diet; United States National Institutes of Health; Woman; Work; black women; burnout; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; clinically significant; cohort; design; early childhood; effectiveness evaluation; effectiveness testing; effectiveness/implementation trial; empowerment; evidence base; experience; family support; feeding; gestational weight gain; health of the mother; improved; infancy; innovation; lifestyle intervention; low socioeconomic status; maternal obesity; maternal weight; medication compliance; modifiable risk; obesity prevention; online delivery; perinatal women; physical inactivity; postnatal; postpartum weight; prenatal; prevent; programs; recruit; remote delivery; sedentary; skills; social health determinants; tv watching; underserved community; waist circumference

Project Summary/Abstract Cardiovascular disease (CVD) is the leading cause of death in US women, accounting for approximately one of every three female deaths. Obesity is arguably the strongest modifiable target for interventions to prevent CVD and is linked with nearly every other major CVD risk factor, including hypertension, elevated glucose, high cholesterol, poor diet, and physical inactivity. Infants of mothers with obesity are also at increased risk for future obesity and CVD. Our team has developed an empirically validated lifestyle intervention that is remotely delivered and highly successful in reducing body weight and improving CVH in Hispanic and non-Hispanic women and children during pregnancy and postpartum. It is now critical to study ways to disseminate this empirically-validated program. Evidence based home visiting programs (EBHV), which support families from the prenatal period through infancy and early childhood, are an ideal setting to promote CVH, however these programs were not designed with an explicit focus on the prevention of obesity and other CVD risk factors. The proposed research will test the effectiveness of our pre- and postnatal lifestyle intervention as an enhancement to EBHV to promote maternal and child CVH. During an initial 2-year UG3 phase, we will: 1) modify our pre- and postnatal intervention to focus on CVH within EBHV; 2) Work with our EBHV partners to integrate CVH messages and develop their related skills; 3) Strengthen partnerships between healthcare providers and EBHV to increase referrals, retention, and improve CVH, and 4) Contribute to the development of a high-impact study design for the subsequent UH3 phase involving a multi-cohort protocol, harmonized interventions, measures and resources. For the subsequent UH3 phase, we propose a Hybrid Type 1 effectiveness-implementation trial in which we recruit 550 perinatal women who will be randomized to receive EBHV alone or EBHV enhanced with our lifestyle intervention to promote CVH. Our primary hypothesis is that, over an average of 36 months, EBHV+CVH (vs. EBHV alone) will result in more favorable maternal and child levels of the Life’s Simple 7 indicators. We will also examine key intervention moderators, focusing on social determinants of health, and mediators, including changes in the home environment, social support, CVH behaviors, and program adherence. Using the RE-AIM framework, we will determine reach, effectiveness, adoption, implementation, and maintenance of EBHV+CVH vs. EBHV alone. Other goals are to empower and reduce burnout among home visitors; develop skills of early-stage investigators, and propose innovative ancillary studies to enhance the scientific contributions. Our team is exceptionally well positioned for this research and includes established investigators with decades of experience conducting NIH funded research, outstanding early stage investigators, and EBHV sites from Central California and Rhode Island.

项目摘要/摘要 心血管疾病（CVD）是美国妇女死亡的主要原因，大约是其中之一 每三个女性死亡。肥胖可以说是防止CVD的强大可修改目标 并与几乎所有其他主要CVD风险因素有关，包括高血压，葡萄糖升高，高 胆固醇，饮食不佳和身体不活跃。肥胖母亲的婴儿也有增加的风险 未来的肥胖和CVD。我们的团队已经开发了经验验证的生活方式干预措施 在减轻体重和改善西班牙裔和非西班牙裔的CVH方面，交付且非常成功 怀孕和产后妇女和儿童。现在，研究散布此方法的方法至关重要 基于证据的家庭访问计划（EBHV），该计划支持来自 通过婴儿期和幼儿期的产前时期是促进CVH的理想场所，但是这些 计划的设计并不明确地关注预防肥胖和其他CVD风险因素。 拟议的研究将测试我们产前和产后生活方式干预的有效性，以增强 向EBHV促进材料和儿童CVH。在最初的2年UG3阶段，我们将：1）修改我们的前 和产后干预，专注于EBHV内的CVH； 2）与我们的EBHV合作伙伴合作以整合CVH 消息并发展其相关技能； 3）加强医疗保健提供者与EBHV之间的伙伴关系 增加推荐，保留和改进CVH，以及4）有助于发展高影响力的研究 随后的UH3阶段的设计，涉及多组方案，统一干预措施，措施 和资源。对于随后的UH3阶段，我们提出了一项杂交1型有效性试验 我们招募了550名围产期妇女，她们将被随机地单独接受EBHV或EBHV增强 通过我们的生活方式干预来促进CVH。我们的主要假设是，在平均36个月内 EBHV+CVH（仅与EBHV）将导致生活中更有利的母亲和儿童级别的简单7 指标。我们还将检查关键干预主持人，专注于社会决定者，以及 调解员，包括家庭环境的变化，社会支持，CVH行为和计划 坚持。使用RE-AIM框架，我们将确定覆盖范围，有效性，采用，实施， 仅维持EBHV+CVH与EBHV的维护。其他目标是授权和减少倦怠 家庭访客；发展早期研究人员的技能，并提出创新的辅助研究以增强 科学贡献。我们的团队在这项研究中的位置非常好，包括既定 具有数十年经验的NIH资助研究经验的调查员，杰出的早期阶段 调查人员以及来自加利福尼亚中部和罗德岛的EBHV地点。